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Sample records for artery median nerve

  1. Median nerve's loop in the arm penetrated by a superficial brachial artery: case report and neurosurgical considerations

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    George K. Paraskevas

    2015-08-01

    Full Text Available Median nerve is commonly formed by the union of the lateral and medial cord of the brachial plexus, which embrace the third part of the axillary artery. Formation of a median nerve's loop is a very rare condition. We present a cadaveric case, in which the right median nerve was found at the upper arm forming a fusiform neural loop penetrated by a superficial brachial artery, which continued over the forearm as the radial artery. The literature concerning nerve loops and traversing arteries is discussed, as well as the relevant embryology. We consider that such nerve loops constitute vulnerable sites of the nerve trunk since it is compressed by the pulsation of the abnormal traversing artery. Moreover, neurosurgeons should keep in mind that in case of existing arterial variation, variation of the associated neural structures may co-exist. [Int J Res Med Sci 2015; 3(8.000: 2123-2125

  2. Five Roots Pattern of Median Nerve Formation

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    Konstantinos Natsis

    2016-04-01

    Full Text Available An unusual combination of median nerve’s variations has been encountered in a male cadaver during routine educational dissection. In particular, the median nerve was formed by five roots; three roots originated from the lateral cord of the brachial plexus joined individually the median nerve’s medial root. The latter (fourth root was united with the lateral (fifth root of the median nerve forming the median nerve distally in the upper arm and not the axilla as usually. In addition, the median nerve was situated medial to the brachial artery. We review comprehensively the relevant variants, their embryologic development and their potential clinical applications.

  3. PERSISTENT MEDIAN ARTERY IN THE CARPAL TUNNEL

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    Raviprasanna.K.H

    2014-09-01

    Full Text Available Introduction: Persistent median artery originates from the anterior interosseous artery in proximal one-third of the forearm and accompanies median nerve. Median artery may regress in the forearm or enter palm through the carpal tunnel deep to flexor retinaculum of wrist and supply palm by anastomosing with the superficial palmar arch. Objective: In present study the objective was to study presence of persistent median artery accompanying median nerve and its termination Materials and Methods: The study included 50 human cadaver upper limb specimens at the Department of Anatomy, Mysore Medical College & Research Institute, Mysore during 2011-13. These specimens fixed in 10% formalin were finely dissected and persistent median artery was traced from origin to termination. Results: Out of 50 human cadaver specimens, persistent median artery was present in 4 specimens (8%. All the 4 median arteries originated from anterior interosseous artery and were of palmar type which reached palm. Out of 4 median arteries, 3 median arteries (6% took part in completion of superficial palmar arch, supplying the distal aspect of palm and 1 median artery (2% directly supplied radial two and half fingers without forming arch. Conclusion: Knowledge of unusual variations helps in proper treatment of disorders of the median nerve. Presence of persistent median artery usually will be asymptomatic but may cause symptoms of carpal tunnel syndrome or pronator teres syndrome when subjected to compression. Rarely this artery can be taken for reconstruction

  4. The Ultrasonographic Findings of Bifid Median Nerve

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    Park, Hee Jin; Park, Noh Hyuck; Joh, Joon Hee [Myoungji Hospital, Gwandong University College of Medicine, Gangneung (Korea, Republic of); Lee, Sung Moon [Dongsan Medical Center, Keimyung University School of Medicine, Daegu (Korea, Republic of)

    2009-09-15

    We wanted to evaluate the ultrasonographic findings of bifid median nerve and its clinical significance. We retrospectively reviewed five cases (three men and two women, mean age: 54 years) of incidentally found bifid median nerve from 264 cases of clinically suspected carpal-tunnel syndrome that were seen at our hospital during last 6 years. Doppler sonography was performed in all five cases and MR angiography was done in one case for detecting a persistent median artery. The difference ({Delta}CSA) between the sum of the cross-sectional areas of the bifid median nerve at the pisiform level (CSA2) and the cross-sectional area proximal to the bifurcation(CSA1) was calculated. The incidence of a bifid median nerve was 1.9%. All the patients presented with a tingling sensation on a hand and two patients had nocturnal pain. All the cases showed bifurcation of the nerve bundle proximal to the carpal tunnel. The margins appeared relatively smooth and each bundle showed a characteristic fascicular pattern. A persistent median artery was noted between the bundles in four cases. {Delta}CSA was more than 2 mm 2 in four cases. Bifid median nerve with a persistent median artery is a relatively rare normal variance and these are very important findings before performing surgical intervention to avoid potential nerve injury and massive bleeding. We highly suggest that radiologists should understand the anatomical characteristics of this anomaly and make efforts to detect it

  5. Low Median Nerve Transfers (Opponensplasty).

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    Chadderdon, Robert Christopher; Gaston, R Glenn

    2016-08-01

    Opposition is the placement of the thumb opposite the fingers into a position from which it can work. This motion requires thumb palmar abduction, flexion, and pronation, which are provided by the abductor pollicis brevis, flexor pollicis brevis (FPB), and opponens pollicis. In the setting of a median nerve palsy, this function is typically lost, although anatomic variations and the dual innervation of the FPB may prevent complete loss at times. There are multiple well described and accepted tendon transfers to restore opposition, none of which have been proven to be superior to the others. PMID:27387078

  6. Intraneural Venous Malformations of the Median Nerve

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    González Rodríguez, Alba; Midón Míguez, José

    2016-01-01

    Venous malformations arising from the peripheral nerve are a rare type of vascular malformation. We present the first case of an intraneural venous malformation of the median nerve to be reported in a child and review the previous two cases of median nerve compression due to a venous malformation that have been reported. These cases presented with painless masses in the volar aspect of the wrist or with symptoms suggestive of carpal tunnel syndrome. Clinical suspicion should lead to the use of Doppler ultrasonography as the first-line diagnostic tool. Magnetic resonance imaging and histopathology can confirm the diagnosis, as phleboliths are pathognomonic of venous malformations. Surgical treatment appears to be the only modality capable of successfully controlling the growth of an intraneural malformation. Sclerotherapy and radiotherapy have never been used to treat this type of malformation.

  7. PERSISTENT MEDIAN ARTERY ASSOCIATED WITH SUPERFICIA L RADIAL ARTERY AT THE WRIST- A CASE REPORT

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    Jayasabarinathan

    2013-02-01

    Full Text Available ABSTRACT: Vascular variations are usually the result of deve lopmental anomaly during the formation of blood vessels in any respective part of the body. In this case a rare unilateral variation was found on the left upper limb during rou tine dissection in the Department of Anatomy. Brachial artery divided into radial artery and a common trunk. The common trunk in turn divided into ulnar, median and common inteross eous artery. The median artery was palmar type, had two proper palmar digital branches in t he palm. The radial artery had normal course in the forearm till the junction between upper two third and lower one third where it turned dorsally and reached the anatomical snuff bo x and ran superficial to the abductor pollicis longus, extensor carpi radialis brevis and extensor carpi radialis longus along the cephalic vein medially and superficial branch of radial nerve late rally. The median artery, arose from the common trunk, had pierced the median nerve about 4cm from its origin then ran along the median nerve in the forearm thereby reached the palm where it gave off two common palmar digital branches but did not anastomose with the ul nar artery hence formed incomplete superficial palmar arch. But on the right side no suc h variations found. These vascular variations have been studied in detail and their cl inical implications and embryological significance are emphasized.

  8. Dual pathology proximal median nerve compression of the forearm.

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    Murphy, Siun M

    2013-12-01

    We report an unusual case of synchronous pathology in the forearm- the coexistence of a large lipoma of the median nerve together with an osteochondroma of the proximal ulna, giving rise to a dual proximal median nerve compression. Proximal median nerve compression neuropathies in the forearm are uncommon compared to the prevalence of distal compression neuropathies (eg Carpal Tunnel Syndrome). Both neural fibrolipomas (Refs. 1,2) and osteochondromas of the proximal ulna (Ref. 3) in isolation are rare but well documented. Unlike that of a distal compression, a proximal compression of the median nerve will often have a definite cause. Neural fibrolipoma, also called fibrolipomatous hamartoma are rare, slow-growing, benign tumours of peripheral nerves, most often occurring in the median nerve of younger patients. To our knowledge, this is the first report of such dual pathology in the same forearm, giving rise to a severe proximal compression of the median nerve. In this case, the nerve was being pushed anteriorly by the osteochondroma, and was being compressed from within by the intraneural lipoma. This unusual case highlights the advantage of preoperative imaging as part of the workup of proximal median nerve compression.

  9. Myofibroma in the Palm Presenting with Median Nerve Compression Symptoms

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    Heidi Sarkozy, PA-C, BS

    2014-08-01

    Full Text Available Summary: A myofibroma is a benign proliferation of myofibroblasts in the connective tissue. Solitary myofibromas are a rare finding especially in an adult. We report a case of a 23-year-old man presenting with an enlarging mass over his right palm. The patient is an active weight lifter. He reported numbness and tingling in the median nerve distribution. Nerve conduction studies and magnetic resonance imaging scans suggested a tumor involving or compressing the median nerve. The final diagnosis of myofibroma was made only after the histopathological diagnosis.

  10. FASCICULAR NEURORRHAPHY FOR NEUROMA IN CONTINUITY OF MEDIAN NERVE

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    Manikumar

    2015-10-01

    Full Text Available It is not common for an orthopaedic surgeon to anastomose or repair a peripheral nerve lesion. Fascicular neurorrhaphy has variable out come with median nerve repairs. The recovery by neuropathy as evidenced by NCVS does not correlate with the clinical out come. We treated a post traumatic median nerve neuroma in continuity of right hand proximal to wrist with sensory hyperaesthesisa. It was treated with excision of neuroma internal neurolysis and fascicular neurorrhaphy along with, carpal tunnel release whi ch gave him good relief from pain in the immediate post - operative period.

  11. Sonoanatomy of the median, ulnar and radial nerves

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    Loewy, J. [Humber River Regional Hospital, Dept. of Radiology, Toronto, Ontario (Canada)

    2002-02-01

    There are 5 nerve roots emerging from the brachial plexus. Three of these are readily seen ultrasonographically and can be followed throughout most of their course. The purpose of this article is twofold - to demonstrate the sonoanatomy of the median, ulnar and radial nerves and to provide background material for understanding the pathologic conditions or abnormalities that may be encountered. Only the most common pathways will be described here; the reader is encouraged to consult anatomy texts for the multitude of variations that can occur. Before delving into the anatomy, the normal ultrasonographic (US) appearance of a nerve will be presented. (author)

  12. Entrapment of the Martin-Gruber branch of median nerve in the forearm

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    Anu Vinod Ranade

    2016-07-01

    Full Text Available We report a rare case of a dual neuro-vascular variation, which was observed in the right extremity of male cadaver. About an inch inferior to the elbow joint, three branches arose from the median nerve. These were the anterior interosseous branch, a Martin-Gruber branch (MGB and a muscular branch. The MGB coursed infero-medially to join with the ulnar nerve by running posterior to the ulnar artery. It was surprising to observe that the MGB passed between the ulnar artery and its venae comitantes. There was an acute angulation of the MGB here, suggesting entrapment at this site.

  13. Entrapment of the Martin-Gruber branch of median nerve in the forearm

    OpenAIRE

    Anu Vinod Ranade; Bukkambudhi Virupakshamurthy Murlimanju; Rajalakshmi Rai; Mohamed Ahmed Eladl

    2016-01-01

    We report a rare case of a dual neuro-vascular variation, which was observed in the right extremity of male cadaver. About an inch inferior to the elbow joint, three branches arose from the median nerve. These were the anterior interosseous branch, a Martin-Gruber branch (MGB) and a muscular branch. The MGB coursed infero-medially to join with the ulnar nerve by running posterior to the ulnar artery. It was surprising to observe that the MGB passed between the ulnar artery and its venae comit...

  14. Intraneural hemangioma of the median nerve: A case report

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    Sevinç Teoman

    2008-02-01

    Full Text Available Abstract Hemangiomas of the median nerve are very rare and, so far, only ten cases of intraneural hemangioma of this nerve have been reported in the literature. We present a case of 14-year-old girl who had a soft tissue mass in the region of the left wrist with signs and symptoms of carpal tunnel syndrome. Total removal of the mass was achieved using microsurgical epineural and interfasicular dissection. The symptoms were relieved completely, after this procedure, without any neurologic deficit. On follow-up two years later, no recurrence was observed. Whenever a child or young adult patient presents with CTS the possibility of a hemangioma involving the median nerve should be kept in mind in the differential diagnosis.

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

    Institute of Scientific and Technical Information of China (English)

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

    2006-01-01

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

  16. Peripheral nerve lipoma: Case report of an intraneural lipoma of the median nerve and literature review

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    Teles, Alisson Roberto; Finger, Guilherme; Schuster, Marcelo N.; Gobbato, Pedro Luis

    2016-01-01

    Adipose lesions rarely affect the peripheral nerves. This can occur in two different ways: Direct compression by an extraneural lipoma, or by a lipoma originated from the adipose cells located inside the nerve. Since its first description, many terms have been used in the literature to mention intraneural lipomatous lesions. In this article, the authors report a case of a 62-year-old female who presented with an intraneural median nerve lipoma and review the literature concerning the classification of adipose lesions of the nerve, radiological diagnosis and treatment. PMID:27695575

  17. Electrodiagnostic Studies of Median and Ulnar Nerves in Cyclists.

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    Jackson, D L

    1989-09-01

    In brief: Twenty long-distance cyclists (13 men, 7 women) completed a questionnaire and underwent a neurologic examination and electrodiagnostic studies of the median and ulnar nerves. The purpose was to determine the frequency, severity, and clinical significance of numbness or pain in the hand or wrist and to assess the correlation of electrodiagnostic findings with these complaints. Results of the studies were normal for all 20 cyclists, nine of whom reported symptoms. These cyclists attributed their discomfort to prolonged riding without changing hand position, especially on rough road surfaces. They also reported that their symptoms diminished after they modified their cycling technique and adjusted their bicycle to better fit their body dimensions.

  18. MEDIAN NERVE AS A NERVE OF ANTERIOR COMPARTMENT OF ARM WITH ITS VARIANT FORMATION: A CASE REPORT

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    Charushila D. Shinde

    2015-06-01

    Full Text Available Absence of Musculocutaneous nerve and unusual formation and innervation of Median nerve were noted in left upper limb during anatomical dissection of 60 yr old female cadaver. Median nerve normally does not give any branch in arm but in this case it innervates all the muscles of anterior compartment of arm in place of Musculocutaneous nerve. Here we discussed its embryology. It is important to be aware of such possible anatomical variations in routine clinical practice.

  19. In vivo three-dimensional reconstruction of human median nerves by diffusion tensor imaging

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    Meek, MF; Stenekes, MW; Hoogduin, HM; Nicolai, JPA

    2006-01-01

    The in vivo assessment of axonal projections of the peripheral nervous system has been severely limited by the lack of noninvasive techniques. We examined whether MR diffusion tensor imaging with fiber tracking of the human median nerve is feasible. The median nerve was examined with a 3-T MRI scann

  20. Combined radial and median nerve injury in diaphyseal fracture of humerus: a case report

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    Rohilla Rajesh; Singla Rohit; Magu Narender Kumar; Singh Roop; Devgun Ashish; Mukhopadhyay Reetadyuti; Gogna Paritosh

    2013-01-01

    【Abstract】Radial nerve palsy is the most common neurological involvement in humeral shaft fractures. But combined radial and median nerve injury in a closed dia- physeal fracture of the humerus is rare. Combined injury to both radial and median nerve can cause significant disability. A detailed clinical examination is therefore necessary fol- lowing humeral shaft fractures. We report a patient with closed diaphyseal humeral fracture (AO 12A-2.3) together with radial an...

  1. Phrenic Nerve Injury during Coronary Artery Bypass

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    Guinn, Gene A.; Beall, Arthur C.; Lamki, Neela; Heibig, Jacques; Thornby, John

    1990-01-01

    After coronary artery bypass, some patients have diaphragmatic elevation, usually on the left side. To test our hypothesis that this phenomenon is due to phrenic nerve injury resulting from either 1) dissection of the proximal portion of the left internal mammary artery or 2) topical cooling of the heart with icy slush, we performed the following 2-part study. First, we reviewed our hospital records of 99 coronary artery bypass patients, 55 of whom had received left internal mammary artery gr...

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

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    侯之启; 徐中和

    2002-01-01

    Objective:To compare the effect of using partial median and ulnar nerves for treatment of C5-6 orC5-7 avulsion of the brachial plexus with that of using phrenic and spinal accessary nerves.Methods:The patients were divided into 2groups randomly according to different surgical procedures.Twelve cases were involved in the first group.The phrenic nerve was transferred to the musculocutaneous nerve or through a sural nerve graft,and the spinal accessary nerve was to the suprascapular nerve.Eleven cases were classified into the second group.A part of the fascicles of median nerve was transferred to be coapted with the motor fascicle of musculocutaneous nerve and a part of fascicles of ulnar nerve was transferred to the axillary nerve.The cases were followed up from 1to 3years and the clinical outcome was compared between the two groups.

  3. A persisting median artery in a patient with symbrachydactyly and carpal tunnel syndrome.

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    Tollan, C J; Sivarajan, V

    2008-07-01

    A persisting median artery associated with carpal tunnel syndrome in a patient with symbrachydactyly has not been previously described in the literature. It is unclear whether there may be a developmental association between persistence of a median artery and Symbrachydactyly.

  4. Differential Diagnosis and Intervention of Proximal Median Nerve Entrapment: A Resident's Case Problem.

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    Bair, Marcus R; Gross, Michael T; Cooke, Jennifer R; Hill, Carla H

    2016-09-01

    Study Design Resident's case problem. Background Entrapment neuropathies represent a diagnostic challenge and require a comprehensive understanding of the nerve's path and the anatomical structures that may cause compression of the nerve. This resident's case problem details the evaluation and differential diagnosis process for median nerve entrapment resulting from forceful and repetitive pronation/supination motions. Diagnosis Median nerve compression syndromes include pronator syndrome, anterior interosseous nerve syndrome, and carpal tunnel syndrome. A cluster of clinical special tests were performed to determine the anatomical site of median nerve entrapment. Based on the patient's history and clinical test results, a diagnosis of pronator syndrome was determined. Provocation testing specific to pronator syndrome assisted with further localizing the site of entrapment to the pronator teres muscle, which guided effective management strategies. Discussion This resident's case problem illustrates the importance of detailed anatomical knowledge and a differential diagnostic process when evaluating a patient with signs and symptoms of an entrapment neuropathy of the median nerve. Electrodiagnostic studies are useful in ruling out carpal tunnel and anterior interosseous nerve syndromes, but are often inconclusive in cases of pronator syndrome. Therefore, a diagnosis of pronator syndrome in this case problem was based on a detailed understanding of median nerve anatomy, potential sites of compression, and unique clinical features associated with this condition. Level of Evidence Differential diagnosis, level 4. J Orthop Sports Phys Ther 2016;46(9):800-808. Epub 5 Aug 2016. doi:10.2519/jospt.2016.6723. PMID:27494058

  5. Median nerve cross-sectional area and MRI diffusion characteristics: normative values at the carpal tunnel

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    Yao, Lawrence; Gai, Neville [Clinical Center, Radiology and Imaging Sciences, Bethesda, MD (United States)

    2009-04-15

    Enlargement of the median nerve is an objective potential imaging sign of carpal tunnel syndrome. Diffusion tensor MRI (DTI) may provide additional structural information that may prove useful in characterizing median neuropathy. This study further examines normal values for median nerve cross-sectional area (CSA), apparent diffusion coefficient (ADC), and fractional anisotropy (FA). Twenty-three wrists in 17 healthy volunteers underwent MRI of the wrist at 3 T. In 13 subjects, DTI was performed at a B value of 600 mm{sup 2}/s. Median nerve CSA, ADC, and FA were analyzed at standardized anatomic levels. Mean (SD) median nerve CSA within the proximal carpal tunnel was 10.0 (3.4) mm{sup 2}. The mean (SD) FA of the median nerve was 0.71 (0.06) and 0.70 (0.13) proximal to and within the carpal tunnel, respectively. There was a significant difference between nerve CSA and ADC, but not FA, at the distal forearm and proximal carpal tunnel. Nerve CSA, ADC, and FA did not differ between men and women or between dominant and non-dominant wrists. Nerve CSA at the proximal carpal tunnel was positively correlated with subject age and body mass index. Our results suggest a 90% upper confidence limit for normal median nerve CSA of 14.4 mm{sup 2} at the proximal carpal tunnel, higher than normal limits reported by many ultrasound studies. We observed a difference between the CSA and ADC, but not the FA, of the median nerve at the distal forearm and proximal carpal tunnel levels. (orig.)

  6. Effects of perineural steroid injections on median nerve conduction during the carpal tunnel release

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    Stepić Nenad

    2008-01-01

    Full Text Available Background/Aim. The treatment outcome of the median nerve compressive neuropathy in the carpal zone due to carpal tunnel syndrome (CTS is represented by recovering the nerves sensibility, conductivity, condition and strength. Perineural application of betamethasone during the surgical decompression might result in faster recovery of compressed median nerve's conduction speed. Methods. In this study 40 patients with CTS were randomly divided in the two groups. In the first group (n = 20 we performed the surgical decompression of the median nerve by the open release of the carpal tunnel, and in the second group (n = 20 we applicated a perineural injection of 1 ml of betamethason immediately after the surgical decompression. We performed the electrodiagnostic (ED examinations 7, 30 and 90 days after the surgery, and measured the conduction speed of the median nerve in the carpal tunnel zone and the sensitivity conduction speed of the median nerve. Results. Significant differences in examined ED respective variable values in different time intervals were obtained. At the final measurements, 90 days after the surgical procedure, both groups evidenced a full recovery of the conduction speed in the carpal tunnel with statistically significant better results in the second group of the patients (t = -2.116; p = 0.043. Conclusion. Intraoperative application of the corticosteroid injection during the surgical decompression results in faster regaining of conduction speed of the median nerve.

  7. Combined radial and median nerve injury in diaphyseal fracture of humerus: a case report

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    Rohilla Rajesh

    2013-12-01

    Full Text Available 【Abstract】Radial nerve palsy is the most common neurological involvement in humeral shaft fractures. But combined radial and median nerve injury in a closed dia- physeal fracture of the humerus is rare. Combined injury to both radial and median nerve can cause significant disability. A detailed clinical examination is therefore necessary fol- lowing humeral shaft fractures. We report a patient with closed diaphyseal humeral fracture (AO 12A-2.3 together with radial and median nerve palsy, its management and review of the literature. As the patient had two nerves involved, surgical exploration was planned. Fracture was reduced and fixed with a 4.5 mm narrow dynamic compres- sion plate. There was no external injury to both radial and median nerves on surgical exploration. Neurological reco- very started at 3 weeks’ follow-up. Complete recovery was seen at 12 weeks. Careful clinical examination is of the ut- most importance in early diagnosis of combined nerve injuries, which allows better management and rehabilitation of the patient. Key words: Humeral fractures; Radial nerve; Me- dian nerve; Diaphyses; Paralysis

  8. The optimal distance between two electrode tips during recording of compound nerve action potentials in the rat median nerve

    Institute of Scientific and Technical Information of China (English)

    Yongping Li; Jie Lao; Xin Zhao; Dong Tian; Yi Zhu; Xiaochun Wei

    2014-01-01

    The distance between the two electrode tips can greatly inlfuence the parameters used for record-ing compound nerve action potentials. To investigate the optimal parameters for these recordings in the rat median nerve, we dissociated the nerve using different methods and compound nerve action potentials were orthodromically or antidromically recorded with different electrode spac-ings. Compound nerve action potentials could be consistently recorded using a method in which the middle part of the median nerve was intact, with both ends dissociated from the surrounding fascia and a ground wire inserted into the muscle close to the intact part. When the distance be-tween two stimulating electrode tips was increased, the threshold and supramaximal stimulating intensity of compound nerve action potentials were gradually decreased, but the amplitude was not changed signiifcantly. When the distance between two recording electrode tips was increased, the amplitude was gradually increased, but the threshold and supramaximal stimulating intensity exhibited no signiifcant change. Different distances between recording and stimulating sites did not produce signiifcant effects on the aforementioned parameters. A distance of 5 mm between recording and stimulating electrodes and a distance of 10 mm between recording and stimulating sites were found to be optimal for compound nerve action potential recording in the rat median nerve. In addition, the orthodromic compound action potential, with a biphasic waveform that was more stable and displayed less interference (however also required a higher threshold and higher supramaximal stimulus), was found to be superior to the antidromic compound action potential.

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

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    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.)

  10. Determination of Median Nerve Somatosensory Evoked Potentials in 27 Patients with Hemiplegia

    Institute of Scientific and Technical Information of China (English)

    刘雅丽; 尤春景; 黄杰; 刘培玲

    2002-01-01

    Summary: Twenty-seven in-patients with hemiplegia following brain injury were studied by using up per extremity median nerve somatosensory evoked patentials (SVEP), Brunnstrom assessment in hemiplegic hand and assessment of the patients' activities of daily lioing (ADL) (Barthel index). The upper extremity median nerve SEP on the affected and normal sides was determined. By using Kovin dba standard, upper extremity median nerve SEP was graded in accordance with N20. The correla tion between the differences of SEP N20 amplitude and the latencies on the both sides and the Barthel index scores was analyzed. A Spearman correlation analysis was made between the median nerve SEP N20 grades and Brunnstrom stages in hand or ADL on the affected side. The results showed that up per extremity median nerve SEP grades were positively correlated with those of the Brunnstrom stages in hand (r1 =0. 6925, P1<0. 01). The correlation coefficient between SEP N20 grades and patients' ADL grades was r2= 0. 5015, P2<0.01. It was concluded that upper extremity median nerve SEP could be used as a sensitive electrophysiological predictor to clinically assess hemiplegic hand function. SEP N20 might play a role in predicting the ADL of the patients with hemiplegia to some extent, but could not be used as a sensitive predictor to directly observe and predict the ADL of the patients.

  11. MRI DIAGNOSIS OF TWO CASES OF FIBROLIPOMATOUS HAMARTOMA OF THE MEDIAN NERVE WITH HISTOPATHOLOGICAL CORRELATION

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    Mary Hazarika

    2015-08-01

    Full Text Available Fibrolipomatous hamartoma is an uncommon congenital disorder, which is characterized by disproportionate hyperplasia of adipose tissue infiltrating along the perineurium, the epineurium and the affected nerve trajectory. 1 The median nerve and its branches are most commonly affected, followed by the radial nerve, ulnar nerve, nerves at the dorsal aspect of the foot, brachial plexus and cranial nerves. 1,2 Magnetic resonance imaging demonstrated a typical fibrolipomatous hamartoma with high signal intensity o f fat on both T1 - weighted and T2 - weighted images, characteristic coaxial cable appearance on axial images, and spaghetti appearance on sagittal images in two of our cases. Fibrolipomatous hamartoma (FLH of nerve is a rare tumor - like condition in which mat ure fat infiltrates the neural sheath, with the majority of the lesions occurring in the median nerve. 3 W e present two cases of Fibrolipomatous hamartoma of median nerve at the wrist with an unusual proximal extension to the forearm in one case.

  12. Compression of the median nerve in the proximal forearm by a giant lipoma: A case report

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    O'Toole Greg A

    2008-06-01

    Full Text Available Abstract Background Compression of the median nerve by a tumour in the elbow and forearm region is rare. We present a case of neuropathy of the median nerve secondary to compression by giant lipoma in the proximal forearm. Case presentation A 46-year-old man presented with a six month history of gradually worsening numbness and paresthesia on the palmar aspect of the left thumb and thenar eminence. Clinical examination reveals a hypoaesthesia in the median nerve area of the left index and thumb compared to the contralateral side. Electromyography showed prolonged sensory latency in the distribution of the median nerve corresponding to compression in the region of the pronator teres (pronator syndrome. Radiological investigations were initially reported as normal. Conservative treatment for one month did not result in any improvement. Surgical exploration was performed and a large intermuscular lipoma enveloped the median nerve was found. A complete excision of the tumour was performed. Postoperative revaluation the X-ray of the elbow was seen to demonstrate a well-circumscribed mass in the anterior aspect of the proximal forearm. At follow-up, 14 months after surgery, the patient noted complete return of the sensation and resolution of the paresthesia. Conclusion In case of atypical findings or non frequent localization of nerve compression, clinically interpreted as an idiopathic compression, it is recommended to make a pre-operative complementary Ultrasound or MRI study.

  13. Combined radial and median nerve injury in diaphyseal fracture of humerus: a case report

    Institute of Scientific and Technical Information of China (English)

    Rajesh Rohilla; Rohit Singla; Narender Kumar Magu; Roop Singh; Ashish Devgun; Reetadyuti Mukhopadhyay; Paritosh Gogna

    2013-01-01

    Radial nerve palsy is the most common neurological involvement in humeral shaft fractures.But combined radial and median nerve injury in a closed diaphyseal fracture of the humerus is rare.Combined injury to both radial and median nerve can cause significant disability.A detailed clinical examination is therefore necessary following humeral shaft fractures.We report a patient with closed diaphyseal humeral fracture (AO 12A-2.3) together with radial and median nerve palsy,its management and review of the literature.As the patient had two nerves involved,surgical exploration was planned.Fracture was reduced and fixed with a 4.5 mm narrow dynamic compression pla te.There was no external injury to both radial and median nerves on surgical exploration.Neurological recovery started at 3 weeks' follow-up.Complete recovery was seen at 12 weeks.Careful clinical examination is of the utmost importance in early diagnosis of combined nerve injuries,which allows better management and rehabilitation of the patient.

  14. Use of adjunctive palmaris longus abductorplasty (Camitz) tendon transfer in pediatric median nerve injury.

    Science.gov (United States)

    Baluch, Narges; Borschel, Gregory H

    2013-05-01

    A number of tendon transfers have been described for opponensplasty. Transfer of the palmaris longus (PL) tendon with a palmar fascial extension was initially described by Camitz. This technique has mostly been combined with carpal tunnel release in patients with long standing median neuropathy with atrophy of the thenar muscles. However, the Camitz transfer has not been previously described in the setting of pediatric median nerve injury. We report 4 cases of Camitz transfer in pediatric patients with median nerve injuries. Four children (all female; age range 3-15 yrs) underwent PL tendon transfer following median nerve injury. The causes of injury included trauma, iatrogenic injury, and neuritis of the brachial plexus. The Camitz procedure was performed at the time of median nerve decompression and/or reconstruction. All patients had excellent early return of function. Transfer of the palmaris longus tendon reliably restores palmar abduction, with minimal to no additional morbidity, in carefully selected pediatric patients with median nerve injury undergoing release of the carpal tunnel. PMID:22981385

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

    Institute of Scientific and Technical Information of China (English)

    侯之启; 徐中和

    2002-01-01

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

  16. Biomechanics of the Median Nerve During Stretching as Assessed by Ultrasonography.

    Science.gov (United States)

    Martínez-Payá, Jacinto Javier; Ríos-Díaz, José; Del Baño-Aledo, María Elena; García-Martínez, David; de Groot-Ferrando, Ana; Meroño-Gallut, Javier

    2015-12-01

    The objective of this observational cross-sectional study was to investigate the normal motion of the median nerve when stretched during a neurodynamic exercise. In recent years, ultrasonography has been increasingly accepted as an imaging technique for examining peripheral nerves in vivo, offering a reliable and noninvasive method for a precise evaluation of nerve movement. Transverse motion of the median nerve in the arm during a neurodynamic test was measured. A volunteer sample of 22 healthy subjects (11 women) participated in the study. Nerve displacement and deformation were assessed by dynamic ultrasonography. Excellent interobserver agreement was obtained, with kappa coefficient of .7-.8. Ultrasonography showed no lateral motion during wrist extension in 68% of nerves, while 73% moved dorsally, with statistically significant differences between sexes (ORlat = 6.3; 95% CI = 1.4-27.7 and ORdor = 8.3; 95% CI = 1.6-44.6). The cross-sectional area was significantly greater in men (3.6 mm2). Quantitative analysis revealed no other statistically significant differences. Our results provide evidence of substantial individual differences in median nerve transverse displacement in response to a neurodynamic exercise. PMID:26213988

  17. Pre- and post-operative diffusion tensor imaging of the median nerve in carpal tunnel syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Hiltunen, Jaana [Aalto University School of Science, Brain Research Unit, Low Temperature Laboratory, Aalto (Finland); Aalto University School of Science, Advanced Magnetic Imaging Centre, Aalto (Finland); Kirveskari, Erika [Aalto University School of Science, Brain Research Unit, Low Temperature Laboratory, Aalto (Finland); Helsinki University Central Hospital, Department of Clinical Neurophysiology, Helsinki (Finland); Numminen, Jussi [Aalto University School of Science, Brain Research Unit, Low Temperature Laboratory, Aalto (Finland); University of Helsinki, Helsinki Medical Imaging Center, Helsinki (Finland); Lindfors, Nina; Goeransson, Harry [Helsinki University Central Hospital, Department of Hand Surgery, Helsinki (Finland); Hari, Riitta [Aalto University School of Science, Brain Research Unit, Low Temperature Laboratory, Aalto (Finland); Aalto University School of Science, Advanced Magnetic Imaging Centre, Aalto (Finland); Helsinki University Central Hospital, Department of Clinical Neurophysiology, Helsinki (Finland)

    2012-06-15

    To use pre- and post-operative diffusion tensor imaging (DTI) to monitor median nerve integrity in patients suffering from carpal tunnel syndrome (CTS). Diffusivity and anisotropy images along the median nerve were compared among 12 patients, 12 age-matched and 12 young control subjects and correlated with electrophysiological neurography results. Slice-wise DTI parameter values were calculated to focus on local changes. Results of pre-operative patients and age-matched control subjects differed only in the distal nerve. Moreover, pre-operative patients differed significantly from young controls and post-operative patients. The main abnormalities were increased diffusivity and decreased anisotropy in the carpal tunnel and distal median nerve. Post-operative clinical improvement was reflected in diffusivity, but not in anisotropy. Slice-wise analysis showed high pre-operative diffusivity at the distal nerve. All groups had relatively large inter-subject variation in both diffusivity and anisotropy. DTI can provide information complementary to clinical examination, electrophysiological recordings and anatomical MRI of diseases and injuries of peripheral nerves. However, similar age-related changes in diffusivity and anisotropy may weaken DTI specificity. Slice-wise analysis is necessary for detection of local changes in nerve integrity. circle Diffusion tensor magnetic resonance imaging provides information complementary to conventional diagnostic methods. circle Age caused similar changes to diffusivity and anisotropy as carpal tunnel syndrome. circle Post-operative clinical improvement was reflected in diffusivity, but not in anisotropy. circle Inter-subject variation in diffusivity and anisotropy was considerable. (orig.)

  18. Post-traumatic Median Nerve Neuroma in Wrist. A Case Report and brief review of Literature

    Directory of Open Access Journals (Sweden)

    Ahmet Aslan

    2013-07-01

    Full Text Available Introduction: Distal median nerve masses may be developed post-traumatic or non-traumatic. In this paper, we aim to present a 52 year old female case with a postraumatic neuroma of the median nerve in the left wrist. Case Report: A 52-year-old female patient had accidental incised wound over her left wrist which was primarily sutured. She presented 6 months later with unrelieved pain and growing swelling at the wrist. USG showed solid mass of size 2×3 cms. Intraoperatively the mass was seen to arise from medial nerve and careful excision was done protecting the nerve. At one year follow up the patient is relived of her symptoms with no sensorimotor deficit. Conclusion: Post traumatic neuroma present as unrelieved pain and progressive swelling. A high index of suspicion should be kept in cases of wound that are primarily sutured over an area with superficial nerves. Careful excision of the lesion is very effective in relieving patients symptoms Keywords: Neuroma, wrist, median nerve, nerve ınjury.

  19. Epithelioid Sarcoma of the Forearm Arising from Perineural Sheath of Median Nerve Mimicking Carpal Tunnel Syndrome

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    Hiromasa Fujii

    2009-01-01

    Full Text Available We report here a case of epithelioid sarcoma in the forearm of a 33-year-old male presenting with symptoms and signs of carpal tunnel syndrome originating from the direct involvement of the median nerve. Due to the slow growing of the tumor, the patient noticed the presence of tumor mass in his forearm after several months from the initial onset of the symptoms. Magnetic resonance imaging showed an 8×4 cm mass involving the median nerve in the middle part of the forearm, and histological analysis of the biopsy specimen revealed the diagnosis of epithelioid sarcoma. Radical surgical resection was performed in conjunction with adjuvant chemotherapy. The function of the flexors were restored by the multiple tendon transfers (EIP→FDS; ECRL→FDP; BrR→FPL; EDM→opponens with superficial cutaneous branch of radial nerve transfer to the resected median nerve. The function of the affected hand showed excellent with the DASH disability/symptom score of 22.5, and both the grasp power and sensory of the median nerve area has recovered up to 50% of the normal side. The patient returned to his original vocation and alive with continuous disease free at 3.5-year follow-up since initial treatment.

  20. Post-traumatic Median Nerve Neuroma in Wrist. A Case Report and brief review of Literature

    OpenAIRE

    Ahmet Aslan; Mehmet Nuri Konya; Serdar Sargın

    2013-01-01

    Introduction: Distal median nerve masses may be developed post-traumatic or non-traumatic. In this paper, we aim to present a 52 year old female case with a postraumatic neuroma of the median nerve in the left wrist. Case Report: A 52-year-old female patient had accidental incised wound over her left wrist which was primarily sutured. She presented 6 months later with unrelieved pain and growing swelling at the wrist. USG showed solid mass of size 2×3 cms. Intraoperatively the mass was see...

  1. Cadaveric Study of Anatomic Far Distal Musculocutaneous and Median Nerve Communication.

    Science.gov (United States)

    Hussain, Namath S

    2016-01-01

    One of the more commonly reported variations in musculocutaneous and median nerves is a communication between the two. Such communications have been noted in the literature for well over a century, and numerous studies have attempted to quantify their rate of incidence and classify their different patterns. Most communications occur close to the brachial plexus in the proximal arm; communications distal to the musculocutaneous nerve perforation of the coracobrachialis have been reported with less frequency, and several rare and unique communication patterns have been reported as case studies. This paper describes a case of a communicating branch between the musculocutaneous and median nerves, distal to the origin of the brachialis muscle. This communication was found during a routine educational dissection and is closer to the level of the elbow than previously documented communications that are distal to the musculocutaneous perforation of the coracobrachialis. Identification and documentation of the variety of musculocutaneous and median nerve communications is relevant to clinical diagnosis of peripheral nerve pathologies, as well as for planning surgical approaches and procedures. PMID:27433406

  2. Cadaveric Study of Anatomic Far Distal Musculocutaneous and Median Nerve Communication.

    Science.gov (United States)

    Hussain, Namath S

    2016-06-02

    One of the more commonly reported variations in musculocutaneous and median nerves is a communication between the two. Such communications have been noted in the literature for well over a century, and numerous studies have attempted to quantify their rate of incidence and classify their different patterns. Most communications occur close to the brachial plexus in the proximal arm; communications distal to the musculocutaneous nerve perforation of the coracobrachialis have been reported with less frequency, and several rare and unique communication patterns have been reported as case studies. This paper describes a case of a communicating branch between the musculocutaneous and median nerves, distal to the origin of the brachialis muscle. This communication was found during a routine educational dissection and is closer to the level of the elbow than previously documented communications that are distal to the musculocutaneous perforation of the coracobrachialis. Identification and documentation of the variety of musculocutaneous and median nerve communications is relevant to clinical diagnosis of peripheral nerve pathologies, as well as for planning surgical approaches and procedures.

  3. Magnetic Resonance Imaging Visualizes Median Nerve Entrapment due to Radius Fracture and Allows Immediate Surgical Release

    Directory of Open Access Journals (Sweden)

    Satoshi Yanagibayashi

    2015-01-01

    Full Text Available Median nerve entrapment with forearm fracture is rare, and surgical exploration in the early stage is rarely performed. We report the case of a 19-year-old man presenting with severe pain and numbness of the thumb, index, and middle fingers and half of the ring finger along with weakness of abduction and opposition of the thumb after fracture of the radial shaft. These symptoms remained unimproved despite precise closed reduction and cast immobilization. The radius fracture was barely displaced, but complaints were increasing, particularly when the wrist and/or fingers were stretched. This suggested direct involvement of the median nerve at the fracture site, so magnetic resonance imaging (MRI of the forearm was performed to identify any entrapment. Short tau inversion recovery MRI visualized significant deviation and entrapment of the median nerve at the fracture site. Surgical release of the entrapment was performed immediately, and complaints resolved shortly thereafter. A positive Tinel sign from the palm to the fingertips and recovery of abduction and opposition of the thumb were seen at 6 months postoperatively. This report highlights the utility of MRI for detecting median nerve entrapment at a fracture site, allowing immediate surgical release.

  4. High-resolution sonography of the palmar cutaneous branch of the median nerve

    NARCIS (Netherlands)

    A. Tagliafico (Alberto); F. Pugliese (Francesca); S. Bianchi (Stefano); G. Bodner (Gerd); L. Padua (Luca); M. Rubino (Maurizio); C. Martinoli (Carlo)

    2008-01-01

    textabstractOBJECTIVE. The aim of this study was to describe the potential value of high-resolution sonography for evaluation of the palmar cutaneous branch of the median nerve (MN). SUBJECTS AND METHODS. The volar wrists of 12 healthy volunteers and 22 consecutive patients with sensory deficit in t

  5. In-continuity neuroma of the median nerve after surgical release for carpal tunnel syndrome: case report

    OpenAIRE

    Depaoli, R.; Coscia, D.R.; Alessandrino, F.

    2014-01-01

    Iatrogenic injuries of the median nerve after surgical release for carpal tunnel syndrome resulting in the formation of a neuroma are rare. We present here the case of two patients, one with a bifid median nerve, showing in-continuity neuroma after surgical release for carpal tunnel syndrome. The patients reported persistent post-operative pain and showing symptoms. In both cases, ultrasound showed an in-continuity neuroma with a hypoechoic and enlarged median nerve at the carpal tunnel. The ...

  6. Fibrolipomatous Hamartoma of Digital Branch of the Median Nerve without Macrodystrophy: Two Case Reports with Magnetic Resonance Imaging Findings

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Woo Sun; Jung, Jee Young; Song, In Sub; Lee, Jae Sung; Lee, Tae Jin; Jung, Yoon Yang [Chung-Ang University Hospital, School of Medicine, Chung-Ang University, Seoul (Korea, Republic of)

    2012-11-15

    Fibrolipomatous hamartoma (FLH) of the nerve is a rare, benign tumor that most commonly originates from the median nerve of the hand. Fibrofatty tissue proliferates around the nerve and infiltrates the epineurium and perineurium. We present two cases of pathologically proven FLH of a digital branch of the median nerve, without macrodystrophy with magnetic resonance imaging, surgical and pathologic findings. Magnetic resonance images of both cases show well-circumscribed mass with fat signal intensity around an enlarged digital branch of the median nerve and characteristic coaxial-cable-like appearance on axial images and spaghetti-like appearance on coronal images.

  7. Recurrent Primary Synovial Sarcoma of Median Nerve: A Case Report and Literature Review.

    Science.gov (United States)

    Bhat, A K; Jayakrishnan, K N; Acharya, A M

    2016-10-01

    We report a case of intraneural synovial sarcoma of the median nerve in a 39 year old lady with multiple local recurrences over thirteen years with no distant metastasis. The diagnosis of biphasic type of synovial sarcoma was confirmed by histopathology and immunohistochemistry. At the time of the fourth recurrence below elbow amputation was performed. This case is being reported for its rarity and propensity for local recurrence without distant metastasis.

  8. Dipole Source Analyses of Early Median Nerve SEP Components Obtained From Subdural Grid Recordings

    OpenAIRE

    Baumgärtner, Ulf; Vogel, Hagen; Ohara, Shinji; Treede, Rolf-Detlef; Lenz, Fred A.

    2010-01-01

    The median nerve N20 and P22 SEP components constitute the initial response of the primary somatosensory cortex to somatosensory stimulation of the upper extremity. Knowledge of the underlying generators is important both for basic understanding of the initial sequence of cortical activation and to identify landmarks for eloquent areas to spare in resection planning of cortex in epilepsy surgery. We now set out to localize the N20 and P22 using subdural grid recording with special emphasis on...

  9. Study of recurrent branch of median nerve (Thenar's muscular branch in relation to the flexor retinaculum and median in 64 hands (32 Men

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    Amirsadri R

    1998-07-01

    Full Text Available Variation of recurred branch of median nerve in relation to the median and flexor retinaculum are significant for both hand surgeons and specialists always. In this study, 64 cadaver hands (32 men have been dissected. The median nerve was identified at the proximal edge of the flexor retinaculum, and in order to expose carpal tunnel the ligament was divided, and the above subjects were studied. The results are: 1 The relation of recurrent nerve to the flexor retinaculum was classified into 4 types: A In (53.1% of subjects, this branch arises from the median after the flexor retinaculum. B In (31.3% of subjects, it arises from the median in the carpal tunnel and the moves around the lower edge of flexor retinaculum and enters the thenar region. C In (14.1% of subjects, it arises from the median in the carpal tunnel and pierces the flexor retinaculum. D In (1.56% of subjects it arises, in the carpal tunnel and it divides into two subbranches here. One follows pattern A and the other pattern C. 2 In this step, the relation of the recurrent branch to the median nerve was studied. The results show that inspite of this image even though most often the recurrent branch arises from the lateral side of median, in (68.75% of subjects it arises from it's anterior surface. The MC Nemar test reveals that there is no relation between manifestation of mentioned patterns with right or left hands.

  10. Transverse ultrasound assessment of median nerve deformation and displacement in the human carpal tunnel during wrist movements.

    Science.gov (United States)

    Wang, Yuexiang; Zhao, Chunfeng; Passe, Sandra M; Filius, Anika; Thoreson, Andrew R; An, Kai-Nan; Amadio, Peter C

    2014-01-01

    The symptoms of carpal tunnel syndrome, a compression neuropathy of the median nerve at the wrist, are aggravated by wrist motion, but the effect of these motions on median nerve motion are unknown. To better understand the biomechanics of the abnormal nerve, it is first necessary to understand normal nerve movement. The purpose of this study was to evaluate the deformation and displacement of the normal median nerve at the proximal carpal tunnel level on transverse ultrasound images during different wrist movements, to have a baseline for comparison with abnormal movements. Dynamic ultrasound images of both wrists of 10 asymptomatic volunteers were obtained during wrist maximal flexion, extension and ulnar deviation. To simplify the analysis, the initial and final shape and position of the median nerve were measured and analyzed. The circularity of the median nerve was significantly increased and the aspect ratio and perimeter were significantly decreased in the final image compared with the first image during wrist flexion with finger extension, wrist flexion with finger flexion and wrist ulnar deviation with finger extension (p carpal tunnel, wrist flexion and ulnar deviation could induce significant transverse displacement and deformation of the median nerve.

  11. Influence of a 50 Hz-1 mT Magnetic Field on Human Median Nerve

    Directory of Open Access Journals (Sweden)

    Özlem COŞKUN

    2009-02-01

    Full Text Available With the increasing use of magnetic fields in recent five decades, the health effects of nonionized electromagnetic radiation is an important investigation subject. While the magnetic field is well known, it is difficult to investigate the health effects of radiation, because of the complex metabolism of human body. However, by the experimental and theorical studies, a lot of significant health effects of magnetic fields have been discovered. But, there are probabilities that can have much more adverse health effects. The purpose of this study is to evaluate the effect of 50 Hz-1 mT magnetic field on human median motor nerve conduction parameters. At this frequency, 1 mT value of magnetic field intensity is known and accepted as the marginal value where biological interaction starts. Standard nerve conduction techniques using constant measured distances were applied to evaluate the median nerve. Consequently in the measures conducted using the device of 4 channel NCS/EMG/ EPS there was a significant decrease in motor distal amplitude after the magnetic field application in comparison to the one during the application (p=0,000573 and also in the motor distal amplitude/ proximal amplitude in comparison to the ones before the application (p=0,037418.

  12. Effects of Whiplash Injury on Median Nerve Mobility: A Comparative Study

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    Muhammad Nazim Farooq

    2012-12-01

    Full Text Available Chronic pain following whiplash injury is a challenging condition for healthcare professionals. Clinical signs of changes in neural mobility have been observed in these patients, which may be responsible for symptoms. The present study used ultrasound imaging to evaluate and compare median nerve movement in subjects who have previously had a whiplash associated disorder (WAD (n=7 with a control group (n=10. Longitudinal and transverse nerve sliding was measured at mid-forearm during neck movement from neutral to contralateral side flexion. Data were analyzed using descriptive and non-parametric statistical methods.Longitudinal nerve movement was reduced by 24% in WAD group compared with control group, where the mean movement was 1.31 (SD=0.49 mm and 1.73 (SD=0.92 mm respectively. Transverse movement was reduced by 66.7% in patient group compared with control group, where the mean movement was -0.06 (SD=0.51 mm and -0.18 (SD=0.54 mm respectively. Overall there was a trend of reduced nerve sliding in whiplash patients but this did not achieve statistical significance. Further research should utilise a larger sample to further evaluate the nature and extend of changes in neural mobility in a patient population.

  13. Electromyography in diagnostic of median nerve lesion in carpal tunnel syndrome of children with mucopolysaccharidoses

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    A. L. Kurenkov

    2013-01-01

    Full Text Available Carpal tunnel syndrome (CTS is a frequent syndrome in adults, but is very rare in children. CTS was described in children with mucopolysaccharidoses (MPS as condition due to the deformation of carpal bones, deposition of glycosaminoglycans in tendosynovial tissue and connective tissue of flexor retinaculum. Electromyography is essential method for diagnostic CTS in children because typical symptoms of CTS (paresthesia, numbness of hand and fingers, atrophy and paresis of certain muscles seen in adults are absent or not realized by children with MPS because of cognitive deficit despite the presence of nerve involvement. EMG results from 40 children with different types of MPS (age 1 year 8 months to 18 years are presented. Neurophysiologic abnormalities related to CTS were found in every child with MPS I, in 80,9 % of cases – with MPS II and in every case – with MPS VI; no EMG signs of median nerve lesions incarpal channel were detected in patients with MPS III and MPS IV. CTS was bilateral in children with MPS I, II and VI, but usuallythere was an asymmetry of changes. We revealed CTS in one patient with MPS II as early as at the age 2 years 11 months. All children with MPS II had already CTS at the age of 4 years except one patient. Children with MPS I and MPS VI were not investigate before the age 4 years old, but one child 4 years old with MPS I had severe CTS. In children with MPS atrophy of thenar eminence muscles developed rapidly as complication of CTS. Therefore we recommend repeating of EMG regularly to identify earliest signs of median nerve disturbance in carpal channel and opportune surgical decompression of the entrapped nerve. It allows preserving normal function of hand that it is very important for adequate child development and quality of life.

  14. Carpal arch and median nerve changes during radioulnar wrist compression in carpal tunnel syndrome patients.

    Science.gov (United States)

    Marquardt, Tamara L; Evans, Peter J; Seitz, William H; Li, Zong-Ming

    2016-07-01

    The purpose of this study was to investigate the morphological changes of the carpal arch and median nerve during the application of radiounlarly directed compressive force across the wrist in patients with carpal tunnel syndrome. Radioulnar compressive forces of 10 N and 20 N were applied at the distal level of the carpal tunnel in 10 female patients diagnosed with carpal tunnel syndrome. Immediately prior to force application and after 3 min of application, ultrasound images of the distal carpal tunnel were obtained. It was found that applying force across the wrist decreased the carpal arch width (p 1234-1240, 2016. PMID:26662276

  15. Influence of the long term use of a computer on median, ulnar and radial sensory nerves in the wrist region

    Directory of Open Access Journals (Sweden)

    Belgin Bamac

    2014-12-01

    Full Text Available Objectives: Repetitive microtrauma or overuse injuries may often affect upper extremities of the long term computer users. The aim of this study was to compare sensory nerve conduction velocities (SNCV for median, radial and ulnar nerves in the wrist of computer users with the same parameters in controls who do not use computers regularly. Material and Methods: Twenty one male computer users (age: mean (M = 28.3 years ± standard deviation (SD = 7.5 years and 21 male control subjects (age: M±SD = 24.1±4.6 years were recruited for the study. Limb length and the perimeters of the dominant arm and forearm were measured for each subject. The neurophysiological study consisted of measuring sensory nerve conduction of the median, ulnar and radial nerves. Results: The sensory conduction velocities of both median and ulnar nerves were significantly delayed in the dominant arm of the computer users compared to the controls. In addition, sensory conduction velocity of the median nerve was significantly delayed in the dominant extremity of the computer users compared to their non-dominant extremity. Conclusions: This study shows that computer users have a tendency toward developing median and ulnar sensory nerve damage in the wrist region. Mechanism of delayed SNCV in the median and ulnar nerves may be due to sustained extension and ulnar deviation of the wrist during computer mouse use and typing. Reduced SNCV changes were more apparent on the dominant side of the median nerve. This may indicate the increased neural deficits related to an increased use of the dominant side. Further investigation is needed to determine how to reduce potential risk factors at this stage in order to prevent development of median or ulnar neuropathy in the long term computer users.

  16. Mechanosensitivity of the median nerve in patients with chronic carpal tunnel syndrome.

    Science.gov (United States)

    Jaberzadeh, Shapour; Zoghi, Maryam

    2013-04-01

    The aim was to investigate the relationship between the effects of median nerve strain during the elbow extension component of the upper limb neurodynamic test 1 (ULNT1) and the evoked musculoskeletal changes. 11 patients with chronic carpal tunnel syndrome (CTS) and 11 matched asymptomatic controls participated in the study. In all subjects, elbow extension was carried out in both ULNT1 and neutral positions of the shoulder and arm. From these two starting positions a KIN-COM(®) dynamometer carried out passive elbow extension while EMG activity of 10 arm and shoulder muscles, elbow-flexor resistive torque and elbow extension ROM were measured concurrently. The result showed that, in the ULNT1 position, increased EMG activity of the involved muscles, increased elbow extension resistive torque and pain responses occurred much earlier in the range of elbow extension in the CTS group compared to healthy controls. These findings demonstrated increased mechanosensitivity of the median nerve in CTS patients compared to healthy controls. PMID:23561861

  17. The cholesterol levels in median nerve and post-mortem interval evaluation.

    Science.gov (United States)

    Vacchiano, G; Maldonado, A Luna; Ros, M Matas; Di Lorenzo, P; Pieri, M

    2016-08-01

    Cholesterol levels in the median nerve were studied at various post-mortem intervals (PMIs). Single median nerve samples were collected from the wrists of 36 subjects during forensic autopsies of subjects with known circumstances and times of death. Although the absolute values varied, increments in cholesterol concentration were recorded. Subsequently, 16 subjects who did not suffer of any neurological and/or metabolic diseases with known times and circumstances of death were enrolled. For each enrolled subject, two samples were collected from the wrist at an interval of approximately two hours (t1 and t2). The obtained results revealed a gradual increase in cholesterol level with increasing time since death. The cholesterol concentration data obtained for each subject at t1 and t2 were correlated with the time since death, a linear interpolation was applied, and the PMI was back-calculated. Similar trends were obtained for the samples collected at similar PMIs; thus, three groups were considered: PMIPMIPMI>78h. Good correlation coefficients were obtained, especially for the first group (R(2)=0.9362) for which the PMI could be calculated with an error that ranged from -4 to 5.9h. Although it requires further confirmation via analyses of larger numbers of samples, the method proposed here can currently be applied to PMI determinations. PMID:26826850

  18. Dipole source analyses of early median nerve SEP components obtained from subdural grid recordings.

    Science.gov (United States)

    Baumgärtner, Ulf; Vogel, Hagen; Ohara, Shinji; Treede, Rolf-Detlef; Lenz, Fred A

    2010-12-01

    The median nerve N20 and P22 SEP components constitute the initial response of the primary somatosensory cortex to somatosensory stimulation of the upper extremity. Knowledge of the underlying generators is important both for basic understanding of the initial sequence of cortical activation and to identify landmarks for eloquent areas to spare in resection planning of cortex in epilepsy surgery. We now set out to localize the N20 and P22 using subdural grid recording with special emphasis on the question of the origin of P22: Brodmann area 4 versus area 1. Electroencephalographic dipole source analysis of the N20 and P22 responses obtained from subdural grids over the primary somatosensory cortex after median nerve stimulation was performed in four patients undergoing epilepsy surgery. Based on anatomical landmarks, equivalent current dipoles of N20 and P22 were localized posterior to (n = 2) or on the central sulcus (n = 2). In three patients, the P22 dipole was located posterior to the N20 dipole, whereas in one patient, the P22 dipole was located on the same coordinate in anterior-posterior direction. On average, P22 sources were found to be 6.6 mm posterior [and 1 mm more superficial] compared with the N20 sources. These data strongly suggest a postcentral origin of the P22 SEP component in Brodmann area 1 and render a major precentral contribution to the earliest stages of processing from the primary motor cortex less likely. PMID:20861430

  19. Intensity Sensitive Modulation Effect of Theta Burst Form of Median Nerve Stimulation on the Monosynaptic Spinal Reflex

    OpenAIRE

    Kuei-Lin Yeh; Po-Yu Fong; Ying-Zu Huang

    2015-01-01

    The effects of electrical stimulation of median nerve with a continuous theta burst pattern (EcTBS) on the spinal H-reflex were studied. Different intensities and durations of EcTBS were given to the median nerve to 11 healthy individuals. The amplitude ratio of the H-reflex to maximum M wave (H/M ratio), corticospinal excitability and inhibition measured using motor evoked potentials (MEPs), short-interval intracortical inhibition and facilitation (SICI/ICF), spinal reciprocal inhibition (RI...

  20. A widely displaced Galeazzi-equivalent lesion with median nerve compromise.

    Science.gov (United States)

    Galanopoulos, Ilias; Fogg, Quentin; Ashwood, Neil; Fu, Katherine

    2012-08-18

    We present the case of a 14-year-old boy with a right distal radial fracture accompanied by a severely displaced complete distal ulnar physeal separation and associated median nerve compromise. This injury is known as Galeazzi-equivalent lesion in children and is an extremely rare injury associated with growth arrest. Recognition of the lesion can be difficult but wide displacement may be associated with other significant injuries such as neurovascular compromise. Prompt intervention reversed the neurological symptoms. At 10-month postoperation there was neither growth arrest nor loss of motion. Complete separation of the ulna physis remains often because of soft tissue interposition or capsule problems and prompt reduction is recommended in the literature as a priority.

  1. Early nerve damage in leprosy: An electrophysiological study of ulnar and median nerves in patients with and without clinical neural deficits

    Directory of Open Access Journals (Sweden)

    Husain Sajid

    2007-01-01

    Full Text Available Background: Peripheral nerve trunk involvement in leprosy is very common. However, by the time it becomes clinically manifest, the damage is quite advanced. If the preclinical nerve damage can be detected early, the deformities and disabilities can be prevented to a large extent. Aims: To assess the electrophysiological functions of the ulnar and median nerve trunks in cases of clinically manifest leprosy with and without manifest nerve damage at different durations of nerve damage. Materials and Methods: Electrophysiological functions of ulnar and median nerves were studied in leprosy patients, both normal and at different stages of disease and damage. PB cases, having disease for six months or less, without neurological symptoms and clinically normal appearing nerve. Statistical Methods: Mean was taken of different values. The changes in values of different parameters were expressed as percentage change with reference to the control values (increase or decrease. Results: Reduced nerve conduction velocities and changes in latency and amplitude were observed. Changes in sensory nerve conduction were more pronounced. Sensory latencies and amplitude changes were more severe than motor latencies and amplitudes in cases with manifest muscle palsies. Changes in MB cases were less marked. Conclusions: Further studies are needed to identify parameters likely to be helpful in the diagnosis of early nerve damage.

  2. Improving the radial nerve neurodynamic test: An observation of tension of the radial, median and ulnar nerves during upper limb positioning.

    Science.gov (United States)

    Manvell, Joshua J; Manvell, Nicole; Snodgrass, Suzanne J; Reid, Susan A

    2015-12-01

    The radial nerve neurodynamic test (ULNT2b), used to implicate symptoms arising from the radial nerve, is proposed to selectively increase strain of the nerve without increasing strain of adjacent tissue, though this has not been established. This study aimed to determine the upper limb position that results in: (1) the greatest tension of the radial nerve and (2) the greatest difference in tension between the radial nerve and the other two major nerves of the upper limb: median and ulnar. Tension (N) of the radial, median and ulnar nerves was measured simultaneously using three buckle force transducers during seven upper limb positions in the axilla of ten embalmed whole body human cadavers (n = 20 limbs). Repeated measures analysis of variance (ANOVA) with Bonferroni post-hoc tests determined differences in tension between nerves and between limb positions. A Composite position consisting of ULNT2b (scapular depression, shoulder internal rotation, elbow extension, forearm pronation, wrist flexion) with the addition of shoulder abduction 40° and extension 25°, wrist ulnar deviation and thumb flexion demonstrated significantly greater tension of the radial nerve than any other tested position (mean tension 11.32N; 95% CI 10.25, 12.29, p < 0.01), including ULNT2b (2.20N; 1.84, 2.57; p < 0.01). Additionally, the Composite position demonstrated the greatest difference in tension between the radial and median (mean difference 4.88N; 95% CI 3.16, 6.61; p < 0.01) and radial and ulnar nerves (9.26N, 7.54, 10.99; p < 0.01). This position constitutes a biomechanically plausible test to detect neuropathic pain related to the radial nerve. PMID:25892706

  3. Median Nerve Palsy following Elastic Stable Intramedullary Nailing of a Monteggia Fracture: An Unusual Case and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Surjit Lidder

    2011-01-01

    Full Text Available Monteggia fractures are rare in children, and subtle radial head dislocations, with minor plastic deformation of the ulna, may be missed in up to a third of cases. Complications of Monteggia fractures-dislocations include persistent radial head dislocation, forearm deformity, elbow stiffness, and nerve palsies at the time of presentation. An unusual case of median nerve palsy following elastic stable intramedullary nailing of a type I Monteggia lesion in a 6-year-old girl is presented, and we highlight that, although most nerve palsies associated with a Monteggia fracture-dislocations are treated expectantly in children, early intervention here probably provided the best outcome.

  4. Fibrolipomatous hamartoma in the median nerve in the arm - an unusual location but with MR imaging characteristics: a case report

    DEFF Research Database (Denmark)

    Nilsson, Jessica; Sandberg, Kristina; Dahlin, Lars Bertil;

    2010-01-01

    ABSTRACT: Fibrolipomatous hamartoma of the median nerve are usually located distally in the forearm and may have characteristic features on MR imaging. Here we report a patient with an extensive fibrolipomatous hamartoma at an unusual location proximally in the arm, where a preoperative MR imagin...

  5. Short-Latency Median-Nerve Somatosensory-Evoked Potentials and Induced Gamma-Oscillations in Humans

    Science.gov (United States)

    Fukuda, Miho; Nishida, Masaaki; Juhasz, Csaba; Muzik, Otto; Sood, Sandeep; Chugani, Harry T.; Asano, Eishi

    2008-01-01

    Recent studies have suggested that cortical gamma-oscillations are tightly linked with various forms of physiological activity. In the present study, the dynamic changes of intracranially recorded median-nerve somatosensory-evoked potentials (SEPs) and somatosensory-induced gamma-oscillations were animated on a three-dimensional MR image, and the…

  6. The effect of tendon excursion velocity on longitudinal median nerve displacement: Differences between carpal tunnel syndrome patients and controls

    NARCIS (Netherlands)

    A. Filius (Anika); A.R. Thoreson (Andrew); Y. Wang (Yuexiang); Passe, S.M. (Sandra M.); C. Zhao; P. An (Ping); P.C. Amadio (Peter )

    2015-01-01

    textabstractThe subsynovial connective tissue (SSCT) is a viscoelastic structure connecting the median nerve (MN) and the flexor tendons in the carpal tunnel. Increased strain rates increases stiffness in viscoelastic tissues, and thereby its capacity to transfer shear load. Therefore, tendon excurs

  7. Resuscitation therapy for traumatic brain injury-induced coma in rats: mechanisms of median nerve electrical stimulation

    Directory of Open Access Journals (Sweden)

    Zhen Feng

    2015-01-01

    Full Text Available In this study, rats were put into traumatic brain injury-induced coma and treated with median nerve electrical stimulation. We explored the wake-promoting effect, and possible mechanisms, of median nerve electrical stimulation. Electrical stimulation upregulated the expression levels of orexin-A and its receptor OX1R in the rat prefrontal cortex. Orexin-A expression gradually increased with increasing stimulation, while OX1R expression reached a peak at 12 hours and then decreased. In addition, after the OX1R antagonist, SB334867, was injected into the brain of rats after traumatic brain injury, fewer rats were restored to consciousness, and orexin-A and OXIR expression in the prefrontal cortex was downregulated. Our findings indicate that median nerve electrical stimulation induced an up-regulation of orexin-A and OX1R expression in the prefrontal cortex of traumatic brain injury-induced coma rats, which may be a potential mechanism involved in the wake-promoting effects of median nerve electrical stimulation.

  8. Resuscitation therapy for traumatic brain injury-induced coma in rats:mechanisms of median nerve electrical stimulation

    Institute of Scientific and Technical Information of China (English)

    Zhen Feng; Ying-jun Zhong; Liang Wang; Tian-qi Wei

    2015-01-01

    In this study, rats were put into traumatic brain injury-induced coma and treated with median nerve electrical stimulation. We explored the wake-promoting effect, and possible mechanisms, of median nerve electrical stimulation. Electrical stimulation upregulated the expression levels of orexin-A and its receptor OX1R in the rat prefrontal cortex. Orexin-A expression gradually in-creased with increasing stimulation, while OX1R expression reached a peak at 12 hours and then decreased. In addition, after the OX1R antagonist, SB334867, was injected into the brain of rats after traumatic brain injury, fewer rats were restored to consciousness, and orexin-A and OXIR expression in the prefrontal cortex was downregulated. Our ifndings indicate that median nerve electrical stimulation induced an up-regulation of orexin-A and OX1R expression in the pre-frontal cortex of traumatic brain injury-induced coma rats, which may be a potential mechanism involved in the wake-promoting effects of median nerve electrical stimulation.

  9. Median nerve deformation in differential finger motions : Ultrasonographic comparison of carpal tunnel syndrome patients and healthy controls

    NARCIS (Netherlands)

    van Doesburg, Margriet H. M.; Henderson, Jacqueline; Yoshii, Yuichi; van der Molen, Aebele B. Mink; Cha, Stephen S.; An, Kai-Nan; Amadio, Peter C.

    2012-01-01

    We investigated the median nerve deformation in the carpal tunnel in patients with carpal tunnel syndrome and controls during thumb, index finger, middle finger, and a four finger motion, using ultrasound. Both wrists of 29 asymptomatic volunteers and 29 patients with idiopathic carpal tunnel syndro

  10. Formation of median nerve without the medial root of medial cord and associated variations of the brachial plexus

    Directory of Open Access Journals (Sweden)

    Bhanu SP

    2010-02-01

    Full Text Available The anatomical variations in the formation, course and termination of brachial plexus are well documented and have clinical significance to surgeons, neurologists and anatomists. The present case report describes the unusual origin of median nerve, arising directly from the lateral cord without the union of lateral and medial roots of brachial plexus. A communicating branch existed between the ulnar nerve and anterior division of middle trunk. The lateral pectoral nerve was arising from anterior divisions of upper and middle trunks as two separate branches instead from lateral cord. The branches then joined together to form the lateral pectoral nerve. The medial cord instead of its five terminal branches, had only three branches, the ulnar nerve, medial pectoral nerve and a single trunk for the medial cutaneous nerve of arm and forearm which got separated at the middle of the arm. The variations of the lateral cord and its branches make it a complicated clinical and surgical approach which is discussed with the developmental background.

  11. Unilateral axillary arch with two slips entrapping neurovascular bundle in axilla and its innervation by the median nerve

    Directory of Open Access Journals (Sweden)

    Somayaji SN

    2009-10-01

    Full Text Available Axillary arch is an additional muscle bundle of various dimensions extending usually from the latissimus dorsi in the posterior fold of the axilla, to the pectoralis major or other neighboring muscles and bones. In the present case presence of such unusual axillary arch innervated by the median nerve has been reported. During routine dissection of axilla region in one of the upper limbs, the occurrence of axillary arch was observed. The muscle fibers were arising from the belly of latissimus dorsi and were getting inserted to the tendon of coracobrachilais and lateral lip of bicipital groove. As it passed through the axilla it divided into 2 slips, enclosing the axillary vessels and nerves related to them. The fleshy fibers of the axillary arch were innervated by 2 small twigs from the median nerve. Though the occurrence of the axillary arch is very common, axillary arch with 2 slips getting innervated by the median nerve is not been reported so far. Further, a detailed literature review was done and the surgical and clinical importance of the case was discussed.

  12. Ultrasonographic measurement of median nerve cross-sectional area reference values in a healthy Han population from Guiyang, China

    Institute of Scientific and Technical Information of China (English)

    Jun Chen; Shan Wu; Jun Ren

    2011-01-01

    High-resolution ultrasonography was used to analyze the nerve cross-sectional area (CSA) of the median nerve at 7 sites: the wrist crease, pisiform bone, hamate bone, 6 cm proximal to the tip of the wrist crease, proximal forearm (where the nerve enters the pronator teres muscle), 4 cm proximal to the tip of the medial epicondyle, and mid-humerus (mid-point between elbow crease and axilla) in 200 healthy volunteers from Guiyang, China. Results showed similar CSA values between the left and right sides, but the CSA 6 cm proximal to the tip of the wrist crease, proximal forearm, 4 cm proximal to tip of the medial epicondyle, and mid-humerus in males was greater than that of females. Moreover, CSA values at the wrist crease, pisiform bone, and hamate bone were greater in the middle-aged and old groups when compared to the young group, and correlated with body mass and height. Thus, reference values of median nerve CSA of the upper limbs can facilitate the analysis of abnormal nerve conditions.

  13. Intraoperative radial nerve injury during coronary artery surgery – report of two cases

    Directory of Open Access Journals (Sweden)

    Tsivgoulis Georgios

    2006-12-01

    Full Text Available Abstract Background Peripheral nerve injury and brachial plexopathy are known, though rare complications of coronary artery surgery. The ulnar nerve is most frequently affected, whereas radial nerve lesions are much less common accounting for only 3% of such intraoperative injuries. Case presentations Two 52- and 50-year-old men underwent coronary artery surgery. On the first postoperative day they both complained of wrist drop on the left. Neurological examination revealed a paresis of the wrist and finger extensor muscles (0/5, and the brachioradialis (4/5 with hypoaesthesia on the radial aspect of the dorsum of the left hand. Both biceps and triceps reflexes were normoactive, whereas the brachioradialis reflex was diminished on the left. Muscles innervated from the median and ulnar nerve, as well as all muscles above the elbow were unaffected. Electrophysiological studies were performed 3 weeks later, when muscle power of the affected muscles had already begun to improve. Nerve conduction studies and needle electromyography revealed a partial conduction block of the radial nerve along the spiral groove, motor axonal loss distal to the site of the lesion and moderate impairment in recruitment with fibrillation potentials in radial innervated muscles below the elbow and normal findings in triceps and deltoid. Electrophysiology data pointed towards a radial nerve injury in the spiral groove. We assume external compression as the causative factor. The only apparatus attached to the patients' left upper arm was the sternal retractor, used for dissection of the internal mammary artery. Both patients were overweight and lying on the operating table for a considerable time might have caused the compression of their left upper arm on the self retractor's supporting column which was fixed to the table rail 5 cm above the left elbow joint, in the site where the radial nerve is directly apposed to the humerus. Conclusion Although very uncommon, external

  14. Nerve damage in leprosy: An electrophysiological evaluation of ulnar and median nerves in patients with clinical neural deficits: A pilot study

    Directory of Open Access Journals (Sweden)

    Sumit Kar

    2013-01-01

    Full Text Available Background : Leprosy involves peripheral nerves sooner or later in the course of the disease leading to gross deformities and disabilities. Sadly, by the time it becomes clinically apparent, the nerve damage is already quite advanced. However, if the preclinical damage is detected early in the course of disease, it can be prevented to a large extent. Materials and Methods: We conducted an electrophysiological pilot study on 10 patients with clinically manifest leprosy, in the Dermatology Department of Mahatma Gandhi Institute of Medical Sciences, Sewagram. This study was done to assess the nerve conduction velocity, amplitude and latency of ulnar and median nerves. Results and Conclusion: We found reduced conduction velocities besides changes in latency and amplitude in the affected nerves. Changes in sensory nerve conduction were more pronounced. Also, sensory latencies and amplitude changes were more severe than motor latencies and amplitude in those presenting with muscle palsies. However, further studies are going on to identify parameters to detect early nerve damage in leprosy.

  15. Hamartoma fibrolipomatoso de nervo mediano: relato de caso Fibrolipomatous hamartoma of the median nerve: case report

    Directory of Open Access Journals (Sweden)

    Paulo José Lorenzoni

    2005-09-01

    Full Text Available O hamartoma fibrolipomatoso é neoplasia benigna rara que em alguns casos esta associada com macrodactilia. Descrevemos o caso de homem de 31 anos que apresentava desde o nascimento aumento de volume em região de punho, segundo e terceiro quirodáctilos da mão esquerda. Aos 23 anos iniciou dor contínua, de forte intensidade, predominante no período noturno e de evolução progressiva em mão esquerda. Associada à dor havia hipoestesia e parestesias de predomínio nos segundo e terceiro quirodáctilos esquerdos. A investigação complementar com radiografia, ultrassonografia, estudo eletrofisiológico e ressonância magnética de mão e punho esquerdos confirmaram a suspeita de síndrome do túnel do carpo secundária a macrodactilia com hamartoma fibrolipomatoso do nervo mediano. O paciente foi submetido à descompressão cirúrgica do túnel do carpo esquerdo devido a ausência de resposta ao tratamento clínico e evoluiu com melhora dos sintomas em avaliação após três meses do procedimento.Fibrolipomatous hamartoma is a rare benign neoplasm that in some cases is associated with macrodactylia. We describe a 31-years-old man who had a tissue enlargement in the wrist, second and third fingers of the left hand since infancy. At 23-years-old he began with continuous, progressive and high intensity pain that occurred more frequently at night, localized in the left hand. It was associated with paraesthesias and hypostesias predominantly at the fingers described above. Investigation with X-ray, ultrasonography, electrodiagnosis, magnetic resonance image of the left wrist and hand showed carpal tunnel syndrome with macrodactylia by fibrolipomatous hamartoma of the median nerve. The patient did not a have good response to clinical therapy, so he was submitted to a surgical decompression of the left carpal tunnel, and after three months of follow up is asymptomatic.

  16. Median and Ulnar Nerve Injuries in Children and Adolescents- Long-term outcome and Cerebral reorganisation

    OpenAIRE

    Chemnitz, Anette

    2013-01-01

    A peripheral nerve injury may lead to serious disability and influence the individual´s quality of life. It is considered that children can regain better sensory and motor function after a peripheral nerve injury, but the exact mechanism behind such superior recovery is not known. The aim of the thesis was to study the long-term clinical outcome after a peripheral nerve injury in patients injured in childhood and adolescence and to relate the clinical outcome to changes in the central and ...

  17. The vascularized sural nerve graft based on a peroneal artery perforator for reconstruction of the inferior alveolar nerve defect.

    Science.gov (United States)

    Hayashida, Kenji; Hiroto, Saijo; Morooka, Shin; Kuwabara, Kaoru; Fujioka, Masaki

    2015-03-01

    The sural nerve has been described for nerve reconstruction of the maxillofacial region since it provides many advantages. We report a case of a vascularized sural nerve graft based on a peroneal artery perforator for immediate reconstruction after the removal of intraosseous neuroma originating in the inferior alveolar nerve. The patient had a neuroma caused by iatrogenic injury to the inferior alveolar nerve. A 4-cm long neuroma existed in the inferior alveolar nerve and was resected. A peroneal perforator was chosen as the pedicle of the vascularized sural nerve graft for the nerve gap. The graft including the skin paddle for monitoring the perfusion supplied by this perforator was transferred to the lesion. The nerve gap between the two stumps of the inferior alveolar nerve was repaired using the 6-cm long vascularized sural nerve. The perforator of the peroneal artery was anastomosed to the branch of the facial artery in a perforator-to-perforator fashion. There was no need to sacrifice any main arteries. The skin paddle with 1 cm × 3 cm in size was inset into the incised medial neck. Perceptual function tests with a Semmes-Weinstein pressure esthesiometer and two-point discrimination in the lower lip and chin at 10 months after surgery showed recovery almost to the level of the normal side. This free vascularized sural nerve graft based on a peroneal artery perforator may be a good alternative for reconstruction of inferior alveolar nerve defects. PMID:25346479

  18. Median Nerve Injury Due to High-Pressure Water Jet Injection: A Case Report and Review of Literature.

    Science.gov (United States)

    Emre, Ufuk; Unal, Aysun

    2009-08-01

    High-pressure injuries that occur accidentally are potentially destructive injuries that often affect the nondominant hands of young men. A variety of products such as paint, gasoline, grease, fuel oil, cement, thinner and solvents have been reported as destructive agents. High-pressure water jet injection injuries to soft tissues have rarely been reported. In this study, we present the first case of median nerve injury due to high-pressure water jet injection by a water spray gun. PMID:26815059

  19. Carpal tunnel syndrome due to a plexiform neurofibroma of the median nerve in a neurofibromatosis type 1 patient: clinical approach

    OpenAIRE

    Freitas, Daniel; Aido, Ricardo; Sousa, Marco; Costa, Luís; Oliveira, Vânia; Cardoso, Pedro

    2013-01-01

    The authors report the case of a 56-year-old male patient with neurofibromatosis type 1 (NF1) diagnosed during adolescence and with an insidious clinical evolution, characterised by an exuberant cutaneous involvement, referred to the orthopaedics outpatient clinic presenting with carpal tunnel syndrome secondary to a plexiform neurofibroma of the median nerve. A comprehensive clinical approach is discussed, considering the natural history of the disease and its potential complications, as wel...

  20. Diffusion tensor imaging of the median nerve: intra-, inter-reader agreement, and agreement between two software packages

    International Nuclear Information System (INIS)

    To assess intra-, inter-reader agreement, and the agreement between two software packages for magnetic resonance diffusion tensor imaging (DTI) measurements of the median nerve. Fifteen healthy volunteers (seven men, eight women; mean age, 31.2 years) underwent DTI of both wrists at 1.5 T. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) of the median nerve were measured by three readers using two commonly used software packages. Measurements were repeated by two readers after 6 weeks. Intraclass correlation coefficients (ICC) and Bland-Altman analysis were used for statistical analysis. ICCs for intra-reader agreement ranged from 0.87 to 0.99, for inter-reader agreement from 0.62 to 0.83, and between the two software packages from 0.63 to 0.82. Bland-Altman analysis showed no differences for intra- and inter-reader agreement and agreement between software packages. The intra-, inter-reader, and agreement between software packages for DTI measurements of the median nerve were moderate to substantial suggesting that user- and software-dependent factors contribute little to variance in DTI measurements. (orig.)

  1. The best cutoff point for median nerve cross sectional area at the level of carpal tunnel inlet.

    Directory of Open Access Journals (Sweden)

    Payam Sarraf

    2014-08-01

    Full Text Available Carpal tunnel syndrome (CTS is the most common entrapment neuropathy. It accounts 90% of all entrapment neuropathies all over the world. Ultrasound is a non-invasive, cost effective and available para-clinical method which could be applied for CTS diagnosis. Cross-sectional area of the median nerve at the level of the inlet is considered as a diagnostic criterion in CTS cases. In this study, thirty-eight patients with electrophysiologically confirmed idiopathic CTS and 22 healthy controls were enrolled. Seventy-one affected nerves and 42 unaffected nerves were evaluated within 14 days after electrophysiological examination. The largest cross-sectional area (CSA was measured at the level of the carpal tunnel inlet and the maximum nerve perimeter was also recorded by means of the software. Mean CSA and perimeter were 14.02 ± 4.5 mm2 and 1.7±0.28m in all patients and 8.2±2.1 mm2, 1.3±0.19 m in controls (P<0.001, P<0.001. Mean CSA and Perimeter were significantly different between patient's groups and control. The best cut off point for CSA of the tunnel inlet was 10.5 mm2 with sensitivity and specificity of 80% and 76% (AUC (Area under the Curve = 0.9, P<0.001. The best cut off point for inlet perimeter was 1.44 m with sensitivity and specificity of 85% and 77 % (AUC=0.87, P<0.001. Our findings showed that median nerve CSA at carpal tunnel inlet could be used as the diagnostic criteria for CTS.

  2. Validity of F-wave minimal latency of median and ulnar nerves for diagnosis and severity assessment of carpal tunnel syndrome in type II diabetes mellitus

    International Nuclear Information System (INIS)

    Type II diabetes mellitus is a common problem and is sometimes associated with Carpal Tunnel Syndrome (CTS) due to compression of median nerve at wrist. Electrophysiological tests are frequently used for its diagnosis. In this work, F-wave minimal latency (FWML) difference between median and ulnar nerve and F-ratio is used to facilitate the diagnosis and severity of CTS in type II diabetes mellitus (T2DM). Methods: Thirty control cases were selected who were physically fit for normal electrophysiological values. Thirty-two patients with a long history of type II diabetes mellitus were studied for electro-diagnostic tests. All patients had clinical evidence of CTS. Among all diabetics about 20 cases had poor glycaemic control (HbA1c>7.5). F-wave minimal latency (FWML) were measured in median and ulnar nerves and F-ratio of median nerve were also noted. The mean values in different groups were compared using t-test and p greater or equal to 0.05 was considered significant. Results: In control group, the ulnar FWML was either equal or slightly longer that the median FWML value. In CTS group with type II diabetes mellitus the FWML value of median nerve were significantly longer than FWML of the ulnar nerve. Moreover, in uncontrolled diabetic patients the FWML values was very much longer than controlled group. Similarly the F-ratio of median nerve was significantly low. Conclusion: In addition to the specific criteria for CTS diagnosis, the parameters like FWML difference in median and ulnar nerve with reduced F-ratio of median nerve can be useful in establishing the diagnosis and severity of CTS in type II diabetes mellitus. (author)

  3. Recurrent isolated abducens nerve paresis associated with persistent trigeminal artery variant.

    Science.gov (United States)

    Nakamagoe, Kiyotaka; Mamada, Naomi; Shiigai, Masanari; Shimizu, Kotone; Koganezawa, Tadachika; Tamaoka, Akira

    2012-01-01

    We report a 74-year-old woman who presented with recurrent isolated abducens nerve paresis. Cranial magnetic resonance imaging revealed that the right abducens nerve was sandwiched between the right internal carotid artery and a persistent trigeminal artery (PTA) variant, which might have led to neurovascular compression of the abducens nerve, resulting in abducens nerve damage. Normal variants of PTA, which are cerebellar arteries originating from a precavernous portion of the internal carotid artery, must be carefully observed as such variants can potentially cause a neurovascular compression of the abducens nerve. PMID:22892506

  4. Examining the effects of age, sex, and body mass index on normative median motor nerve excitability measurements.

    LENUS (Irish Health Repository)

    McHugh, John C

    2012-02-01

    OBJECTIVES: The purpose of this study was to build a large reference database of excitability measures in normal subjects and to examine the effects of age, sex, and BMI. METHODS: One hundred and five healthy subjects had median motor nerve excitability testing performed at the wrist using the automated threshold-tracking program, QTRAC. Statistical linear regression was used to explore relationships between nerve excitability and the independent variables. RESULTS: The main effect of age is a reduced superexcitability. Lesser effects are flattening of the normalized stimulus response curve and reduction in threshold change following strong hyperpolarizing currents. Females have lower thresholds than males and small but significant differences in voltage-gated potassium channel (KCNQ) mediated properties (late subexcitability, accommodation half time, and threshold undershoot following depolarizing electrotonus), as well as a small increase in superexcitability. BMI has no influence on nerve excitability data and does not explain sex-related differences in threshold. CONCLUSIONS: Age and sex have few and small effects on excitability parameters. SIGNIFICANCE: The expression of nodal KCNQ channels appears to be greater in females. Age-related increases in subexcitability may be attributable to changes in the muscle fibre and not the nerve.

  5. Carpal tunnel syndrome due to a plexiform neurofibroma of the median nerve in a neurofibromatosis type 1 patient: clinical approach.

    Science.gov (United States)

    Freitas, Daniel; Aido, Ricardo; Sousa, Marco; Costa, Luís; Oliveira, Vânia; Cardoso, Pedro

    2013-01-01

    The authors report the case of a 56-year-old male patient with neurofibromatosis type 1 (NF1) diagnosed during adolescence and with an insidious clinical evolution, characterised by an exuberant cutaneous involvement, referred to the orthopaedics outpatient clinic presenting with carpal tunnel syndrome secondary to a plexiform neurofibroma of the median nerve. A comprehensive clinical approach is discussed, considering the natural history of the disease and its potential complications, as well as the lack of consensus regarding standard therapeutic options for the compressive peripheral neuropathies in the NF1 disease. PMID:23853185

  6. Enhancement of Median Nerve Regeneration by Mesenchymal Stem Cells Engraftment in an Absorbable Conduit: Improvement of Peripheral Nerve Morphology with Enlargement of Somatosensory Cortical Representation.

    Directory of Open Access Journals (Sweden)

    Julia Teixeira Oliveira

    2014-10-01

    Full Text Available We studied the morphology and the cortical representation of the median nerve (MN, 10 weeks after a transection immediately followed by treatment with tubulization using a polycaprolactone (PCL conduit with or without bone marrow-derived mesenchymal stem cell (MSC transplant. In order to characterize the cutaneous representation of MN inputs in primary somatosensory cortex (S1, electrophysiological cortical mapping of the somatosensory representation of the forepaw and adjacent body parts was performed after acute lesion of all brachial plexus nerves, except for the MN. This was performed in ten adult male Wistar rats randomly assigned in 3 groups: MN Intact (n=4, PCL-Only (n=3 and PCL+MSC (n=3. Ten weeks before mapping procedures in animals from PCL-Only and PCL+MSC groups, animal were subjected to MN transection with removal of a 4-mm-long segment, immediately followed by suturing a PCL conduit to the nerve stumps with (PCL+MSC group or without (PCL-Only group injection of MSC into the conduit. After mapping the representation of the MN in S1, animals had a segment of the regenerated nerve processed for light and transmission electron microscopy. For histomorphometric analysis of the nerve segment, sample size was increased to 5 animals per experimental group. The PCL+MSC group presented a higher number of myelinated fibers and a larger cortical representation of MN inputs in S1 (3,383±390 fibers; 2.3 mm2, respectively than the PCL-Only group (2,226±575 fibers; 1.6 mm2. In conclusion, MSC-based therapy associated with PCL conduits can improve MN regeneration. This treatment seems to rescue the nerve representation in S1, thus minimizing the stabilization of new representations of adjacent body parts in regions previously responsive to the MN.

  7. Comparison of High Resolution Ultrasonography and Nerve Conduction Study in the Diagnosis of Carpal Tunnel Syndrome: Diagnostic Value of Median Nerve Cross-Sectional Area

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    A. Mohammadi

    2009-11-01

    Full Text Available Background/Objective: Carpal tunnel syndrome (CTS is a common peripheral entrapment neuropathy. This study was performed to evaluate whether high-resolution ultrasonography may be an alternative diagnostic method for nerve conduction study (NCS in the diagnosis of carpal tunnel syndrome. "nPatients and Methods: 132 wrists of 82 patients and 152 wrists of controls were enrolled in the study. The cross sectional area of the median nerve was measured at the carpal tunnel inlet and outlet in all patients and controls. All patients had a nerve conduction study. Then comparison between ultrasonography and NCS was performed. Combination of clinical diagnosis and NCS was used as the gold standard. "nResults: The mean cross-sectional area (CSA of the median nerve at the tunnel inlet was 11.4±1.7 mm2 for the patient group and 5.78 ±0.9 mm2 for the control group (P<0.001. The mean cross-sectional area at the tunnel outlet was 9.9±1.2 mm2 for the patient group and 4.7±0.7 mm2 for the control group (P<0.001. The best cut-off value of CSA at the tunnel inlet and the outlet was 7.5 mm2. "nConclusion: In patients with clinical diagnosis of CTS we confirmed that the diagnostic value of ultrasonography is similar to NCS and sonography may be used in primary evaluation of CTS.

  8. The Role of median nerve terminal latency index in the diagnosis of carpal tunnel syndrome in comparison with other electrodiagnostic parameters

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    Babak Vahdatpour

    2016-01-01

    Conclusion: Although in early stages of CTS, we usually expect only abnormalities in the sensory studies, but TLI may better demonstrate the effect on median nerve motor fiber even in mild cases of CTS.

  9. 腕管内正中神经变异的声像图表现及其临床意义%Sonographic appearance and clinical significance of anatomic variation of carpal tunnel median nerve

    Institute of Scientific and Technical Information of China (English)

    傅强; 崔立刚; 李志强; 王金锐; 陈文; 贾建文

    2012-01-01

    Objective To investigate the incidence,sonographic appearance of the anatomic variation of carpal tunnel median nerve and its accompanying structures in healthy volunteers and explore the value of this variation in carpal tunnel syndrome.Methods A total of 360 hands of 180 healthy volunteers were included in the study.The full course of the median nerve in the forearm and carpal tunnel was examined with high-frequency ultrasound.The median nerve was first located in cross section at wrist and then with continuous cross-sectional scanning to observe the the full course of the median nerve in the forearm and carpal tunnel with high-frequency ultrasound.Results Anatomic variation of carpal tunnel median nerve and its accompanying structures were observed:① High division median nerve were found in 2 wrists (0.56 %) ;②Bifid median nerve were found in 17 wrists (4.72%) ;③Persistent median artery were found in 22 wrists (6.11%),and 2 wrists (0.56%) were also found accompanied vein.Aanatomic variation of carpal tunnel median nerve accompanied with persistent median artery were observed in 16 wrists (4.44 %).Conclusions High-frequency ultrasound was sensitive to diagnose the anatomic variation of carpal tunnel median nerve and its accompanying structures.Recognition of these variations can help us to make correct diagnosis of carpal tunnel syndrome.%目的 探讨腕管正中神经及伴行结构变异在人群中的发生率、超声表现及其在腕管综合征诊断中的意义.方法 对180位健康志愿者的360只手腕部腕管结构及前臂进行高频超声检查.检查前臂和腕部正中神经走行,先进行腕管结构的横断面扫查,确认正中神经位置后,采用连续横断面扫查法向近端前臂进行动态观察并适当结合纵断面扫查,记录图像资料.结果 腕管正中神经及伴行结构变异:①正中神经高位分叉2例(0.56%);②正中神经裂17例(4.72%);③腕部正中神

  10. A single dose of lorazepam reduces paired-pulse suppression of median nerve evoked somatosensory evoked potentials.

    Science.gov (United States)

    Stude, Philipp; Lenz, Melanie; Höffken, Oliver; Tegenthoff, Martin; Dinse, Hubert

    2016-05-01

    Paired-pulse behaviour in the somatosensory cortex is an approach to obtain insights into cortical processing modes and to obtain markers of changes of cortical excitability attributable to learning or pathological states. Numerous studies have demonstrated suppression of the response to the stimulus that follows a first one after a short interval, but the underlying mechanisms remain elusive, although there is agreement that GABAergic mechanisms seem to play a crucial role. We therefore aimed to explore the influence of the GABAA agonist lorazepam on paired-pulse somatosensory evoked potentials (SEPs). We recorded and analysed SEPs after paired median nerve stimulation in healthy individuals before and after they had received a single dose of 2.5 mg of lorazepam as compared with a control group receiving placebo. Paired-pulse suppression was expressed as a ratio of the amplitudes of the second and the first peaks. We found that, after lorazepam application, paired-pulse suppression of the cortical N20 component remained unchanged, but suppression of the N20-P25 complex was significantly reduced, indicative of GABAergic involvement in intracortical processing. Our data suggest that lorazepam most likely enhances inhibition within the cortical network of interneurons responsible for creating paired-pulse suppression, leading to reduced inhibitory drive with a subsequently reduced amount of suppression. The results provide further evidence that GABAA -mediated mechanisms are involved in the generation of median nerve evoked paired-pulse suppression. PMID:26929110

  11. Schwannoma of the Median Nerve at the Wrist and Palmar Regions of the Hand: A Rare Case Report

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    Harun Kütahya

    2013-01-01

    Full Text Available Schwannomas are also known as neurolemmas that are usually originated from Schwann cells located in the peripheric nerve sheaths. They are the most common tumours of the hand (0.8–2%. They usually present solitary swelling along the course of the nerve however multiple lesions may be present in cases of NF type 1, familial neurofibromatosis, and sporadic schwannomatosis. Schwannomas are generally represented as an asymptomatic mass; however pain, numbness and fatigue may take place with the increasing size of the tumour. EMG (electromyelography, MRI (magnetic resonance imagination, and USG (ultrasound are helpful in the diagnosis. Surgical removal is usually curative. In this paper, we present a 24-year-old male referred to our clinic for a lump located at the volar side of the left wrist and a lump located in his left palm and numbness at his 3rd and 4th fingers. Total excision was performed for both lesions. Histopathological examination of the masses revealed typical features of schwannoma. At the 6th-month followup the patient was symptom-free except for slight paresthesia of the 3rd and the 4th fingers. For our knowledge, this is the second case in the literature presenting wrist and palm involvement of the median nerve schwannoma.

  12. Alternation in F-wave parameters of median nerve from unaffected extremity in stroke patients with hemiplegia under dynamic state

    Institute of Scientific and Technical Information of China (English)

    Hang Zhao; Yong Lin; Wenhua Qi; Shuping Yin; Jiachun Feng

    2006-01-01

    BACKGROUND: For many years, the extremities of stroke patients are divided into affected side and unaffected side according to clinical symptoms and body signs. Moreover, previous rehabilitation function training is developed simply aiming to the dysfunction manifested by unaffected extremity. Problems of unaffected extremity are always ignored, such as left- and right- side connection dysfunction, abnormal muscular tension of unaffected side and so on.OBJECTIVE: To observe neurophysiological change characteristics of unaffected extremity of stroke patients with hemiplegia by electromyographical method.DESIGN: Case-control observation.SETTING: First Hospital, Jilin University.PARTICIPANTS: Eighty stroke patients with hemiplegia confirmed by skull CT or MRI, who firstly hospitalized in the Department of Neurology, First Hospital, Jilin University between July 2004 and March 2005, were retrieved. They were scored > 8 points in Glasgow Coma Scale and had stable vital sign. Nineteen normal persons who received healthy examination in the clinic were involved in normal control group. Following the classification criteria of Brunnstrom's Recovery Stages of Stroke (BRSS), 80 stroke patients with hemiplegia were assigned into 3 groups: BRSS Ⅰ -Ⅱ group (n =36), BRSS Ⅲ-Ⅳ group (n =23) and BRSSⅤ-Ⅵ (n=21).METHODS: F-wave parameters of median nerve of unaffected extremity were detected by electromyographical technique. The recording electrode (muscular belly of abductor pollicis brevis) and reference electrode (first finger bone) were connected with grounding electrode. Stimulating electrode was placed in the median part of wrist joint with stimulation intensity of 130% that of threshold stimulation, stimulation frequency of 2 Hz, current pulse width of 0.2 ms, time course of 5 ms and sensitivity of 2 mV. The F-wave of median nerve of affected extremity under the resting stage (static status) and that of unaffected extremity under the maximum resistant contracted

  13. Assessment of the Kinetic Trajectory of the Median Nerve in the Wrist by High-Frequency Ultrasound

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    Yi-Hsun Lin

    2014-04-01

    Full Text Available Carpal tunnel syndrome (CTS is typically diagnosed by physical examination or nerve conduction measurements. With these diagnostics however it is difficult to obtain anatomical information in the carpal tunnel. To further improve the diagnosis of CTS, an attempt using 30 MHz high-frequency ultrasound to noninvasively detect the local anatomical structures and the kinetic trajectory of the median nerve (MN in the wrist was explored. Measurements were performed on the right wrist of 14 asymptomatic volunteers. The kinetic trajectory of the MN corresponding to flexion (from 0° to 90° and extension (from 90° to 0° movements of the fingers were detected by a cross correlation-based motion tracking technique. The average displacements of the MN according to finger movements were measured to be 3.74 and 2.04 mm for male and female subjects, respectively. Moreover, the kinetic trajectory of the MN in both the ulnar-palmar and total directions generally follows a sigmoidal curve tendency. This study has verified that the use of high-frequency ultrasound imaging and a motion tracking technique to sensitively detect the displacement and kinetic trajectory of the MN for the assessment of CTS patients is feasible.

  14. Does the ratio of the carpal tunnel inlet and outlet cross-sectional areas in the median nerve relfect carpal tunnel syndrome severity?

    Institute of Scientific and Technical Information of China (English)

    Li Zhang; Aierken Rehemutula; Feng Peng; Cong Yu; Tian-bin Wang; Lin Chen

    2015-01-01

    Although ultrasound measurements have been used in previous studies on carpal tunnel syn-drome to visualize injury to the median nerve, whether such ultrasound data can indicate the severity of carpal tunnel syndrome remains controversial. The cross-sectional areas of the median nerve at the tunnel inlet and outlet can show swelling and compression of the nerve at the carpal. We hypothesized that the ratio of the cross-sectional areas of the median nerve at the carpal tunnel inlet to outlet accurately relfects the severity of carpal tunnel syndrome. To test this, high-resolution ultrasound with a linear array transducer at 5–17 MHz was used to assess 77 pa-tients with carpal tunnel syndrome. The results showed that the cut-off point for the inlet-to-outlet ratio was 1.14. Signiifcant differences in the inlet-to-outlet ratio were found among patients with mild, moderate, and severe carpal tunnel syndrome. The cut-off point in the ratio of cross-section-al areas of the median nerve was 1.29 between mild and more severe (moderate and severe) carpal tunnel syndrome patients with 64.7% sensitivity and 72.7% speciifcity. The cut-off point in the ratio of cross-sectional areas of the median nerve was 1.52 between the moderate and severe carpal tunnel syndrome patients with 80.0% sensitivity and 64.7% speciifcity. These results suggest that the inlet-to-outlet ratio relfected the severity of carpal tunnel syndrome.

  15. Does the ratio of the carpal tunnel inlet and outlet cross-sectional areas in the median nerve reflect carpal tunnel syndrome severity?

    Directory of Open Access Journals (Sweden)

    Li Zhang

    2015-01-01

    Full Text Available Although ultrasound measurements have been used in previous studies on carpal tunnel syndrome to visualize injury to the median nerve, whether such ultrasound data can indicate the severity of carpal tunnel syndrome remains controversial. The cross-sectional areas of the median nerve at the tunnel inlet and outlet can show swelling and compression of the nerve at the carpal. We hypothesized that the ratio of the cross-sectional areas of the median nerve at the carpal tunnel inlet to outlet accurately reflects the severity of carpal tunnel syndrome. To test this, high-resolution ultrasound with a linear array transducer at 5-17 MHz was used to assess 77 patients with carpal tunnel syndrome. The results showed that the cut-off point for the inlet-to-outlet ratio was 1.14. Significant differences in the inlet-to-outlet ratio were found among patients with mild, moderate, and severe carpal tunnel syndrome. The cut-off point in the ratio of cross-sectional areas of the median nerve was 1.29 between mild and more severe (moderate and severe carpal tunnel syndrome patients with 64.7% sensitivity and 72.7% specificity. The cut-off point in the ratio of cross-sectional areas of the median nerve was 1.52 between the moderate and severe carpal tunnel syndrome patients with 80.0% sensitivity and 64.7% specificity. These results suggest that the inlet-to-outlet ratio reflected the severity of carpal tunnel syndrome.

  16. Peripheral communications of intercostobrachial nerve Peripheral communications of the intercostobrachial nerve in relation to the alar thoracic artery

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    Shaifaly Madan Rustagi

    2015-01-01

    Full Text Available The intercostobrachial nerve (ICBN is often encountered during axillary dissection for axillary lymph node dissection (ALND for diagnostic and therapeutic surgery for mastectomy. The present report is a case observed in the Department of Anatomy at Vardhman Mahavir Medical College, Delhi during routine dissection of the upper extremity of a male cadaver for first year undergraduate medical students. On the right side , the medial cord of brachial plexus gave two medial cutaneous nerves of arm. Both the nerves were seen communicating with the branches of the ICBN. The ICBN and one of its branches were surrounding the termination of an alar thoracic artery. These peripheral neural connections of the ICBN with the branches of the medial cord can be a cause of sensory impairment during axillary procedures done for mastectomy or exploration of long thoracic nerves. The alar thoracic artery found in relation to the ICBN could further be a cause of vascular complications during such procedures.

  17. Peripheral communications of intercostobrachial nerve Peripheral communications of the intercostobrachial nerve in relation to the alar thoracic artery.

    Science.gov (United States)

    Rustagi, Shaifaly Madan; Sharma, Mona; Singh, Nidhi; Mehta, Vandana; Suri, Rajesh K; Rath, Gayatri

    2015-01-01

    The intercostobrachial nerve (ICBN) is often encountered during axillary dissection for axillary lymph node dissection (ALND) for diagnostic and therapeutic surgery for mastectomy. The present report is a case observed in the Department of Anatomy at Vardhman Mahavir Medical College, Delhi during routine dissection of the upper extremity of a male cadaver for first year undergraduate medical students. On the right side, the medial cord of brachial plexus gave two medial cutaneous nerves of arm. Both the nerves were seen communicating with the branches of the ICBN. The ICBN and one of its branches were surrounding the termination of an alar thoracic artery. These peripheral neural connections of the ICBN with the branches of the medial cord can be a cause of sensory impairment during axillary procedures done for mastectomy or exploration of long thoracic nerves. The alar thoracic artery found in relation to the ICBN could further be a cause of vascular complications during such procedures.

  18. Repeatability and Minimal Detectable Change in Longitudinal Median Nerve Excursion Measures During Upper Limb Neurodynamic Techniques in a Mixed Population: A Pilot Study Using Musculoskeletal Ultrasound Imaging.

    Science.gov (United States)

    Paquette, Philippe; Lamontagne, Martin; Higgins, Johanne; Gagnon, Dany H

    2015-07-01

    This study determined test-retest reliability and minimum detectable change in longitudinal median nerve excursion during upper limb neurodynamic tests (ULNTs). Seven participants with unilateral or bilateral carpal tunnel syndrome and 11 healthy participants were randomly tested with two ULNTs (i.e., tensioner and slider). Each ULNT was performed three times each at 45° and 90° of shoulder abduction on two separate visits. Video sequences of median nerve excursion, recorded by a physical therapist using ultrasound imaging, were quantified using computer software. The generalizability theory, encompassing a G-Study and a D-study, measured the dependability coefficient (Φ) along with standard error of measurement (SEM) accuracy and allowed various testing protocols to be proposed. The highest reliability (Φ = 0.84) and lowest minimal measurement error (SEM = 0.58 mm) of the longitudinal median nerve excursion were reached during the ULNT-slider performed with 45° of shoulder abduction and when measures obtained from three different image sequences recorded during a single visit were averaged. It is recommended that longitudinal median nerve excursion measures computed from three separate image sequences recorded during a single visit be averaged in clinical practice. Ideally, adding a second visit (six image sequences) is also suggested in research protocols. PMID:25868536

  19. Median nerve neuropathy in the forearm due to recurrence of anterior wrist ganglion that originates from the scaphotrapezial joint: Case Report

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    Okada Kiyoshi

    2012-01-01

    Full Text Available Abstract Background Median nerve neuropathy caused by compression from a tumor in the forearm is rare. Cases with anterior wrist ganglion have high recurrence rates despite surgical treatment. Here, we report the recurrence of an anterior wrist ganglion that originated from the Scaphotrapezial joint due to incomplete resection and that caused median nerve neuropathy in the distal forearm. Case presentation A 47-year-old right-handed housewife noted the appearance of soft swelling on the volar aspect of her left distal forearm, and local resection surgery was performed twice at another hospital. One year after the last surgery, the swelling reappeared and was associated with numbness and pain in the radial volar aspect of the hand. Magnetic resonance imaging revealed that the multicystic lesion originated from the Scaphotrapezial joint and had expanded beyond the wrist. Exploration of the left median nerve showed that it was compressed by a large ovoid cystic lesion at the distal forearm near the proximal end of the carpal tunnel. We resected the cystic lesion to the Scaphotrapezial joint. Her symptoms disappeared 1 week after surgery, and complications or recurrent symptoms were absent 13 months after surgery. Conclusions A typical median nerve compression was caused by incomplete resection of an anterior wrist ganglion, which may have induced widening of the cyst. Cases with anterior wrist ganglion have high recurrence rates and require extra attention in their treatment.

  20. Transverse Plane Tendon and Median Nerve Motion in the Carpal Tunnel : Ultrasound Comparison of Carpal Tunnel Syndrome Patients and Healthy Volunteers

    NARCIS (Netherlands)

    van Doesburg, Margriet H. M.; Henderson, Jacqueline; van der Molen, Aebele B. Mink; An, Kai-Nan; Amadio, Peter C.

    2012-01-01

    Background: The median nerve and flexor tendons are known to translate transversely in the carpal tunnel. The purpose of this study was to investigate these motions in differential finger motion using ultrasound, and to compare them in healthy people and carpal tunnel syndrome patients. Methods: Tra

  1. Microanatomical study of the nutrient artery of the glossopharyngeal nerve root

    Institute of Scientific and Technical Information of China (English)

    Jinhua Zheng; Xiaohua He

    2008-01-01

    BACKGROUND:Because the artery leading to the glossopharyngeal nerve is small and complex,insufficient blood supply can occur due to atherosclerosis,occlusion,or injury.This sometimes results in corresponding newe degeneration,demyelination,and/or arachnoid adhesion.OBJECTIVE:To observe the nutrient artery origin of the glossopharyngeal nerve root in the medulla oblongata region,as well as the relationship between the artery and glossopharyngeal nerve root,to verify dependence of primary glossopharyngeal neuralgia,which is related to contact and compression of the nutrient artery of the glossopharyngeal nerve root.DESIGN,TIME AND SETTING:Repetitive measurement.The experiment was performed at Harbin Medical University and Daqing Oilfields General Hospital between November 2006 and April 2007.MATERIALS:Ten cadaver heads(seven male and three female)were supplied bv the Department of Anatomy,Harbin Medical University.A total of 15 patients(nine male and six female),aged 38-56,that suffered from glossopharyngeal neuralgia were treated at Daqing Oilfields General Hospital and were between 38-56 years old.All cadaver heads were strictly handled according to the Guideline for Medical Ethics Committee.The patients agreed to the criteria set for the study objects.METHODS:(1)The bilateral veins of the nutrient artery were dissected under a surgery microscope.A sliding caliper was used to measure the length of the glossopharyngeal nerve from the oblongata to the iugular foramen.The origin of the nutrient artery was noted.as well as the courser and diameter to explore the relationship between the glossopharyngeal nerve root and the vertebral artery.posterior inferior cerebellar artery,anterior inferior cerebellar artery,as well as the branching veins.(2)A total of 15 patients received glossopharyngeal neuralgia surgery.Contact or oppression of the glossopharyngeal nerve with the posterior inferior cerebellar artery,the anterior inferior cerebellar artery,vertebral artery,and its

  2. Nerve growth factor facilitates redistribution of adrenergic and non-adrenergic non-cholinergic perivascular nerves injured by phenol in rat mesenteric resistance arteries.

    Science.gov (United States)

    Yokomizo, Ayako; Takatori, Shingo; Hashikawa-Hobara, Narumi; Goda, Mitsuhiro; Kawasaki, Hiromu

    2016-01-01

    We previously reported that nerve growth factor (NGF) facilitated perivascular sympathetic neuropeptide Y (NPY)- and calcitonin gene-related peptide (CGRP)-containing nerves injured by the topical application of phenol in the rat mesenteric artery. We also demonstrated that mesenteric arterial nerves were distributed into tyrosine hydroxylase (TH)-, substance P (SP)-, and neuronal nitric oxide synthase (nNOS)-containing nerves, which had axo-axonal interactions. In the present study, we examined the effects of NGF on phenol-injured perivascular nerves, including TH-, NPY-, nNOS-, CGRP-, and SP-containing nerves, in rat mesenteric arteries in more detail. Wistar rats underwent the in vivo topical application of 10% phenol to the superior mesenteric artery, proximal to the abdominal aorta, under pentobarbital-Na anesthesia. The distribution of perivascular nerves in the mesenteric arteries of the 2nd to 3rd-order branches isolated from 8-week-old Wistar rats was investigated immunohistochemically using antibodies against TH-, NPY-, nNOS-, CGRP-, and SP-containing nerves. The topical phenol treatment markedly reduced the density of all nerves in these arteries. The administration of NGF at a dose of 20µg/kg/day with an osmotic pump for 7 days significantly increased the density of all perivascular nerves over that of sham control levels. These results suggest that NGF facilitates the reinnervation of all perivascular nerves injured by phenol in small resistance arteries.

  3. Branch facial nerve trauma after superficial temporal artery biopsy: a case report

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    Rison Richard A

    2011-01-01

    Full Text Available Abstract Introduction Giant cell arteritis is an emergency requiring prompt diagnosis and treatment. Superficial temporal artery biopsy is the gold diagnostic standard. Complications are few and infrequent; however, facial nerve injury has been reported, leaving an untoward cosmetic outcome. This case report is to the best of our knowledge only the fourth one presented in the available literature so far regarding facial nerve injury from superficial temporal artery biopsy. Case presentation A 73-year-old Caucasian woman presented for neurological evaluation regarding eyebrow and facial asymmetry after a superficial temporal artery biopsy for presumptive giant cell arteritis-induced cephalalgia. Conclusion Damage to branches of the facial nerve may occur after superficial temporal artery biopsy, resulting in eyebrow droop. Although an uncommon and sparsely reported complication, all clinicians of various specialties involved in the care of these patients should be aware of this given the gravity of giant cell arteritis and the widespread use of temporal artery biopsy.

  4. Primary study on median nerve stimulation therapy in improving the level of consciousness of patients in coma caused by head traumas

    International Nuclear Information System (INIS)

    Objective: To investigate the therapeutic effect of median nerve stimulation in improving the level of consciousness of patients in coma caused by severe head traumas and the possible mechanism of its hastening awakening from coma. Methods: 30 unconscious patients with severe brain traumas were randomly assigned to the treated group (n=15) and the control group (n=15). The patients in the control group were treated routinely. Besides routine therapy the patients in the treated group were treated with median nerve electrical stimulation. As the treated group were treated with initial stimulation, SPECT brain perfusion imaging was performed before and after 30 minutes' median nerve electrical stimulation under the same condition. The changes of the regional cerebral blood flow (rCBF) of lesion spot of brain were compared and analysed with visual method and semi-quantitative method in BFCK% mathematical model. A week after stimulation authors assess the therapeutic effect in the two groups with GCS scores. Results: The patients in the treated group's rCBF of the lesion spot increased significantly after stimulation. A week later the patients in the treated group had improved by average of 4.8 on the GCS in contrast to 2.0 on the GCS in the control group which showed that the GCS scores of the two groups had significant difference (P<0.05). Conclusion: The median nerve electrical stimulation can improve the level of consciousness of patients in coma caused by severe head traumas. The increase of rCBF of lesion spot of brain can be one of mechanisms of its hastening awakening from coma

  5. 小颗粒明胶海绵栓塞犬髂内动脉及骶正中动脉后并发症的研究%COMPLICATION AFTER SELECTIVE ARTERIAL EMBOLIZATION IN INTERNAL ILIAC ARTERY AND MEDIAN SACRAL ARTERY WITH GELFOAM PARTICLE IN DOGS

    Institute of Scientific and Technical Information of China (English)

    李叶天; 尹宗生; 王伟; 秦坤鹏; 王亚光

    2011-01-01

    Objective To observe the complication after embol izing the bilateral internal iliac arteries and the median sacral artery of dogs by different combinations and embolization levels with gelfoam particle, and to provide a reference for safety application of gelfoam in clinic.Methods Sixteen common grade adult healthy dogs (weighing 10-13 kg, 14 males and 2 females) were randomly divided into 5 groups.Under the monitoring of digital subtraction angiography (DSA), the embolization was performed with gelfoam particle (diameter, 50-150 μm) in bilateral internal iliac arteries and the main branch of the median sacral artery (group A, n=3), in bilateral internal iliac arteries and the first branch of the median sacral artery (group B, n=3), in the main branch of bilateral internal iliac arteries (group C, n=3), in the unilateral internal iliac artery and the main branch of the median sacral artery (group D, n=4), and in the main branch of unilateral internal iliac artery (group E, n=3).Under the DSA,the anatomic relationships of the abdominal aorta, bilateral external iliac arteries, bilateral internal iliac arteries, and median sacral artery were observed before embolization.The survival dogs were observed and the specimens of bladder, rectum, sciatic nerve, and gluteal muscles were harvested for the general and histological observations at 3 days after embolization.Results In dogs, there was no common iliac artery; bilateral external iliac arteries originated from the abdominal aorta and the starting of the median sacral artery had variation.Seven dogs (3 in group A, 3 in group C, and 1 in group D) died within 2 days after embolization, and the others survived to the end of the experiment.In the dead dogs of groups A, C, and D, the darkening and necrosis of the rectum were observed; the bladder presented lamellar obfuscation and focal hemorrhage and edema; and the median urinary volume in bladder was 270.6 mL.In survival dogs, no obvious change was observed in the

  6. Schwannoma of the Median Nerve at the Wrist and Palmar Regions of the Hand: A Rare Case Report

    OpenAIRE

    Harun Kütahya; Ali Güleç; Yunus Güzel; Burkay Kacira; Serdar Toker

    2013-01-01

    Schwannomas are also known as neurolemmas that are usually originated from Schwann cells located in the peripheric nerve sheaths. They are the most common tumours of the hand (0.8–2%). They usually present solitary swelling along the course of the nerve however multiple lesions may be present in cases of NF type 1, familial neurofibromatosis, and sporadic schwannomatosis. Schwannomas are generally represented as an asymptomatic mass; however pain, numbness and fatigue may take place with the ...

  7. A study of retrograde degeneration of median nerve forearm segment in carpal tunnel syndrome of variable severities

    Directory of Open Access Journals (Sweden)

    Mona Mokhtar El Bardawil

    2014-12-01

    Conclusions: Retrograde degeneration exists in patients with CTS. Forearm median motor NCV and median mixed conduction study are valid electrophysiologic tools for the assessment of RGD in patients with CTS. Retrograde degeneration is not related to grade of severity of CTS.

  8. Microsurgical decompression of the median nerves for treating diabetic peripheral neuropathy in the upper limbs: A 21-month follow-up

    Institute of Scientific and Technical Information of China (English)

    Peng Lin; Li Zhang; Yanbing Yu; Xiaoli Xu; Jiang Liu; Fang Li; Jun Xu

    2007-01-01

    BACKGROUND: Peripheral nerve injured by abnormal glucose metabolism is compressed, which is an important etiological factor of diabetic peripheral neuropathy (DPN). Microsurgical decompression of peripheral nerve maybe effectively releases the symptoms of DPN.OBJECTIVE: To investigate the curative effects of microsurgical decompression of median nerves for treatment of DPN in upper limbs.DESIGN: Case-follow up observation.SETTING: Department of Orthopaedics, Department of Neurosurgery, China-Japan Friendship Hospital,Ministry of Health.PARTICIPANTS: Twelve patients with DPN in upper limbs (19 hands) who received treatment in the Department of Orthopaedics, Department of Neurosurgery, China-Japan Friendship Hospital, Ministry of Public Health between March 2004 and July 2006 were involved in this experiment. The involved patients, 5 male and 7 female, were aged 44 to 77 years, with DPN course of 6 months to 16 years. They all met 1999 WHO diabetic diagnosis criteria. Both two hands had symptom in 7 patients, and only one hand had symptom in 5 patients. Informed consents of detected items were obtained from all the patients, who also received 21 months of follow-up treatment.microscope, transverse carpal ligament was exposed. Subsequently, transverse carpal ligament, forearm superficial fascia and palmar aponeurosis were fully liberated, and then part of them was cut off. Connective tissue around median nerve, superficial flexor muscle of fingers, radial flexor, palmaris longus and other flexor tendons were completely loosened. Finally, epineurium was opened with microinstrument for neurolysis. After tourniquet was loosened, and bipolar coagulator was used to stop bleeding, and the incision distance of two normal points was 3 to 6 mm), nerve conduction velocity and action potential amplitude (short abductor muscle of thumb end Lat < 4.5 ms; Motor nerve conduction velocity of forearm > 50 m/s),etc. of all the patients were followed up.MAIN OUTCOME MEASURES: The

  9. Accelerated magnetic resonance diffusion tensor imaging of the median nerve using simultaneous multi-slice echo planar imaging with blipped CAIPIRINHA

    Energy Technology Data Exchange (ETDEWEB)

    Filli, Lukas; Kenkel, David; Boss, Andreas; Manoliu, Andrei; Andreisek, Gustav; Runge, Val M.; Guggenberger, Roman [University Hospital of Zurich, University of Zurich, Institute of Diagnostic and Interventional Radiology, Zurich (Switzerland); Piccirelli, Marco [University Hospital of Zurich, Department of Neuroradiology, Zurich (Switzerland); Bhat, Himanshu [Siemens Medical Solutions USA Inc, Charlestown, MA (United States)

    2016-06-15

    To investigate the feasibility of MR diffusion tensor imaging (DTI) of the median nerve using simultaneous multi-slice echo planar imaging (EPI) with blipped CAIPIRINHA. After federal ethics board approval, MR imaging of the median nerves of eight healthy volunteers (mean age, 29.4 years; range, 25-32) was performed at 3 T using a 16-channel hand/wrist coil. An EPI sequence (b-value, 1,000 s/mm{sup 2}; 20 gradient directions) was acquired without acceleration as well as with twofold and threefold slice acceleration. Fractional anisotropy (FA), mean diffusivity (MD) and quality of nerve tractography (number of tracks, average track length, track homogeneity, anatomical accuracy) were compared between the acquisitions using multivariate ANOVA and the Kruskal-Wallis test. Acquisition time was 6:08 min for standard DTI, 3:38 min for twofold and 2:31 min for threefold acceleration. No differences were found regarding FA (standard DTI: 0.620 ± 0.058; twofold acceleration: 0.642 ± 0.058; threefold acceleration: 0.644 ± 0.061; p ≥ 0.217) and MD (standard DTI: 1.076 ± 0.080 mm{sup 2}/s; twofold acceleration: 1.016 ± 0.123 mm{sup 2}/s; threefold acceleration: 0.979 ± 0.153 mm{sup 2}/s; p ≥ 0.074). Twofold acceleration yielded similar tractography quality compared to standard DTI (p > 0.05). With threefold acceleration, however, average track length and track homogeneity decreased (p = 0.004-0.021). Accelerated DTI of the median nerve is feasible. Twofold acceleration yields similar results to standard DTI. (orig.)

  10. Anatomical and clinical study of median nerve entrapment at the elbow%肘部正中神经卡压解剖与临床研究

    Institute of Scientific and Technical Information of China (English)

    刘鹏程; 王克利; 宫旭; 路来金; 崔建礼; 蒋子平

    2013-01-01

    Objective To provide anatomic and clinical basis for diagnosis and treatment of median nerve entrapment at the elbow.Methods Microanatomical dissection of the median nerve was done in 10 cadaver upper limb specimens to observe the anatomical factors that cause compression of the median nerve at the elbow and shape of the median nerve.Case analysis was conducted in 14 patients with median nerve entrapment at the elbow who were treated in our department.Results Anatomic studies in the 10 dissected specimens showed three types of relationship between the bicepital aponeurosis and median nerve:complete-covering (2 specimens,20%),partial-covering (1 specimen,10%) and non-covering (7 specimens,70%).Thickened fascia in the superficial layer of pronator teres ulnar head was seen in 9 specimem (90%).Intramuscular tendinous bundles in the anconeus were observed in 2 specimem (20%).The reverse fascia that traversed the median nerve was seen in 6 specimens (60%).The structures of the origins of two heads of the flexor digitorum superficialis (FDS) had three types:intramuscular tendinous bundle (1 specimen,10%),fibrous arch (1 specimen,10%),and conjoined tendinous arch (8 specimens,80%).Of the 14 patients who had median nerve entrapment at the elbow,5 were diagnosed as pronator teres syndrome while 9 were diagnosed as anterior interosseous nerve(AIN) compression.The compression points in the pronator syndrome cases were ulnar side of the thickened and taut bicepital aponeurosis (2 cases),deep tendinous arch of pronator teres (2 cases),and between two heads of pronator teres (1 case).The compression points in the AIN compression cases were deep tendinous arch of pronator teres (2 cases),ulnar head of pronator teres (1 case),between two heads of pronator teres (1 case),and thickened and taut FDS origin (5 cases).Six patients were follow-up.The average follow-up time was 2 years and 4 months.Good to excellent recovery of motor function was achieved in these

  11. Arterial compression of nerve is the primary cause of trigeminal neuralgia

    OpenAIRE

    Chen, Guo-Qiang; Wang, Xiao-Song; Wang, Lin; Zheng, Jia-ping

    2013-01-01

    Whether arterial or venous compression or arachnoid adhesions are primarily responsible for compression of the trigeminal nerve in patients with trigeminal neuralgia is unclear. The aim of this study was to determine the causes of trigeminal nerve compression in patients with trigeminal neuralgia. The surgical findings in patients with trigeminal neuralgia who were treated by micro vascular decompression were compared to those in patients with hemifacial spasm without any signs or symptoms of...

  12. Multidimensional ultrasound imaging of the wrist: Changes of shape and displacement of the median nerve and tendons in carpal tunnel syndrome.

    Science.gov (United States)

    Filius, Anika; Scheltens, Marjan; Bosch, Hans G; van Doorn, Pieter A; Stam, Henk J; Hovius, Steven E R; Amadio, Peter C; Selles, Ruud W

    2015-09-01

    Dynamics of structures within the carpal tunnel may alter in carpal tunnel syndrome (CTS) due to fibrotic changes and increased carpal tunnel pressure. Ultrasound can visualize these potential changes, making ultrasound potentially an accurate diagnostic tool. To study this, we imaged the carpal tunnel of 113 patients and 42 controls. CTS severity was classified according to validated clinical and nerve conduction study (NCS) classifications. Transversal and longitudinal displacement and shape (changes) were calculated for the median nerve, tendons and surrounding tissue. To predict diagnostic value binary logistic regression modeling was applied. Reduced longitudinal nerve displacement (p≤ 0.019), increased nerve cross-sectional area (p≤ 0.006) and perimeter (p≤ 0.007), and a trend of relatively changed tendon displacements were seen in patients. Changes were more convincing when CTS was classified as more severe. Binary logistic modeling to diagnose CTS using ultrasound showed a sensitivity of 70-71% and specificity of 80-84%. In conclusion, CTS patients have altered dynamics of structures within the carpal tunnel.

  13. Arterial catecholamine levels in morphine-treated rats subjected to sympathetic nerve stimulation.

    OpenAIRE

    Leung, C. M.; S. Dai; Ogle, C. W.

    1989-01-01

    1. The effect of acute or chronic morphine treatment on the changes in arterial noradrenaline and adrenaline levels in response to sympathetic nerve stimulation was studied in rats. 2. Rats which had been chronically treated with morphine in their drinking fluid for 21 days were shown to be morphine-tolerant, as revealed by the tail-immersion test for analgesia. 3. It was found that animals given either acute or chronic morphine treatment had similar basal concentrations of arterial catechola...

  14. Resolution of third nerve palsy despite persistent aneurysmal mass effect after flow diversion embolization of posterior communicating artery aneurysms.

    Science.gov (United States)

    Binyamin, Tamar R; Dahlin, Brian C; Waldau, Ben

    2016-09-01

    Posterior communicating artery (PCOM) aneurysms may cause third nerve palsies. The optimal treatment with clipping versus coiling remains controversial. Here we report on two cases of resolution of third nerve palsy after flow diversion embolization of large and giant PCOM aneurysms without adjuvant coil placement. The resolution of third nerve palsy was not preceded by significant shrinkage of the aneurysmal sac on MRI. However, one patient showed resolution of T2-weighted signal abnormalities in the midbrain and mesial temporal lobe despite a similar size of the aneurysm. Therefore, flow diversion embolization of a PCOM aneurysm may resolve oculomotor nerve palsies through decreasing arterial pulsations against the nerve or midbrain. PMID:27183957

  15. Pudendal Nerve and Internal Pudendal Artery Damage May Contribute to Radiation-Induced Erectile Dysfunction

    Energy Technology Data Exchange (ETDEWEB)

    Nolan, Michael W., E-mail: mwnolan@ncsu.edu [Department of Clinical Sciences, and Center for Comparative Medicine and Translational Research, North Carolina State University, Raleigh, North Carolina (United States); Department of Environmental and Radiologic Health Sciences, Colorado State University, Fort Collins, Colorado (United States); Marolf, Angela J. [Department of Environmental and Radiologic Health Sciences, Colorado State University, Fort Collins, Colorado (United States); Ehrhart, E.J. [Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado (United States); Rao, Sangeeta [Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado (United States); Kraft, Susan L. [Department of Environmental and Radiologic Health Sciences, Colorado State University, Fort Collins, Colorado (United States); Engel, Stephanie [Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado (United States); Yoshikawa, Hiroto; Golden, Anne E. [Department of Environmental and Radiologic Health Sciences, Colorado State University, Fort Collins, Colorado (United States); Wasserman, Todd H. [Department of Radiation Oncology, Washington University, St. Louis, Missouri (United States); LaRue, Susan M. [Department of Environmental and Radiologic Health Sciences, Colorado State University, Fort Collins, Colorado (United States)

    2015-03-15

    Purpose/Objectives: Erectile dysfunction is common after radiation therapy for prostate cancer; yet, the etiopathology of radiation-induced erectile dysfunction (RI-ED) remains poorly understood. A novel animal model was developed to study RI-ED, wherein stereotactic body radiation therapy (SBRT) was used to irradiate the prostate, neurovascular bundles (NVB), and penile bulb (PB) of dogs. The purpose was to describe vascular and neurogenic injuries after the irradiation of only the NVB or the PB, and after irradiation of all 3 sites (prostate, NVB, and PB) with varying doses of radiation. Methods and Materials: Dogs were treated with 50, 40, or 30 Gy to the prostate, NVB, and PB, or 50 Gy to either the NVB or the PB, by 5-fraction SBRT. Electrophysiologic studies of the pudendal nerve and bulbospongiosus muscles and ultrasound studies of pelvic perfusion were performed before and after SBRT. The results of these bioassays were correlated with histopathologic changes. Results: SBRT caused slowing of the systolic rise time, which corresponded to decreased arterial patency. Alterations in the response of the internal pudendal artery to vasoactive drugs were observed, wherein SBRT caused a paradoxical response to papaverine, slowing the systolic rise time after 40 and 50 Gy; these changes appeared to have some dose dependency. The neurofilament content of penile nerves was also decreased at high doses and was more profound when the PB was irradiated than when the NVB was irradiated. These findings are coincident with slowing of motor nerve conduction velocities in the pudendal nerve after SBRT. Conclusions: This is the first report in which prostatic irradiation was shown to cause morphologic arterial damage that was coincident with altered internal pudendal arterial tone, and in which decreased motor function in the pudendal nerve was attributed to axonal degeneration and loss. Further investigation of the role played by damage to these structures in RI-ED is

  16. Pudendal Nerve and Internal Pudendal Artery Damage May Contribute to Radiation-Induced Erectile Dysfunction

    International Nuclear Information System (INIS)

    Purpose/Objectives: Erectile dysfunction is common after radiation therapy for prostate cancer; yet, the etiopathology of radiation-induced erectile dysfunction (RI-ED) remains poorly understood. A novel animal model was developed to study RI-ED, wherein stereotactic body radiation therapy (SBRT) was used to irradiate the prostate, neurovascular bundles (NVB), and penile bulb (PB) of dogs. The purpose was to describe vascular and neurogenic injuries after the irradiation of only the NVB or the PB, and after irradiation of all 3 sites (prostate, NVB, and PB) with varying doses of radiation. Methods and Materials: Dogs were treated with 50, 40, or 30 Gy to the prostate, NVB, and PB, or 50 Gy to either the NVB or the PB, by 5-fraction SBRT. Electrophysiologic studies of the pudendal nerve and bulbospongiosus muscles and ultrasound studies of pelvic perfusion were performed before and after SBRT. The results of these bioassays were correlated with histopathologic changes. Results: SBRT caused slowing of the systolic rise time, which corresponded to decreased arterial patency. Alterations in the response of the internal pudendal artery to vasoactive drugs were observed, wherein SBRT caused a paradoxical response to papaverine, slowing the systolic rise time after 40 and 50 Gy; these changes appeared to have some dose dependency. The neurofilament content of penile nerves was also decreased at high doses and was more profound when the PB was irradiated than when the NVB was irradiated. These findings are coincident with slowing of motor nerve conduction velocities in the pudendal nerve after SBRT. Conclusions: This is the first report in which prostatic irradiation was shown to cause morphologic arterial damage that was coincident with altered internal pudendal arterial tone, and in which decreased motor function in the pudendal nerve was attributed to axonal degeneration and loss. Further investigation of the role played by damage to these structures in RI-ED is

  17. Central Retinal Artery Occlusion and Third Cranial Nerve Palsy Following Nasal Septoplasty

    Directory of Open Access Journals (Sweden)

    G.Nageswar Rao

    2012-10-01

    Full Text Available Background: Postoperative vision loss following routine nasal surgery is an extremely rare and devastating complication. We report a case of unilateral blindness due to central retinal artery occlusion associated with third cranial nerve following septoplasty. Case Report: We report a patient who developed an unusual central retinal artery occlusion with unilateral blindness following nasal surgery under general anesthesia. A 45-year-old man underwent a nasal septal surgery for severe epistaxis. Soon after recovery, the patient noticed loss of vision in his right eye and was unable to lift his upper eyelid. Upon ophthalmic examinations, we determined that he had right-sided third cranial nerve palsy with central retinal artery obstruction and ptosis of right upper eyelid, restriction of ocular movements, and no perception of light in the right eye. Postoperative computerized tomography scan revealed multiple fractures of the left medial orbital wall, including one near the optic canal. Ptosis and ocular defects were recovered partially, but visual loss persisted until the last follow-up. Conclusion: This paper highlights one case of complete unilateral blindness from direct central retinal artery occlusion associated with third cranial nerve palsy following an apparently uneventful septorhinoplasty. Ophthalmologists and otolaryngologists should therefore be aware of the possible occurrence of such complications.

  18. Management of carotid Dacron patch infection: a case report using median sternotomy for proximal common carotid artery control and in situ polytetrafluoroethylene grafting.

    Science.gov (United States)

    Illuminati, Giulio; Calio', Francesco G; D'Urso, Antonio; Ceccanei, Gianluca; Pacilè, Maria Antonietta

    2009-01-01

    We report on a 58-year-old male who presented with an enlarging cervical hematoma 3 months following carotid endarterectomy with Dacron patch repair, due to septic disruption of the Dacron patch secondary to presumed infection. The essential features of this case are the control of the proximal common carotid artery gained through a median sternotomy, because the patient was markedly obese with minimal thyromental distance, and the treatment consisting of in situ polytetrafluoroethylene bypass grafting, due to the absence of a suitable autogenous saphenous vein. Median sternotomy is rarely required in case of reintervention for septic false aneurysms and hematomas following carotid endarterectomy but should be considered whenever difficult control of the common carotid artery, when entering the previous cervicotomy, is anticipated. In situ polytetrafluoroethylene grafting can be considered if autogenous vein material is lacking. PMID:19875014

  19. Mechanisms responsible for the effect of median nerve electrical stimulation on traumatic brain injury-induced coma: orexin-A-mediated N-methyl-D-aspartate receptor subunit NR1 upregulation

    Science.gov (United States)

    Feng, Zhen; Du, Qing

    2016-01-01

    Electrical stimulation of the median nerve is a noninvasive technique that facilitates awakening from coma. In rats with traumatic brain injury-induced coma, median nerve stimulation markedly enhances prefrontal cortex expression of orexin-A and its receptor, orexin receptor 1. To further understand the mechanism underlying wakefulness mediated by electrical stimulation of the median nerve, we evaluated its effects on the expression of the N-methyl-D-aspartate receptor subunit NR1 in the prefrontal cortex in rat models of traumatic brain injury-induced coma, using immunohistochemistry and western blot assays. In rats with traumatic brain injury, NR1 expression increased with time after injury. Rats that underwent electrical stimulation of the median nerve (30 Hz, 0.5 ms, 1.0 mA for 15 minutes) showed elevated NR1 expression and greater recovery of consciousness than those without stimulation. These effects were reduced by intracerebroventricular injection of the orexin receptor 1 antagonist SB334867. Our results indicate that electrical stimulation of the median nerve promotes recovery from traumatic brain injury-induced coma by increasing prefrontal cortex NR1 expression via an orexin-A-mediated pathway.

  20. Neurological Study of Radial Nerve Conduction During Endoscopic Radial Artery Harvesting:An Intra‐Operative Evaluation

    Directory of Open Access Journals (Sweden)

    Gianluigi Bisleri

    2014-08-01

    Full Text Available Endoscopic radial artery harvesting (ERAH is a feasible and attractive minimally invasive approach for conduit procurement, however there have been concerns about a potential neurological damage occurring at the harvest limb site secondary to injury of the radial nerve during endoscopic harvesting. We present a case of ERAH in which we evaluated intraoperatively the characteristics of radial nerve conduction by means of electroneuromyography (ENM during harvesting. No pathological changes of nerve conduction were detected at the harvest limb site during surgery and postoperatively, thereby supporting the benefits of the endoscopic approach in terms of neurological outcomes following radial artery procurements with a less invasive approach.

  1. Aligned Nanofibers for Regenerating Arteries, Nerves, and Muscles

    Science.gov (United States)

    McClendon, Mark Trosper

    thesis describes a new series of PA molecules designed to degrade upon exposure to UV lightstate here why is this of interest in the context of the work described in the thesis. This was done to understand the degradation behavior of PA nanofibers and provide a controlled approach to changing the rheological properties post gelation.The three PA molecules in this series contained the same peptide sequence V3A3E3, while varying the location of a nitrobenzyl UV-reactive group along the backbone of the molecule. This system allowed for a quick reaction that cleaves the molecule at the reactive nitrobenzyl site without introducing any other reactive molecules. While all three molecules produced nanofibers that remained intact upon UV exposure, the PA having its cleavage point nearest to the hydrophobic core resulted in the most dramatic drop in storage modulus. This work has demonstrated the control of alignment, macroscopic shape, and rheological properties of nanofiber gels tailored to assist in the regeneration of tissues with orientational order such as blood vessels, peripheral nerves, and muscle tissue.

  2. Toxicity and median effective doses of oxime therapies against percutaneous organophosphorus pesticide and nerve agent challenges in the Hartley guinea pig.

    Science.gov (United States)

    Snider, Thomas H; Babin, Michael C; Jett, David A; Platoff, Gennady E; Yeung, David T

    2016-01-01

    Anticholinesterases, such as organophosphorus pesticides and warfare nerve agents, present a significant health threat. Onset of symptoms after exposure can be rapid, requiring quick-acting, efficacious therapy to mitigate the effects. The goal of the current study was to identify the safest antidote with the highest therapeutic index (TI = oxime 24-hr LD50/oxime ED50) from a panel of four oximes deemed most efficacious in a previous study. The oximes tested were pralidoxime chloride (2-PAM Cl), MMB4 DMS, HLö-7 DMS, and obidoxime Cl2. The 24-hr median lethal dose (LD50) for the four by intramuscular (IM) injection and the median effective dose (ED50) were determined. In the ED50 study, male guinea pigs clipped of hair received 2x LD50 topical challenges of undiluted Russian VX (VR), VX, or phorate oxon (PHO) and, at the onset of cholinergic signs, IM therapy of atropine (0.4 mg/kg) and varying levels of oxime. Survival was assessed at 3 hr after onset clinical signs. The 3-hr 90th percentile dose (ED90) for each oxime was compared to the guinea pig pre-hospital human-equivalent dose of 2-PAM Cl, 149 µmol/kg. The TI was calculated for each OP/oxime combination. Against VR, MMB4 DMS had a higher TI than HLö-7 DMS, whereas 2-PAM Cl and obidoxime Cl2 were ineffective. Against VX, MMB4 DMS > HLö-7 DMS > 2-PAM Cl > obidoxime Cl2. Against PHO, all performed better than 2-PAM Cl. MMB4 DMS was the most effective oxime as it was the only oxime with ED90 < 149 µmol/kg against all three topical OPs tested. PMID:27432237

  3. [Unilateral visual field defect due to optic nerve compression by sclerotic internal carotid artery: a case report].

    Science.gov (United States)

    Uchino, M; Nemoto, M; Ohtsuka, T; Kuramitsu, T; Isobe, Y

    1999-02-01

    A case of unilateral visual field defect due to optic nerve compression by a sclerotic internal carotid artery was reported. A 71-year-old woman was admitted to our department because of constricted visual field of the right eye. MRI showed elevation of the right optic nerve compressed by an internal carotid artery. The right carotid angiography revealed elevation and distortion of the C1-2 portion. Frontal craniotomy was carried out and the optic nerve was visualized on this side. The right optic nerve was found to have been compressed by the sclerotic internal carotid artery. The optic canal was then unroofed. The post-operative course was uneventful. The visual field was improved. When last seen 6 months after surgery, her visual field remained in the improved condition. Nasal field abnormalities are most frequently encountered in retinal and anterior optic nerve pathology. Our success in improving the visual field disturbance may be accounted for by the fact that the preoperative period was short and the operation was performed before atrophy of ocular fundi occurred. Nasal field loss caused by intracranial lesions of the optic pathway is rare. It is probably impossible to determine degree of the symptomatology caused by direct-pressure compression as opposed to that caused by ischemia secondary to occlusion of small arterial supply branches. Vascular compressive neuropathy of optic nerve should not be diagnosed simply by the radiological finding of the optic nerve dislocation. However, optic nerve compression by surrounding arteries should be remembered as one of the possible causes of visual field defect which needs to be treated surgically. PMID:10065453

  4. Intermittent hypoglossal nerve palsy caused by a calcified persistent hypoglossal artery: an uncommon neurovascular compression syndrome.

    Science.gov (United States)

    Meila, Dan; Wetter, Axel; Brassel, Friedhelm; Nacimiento, Wilhelm

    2012-12-15

    Neurovascular compression is assumed to cause symptoms like trigeminal neuralgia, hemifacial spasm and vestibular paroxysmia. We present a patient with recurrent episodes of transient dysarthria due to isolated right hypoglossal nerve (HN) palsy. We describe the first case of a calcified persistent hypoglossal artery (PHA) as the putative cause of a hypoglossal neurovascular compression syndrome. Our patient received a daily low-dose medication of carbamazepine resulting in complete relief of symptoms. In conclusion, PHA is not only an anatomic variation but also a possible cause of a neurovascular compression syndrome leading to intermittent HN palsy. PMID:23020989

  5. Vasopressin responses to unloading arterial baroreceptors during cardiac nerve blockade in conscious dogs

    Science.gov (United States)

    O'Donnell, C. P.; Keil, L. C.; Thrasher, T. N.

    1992-01-01

    We examined the relative contributions of afferent input from the heart and from arterial baroreceptors in the stimulation of arginine vasopressin (AVP) secretion in response to hypotension caused by thoracic inferior vena caval constriction (TIVCC). Afferent input from cardiac receptors was reversibly blocked by infusing 2% procaine into the pericardial space to anesthetize the cardiac nerves. Acute cardiac nerve blockade (CNB) alone caused a rise in mean arterial pressure (MAP) of 24 +/- 3 mmHg but no change in plasma AVP. If the rise in MAP was prevented by TIVCC, plasma AVP increased by 39 +/- 15 pg/ml, and if MAP was allowed to increase and then was forced back to control by TIVCC, plasma AVP increased by 34 +/- 15 pg/ml. Thus the rise in MAP during CNB stimulated arterial baroreceptors, which in turn compensated for the loss of inhibitory input from cardiac receptors on AVP secretion. These results indicate that the maximum secretory response resulting from complete unloading of cardiac receptors at a normal MAP results in a mean increase in plasma AVP of 39 pg/ml in this group of dogs. When MAP was reduced 25% below control levels (from 95 +/- 5 to 69 +/- 3 mmHg) by TIVCC during pericardial saline infusion, plasma AVP increased by 79 +/- 42 pg/ml. However, the same degree of hypotension during CNB (MAP was reduced from 120 +/- 5 to 71 +/- 3 mmHg) led to a greater (P less than 0.05) increase in plasma AVP of 130 +/- 33 pg/ml. Because completely unloading cardiac receptors can account for an increase of only 39 pg/ml on average in this group of dogs, the remainder of the increase in plasma AVP must be due to other sources of stimulation. We suggest that the principal stimulus to AVP secretion after acute CNB in these studies arises from unloading the arterial baroreceptors.

  6. Effects of Intrinsic and Extrinsic Cardiac Nerves on Atrial Arrhythmia in Experimental Pulmonary Artery Hypertension.

    Science.gov (United States)

    Zhao, Qingyan; Deng, Hongping; Jiang, Xuejun; Dai, Zixuan; Wang, Xiaozhan; Wang, Xule; Guo, Zongwen; Hu, Wei; Yu, Shengbo; Yang, Bo; Tang, Yanhong; Huang, Congxin

    2015-11-01

    Atrial arrhythmia, which includes atrial fibrillation (AF) and atrial flutter (AFL), is common in patients with pulmonary arterial hypertension (PAH), who often have increased sympathetic nerve activity. Here, we tested the hypothesis that autonomic nerves play important roles in vulnerability to AF/AFL in PAH. The atrial effective refractory period and AF/AFL inducibility at baseline and after anterior right ganglionated plexi ablation were determined during left stellate ganglion stimulation or left renal sympathetic nerve stimulation in beagle dogs with or without PAH. Then, sympathetic nerve, β-adrenergic receptor densities and connexin 43 expression in atrial tissues were assessed. The sum of the window of vulnerability to AF/AFL was increased in the right atrium compared with the left atrium at baseline in the PAH dogs but not in the controls. The atrial effective refractory period dispersion was increased in the control dogs, but not in the PAH dogs, during left stellate ganglion stimulation. The voltage thresholds for inducing AF/AFL during anterior right ganglionated plexi stimulation were lower in the PAH dogs than in the controls. The AF/AFL inducibility was suppressed after ablation of the anterior right ganglionated plexi in the PAH dogs. The PAH dogs had higher sympathetic nerve and β1-adrenergic receptor densities, increased levels of nonphosphorylated connexin 43, and heterogeneous connexin 43 expression in the right atrium when compared with the control dogs. The anterior right ganglionated plexi play important roles in the induction of AF/AFL. AF/AFL induction was associated with right atrium substrate remodeling in dogs with PAH.

  7. Restoring motor control and sensory feedback in people with upper extremity amputations using arrays of 96 microelectrodes implanted in the median and ulnar nerves

    Science.gov (United States)

    Davis, T. S.; Wark, H. A. C.; Hutchinson, D. T.; Warren, D. J.; O'Neill, K.; Scheinblum, T.; Clark, G. A.; Normann, R. A.; Greger, B.

    2016-06-01

    Objective. An important goal of neuroprosthetic research is to establish bidirectional communication between the user and new prosthetic limbs that are capable of controlling >20 different movements. One strategy for achieving this goal is to interface the prosthetic limb directly with efferent and afferent fibres in the peripheral nervous system using an array of intrafascicular microelectrodes. This approach would provide access to a large number of independent neural pathways for controlling high degree-of-freedom prosthetic limbs, as well as evoking multiple-complex sensory percepts. Approach. Utah Slanted Electrode Arrays (USEAs, 96 recording/stimulating electrodes) were implanted for 30 days into the median (Subject 1-M, 31 years post-amputation) or ulnar (Subject 2-U, 1.5 years post-amputation) nerves of two amputees. Neural activity was recorded during intended movements of the subject’s phantom fingers and a linear Kalman filter was used to decode the neural data. Microelectrode stimulation of varying amplitudes and frequencies was delivered via single or multiple electrodes to investigate the number, size and quality of sensory percepts that could be evoked. Device performance over time was assessed by measuring: electrode impedances, signal-to-noise ratios (SNRs), stimulation thresholds, number and stability of evoked percepts. Main results. The subjects were able to proportionally, control individual fingers of a virtual robotic hand, with 13 different movements decoded offline (r = 0.48) and two movements decoded online. Electrical stimulation across one USEA evoked >80 sensory percepts. Varying the stimulation parameters modulated percept quality. Devices remained intrafascicularly implanted for the duration of the study with no significant changes in the SNRs or percept thresholds. Significance. This study demonstrated that an array of 96 microelectrodes can be implanted into the human peripheral nervous system for up to 1 month durations. Such an

  8. [Therapy of arterial vascular occlusions of retinal and optic nerve (author's transl)].

    Science.gov (United States)

    Küchle, H J; Richard, G

    1979-01-01

    The authors report on 136 cases of arterial occlusion (80 patients suffering from occlusion of the retinal vessels and 56 patients with vascular occlusion in the optic nerve) who were treated with the vasoactive xanthic substance Pentoxifylline (Trental). A part from its positive effect on the vascular circulation, Trental also helps to improve microcirculation in the retinal and optic nerve tissue damaged by hypoxia. After a 2-week infusion therapy with additional digitalisation, treatment was continued for another 3-6 months with oral administration of Trental 400. In 50 cases therapy was combined with the systemic administration of corticosteroids. Under the mentioned therapy a definitely improved visual acuity (at least 3 lines on the eye charts) was achieved in 56% of the cases with occlusion of the retinal vessels and in 51% of the cases with vascular occlusion in the optic nerve, i.e., in 54% of the total number of patients. Whether or not the additional administration of corticosteroids helped to this effect was not proved. PMID:545196

  9. Characterization of nerve and microvessel damage and recovery in type 1 diabetic mice after permanent femoral artery ligation.

    Science.gov (United States)

    Lozeron, Pierre; Mantsounga, Chris S; Broqueres-You, Dong; Dohan, Anthony; Polivka, Marc; Deroide, Nicolas; Silvestre, Jean-Sébastien; Kubis, Nathalie; Lévy, Bernard I

    2015-09-01

    Neuropathy is the most common complication of the peripheral nervous system during the progression of diabetes. The pathophysiology is unclear but may involve microangiopathy, reduced endoneurial blood flow, and tissue ischemia. We used a mouse model of type 1 diabetes to study parallel alterations of nerves and microvessels following tissue ischemia. We designed an easily reproducible model of ischemic neuropathy induced by irreversible ligation of the femoral artery. We studied the evolution of behavioral function, epineurial and endoneurial vessel impairment, and large nerve myelinated fiber as well as small cutaneous unmyelinated fiber impairment for 1 month following the onset of ischemia. We observed a more severe hindlimb dysfunction and delayed recovery in diabetic animals. This was associated with reduced density of large arteries in the hindlimb and reduced sciatic nerve epineurial blood flow. A reduction in sciatic nerve endoneurial capillary density was also observed, associated with a reduction in small unmyelinated epidermal fiber number and large myelinated sciatic nerve fiber dysfunction. Moreover, vascular recovery was delayed, and nerve dysfunction was still present in diabetic animals at day 28. This easily reproducible model provides clear insight into the evolution over time of the impact of ischemia on nerve and microvessel homeostasis in the setting of diabetes. © 2015 Wiley Periodicals, Inc. PMID:25944265

  10. Regional anatomy of median nerve palmar cutaneous branch and its clinical significance%正中神经掌皮支的局部解剖与临床意义

    Institute of Scientific and Technical Information of China (English)

    丁洁; 梁炳生; 贾英伟; 达志峰; 朱志祥

    2013-01-01

    .The vertical distance of PCB to the scaphoid tubercle midpoint was (8.3±2.8) mm.3 branches of PCB were found in 31 specimens (59.6%),2 branches in 15 specimens (28.9%) and 1 branch in 6 specimens (11.5%).Distribution of the PCB was mainly in the thenar and midpalm area.Palmar cutaneous branch nutritional artery either entered the PCB directly,accompanying it or by way of muscular branch.Conclusion The origin and course of PCB is relatively constant.Surgical incisions at the wrist or palm should be ulnar to the longitudinal axis of the ring finger and close to the fourth metacarpal,to avoid inadvertent injury of the median nerve PCB and its nutrient vessels.

  11. Case of Behçet's disease complicated by oculomotor nerve palsy associated with internal carotid artery-posterior communicating artery aneurysm.

    Science.gov (United States)

    Yamaoka, Toshifumi; Murota, Hiroyuki; Katayama, Ichiro

    2015-03-01

    Behçet's disease (BD) is a relapsing systemic inflammatory disorder of unknown etiology involving systemic vasculitis. Vasculitis in BD results from the involvement of arteries, veins and blood vessels of all sizes, which leads to the three major manifestations of this condition: venous occlusion, arterial occlusion and aneurysm formation. Therefore, whole-body vascular involvement should always be considered in BD patients. Here, we describe the first appearance of an internal carotid-posterior communicating artery aneurysm, resulting in complete oculomotor nerve palsy in a BD patient. A 44-year-old Japanese man suffered from recurrent episodes of erythema nodosum that had presented on the lower extremities for the past 2 years. His condition was diagnosed as an incomplete type of BD based on relapsing oral and genital ulcers, skin eruptions, such as erythema nodosum and folliculitis, a positive pathergy test and systemic arthralgia. Ten years after his initial clinical presentation, he had manifestations of right-sided ptosis and cyclic dull pain in his right temporal region. Magnetic resonance imaging and angiography revealed a right internal carotid artery-posterior communicating artery aneurysm. Although oculomotor nerve palsy associated with internal carotid artery-posterior communicating artery aneurysm in a BD patient has not been reported previously, our report highlights the fact that this abnormal manifestation should be considered in those with vasculo-BD. PMID:25573207

  12. The characteristics of median nerve compound nerve action potential at different post injury and repair intervals and their correlation with nerve regeneration in rats%大鼠正中神经修复后不同时段的电生理变化与神经再生的相关性分析

    Institute of Scientific and Technical Information of China (English)

    李永平; 劳杰; 赵新; 刘靖波; 田东; 张凯丽; 朱艺

    2011-01-01

    目的 探讨大鼠正中神经切断缝合后的不同时段,其复合神经动作电位(CNAP)与形态学方面的特点及其相关性分析.方法 在大鼠上臂正中神经中段切断缝合后的不同时间点(2、3、4、6、8和12周)进行CNAP检测,随后取正中神经组织进行形态学检查.结果 术后第2周可以记录到CNAP.术后再生神经记录的CNAP幅度比对照组显著减低(P<0.01),波幅下面积(Area)也显著低于对照组(P<0.01),传导速度(CV)显著慢于对照组(P<0.01).术后2~6周的潜伏期(Lat)均比对照组明显延长(P<0.05);术后2~8周刺激强度,即阈强度(THI)和超大刺激强度(SSI)显著低于对照组.CNAP的第一峰波幅(FPA)、峰-峰波幅(PPA)、Area、CV变化趋势为随时间增加而逐渐增高,而其参数Lat、THI、SSI随时间增加而逐渐降低.神经修复后2周缝合口远端已有少量的新生轴突,随着再生时间延长,越来越多的再生轴突延伸至远端.远端记录的CNAP波幅与其有髓神经纤维计数之间有强的正相关(相关系数为0.953).线性回归分析表明,存在线性关系.术后8周髓鞘趋向于成熟.结论 CNAP是早期诊断和评价损伤神经再生程度的良好指标.正常正中神经的CNAP波幅可能与有髓神经纤维的计数呈线性关系.术后第8周,CNAP参数趋向于稳定,神经髓鞘渐趋向于成熟.%Objective To explore the characteristics of compound nerve action potential (CNAP) after rat median nerve transection and repair,and their correlation with neuromorphometry at various time points. Methods The median nerve was transected and sutured at mid-arm level. At various time points from 2 to 12 weeks postoperatively,CNAP recording was performed and the median nerve was harvested for morphological examination. Results CNAP could be recorded at 2 weeks after nerve repair. The CNAP amplitude,the area below the curve (Area) and conduction velocity (CV) of regenerated nerve were significantly lower than those

  13. Operative strategy of complex internal carotid artery-posterior communicating artery aneurysms Defensive effect on perioperative nerve injury

    Institute of Scientific and Technical Information of China (English)

    Xinmin Wang; Wende Xiong; Xuqin Li

    2007-01-01

    BACKGROUND: The two problems in treating intracranial aneurysm are the vascular reconstruction and brain protection, especially for complex internal carotid artery-posterior communicating artery (ICA-PComA)aneurysms.OBJECTIVE: To analyze the anatomic features and operative technique of complex ICA-PComA aneurysms, and investigate how to better protect the brain tissue.DESIGN: A retrospective case analysis.SETTING: Department ofNeurosurgery, Dalian Central Hospital.PARTICIPANTS: Totally 154 inpatients with ICA-PComA aneurysms were selected from the Department of Neurosurgery, Dalian Central Hospital from January 1998 to December 2006, including 19 cases (12.3%)of complex ICA-PComA aneurysms, 8 males and 11 females, 38 - 67 years of age. Informed contents for surgery and observation were obtained from all the patients or their relatives.METHODS: The clinical manifestations, including initial symptoms and Hunt&Hess grading, were observed. Corresponding strategies were selected for different types of ICA-PComA aneurysms. The patients were followed up at 3 months postoperatively. According to the results of Glasgow scoring, the curative effects were classified as good (4 - 5 points), bad (2 - 3 points) and dead (1 point). The results at discharge were taken as early results, whereas the follow-up results as late results.MAIN OUTCOME MEASURES: Clinical manifestations and curative effects of the patients.RESULTS: All the 19 patients with ICA-PComA were involved in the analysis of results. For clinical manifestations, the initial symptoms were subarachnoid hemorrhage (n =15), paralysis of oculomotor nerve (n =3), and occasional attack (n =1); The Hunt&Hess grading was grade Ⅰ in 4 cases, grade Ⅱ in 6 cases,grade Ⅲ in 6 cases, grade Ⅳ in 2 cases, and grade Ⅴ in 1 case. The curative effects were that aneurysm breakage and bleeding occurred in 6 cases perioperatively, uncomplete clipping of aneurysm in 2 cases and constriction of parent artery in 1 case. The

  14. Arterial supply to the thyroid gland and the relationship between the recurrent laryngeal nerve and the inferior thyroid artery in human fetal cadavers.

    Science.gov (United States)

    Ozgüner, G; Sulak, O

    2014-11-01

    The aim of this study was to identify the arterial supply to the thyroid gland and the relationship between the inferior thyroid artery (ITA) and the recurrent laryngeal nerve (RLN) in fetal cadavers using anatomical dissection. The anterior necks of 200 fetuses were dissected. The origins of the superior thyroid artery (STA) and the ITA and location of the ITA in relation to the entrance of the thyroid lobe were examined. The relationship between the ITA and the RLN was determined. The origins of the STA were classified as: external carotid artery, common carotid artery (CCA), and the thyrolingual trunk. The origins of the ITA were the thyrocervical trunk and the CCA. The ITA was absent on the left side in two cases. The relationship of the RLN to the ITA fell into seven different types. Type 1: the RLN lay posterior to the artery; right (42.5%), left (65%). Type 2: the RLN lay anterior to the artery; right (40.5%), left (22.5%). Type 3: the RLN lay parallel to the artery; right (11.5%), left (7%). Type 4: the RLN lay between the two branches of the artery; right (1%), left (3.5%). Type 5: The extralaryngeal branch of the RLN was detected before it crossed the ITA; right (4.5%), left (0%). Type 6: the ITA lay between the two branches of the RLN; right (0%), left (0.5%). Type 7: the branches of the RLN lay among the branches of the ITA; right (0%), left (0.5%). The results from this study would be useful in future thyroid surgeries.

  15. The Value of Median Nerve Sonography as a Predictor for Short- and Long-Term Clinical Outcomes in Patients with Carpal Tunnel Syndrome: A Prospective Long-Term Follow-Up Study

    Science.gov (United States)

    Marschall, Alexander; Ficjian, Anja; Husic, Rusmir; Zauner, Dorothea; Seel, Werner; Simmet, Nicole E.; Klammer, Alexander; Heizer, Petra; Brickmann, Kerstin; Gretler, Judith; Fürst-Moazedi, Florentine C.; Thonhofer, Rene; Hermann, Josef; Graninger, Winfried B.; Quasthoff, Stefan; Dejaco, Christian

    2016-01-01

    Objectives To investigate the prognostic value of B-mode and Power Doppler (PD) ultrasound of the median nerve for the short- and long-term clinical outcomes of patients with carpal tunnel syndrome (CTS). Methods Prospective study of 135 patients with suspected CTS seen 3 times: at baseline, then at short-term (3 months) and long-term (15–36 months) follow-up. At baseline, the cross-sectional area (CSA) of the median nerve was measured with ultrasound at 4 levels on the forearm and wrist. PD signals were graded semi-quantitatively (0–3). Clinical outcomes were evaluated at each visit with the Boston Questionnaire (BQ) and the DASH Questionnaire, as well as visual analogue scales for the patient’s assessment of pain (painVAS) and physician’s global assessment (physVAS). The predictive values of baseline CSA and PD for clinical outcomes were determined with multivariate logistic regression models. Results Short-term and long-term follow-up data were available for 111 (82.2%) and 105 (77.8%) patients, respectively. There was a final diagnosis of CTS in 84 patients (125 wrists). Regression analysis revealed that the CSA, measured at the carpal tunnel inlet, predicted short-term clinical improvement according to BQ in CTS patients undergoing carpal tunnel surgery (OR 1.8, p = 0.05), but not in patients treated conservatively. Neither CSA nor PD assessments predicted short-term improvement of painVAS, physVAS or DASH, nor was any of the ultrasound parameters useful for the prediction of long-term clinical outcomes. Conclusions Ultrasound assessment of the median nerve at the carpal tunnel inlet may predict short-term clinical improvement in CTS patients undergoing carpal tunnel release, but long-term outcomes are unrelated to ultrasound findings. PMID:27662617

  16. Arterial baroreceptor reflex control of renal sympathetic nerve activity following chronic myocardial infarction in male, female, and ovariectomized female rats.

    Science.gov (United States)

    Pinkham, Maximilian I; Whalley, Gillian A; Guild, Sarah-Jane; Malpas, Simon C; Barrett, Carolyn J

    2015-07-15

    There is controversy regarding whether the arterial baroreflex control of renal sympathetic nerve activity (SNA) in heart failure is altered. We investigated the impact of sex and ovarian hormones on changes in the arterial baroreflex control of renal SNA following a chronic myocardial infarction (MI). Renal SNA and arterial pressure were recorded in chloralose-urethane anesthetized male, female, and ovariectomized female (OVX) Wistar rats 6-7 wk postsham or MI surgery. Animals were grouped according to MI size (sham, small and large MI). Ovary-intact females had a lower mortality rate post-MI (24%) compared with both males (38%) and OVX (50%) (P renal SNA. As a result, the male large MI group (49 ± 6 vs. 84 ± 5% in male sham group) and OVX large MI group (37 ± 3 vs. 75 ± 5% in OVX sham group) displayed significantly reduced arterial baroreflex range of control of normalized renal SNA (P renal SNA was unchanged regardless of MI size. In males and OVX there was a significant, positive correlation between left ventricle (LV) ejection fraction and arterial baroreflex range of control of normalized renal SNA, but not absolute renal SNA, that was not evident in ovary-intact females. The current findings demonstrate that the arterial baroreflex control of renal SNA post-MI is preserved in ovary-intact females, and the state of left ventricular dysfunction significantly impacts on the changes in the arterial baroreflex post-MI.

  17. Detection of catecholamine and luteinizing hormone-releasing hormone (LH-RH) containing nerve endings in the median eminence and the organon vasculosum laminae terminalis by fluorescence histochemistry and immunohistochemistry on the same microscopic sections.

    Science.gov (United States)

    Ibata, Y; Watanabe, K; Kinoshita, H; Kubo, S; Sano, Y; Sin, S; Hashimura, E; Imagawa, K

    1979-02-01

    Distribution of catecholamine (CA) and LH-RH nerve endings in the median eminence (ME) and the organon vasculosum laminae terminalis (OVLT) of the rat was investigated by application of fluorescence histochemistry and immunohistochemistry on the same sections of the tissue. In the ME, those two kinds of endings coexisted in the lateral portion of the middle part of ME, and in the wall of tuberoinfundibular sulcus, where they might be considered to have functional correlation. In the OVLT they were also distributed in fairly near distance, but they were not so closely associated as observed in the ME.

  18. Median arcuate ligament syndrome: a nonvascular, vascular diagnosis.

    Science.gov (United States)

    Skeik, Nedaa; Cooper, Leslie T; Duncan, Audra A; Jabr, Fadi I

    2011-07-01

    Median arcuate ligament syndrome (MALS) is often diagnosed when idiopathic, episodic abdominal pain is associated with dynamic compression of the proximal celiac artery by fibers of the median arcuate ligament. The character of the abdominal pain is often postprandial and associated with gradual weight loss from poor food intake, suggestive of chronic mesenteric ischemia. However, the pathognomonic imaging feature of dynamic, ostial celiac artery compression with expiration does not consistently predict clinical improvement from revascularization. Proposed but unproven pathophysiological mechanisms include neurogenic pain from compression of the splanchnic nerve plexus and intermittent ischemia from compression of the celiac artery. Alterations in blood flow and ganglion compression are both associated with delayed gastric emptying, another physiological correlate of the clinical syndrome. Published reports describe a variable response to revascularization and nerve plexus resection suggest a need for translational research to better characterize this poorly understood clinical entity. We illustrate the current gaps in our knowledge of MALS with the case of a 51-year-old woman with a 4-year history of chronic abdominal pain who responded to a combination of ganglion resection and celiac artery reconstruction. PMID:21536596

  19. Arterial baroreceptor reflex control of renal sympathetic nerve activity following chronic myocardial infarction in male, female, and ovariectomized female rats.

    Science.gov (United States)

    Pinkham, Maximilian I; Whalley, Gillian A; Guild, Sarah-Jane; Malpas, Simon C; Barrett, Carolyn J

    2015-07-15

    There is controversy regarding whether the arterial baroreflex control of renal sympathetic nerve activity (SNA) in heart failure is altered. We investigated the impact of sex and ovarian hormones on changes in the arterial baroreflex control of renal SNA following a chronic myocardial infarction (MI). Renal SNA and arterial pressure were recorded in chloralose-urethane anesthetized male, female, and ovariectomized female (OVX) Wistar rats 6-7 wk postsham or MI surgery. Animals were grouped according to MI size (sham, small and large MI). Ovary-intact females had a lower mortality rate post-MI (24%) compared with both males (38%) and OVX (50%) (P < 0.05). Males and OVX with large MI, but not small MI, displayed an impaired ability of the arterial baroreflex to inhibit renal SNA. As a result, the male large MI group (49 ± 6 vs. 84 ± 5% in male sham group) and OVX large MI group (37 ± 3 vs. 75 ± 5% in OVX sham group) displayed significantly reduced arterial baroreflex range of control of normalized renal SNA (P < 0.05). In ovary-intact females, arterial baroreflex control of normalized renal SNA was unchanged regardless of MI size. In males and OVX there was a significant, positive correlation between left ventricle (LV) ejection fraction and arterial baroreflex range of control of normalized renal SNA, but not absolute renal SNA, that was not evident in ovary-intact females. The current findings demonstrate that the arterial baroreflex control of renal SNA post-MI is preserved in ovary-intact females, and the state of left ventricular dysfunction significantly impacts on the changes in the arterial baroreflex post-MI. PMID:25994953

  20. Persistent trigeminal artery supply to an intrinsic trigeminal nerve arteriovenous malformation: a rare cause of trigeminal neuralgia.

    Science.gov (United States)

    Choudhri, Omar; Heit, Jeremy J; Feroze, Abdullah H; Chang, Steven D; Dodd, Robert L; Steinberg, Gary K

    2015-02-01

    Infratentorial arteriovenous malformations (AVM) associated with the trigeminal nerve root entry zone are a known cause of secondary trigeminal neuralgia (TN). The treatment of both TN and AVM can be challenging, especially if the AVM is embedded within the trigeminal nerve. A persistent trigeminal artery (PTA) can rarely supply these intrinsic trigeminal nerve AVM. We present a 64-year-old man with TN from a right trigeminal nerve AVM supplied by a PTA variant. The patient underwent microvascular decompression and a partial resection of the AVM with relief of facial pain symptoms. His residual AVM was subsequently treated with CyberKnife radiosurgery (Accuray, Sunnyvale, CA, USA). A multimodality approach may be required for the treatment of trigeminal nerve associated PTA AVM and important anatomic patterns need to be recognized before any treatment. Herein, we report to our knowledge the third documented patient with a posterior fossa AVM supplied by a PTA and the first PTA AVM presenting as facial pain. PMID:25070632

  1. The anatomical study of the muscular branches of the musculus flexor digitorum superficialis repairing ulnar nerve motor branch from the median nerve%正中神经指浅屈肌肌支移位修复尺神经运动支的应用解剖

    Institute of Scientific and Technical Information of China (English)

    赵民朝; 于亚东; 李统; 马涛; 毕伟东

    2010-01-01

    目的 通过对正中神经指浅屈肌肌支和尺神经运动支的解剖学研究,为正中神经指浅屈肌肌支移位修复尺神经运动支,恢复手内在肌功能的临床应用提供解剖学基础.方法 选用20例40侧近期经福尔马林浸泡固定的成人上肢标本,暴露正中神经、尺神经,测量正中神经指浅屈肌肌支各项解剖学数据;应用图像分析系统对组织切片做定量分析,测算该肌支有髓神经纤维数目.临床模拟操作正中神经指浅屈肌肌支移位修复尺神经运动支.结果 正中神经第4肌支发出部位距离桡骨茎突和尺骨茎突连线(48.4±2.4)mm,入肌部位距离桡骨茎突和尺骨茎突连线(21.4±1.8)mm,可分离长度(27.1±1.2)mm,横径(1.2±0.2)mm,前后径(0.7±0.1)mm;尺神经的运动支和感觉支之间自然分束无损伤分离.长度为(7.1±0.70)cm;组织切片及图片系统测得正中神经指浅屈肌第4肌支有髓神经纤维数目为(1378.9±107.9)条.结论 正中神经指浅屈肌第4肌支可修复尺神经运动支,以期恢复手内在肌的功能.%Objective To provide a good anatomical foundation for transposition of the branch of median nerve superficial flexor muscle repairing the movement branch of ulnar nerve to recover the function of intrinsic muscle, by anatomic study of the muscle branch of the superficial flexor muscle of the median nerve and the movement branch of ulnar nerve. Methods Twenty adult upper limb specimens immersed fixed by formalin were elected and expose the midian nerve and ulnar nerve. Then every anatomical index was measured. Simulate to manipulate that the branch of superficial flexor muscle repair the motor b ranch of ulnar nerve. Calculate the number of myelinated nerve fibers of the branch of superficial flexor muscle. Results The distance between the position into muscle and styloid process of radius and styloid process of ulna: (21.4±1.8)mm, the distance that can be separated: (27.1±1.2)mm, the transverse

  2. The identification of recurrent laryngeal nerve by injection of blue dye into the inferior thyroid artery in elusive locations.

    Science.gov (United States)

    Hepgul, Gulcin; Kucukyilmaz, Meltem; Koc, Oguz; Duzkoylu, Yigit; Sari, Yavuz Selim; Erbil, Yesim

    2013-01-01

    Introduction. Thyroidectomy creates a potential risk for all parathyroid glands and the recurrent laryngeal nerve (RLN). The identification and dissection of the RLN is the gold standard for preserving its function. In some cases, it may be quite difficult to identify the nerve localization. In such elusive locations, we aimed to identify RLNs using peroperative injection of a blue dye into the inferior thyroid artery. Materials and Methods. This study included 10 selected patients whose RLN identification had been difficult peroperatively during the period from April 2008 to June 2009. When the RLNs became elusive in location, the branches of the inferior thyroid artery (ITA) on the capsule of the thyroid lobe were isolated, and then 0.5 mL isosulphan blue dye was injected into the artery. Results. RLN was carefully dissected in the tracheoesophageal groove. RLN was clearly visualized, in all patients. All RLNs were identified along their course in the dyed surrounding tissue. No RLN palsy was encountered. Conclusion. The injection of blue dye into the ITA branches can be used as an alternate method in case of difficulty in identification of RLNs.

  3. Median Nerve with Intraoperative Monitor and Supramaximal Stimulation by Electrophysiology to Cure Carpal Tunnel Syndrome%术中超强电刺激治疗腕管综合征的临床效果研究

    Institute of Scientific and Technical Information of China (English)

    蒋毅; 张航; 田通; 赵睿

    2015-01-01

    目的:评估正中神经松解术结合术中超强电刺激治疗腕管综合征的临床效果。方法:将40例重度腕管综合征患者随机分为对照组和研究组,每组各纳入20名患者。对照组患者仅行正中神经松解术;研究组患者给予正中神经松解术结合术中超强电刺激治疗(80mA,2Hz,5min)。分别记录两组患者大鱼际肌复合肌肉动作电位(CMAP)的潜伏期及波幅并进行比较。结果:研究组患者正中神经外膜松解加超强电刺激后大鱼际肌CMAP的潜伏期和波幅分别为(7.2±0.5)ms和(2.4±0.3)mV,对照组正中神经外膜松解后大鱼际肌CMAP的潜伏期和波幅分别为(8.3±0.4)ms和(1.9±0.4)mV,两组数据均较术前明显恢复,两组间比较具有统计学意义(P<0.05)。结论:术中超强电刺激对腕管综合征患者的正中神经功能恢复具有辅助治疗作用。%Objective: To evaluate the therapeutic effect of the decompression of median nerve combined with intraoperative supramaximal stimulation.Methods:40 patients, who were diagnosed as carpal tunnel syndrome in severe damage, were randomly divided into the control group and the study group, and each group had 20 patients. Only decompression of median nerve was conducted to the patients in the control group. Decompression of median nerve combined with intraoperative supramaximal stimulation (80mA, 2Hz, 10min) was given to the patients in the study group. Record and analyze the latency period and amplitude of CMAP of the patients’ muscle of thenar in the two groups respectively.Results:In the study group, the latency period and amplitude of CMAP of muscle of thenar after decompression and supramaximal stimulation were (7.2±0.5) ms and (2.4±0.3) mV respectively. In the control group, the latency period and amplitude of CMAP were (8.3±0.4) ms and (1.9±0.4) mV respectively. Compared the study group with the control group, there was significant

  4. The anatomical research of grafting ring finger radial digital branch of median nerve for repairing injuried deep branch of ulnar nerve defects%正中神经环指桡侧指神经支移植修复尺神经深支缺损的应用解剖

    Institute of Scientific and Technical Information of China (English)

    王斌; 尹佳丽; 董秀芝; 陈超; 韩海生; 李浩

    2011-01-01

    目的 为研究环指桡侧指神经支移植修复尺神经深支缺损提供解剖学基础. 方法 对16例32侧新鲜成人上肢进行观测.在10倍手术显微镜下对腕部尺神经深支、正中神经旋前方肌支和环指桡侧指神经支进行显微解剖及测量. 结果 正中神经旋前方肌支直径为(1.13±0.02)mm,正中神经环指桡侧指神经支直径为(1.17±0.05)mm,对掌肌管出口处尺神经深支直径为(1.75±0.07)mm.显微镜下分离环指桡侧指神经支,对掌肌管出口处尺神经深支至旋前方肌支入肌长度即移植段神经长度为(104.59±20.25)mm. 结论 环指桡侧指神经支移植为带血运的神经移植,属肌支对肌支的吻合,是修复尺神经深支缺损的有效方法.%Objective To provide anatomical basis of neural transplantation to repair deep branch of ulnar nerve defect with the ring finger radial digital branch. Methods Thirty-two sides of 16 cases fresh forearms were dissected and observed.Microdissect and measure the deep branch of ulnar nerve,quadrate pronator of median nerve and it's ring finger radial digital branch under 10-times operating microscope. Results The diameter of quadrate pronator of median nerve was (1.13 ± 0.02)mm,ring finger radial digital branch of median nerve was (1.17 ± 0.05)mm,mid-palmar section of deep branch of ulnar nerve was(1.75± 0.07)mm.Dissect ring finger radial digital branch of median nerve to muscular branch of quadrate pronator under operating microscope,retaining it's blood supply.The length between the deep branch of ulnar nerve and ring finger radial digital branch was( 104.59 ± 20.25)mm.Conclusion ①Solving the problem of nerve grafting without blood supply before,benefit to the survival of the grafting segment and the regeneration of the neuro fiber,and function restoring.②This kind of grafting is the bridging of muscular branch to muscular branch,abide by the principle of neurophysiology.③Neural transplantation to repair deep

  5. MORPHOLOGY OF ULNAR NERVE IN AXILLA & ARM & ITS VARIATIONS

    Directory of Open Access Journals (Sweden)

    Vijay Kumar S

    2014-11-01

    Full Text Available The ulnar nerve arises from the medial cord (C8, T1; medial cord also receives fibres from the ventral ramus of C7. Lesions of the ulnar nerve occur behind the medial epicondyle & in the cubital tunnel. When muscles are affected due to ulnar nerve dysfunction, there is ulnar neuropathy at the shoulder, arm & elbow. The study was done on 50 embalmed human cadavers (25 right & 25 left of both sexes of South Indian adult population obtained from the Department of Anatomy, Bangalore Medical College and Research Institute, Bangalore. Variations in the ulnar nerve in its presence, origin, relations, distribution & communications were observed. Ulnar nerve was present in all 50 upper limb specimens (100%. Ulnar nerve originated from the medial cord of the brachial plexus in 49 cases (98%. In 1 case (2%, the ulnar nerve received C7 fibers from lateral cord i.e. the lateral root of the median nerve and then later fused with the median root of the median nerve. In 49 specimens (98% ulnar nerve took origin from the tip of the acromion processes. In 1 case (2% it took origin from distal to the tip of the acromion process. 49 specimens (98% showed the normal course, i.e. medial to axillary & brachial artery. 1 case (2% showed ulnar nerve present anterior to the third part of the axillary artery and brachial artery. In the midarm it passed medially as a normal course, then runs distally through the cubital tunnel. The awareness of these variations along the normal pattern are helpful for the interventional radiologists, orthopaedicians and neurologists in preventing untoward iatrogenic injury to the ulnar nerve during radiological procedures or operating on fractured patients or diagnostic therapy.

  6. Isolated median sensory neuropathy after acupuncture.

    Science.gov (United States)

    Lee, Chang Ho; Hyun, Jung Keun; Lee, Seong Jae

    2008-12-01

    A 47-year-old left-handed man presented with pain and numbness in his left thumb and index finger after acupuncture treatment on an acupoint in his left wrist. A technique of herbal acupuncture, involving the use of a needle coated with apricot seed extract, was used. Median nerve conduction study showed an absence of sensory nerve action potential in the left index finger, whereas the results were normal in all other fingers. The radial and ulnar nerves in the left thumb and ring finger, respectively, showed no abnormality. Infrared thermography of the left index finger showed severe hypothermia. The patient was diagnosed as having an isolated injury to the sensory nerve fibers of the median nerve innervating the index finger. This is the first case report of complications from an herbal acupuncture treatment, and it highlights the possibility of focal peripheral nerve injury caused by acupuncture. PMID:19061751

  7. Tendon transfer for median nerve palsy

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    K Sridhar

    2011-01-01

    Full Text Available The article describes the approach practiced by the author from 1995. Mainly Hansen′s patients and lower forearm injuries formed the bulk of these. In Opponen′s transfer ECU was used only when others were not available as the wrist developed a tendency to radial deviation even when FCU was acting. PL with palmar aponeurosis as extension was used again in limited cases. The main stay was FDS and EIP. The Guyan′s canal and lower end of ulna were the common pulleys. APB and EPL two slip inserts yielded good results. The approach describes the procedure under three distinct headings of choosing motor, Pulley and insert. Varying combinations of these can be used as per requirement.

  8. Modified Tajima technique for reconstruction of thumb opposition after median nerve palsy%高位正中神经麻痹改良津下法重建拇对掌功能

    Institute of Scientific and Technical Information of China (English)

    朱春雷; 李炳万; 赵世伟; 李光; 田东

    2012-01-01

    Objective To introduce the application of extensor digiti minimi tendon transfer(modified Tajima technique)for functional reconstruction of thumb opposition following median nerve palsy.Methods Thumb opponenplasty was done in 11 cases of high median nerve injury with irreversible palsy.Modified Tajima technique was used to transfer the extensor digiti minimi tendon.The proximal band was anchored onto the extensor pollicis longus tendon at the metacarpal neck.The distal band was inserted in the medullary cavity of the proximal phalanx.Results The patients were follow-up for 4 to 38 months with an average of 18.5 months.Thumb opposition was restored in all 11 patients with 100% success rate.The extension of the donor finger was not affected.Conclusion Modified Tajima method is a simple and reliable method to reconstruct thumb opposition function.%目的 介绍应用小指固有伸肌腱(改良津下法)重建拇对掌功能的方法及疗效.方法 对11例高位正中神经不可逆损伤拇对掌功能丧失的患者,采用小指固有伸肌腱双束法移位重建拇对掌功能,近侧束固定于掌骨颈部拇长伸肌肌腱上,远侧束固定于近节指骨髓腔内.结果 术后随访4~ 38个月,平均18.5个月,11例拇对掌功能全部恢复,优良率达100%.供区伸指功能无影响.结论 小指固有伸肌腱改良移位术是合理且简单、疗效满意的术式,可作为拇对掌功能重建的理想方法.

  9. Ipsilateral common iliac artery plus femoral artery clamping for inducing sciatic nerve ischemia/reperfusion injury in rats: a reliable and simple method

    Directory of Open Access Journals (Sweden)

    Barzegar-Fallah Anita

    2008-12-01

    Full Text Available Abstract The aim of this study was to develop a practical model of sciatic ischemia reperfusion (I/R injury producing serious neurologic deficits and being technically feasible compared with the current time consuming or ineffective models. Thirty rats were divided into 6 groups (n = 5. Animal were anesthetized by using ketamine (50 mg/kg and xylazine (4 mg/kg. Experimental groups included a sham-operated group and five I/R groups with different reperfusion time intervals (0 h, 3 h, 1 d, 4 d, 7 d. In I/R groups, the right common iliac artery and the right femoral artery were clamped for 3 hrs. Sham-operated animals underwent only laparotomy without induction of ischemia. Just before euthanasia, behavioral scores (based on gait, grasp, paw position, and pinch sensitivity were obtained and then sciatic nerves were removed for light-microscopy studies (for ischemic fiber degeneration (IFD and edema. Behavioral score deteriorated among the ischemic groups compared with the control group (p

  10. Coronary blood flow dynamics during transcutaneous electrical nerve stimulation for stable angina pectoris associated with severe narrowing of one major coronary artery

    NARCIS (Netherlands)

    Jessurun, GAJ; Tio, RA; De Jongste, MJL; Hautvast, RWM; Den Heijer, P; Crijns, HJGM

    1998-01-01

    To study the effect of transcutaneous electrical nerve stimulation (TENS) on coronary vasomotion, patients with New York Heart Association class III angina pectoris and significant single-vessel left coronary artery disease and who were also scheduled for elective percutaneous transluminal coronary

  11. Median nerve somatosensory evoked potentials studies on latency variability as a function of subject height, limb length and nerve conduction velocity: estudos de variabilidade das latências em função da altura, comprimento do membro superior e velocidade de condução nervosa.

    Directory of Open Access Journals (Sweden)

    Joaquim P. Brasil-Neto

    1991-06-01

    Full Text Available Report on the results of regression analysis studies concerning median nerve somatosensory evoked potentials (SEPs latencies, as dependent variables, and subject height, limb length and nerve conduction velocity (NCV, as independent variables. The tests were performed on 23 normal volunteers. Absolute SEP latencies could be predicted by a linear regression model when the independent variable was arm length; when it was subject height, however, both exponential and polynomial models proved better, the Latter showing the best coefficients of determination, R 2. Multiple linear regression with two independent variables (arm length and NCV was found to be better than simple linear regression for predicting P/N13 latency. The regression line for EP-P/N13 latency on height was found to be a polynomial curve; although the regression was found to be significant by the «F» test (alpha= 1%, the model had a low R2 value (0.41. The same applies to the P/N13-N19 interpeak latency regression curve, but the regression was significant for alpha =5% in that case. Although interwave latencies are the most useful parameters for clinical interpretation of median SEPs, absolute latencies may occasionally be important, and should be corrected for body size; in unusually tall subjects, it might be useful to double-check EP-P/N13 interwave latency prolongation by estimating the maximum expected P/N13 latency, using a model that takes into account both limb length and NCV.

  12. Potenciales Evocados Somatosensitivos (PESS obtenidos por estimulación del nervio Mediano (registros espinal y craneano en caninos Somatosensory Evoked Potentials Obtained by Stimulating the Median Nerve (Spinal Cord and Cranial Recordings in Dogs

    Directory of Open Access Journals (Sweden)

    F.C Pellegrino

    2005-12-01

    Full Text Available Se investigaron los PESS espinal y craneano y su génesis por estimulación del nervio mediano en 22 perros sanos cuya edad promedio fue 7 años. La velocidad de conducción (VC del nervio surgió del cociente entre la distancia desde el estímulo al registro espinal y la latencia del pico negativo de la onda obtenida. Se obtuvo el tiempo de conducción central (TCC midiendo la diferencia entre las latencias de los potenciales craneano y espinal. Se emplearon electrodos de aguja entre C7-T1 y en la piel del cráneo contralateralmente al estímulo. El potencial espinal mostró una primera deflexión positiva, seguida por una negativa finalizando con una positiva.La latencia media al pico negativo fue de 4.95+/-0.92ms. La media para la VC del nervio fue 60.79+/-13.53m/s. El potencial craneano tuvo forma de "w". La latencia media al pico negativo fue de 14.62+/-1.83ms. El TCC medio fue de 9.67+/-2.02ms. En 6 perros la estimulación se hizo también más distalmente, permitiendo medir la VC segmentaria del nervio; la media obtenida fue de 59.83+/-21.44m/s, que no difirió significativamente de la primera. El potencial espinal probablemente surja de la sumación espacial de la actividad de diferentes estructuras ubicadas en el lugar del registro, mientras que el obtenido en el cráneo sea debido a la acción de las conexiones tálamo-corticales y de la corteza de recepción.We investigated SSEPs in 22 normal dogs of both sexes (12 females, aged between 3 and 14 years (mean: 7 +/- 4 years old by recording the electrical signal at the spinal cord (L7-S1 and L5-L6 and at the scalp (frontoparietal region in response to median nerve stimulation. Conduction velocity (CV of median nerve and its roots was calculated, measuring the distance between the stimulating cathode and the recording electrode, and dividing it into the latency of the of the spinal cord arrival corresponding negative peak. Central conduction time (CCT was estimated subtracting the

  13. Median nerve SEP after a high medullary lesion: preserved N18 and absent P14 components (case report PESS do nervo mediano após lesão bulbar alta: componente N18 preservado e P14 ausente. Relato de caso

    Directory of Open Access Journals (Sweden)

    G. M. MANZANO

    1999-06-01

    Full Text Available Median nerve SEPs recorded from a patient with a high medullary lesion are described. The lesion involved the anteromedial and anterolateral right upper third of the medulla, as documented by MRI. Forty one days after the lesion, left median nerve SEP showed preserved N18 and absent P14 and N20 components; stimulation of the right median nerve evoked normal responses. These findings agree with the proposition that low medullary levels are involved in the generation of the N18 component of the median nerve SEP.Descrevemos os potenciais evocados somatossensitivos obtidos por estimulação dos nervos medianos em um paciente apresentando uma lesão localizada, envolvendo as porções anteromedial e anterolateral do terço superior do bulbo, documentada por ressonância nuclear magnética. Quarenta e um dias após o estabelecimento da lesão os potenciais evocados por estimulação do nervo mediano esquerdo evidenciaram ausência dos componentes P14 e N20 e preservação do componente N18; após estimulação do nervo mediano direito as respostas apresentaram-se normais. Estes achados estão de acordo com a sugestão de que as porções baixas do bulbo estão envolvidas na geração do componente N18.

  14. 肌电图在前臂正中神经卡压的诊断和鉴别诊断中的应用价值%THE VALUE APPLIED OF ELECTROMYOGRAM IN DIAGNOSIS OF MEDIAN NERVE ENTRAPMENT IN FOREARM

    Institute of Scientific and Technical Information of China (English)

    田东; 张航; 韩峰

    2011-01-01

    目的:探讨肌电图检测在前臂正中神经卡压诊断和鉴别诊断中的应用价值.方法:回顾分析100例临床诊断并经手术证实的前臂正中神经的神经肌电图检查资料,分析其电生理阳性指标.其中腕管综合症(carpal tunnelsyndrome,CTS)75例,前骨间神经卡压综合征(anterior interosseous entrapment nerve syndrome,AINS) 12例,旋前园肌综合征(pronator teres syndrome,PTS)10例,正中神经返支卡压征(recurrent median nerve entrapment syndrome RMNES)3例.结果:肌电图检测发现CTS患者正中神经腕部潜伏期延长,腕部以下正中神经感觉神经动作电位异常;AINS患者正中神经感觉神经功能正常,拇短展肌EMG正常,前骨间神经支配肌有自发电位或潜伏期延长,波幅降低;PTS患者正中神经支配肘下肌有自发电位,前臂NCV减慢,波幅降低,正中神经干动作电位及感觉神经动作电位异常.正中神经返支卡压综合症仅拇短展肌有异常电位,掌部潜伏期延长,感觉神经功能正常.结论:肌电图技术在诊断和鉴别前臂正中神经卡压疾病中有重要价值.

  15. Proximal tibial and fibular physeal fracture causing popliteal artery injury and peroneal nerve injury: A case report and review of literature

    Institute of Scientific and Technical Information of China (English)

    Uday Guled; Nirmal Raj Gopinathan; Vijay G.Goni; Arjun Rhh; Rakesh John; Prateek Behera

    2015-01-01

    Either proximal tibial or tibial physeal injuries are rare.The combination of both is even rarer,let alone causes a vascular injury.Early intervention is the key for management.We hereby present an interesting case of simultaneous proximal tibiofibular physeal injury with popliteal arterial occlusion and common peroneal nerve injury.The present case is important in two aspects:firstly it reports a very rare occurrence of simultaneous proximal tibiofibular physeal injury associated with vascular insult and common peroneal nerve injury;secondly it highlights that with timely intervention excellent results can be achieved in paediatric patients.

  16. Superior Hypogastric Nerve Block to Reduce Pain After Uterine Artery Embolization: Advanced Technique and Comparison to Epidural Anesthesia

    Energy Technology Data Exchange (ETDEWEB)

    Binkert, Christoph A., E-mail: christoph.binkert@ksw.ch [Kantonsspital Winterthur, Institute of Radiology and Nuclear Medicine (Switzerland); Hirzel, Florian C. [Kantonsspital Winterthur, Department of Gynecology (Switzerland); Gutzeit, Andreas; Zollikofer, Christoph L. [Kantonsspital Winterthur, Institute of Radiology and Nuclear Medicine (Switzerland); Hess, Thomas [Kantonsspital Winterthur, Department of Gynecology (Switzerland)

    2015-10-15

    PurposeTo evaluate a modified superior hypogastric nerve block (SHNB) to reduce pain after uterine artery embolization (UAE) compared to epidural anesthesia.Materials and methodsIn this retrospective study, the amount of opiate drugs needed after UAE was compared between SHNB and epidural anesthesia. Eighty one consecutive women (mean age: 43.67 years) were in the SHNB group and 27 consecutive women (mean age: 43.48 years) treated earlier at the same institution in the epidural anesthesia group. UAE was performed from a unilateral femoral artery approach using a 4F catheter. 500–700 or 700–900 μm trisacryl gelatine microspheres were used as embolic agents. The SHNB was performed by advancing a 21G from the abdominal wall below the umbilicus to the anterior portion of the 5th vertebral body. For optimal guidance a cranio-caudal tilt of 5°–15° was used. On a lateral view the correct contrast distribution in front of the vertebral body is confirmed. Then 20 ml local anesthesia (ropivacain 0.75 %) is injected. In case of an asymmetric right–left distribution the needle was repositioned.ResultsAll SHNB were successful without severe complications. The mean time for the SHNB was 4 min 38 s (2 min 38 s–9 min 27 s). The needle was repositioned in average 0.87 times. The opiate dose for the SHNB group was 19.33 ± 22.17 mg which was significantly lower. The average time to receive an opiate drug after SHNB was 4 h 41 min.ConclusionThe SHNB is a safe and minimally time-consuming way to reduce pain after UAE especially within the first 4 h.

  17. Nerve regeneration and elastin formation within poly(glycerol sebacate)-based synthetic arterial grafts one-year post-implantation in a rat model

    Science.gov (United States)

    Allen, Robert A.; Wu, Wei; Yao, Mingyi; Dutta, Debaditya; Duan, Xinjie; Bachman, Timothy N.; Champion, Hunter C.; Stolz, Donna B.; Robertson, Anne M.; Kim, Kang; Isenberg, Jeffrey S.; Wang, Yadong

    2013-01-01

    The objective of this study was to evaluate the long term performance of cell-free vascular grafts made from a fast-degrading elastic polymer. We fabricated small arterial grafts from microporous tubes of poly(glycerol sebacate) (PGS) reinforced with polycaprolactone (PCL) nanofibers on the outer surface. Grafts were interpositioned in rat abdominal aortas and characterized at 1 year post-implant. Grafts remodeled into “neoarteries” (regenerated arteries) with similar gross appearance to native rat aortas. Neoarteries mimic arterial tissue architecture with a confluent endothelium and media and adventita-like layers. Patent vessels (80%) showed no significant stenosis, dilation, or calcification. Neoarteries contain nerves and have the same amount of mature elastin as native arteries. Despite some differences in matrix organization, regenerated arteries had similar dynamic mechanical compliance to native arteries in vivo. Neoarteries responded to vasomotor agents, albeit with different magnitude than native aortas. These data suggest that an elastic vascular graft that resorbs quickly has potential to improve the performance of vascular grafts used in small arteries. This design may also promote constructive remodeling in other soft tissues. PMID:24119457

  18. Electrophysiologic study of chronic inflammatory demyelinating polyneuropathy by using segmental stimulation in the median nerve and ulnar nerve%正中神经和尺神经分段刺激在慢性炎性脱髓鞘性多发性神经病中的电生理研究

    Institute of Scientific and Technical Information of China (English)

    王晋荣; 王进华; 叶憬; 杨伟丽

    2013-01-01

    目的 探讨运动神经传导速度(MCV)、复合肌肉动作电位(CMAP)与肌力减退的关系和传导阻滞(CB)在慢性炎性脱髓鞘性多发性神经病(chronic inflammatory demyelinating polyradiculoneuritis,CIDP)中的表现特点.方法 30例CIDP患者在进行常规MCV、远端潜伏期(DML)、F波、感觉神经传导速度(SCV)、肌电图(EMG)测定的基础上,在正中神经采用由远到近的“腕-肘-腋-Erb's点”4点3段刺激,尺神经采用由远到近的“腕-肘下-肘上-腋-Erb's点”5点4段刺激,记录各段刺激后CMAP各参数及MCV的变化.结果 CMAP波幅衰减、面积衰减、时程增加以及MCV减慢与临床肌力减退无相关性,dCMAP波幅与上肢远端肌力呈正相关;患者中80.00%在正中神经、73.33%在尺神经发现了1个或多个节段的CB,且出现节段无明显选择性.结论 dCMAP波幅降低与CIDP患者肌力减退有相关性.在CIDP中CB出现率高,且较为弥散地在各节段中出现.%Objective To investigate the relationship between motor conduction velocity (MCV) and compound muscle action potential (CMAP) and muscle strength impairment; and to study the characteristics of conduction block (CB) in chronic inflammatory demyelinating polyneuropathy (CIDP). Methods 30 patients with CIDP formed the study population. All patients were examined by MCV, distal motor latency (DML), F wave, sensory nerve conduction velocity (SCV) and electromyography (EMG). Stimulations were perfomed at 4 sites of the median nerve from distal to proximal (wrist, elbow, axilla, Erb' s point) and 5 sites of the ulnar nerve (wrist, below elbow, above elbow, axilla, Erb' s point), while all the parameters of CMAP and MCV were recorded. Results There were no correlations between the CAMP amplitude attenuation, area, duration increase, MCV reduction and the clinical muscle strength. However, there was positive correlation between the amplitude of the dCMAP and the distal muscle strength in the upper

  19. Modified skin incision for avoiding the lesser occipital nerve and occipital artery during retrosigmoid craniotomy: potential applications for enhancing operative working distance and angles while minimizing the risk of postoperative neuralgias and intraoperative hemorrhage.

    Science.gov (United States)

    Tubbs, R Shane; Fries, Fabian N; Kulwin, Charles; Mortazavi, Martin M; Loukas, Marios; Cohen-Gadol, Aaron A

    2016-10-01

    Chronic postoperative neuralgias and headache following retrosigmoid craniotomy can be uncomfortable for the patient. We aimed to better elucidate the regional nerve anatomy in an effort to minimize this postoperative complication. Ten adult cadaveric heads (20 sides) were dissected to observe the relationship between the lesser occipital nerve and a traditional linear versus modified U incision during retrosigmoid craniotomy. Additionally, the relationship between these incisions and the occipital artery were observed. The lesser occipital nerve was found to have two types of course. Type I nerves (60%) remained close to the posterior border of the sternocleidomastoid muscle and some crossed anteriorly over the sternocleidomastoid muscle near the mastoid process. Type II nerves (40%) left the posterior border of the sternocleidomastoid muscle and swung medially (up to 4.5cm posterior to the posterior border of the sternocleidomastoid muscle) as they ascended over the occiput. The lesser occipital nerve was near a midpoint of a line between the external occipital protuberance and mastoid process in all specimens with the type II nerve configuration. Based on our findings, the inverted U incision would be less likely to injure the type II nerves but would necessarily cross over type I nerves, especially more cranially on the nerve at the apex of the incision. As the more traditional linear incision would most likely transect the type I nerves and more so near their trunk, the U incision may be the overall better choice in avoiding neural and occipital artery injury during retrosigmoid approaches. PMID:27396377

  20. Anatomical Research of the Three-dimensional Route of the Thoracodorsal Nerve, Artery, and Veins in Latissimus Dorsi Muscle

    Directory of Open Access Journals (Sweden)

    Nagahiro Takahashi, MD

    2013-05-01

    Conclusions: The thoracodorsal nerves ran in a shallower layer, and the depth to the nerve in the muscle flap in actual facial reanimation surgery is safe enough to avoid damage to the nerves. The LD muscle may be thinned to half its original thickness safely.

  1. Síndrome do túnel do carpo: estudo comparativo entre a medição ultrassonográfica e cirúrgica do nervo mediano nos casos moderados e severos da doença Carpal tunnel syndrome: comparative study between sonographic and surgical measurements of the median nerve in moderate and severe cases of disease

    Directory of Open Access Journals (Sweden)

    Marcelo de Pinho Teixeira Alves

    2013-02-01

    Full Text Available OBJETIVO: Comparar os perímetros ultrassonográfico e cirúrgico do nervo mediano, avaliar o diagnóstico da síndrome do túnel do carpo pela área seccional do nervo mediano, verificar associação entre área seccional do nervo mediano e gravidade da síndrome do túnel do carpo. MATERIAIS E MÉTODOS: Estudo de 30 pacientes com síndrome do túnel do carpo. Mediram-se a área seccional e o perímetro ultrassonográfico do nervo mediano. Avaliaram-se correlação clínica-ultrassonográfica e associação com a gravidade da doença. Compararam-se os perímetros ultrassonográfico e cirúrgico. Compararam-se classificação clínica com perímetro cirúrgico, área seccional e perímetro ultrassonográfico. RESULTADOS: Cinco perdas, 25 pacientes estudados; 60% dos pacientes com doença moderada, 60% de casos graves ultrassonográficos (área seccional > 0,15 cm². Distribuição não normal de perímetro cirúrgico (p = 0,5, distribuição normal de perímetro ultrassonográfico (p = 0. Diferença significativa entre perímetros (teste-t de amostras pareadas; p 0,09 cm² em todos os pacientes. CONCLUSÃO: Não houve associação entre perímetro ultrassonográfico e perímetro cirúrgico do nervo mediano. Área seccional do nervo mediano > 0,09 cm² foi válida para o diagnóstico. Não houve associação entre área seccional e gravidade da doença.OBJECTIVE: To compare sonographic and surgical measured perimeters of the median nerve; to evaluate the diagnosis of carpal tunnel syndrome by median nerve cross-sectional area; to verify the association between cross-sectional area of the median nerve and carpal tunnel syndrome severity. MATERIALS AND METHODS: Thirty patients with established carpal tunnel syndrome were studied. Cross-sectional area and sonographic perimeter of the median nerve were measured. The correlation between clinical and sonographic findings and association with carpal tunnel syndrome severity were evaluated. Sonographic

  2. Evaluation of cardiac autonomic nerves by iodine-123 metaiodobenzylguanidine scintigraphy and ambulatory electrocardiography in patients after arterial switch operations

    Energy Technology Data Exchange (ETDEWEB)

    Sakurai, Hajime; Maeda, Masanobu; Miyahara, Ken [Shakaihoken Chukyo Hospital, Nagoya (Japan)] [and others

    2000-05-01

    The autonomic cardiac nerves reach the heart after passing through the vicinity of the aortic root and the pulmonary trunk. The arterial switch operation (ASO) completely transects the ascending aorta and the pulmonary trunk. Therefore, this surgical procedure virtually denerves the heart. Cardiac sympathetic denervation and reinnervation were evaluated in patients after ASO using iodine-123 metaiodobenzylguanidine (MIBG) myocardial scintigraphy and parasympathetic denervation and reinnervation using ambulatory electrocardiography [Holter electrocardiogram (ECG)]. MIBG scintigraphy was performed in 14 patients who underwent ASO (ASO group) and 3 patients who underwent other open heart surgery (control group). All patients in the ASO group underwent the operation in the neonatal or infantile period. Planar and single photon emission computed tomography (SPECT) images of the myocardium were obtained. Defect score was determined by the SPECT images as a semi-quantitative index. The mean interval between ASO and MIBG scintigraphy was 25.6{+-}14.6 months. Holter ECG was also performed in 14 patients in the ASO group and 19 age-matched normal children. The Holter ECGs were plotted on a Lorenz plot. The H index, which is related to vagal tone for the cardiovascular system, was calculated from the R-R intervals. The mean interval between the ASO and Holter ECG was 8.3{+-}9.7 months. MIBG scintigraphy in the control group demonstrated an almost normal homogeneous tracer uptake, but showed extremely reduced tracer uptake and significantly higher defect score in the ASO group. The extent and degree of the reduction of MIBG uptake improved with time after the ASO. The heart-to-mediastinum MIBG count ratio tended to increase with time. The H index of the ASO group was lower than that of normal children (<12 months: Control group 0.0280{+-}0.0068 vs ASO group 0.0219{+-}0.0083), and gradually increased with time (1-3 years: 0.0470{+-}0.0157 vs 0.0314{+-}0.0124). (author)

  3. Effects of three days of dry immersion on muscle sympathetic nerve activity and arterial blood pressure in humans.

    Science.gov (United States)

    Iwase, S; Sugiyama, Y; Miwa, C; Kamiya, A; Mano, T; Ohira, Y; Shenkman, B; Egorov, A I; Kozlovskaya, I B

    2000-03-15

    The present study was performed to determine how sympathetic function is altered by simulated microgravity, dry immersion for 3 days, and to elucidate the mechanism of post-spaceflight orthostatic intolerance in humans. Six healthy men aged 21-36 years old participated in the study. Before and after the dry immersion, subjects performed head-up tilt (HUT) test to 30 degrees and 60 degrees (5 min each) with recordings of muscle sympathetic nerve activity (MSNA, by microneurography), electrocardiogram, and arterial blood pressure (Finapres). Resting MSNA was increased after dry immersion from 23.7+/-3.2 to 40.9+/-3.0 bursts/min (p<0.005) without significant changes in resting heart rate (HR). MSNA responsiveness to orthostasis showed no significant difference but HR response was significantly augmented after dry immersion (p<0. 005). A significant diastolic blood pressure fall at 5th min of 60 degrees HUT was observed in five orthostatic tolerant subjects despite enough MSNA discharge after dry immersion. A subject suffered from presyncope at 2 min after 60 degrees HUT. He showed gradual blood pressure fall 10 s after 60 degrees HUT with initially well-maintained MSNA response and then with a gradually attenuated MSNA, followed by a sudden MSNA withdrawal and abrupt blood pressure drop. In conclusion, dry immersion increased MSNA without changing MSNA response to orthostasis, and resting HR, while increasing the HR response to orthostasis. Analyses of MSNA and blood pressure changes in orthostatic tolerant subjects and a subject with presyncope suggested that not only insufficient vasoconstriction to sympathetic stimuli, but also a central mechanism to induce a sympathetic withdrawal might play a role in the development of orthostatic intolerance after microgravity exposure.

  4. Reappearance of Cranial Nerve Dysfunction Symptoms Caused by New Artery Compression More than 20 Years after Initially Successful Microvascular Decompression: Report of Two Cases.

    Science.gov (United States)

    Inoue, Hiroto; Kondo, Akinori; Shimano, Hiroshi; Yasuda, Soichiro; Murao, Kenichi

    2016-01-01

    Reappearance of symptoms of cranial nerve dysfunction is not uncommon after successful microvascular decompression (MVD). The purpose of this study was to report two quite unusual cases of recurrent and newly developed hemifacial spasm (HFS) caused by a new conflicting artery more than 20 years after the first successful surgery. In Case 1, the first MVD was performed for HFS caused by the posterior inferior cerebellar artery (PICA) when the patient was 38 years old. After 26 symptom-free years, HFS recurred on the same side of the face due to compression by the newly developed offending AICA. In Case 2, the patient was first operated on for trigeminal neuralgia by transposition of the AICA at 49 years old, but 20 symptom-free years after the first MVD, a new offending PICA compressed the facial nerve on the same side, causing HFS. These two patients underwent reoperation and gained satisfactory results postoperatively. Reappearance of symptoms related to compression of the root exit zone (REZ) by a new offending artery after such a long symptom-free interval since the first effective MVD is rare. Here, we describe two such unusual cases and discuss how to manage and prevent such reappearance of symptoms after a long time interval. PMID:26804190

  5. Functional Median Polish

    KAUST Repository

    Sun, Ying

    2012-08-03

    This article proposes functional median polish, an extension of univariate median polish, for one-way and two-way functional analysis of variance (ANOVA). The functional median polish estimates the functional grand effect and functional main factor effects based on functional medians in an additive functional ANOVA model assuming no interaction among factors. A functional rank test is used to assess whether the functional main factor effects are significant. The robustness of the functional median polish is demonstrated by comparing its performance with the traditional functional ANOVA fitted by means under different outlier models in simulation studies. The functional median polish is illustrated on various applications in climate science, including one-way and two-way ANOVA when functional data are either curves or images. Specifically, Canadian temperature data, U. S. precipitation observations and outputs of global and regional climate models are considered, which can facilitate the research on the close link between local climate and the occurrence or severity of some diseases and other threats to human health. © 2012 International Biometric Society.

  6. Modified cytoplasmic Ca2+ sequestration contributes to spinal cord injury-induced augmentation of nerve-evoked contractions in the rat tail artery.

    Directory of Open Access Journals (Sweden)

    Hussain Al Dera

    Full Text Available In rat tail artery (RTA, spinal cord injury (SCI increases nerve-evoked contractions and the contribution of L-type Ca2+ channels to these responses. In RTAs from unoperated rats, these channels play a minor role in contractions and Bay K8644 (L-type channel agonist mimics the effects of SCI. Here we investigated the mechanisms underlying the facilitatory actions of SCI and Bay K8644 on nerve-evoked contractions of RTAs and the hypothesis that Ca2+ entering via L-type Ca2+ channels is rapidly sequestered by the sarcoplasmic reticulum (SR limiting its role in contraction. In situ electrochemical detection of noradrenaline was used to assess if Bay K8644 increased noradrenaline release. Perforated patch recordings were used to assess if SCI changed the Ca2+ current recorded in RTA myocytes. Wire myography was used to assess if SCI modified the effects of Bay K8644 and of interrupting SR Ca2+ uptake on nerve-evoked contractions. Bay K8644 did not change noradrenaline-induced oxidation currents. Neither the size nor gating of Ca2+ currents differed between myocytes from sham-operated (control and SCI rats. Bay K8644 increased nerve-evoked contractions in RTAs from both control and SCI rats, but the magnitude of this effect was reduced by SCI. By contrast, depleting SR Ca2+ stores with ryanodine or cyclopiazonic acid selectively increased nerve-evoked contractions in control RTAs. Cyclopiazonic acid also selectively increased the blockade of these responses by nifedipine (L-type channel blocker in control RTAs, whereas ryanodine increased the blockade produced by nifedipine in both groups of RTAs. These findings suggest that Ca2+ entering via L-type channels is normally rapidly sequestered limiting its access to the contractile mechanism. Furthermore, the findings suggest SCI reduces the role of this mechanism.

  7. Sosiaalisen median merkitys verkkokauppatoiminnassa

    OpenAIRE

    Nieminen, Kira

    2014-01-01

    Opinnäytetyön aiheena on sosiaalisen median merkitys verkkokauppatoiminnassa. Tavoitteenani on selventää yritysten tarvetta sosiaalisen median palveluihin ja miten sitä voidaan hyödyntää yrityksen toiminnassa. Opinnäytetyön alussa käydään läpi sosiaalinen media terminä ja sen lisäksi mainitaan yritysten yleisimmin käyttämät sosiaalisen median palvelut sekä käydään läpi markkinointiviestinnän käsitettä digitaalisessa mediassa. Työssä pohjustetaan yritysten mediasuunnitteluprosessia ja sen vaih...

  8. Sosiaalisen median vallankumous

    OpenAIRE

    Suomijoki, Riku

    2012-01-01

    Tässä opinnäytetyössä selvitettiin, miten ihmiset toimivat sosiaalisessa mediassa ja käyttävät hyväkseen sen tuomia mahdollisuuksia sekä miten netin käyttäjät osallistuvat erilaisiin verkkopalvelutoimintoihin ja sosiaalisen median käyttöön. Opinnäytetyössä pohdittiin, miten digiaikana kasvanut sukupolvi mahdollisesti erottuu vanhemmista sukupolvista käyttäytymisellään ja minkälaisia arvoja sosiaalisen median mukana kasvaneet nuoret edustavat. Lisäksi tarkasteltiin, onko ihmisen yksityisyy...

  9. Towards optimal range medians

    DEFF Research Database (Denmark)

    Brodal, Gerth Stølting; Gfeller, Beat; Jørgensen, Allan Grønlund;

    2011-01-01

    We consider the following problem: Given an unsorted array of n elements, and a sequence of intervals in the array, compute the median in each of the subarrays defined by the intervals. We describe a simple algorithm which needs O(nlog k + klog n) time to answer k such median queries. This improves...... where the time per query is reduced to O(log n / log log n). We also give efficient dynamic variants of both data structures, achieving O(log2 n) query time using O(nlog n) space in the comparison model and O((log n/loglog n)2) query time using O(nlog n/log log n) space in the RAM model, and show...... that in the cell-probe model, any data structure which supports updates in O(logO(1)n) time must have Ω(log n/loglog n) query time. Our approach naturally generalizes to higher-dimensional range median problems, where element positions and query ranges are multidimensional - it reduces a range median query...

  10. Hyperbolicity in Median Graphs

    Indian Academy of Sciences (India)

    José M Sigarreta

    2013-11-01

    If is a geodesic metric space and $x_1,x_2,x_3\\in X$, a geodesic triangle $T=\\{x_1,x_2,x_3\\}$ is the union of the three geodesics $[x_1 x_2],[x_2 x_3]$ and $[x_3 x_1]$ in . The space is -hyperbolic (in the Gromov sense) if any side of is contained in a -neighborhood of the union of the two other sides, for every geodesic triangle in . If is hyperbolic, we denote by () the sharp hyperbolicity constant of , i.e.,$(X)=\\inf\\{≥ 0: X \\quad\\text{is}\\quad -\\text{hyperbolic}\\}$. In this paper we study the hyperbolicity of median graphs and we also obtain some results about general hyperbolic graphs. In particular, we prove that a median graph is hyperbolic if and only if its bigons are thin.

  11. A clinical study on prevention of median nerve injury in endoscopic carpal tunnel release%腕管综合征内窥镜手术预防正中神经损伤的临床研究

    Institute of Scientific and Technical Information of China (English)

    姜晓琪; 陈臣; 叶作舟; 王斌; 史其林

    2011-01-01

    目的 介绍腕管综合征内窥镜手术(endoscopic carpal tunnel release,ECTR)预防正中神经损伤并发症的方法.方法 利用彩色多普勒超声仪(B超)对37例74手患者术前进行检测.结果 71例正中神经走行在桡侧腕屈肌腱与掌长肌腱之间,3例走行在掌长肌腱与尺侧腕屈肌腱之间,并术中确认.结论 正中神经变异走行在掌长肌腱与尺侧腕屈肌腱之间是ECTR的禁忌证,B超能准确定位正中神经与掌长肌腱关系,避免内窥镜手术损伤正中神经,更具有简单、经济、方便可靠等优点.%Objective To introduce a method of preventing median never injury during endoscopic carpal tunnel release (ECTR). Methods Ultrasonography of both wrists was done to 37 patients of carpal tunnel syndrome who were going to undergo open release of the transverse carpal ligament. Structures in the carpal tunnel were visualized to guide surgical decision-making. Results Ultrasonography showed that median never lies between the tendon of flexor carpi radialis and palmaris longus in 71 patients and lies between the tendon of palmaris longus and flexor carpi ulnaris in 3 patients. These findings were confirmed during the surgeries. Conclusion It is a contraindication of ECTR if median never lies between palmaris longus and flexor carpi ulnaris. Ultrasonography can accurately reveal the relative position of median never to the palmaris longus tendon. Pre-operative ultrasonography of the wrist is a simple, inexpensive and convenient method to exclude these contraindications and thus prevent median never injuries in ECTR.

  12. Transfer of pronator teres branch of the median nerve: an anatomical and clinical study%正中神经旋前圆肌肌支移位术的解剖与临床研究

    Institute of Scientific and Technical Information of China (English)

    许彬; 董震; 张成钢

    2014-01-01

    Objective To introduce a new donor nerve and design a new procedure for augmenting finger flexion in middle and lower trunk brachial plexus injuries.Methods The pronator teres branch and anterior interosseous nerve were dissected and measured in 10 fresh cadaveric upper limbs.The anatomic findings were used to design a surgical procedure to transfer the pronator teres branch to the anterior interosseous nerve in combination with the brachialis motor branch transfer to the flexor digitorum superficialis branch.This combined transfer was applied to treat one male patient of lower trunk brachial plexus injury.Results The anatomical study revealed three branching patterns of pronator teres branch.Type Ⅰ (6/10) was defined as a triple-branch pattern,type Ⅱ (2/10) as a double-branch pattern,and Type Ⅲ (2/10) as a single branch pattern.Regardless of its branching pattern,there were always three twigs that entered the pronator teres.Follow-up evaluation of the one case showed no impairment of pronation after the surgery.Moreover,recovery of both the superficial and deep finger flexors was achieved.At 18 months postoperatively muscle power of flexor pollicis longus and flexor digitorum profundus of the index finger reached M4.Muscle power of the flexor digitorum superficialis of the middle and ring fingers recovered to M3.Grip strength was 2.6 kg.Conclusion Transfer the pronator teres branch to the anterior interosseous nerve can effectively augment finger flexion in patients with middle and lower trunk brachial plexus injuries.It is a practical,safe and effective procedure.%目的 臂丛神经中、下干损伤后,在肌皮神经肱肌肌支移位术的基础上,同时引入新的动力神经并设计新的术式,以期加强患者屈指功能的恢复.方法 通过对10侧新鲜尸体上肢标本,观察和测量正中神经旋前圆肌肌支及骨间前神经的解剖学研究.对1例臂丛神经下干损伤的男性患者,设计正中神经旋前圆肌肌支移位

  13. 高龄冠状动脉旁路移植术患者的中期疗效分析%Analysis of median-term therapeutic effect of coronary artery bypass grafting in the elderly patients

    Institute of Scientific and Technical Information of China (English)

    徐根兴; 郑家豪; 朱洪生; 薛松; 申达甫; 黄日太; 刘沙; 胡振雷; 连锋; 谢波; 叶清

    2009-01-01

    Objective To summarize the clinical experiences and early-to median effect of coronary artery bypass grafting(CABG)in patients aged 70 years or above.Methods From Dec.2006 to Dec.2007,86 patients aged 70 or above underwent CABG,of whom 71 cases underwent off-pump coronary artery bypass grafting(OPCAB),15 cases had CABG with cardiopulmonary bypass(CPB).5 cases underwent mitral valve replacement,3 underwent aortic valve replacement besides CABG,and one case underwent removal of ventricular aneurysm.Their clinical data were retrospectively analyzed.Results There was one case who died of enterobrosis after operation.The average ICU stay time was(77.4±49.6)h,the average postoperative stay time was 15 d,and the average drainage was 530 ml.22 postoperative complications were found.76 cases were followed up for 10-22 months.Follow up effect was better showing cardiac classification I-II and no angina pectoris,myocardial infarction and late death.Conclusion Patients with coronary heart disease in good condition will have not remarkable improvement in mortality as compared with ordinary patients but attention should be paid to their preoperative pulmonary function and angina pectoffs.OPCABG would have encouraging result in reducing the rate of postoperative complications and hospital death,which should be recommended as the first choice for the elderly patients.%目的 总结70岁以上高龄冠心病患者行冠状动脉搭桥术的早、中期结果和经验教训,以期提高手术治疗效果.方法 回顾性分析我院2006年12月至2007年12月86例70岁以上冠心病患者进行冠状动脉旁路移植术(CABG)的临床资料,其中行不停搏CABG 71例,体外循环下CABG 15例,同时行二尖瓣置换5例、主动脉瓣置换3例和室壁瘤切除1例.结果 1例术后死亡,死亡原因为术后肠穿孔.平均术后气管插管时间8 h,ICU停留时间(77.4±49.6)h,术后住院时间15 d,术后引流量平均530 ml.共有22例次术后

  14. Role of nitric oxide of the median preoptic nucleus (MnPO in the alterations of salivary flow, arterial pressure and heart rate induced by injection of pilocarpine into the MnPO and intraperitoneally

    Directory of Open Access Journals (Sweden)

    Wilson A. Saad

    2003-07-01

    Full Text Available We investigated the effect of L-NAME, a nitric oxide (NO inhibitor and sodium nitroprusside (SNP, an NO-donating agent, on pilocarpine-induced alterations in salivary flow, mean arterial blood pressure (MAP and heart rate (HR in rats. Male Holtzman rats (250-300 g were implanted with a stainless steel cannula directly into the median preoptic nucleus (MnPO. Pilocarpine (10, 20, 40, 80, 160 µg injected into the MnPO induced an increase in salivary secretion (P<0.01. Pilocarpine (1, 2, 4, 8, 16 mg/kg ip also increased salivary secretion (P<0.01. Injection of L-NAME (40 µg into the MnPO prior to pilocarpine (10, 20, 40, 80, 160 µg injected into the MnPO or ip (1, 2, 4, 8, 16 mg/kg increased salivary secretion (P<0.01. SNP (30 µg injected into the MnPO or ip prior to pilocarpine attenuated salivary secretion (P<0.01. Pilocarpine (40 µg injection into the MnPO increased MAP and decreased HR (P<0.01. Pilocarpine (4 mg/kg body weight ip produced a decrease in MAP and an increase in HR (P<0.01. Injection of L-NAME (40 µg into the MnPO prior to pilocarpine potentiated the increase in MAP and reduced HR (P<0.01. SNP (30 µg injected into the MnPO prior to pilocarpine attenuated (100% the effect of pilocarpine on MAP, with no effect on HR. Administration of L-NAME (40 µg into the MnPO potentiated the effect of pilocarpine injected ip. SNP (30 µg injected into the MnPO attenuated the effect of ip pilocarpine on MAP and HR. The present study suggests that in the rat MnPO 1 NO is important for the effects of pilocarpine on salivary flow, and 2 pilocarpine interferes with blood pressure and HR (side effects of pilocarpine, that is attenuated by NO.

  15. Avulsão do plexo braquial em cães - 2: biópsia fascicular e histologia dos nervos radial, mediano, ulnar e musculocutâneo Brachial plexus avulsion in dogs - 2: fascicular biopsy and histology of the radial, median, ulnar and musculocutaneous nerves

    Directory of Open Access Journals (Sweden)

    Mônica Vicky Bahr Arias

    1997-03-01

    Full Text Available O objetivo deste trabalho foi demonstrar os aspectos clínicos e neurológicos relevantes para o diagnóstico da avulsão do plexo braquial em cães, relacionando estes achados com os resultados da histologia dos nervos radiais, medianos, ulnar e músculo cutânea. A biópsia fascicular destes nervos foi realizada após abordagem cirúrgica às faces lateral e medial do braço afetado. Todos os fascículos submetidos ao exame histológico apresentaram alterações como tumefação axonal, degeneração walleriana e infiltrado inflamatório em graus variados, havendo principalmente nos nervos radial, mediano e ulnar a proliferação de colagem endoneural. A associação destes resultados com as alterações neurológicas e da eletroneuroestimulação (relatados na parte 1 e 3 deste trabalho respectivamente sugeriu envolvimento quase que total das raízes do plexo braquial em todos os casos.The main purposes of this work were the neurological evaluation of dogs with brachial plexus avulsion and correlation of these findings with the results of histology of the radial, median, and ulnar and muscle cutaneous nerves. Fascicular nerve biopsy was performed after surgical approach of medial and lateral aspect of the arm. Ali the submitted fascicles presented histologic alterations compatible with wallerian degeneration, axonal swelling, and inflammatory infiltrate ranging from mild to pronounced, with endoneural collagen proliferation mainly in radial, median and ulnar nerves. The association of these results with neurological and electroneurostimulation exams (respectively described in part 1 and 3 of this work suggested in all cases an almost total involvement of brachial plexus roots.

  16. Range Selection and Median

    DEFF Research Database (Denmark)

    Jørgensen, Allan Grønlund; Larsen, Kasper Green

    2011-01-01

    Range selection is the problem of preprocessing an input array A of n unique integers, such that given a query (i; j; k), one can report the k'th smallest integer in the subarray A[i];A[i+1]; : : : ;A[j]. In this paper we consider static data structures in the word-RAM for range selection...... selection problem. In the former, data structures must support prex selection queries under the assumption that k for some value n given at construction time, while in the latter, data structures must support range selection queries where k is xed beforehand for all queries. We prove cell probe lower bounds...... for range selection, prex selection and range median, stating that any data structure that uses S words of space needs (log n= log(Sw=n)) time to answer a query. In particular, any data structure that uses n logO(1) n space needs (log n= log log n) time to answer a query, and any data structure...

  17. 正中神经松解范围对重度腕管综合征术后疗效的临床研究%Clinical research on influence of relaxation extent in median nerve on results of surgical treatment for serious carpal tunnel syndrome

    Institute of Scientific and Technical Information of China (English)

    魏锦辉; 谭伟欣

    2013-01-01

    Objective To explore the relationship between the scope of surgery to loosen median nerve entrapment with serious carpal tunnel syndrome and the curative effect after surgery.Methods Referencing to patients' condition and results of Electromyologram,we classified the serious ones from the patients with carpal tunnel syndrome.According to the patients' condition,they were randomly divided into 2 groups before the surgery.Every group had 20 cases.Every group had different scope of surgery.Follow up evaluation was carried out after surgery.Electromyologram (EMG) was applied regularly,and then we observed the clinical symptoms.Results By comparison in the two groups,managed by t-test,there were significant differences in the two groups (P < 0.01).Through the statistical analysis of the results,cases in group which were released transverse carpal ligament and nerve,displayed that the latency of compound muscle action potential (CMAP) in the abductor pollicis hrevis and sensory nerve action potential (SNAP)of ring finger has recovered most quickly through the EMG.The way of group C relieving clinical symptoms was best.Conclusions The scope of surgery which were released transverse carpal ligament and nerve,not only released the median nerve effectively,but also protected the continuity of nerve and the blood supply of nerve.It enhanced the recovery of CMAP and SNAP obviously.It also promoted the recovery of the sense in the peripheral part and the motor functions of the nerve.It was a simple and effective therapy for severe carpal tunnel syndrome.But concerning the complete damage to the median nerve,with muscular atrophy of abductions,it can only promote the sense in the peripheral part after treatment,not the motor functions.%目的 研究临床上重度腕管综合征正中神经卡压的手术松解范围与术后疗效的关系.方法 根据病情及电生理检测分度,筛选出腕管综合征中重度压迫者,随机分为两组,每组20例,给予不同的手

  18. Avulsão do plexo braquial em cães - 3: eletroneuroestimulação dos nervos radial, mediano, ulnar e musculocutâneo Brachial plexus avulsion in dogs - 3: electroneurostimulation of radial, median, ulnar and musculocutaneous nerves

    Directory of Open Access Journals (Sweden)

    Mônica Vicky Bahr Arias

    1997-03-01

    Full Text Available O objetivo deste trabalho foi relacionar os aspectos clínicos, neurológicos e histopatológicos (descritos nas partes l e 2 deste trabalho com os resultados obtidos após estimulação elétrica dos nervos radiai, mediano, ulnar e musculocutâneo. Realizou-se a estimulação elétrica destes nervos durante o ato cirúrgico no qual foram coletados os fascículos para histopatolo gia. Os nervos radial, mediano e ulnar de todos os cães submetidos à eletroneuroestimulação apresentaram evidências de degenera- ção. enquanto que o nervo musculocutâneo apresentava função próxima do normal em 25% dos casos. A associação dos resultados do exame neurológico, da histologia e da eletroneuroestimulação sugeriu envolvimento quase que total das raízes do plexo braquial, enfatizando a necessidade de continuidade de pesquisas na área, visando principalmente a recuperação das raízes nervosas envolvidas.The purpose ofthis work was to relate lhe clinicai, neurological and histopathotogical aspects (as described in the sections I and 2 ofthis work with the obtained results after the electric stimulation of radial, median, ulnar and musculocutaneous nerrves. The electric stimulation of these nerves was realized during the cirurgic act, when the fascicle were obtained for the histopathologic examination. The radial, median and ulnar nerves of ali dogs submitted to electroneurostimulation presented evidences of degeneration, while the musculocutaneous nerve present almost normal functions in 25% of the cases. The interpretation ofthe results obtained from neurologic, histologic and electroneurostimulation examination suggested the almost total involvement of brachial plexus in ali cases. This work emphasized the need for further research in this área with lhe main purpose of recuperating the involved roots.

  19. Intracerebral malignant peripheral nerve sheath tumor in a child with neurofibromatosis Type 1 and middle cerebral artery aneurysm treated with endovascular coil embolization.

    Science.gov (United States)

    Ellis, Michael J; Cheshier, Samuel; Sharma, Sunjay; Armstrong, Derek; Hawkins, Cynthia; Bouffet, Eric; Rutka, James T; Taylor, Michael D

    2011-10-01

    Among the neoplastic conditions that affect patients with neurofibromatosis Type 1 (NF1) are malignant peripheral nerve sheath tumors (MPNSTs), which typically arise from peripheral nerves of the limbs, trunk, and lumbar and brachial plexuses. Ionizing radiation is an established risk factor for MPNST development, especially in susceptible patients such as those with NF1. Patients with NF1 are also at risk for intracranial aneurysms, which are increasingly being successfully managed with endovascular therapies. The authors describe the case of a 9-year-old, previously healthy girl who presented in extremis with a right frontal intracerebral hemorrhage resulting from a ruptured right middle cerebral artery (MCA) trifurcation aneurysm. Following urgent decompressive craniectomy, the patient underwent endovascular coil embolization of the MCA aneurysm without complication. Given her mother's history of NF1, the child underwent genetic testing, which disclosed signs positive for NF1. The patient recovered well, but follow-up MR imaging and MR angiography performed at 14 months demonstrated a large frontotemporal mass encasing the right MCA trifurcation. The patient underwent frontotemporal craniotomy and subtotal resection of the mass, which was histologically found to be an intracranial MPNST. The patient received chemotherapy and focal radiation therapy and remains alive at 6 months postresection. To the authors' knowledge, this represents the only known case of intracranial neoplasm arising in the region of an intracranial aneurysm repaired by endovascular coil embolization. While patients with NF1 represent a population with genetic susceptibility to radiation-induced tumors, the pathogenesis of intracerebral MPNSTs remains poorly understood. PMID:21961539

  20. Nerve Transfers for the Restoration of Wrist, Finger, and Thumb Extension After High Radial Nerve Injury.

    Science.gov (United States)

    Pet, Mitchell A; Lipira, Angelo B; Ko, Jason H

    2016-05-01

    High radial nerve injury is a common pattern of peripheral nerve injury most often associated with orthopedic trauma. Nerve transfers to the wrist and finger extensors, often from the median nerve, offer several advantages when compared to nerve repair or grafting and tendon transfer. In this article, we discuss the forearm anatomy pertinent to performing these nerve transfers and review the literature surrounding nerve transfers for wrist, finger, and thumb extension. A suggested algorithm for management of acute traumatic high radial nerve palsy is offered, and our preferred surgical technique for treatment of high radial nerve palsy is provided. PMID:27094891

  1. Ultrasound-Guided Peripheral Nerve Procedures.

    Science.gov (United States)

    Strakowski, Jeffrey A

    2016-08-01

    Ultrasound guidance allows real-time visualization of the needle in peripheral nerve procedures, improving accuracy and safety. Sonographic visualization of the peripheral nerve and surrounding anatomy can provide valuable information for diagnostic purposes and procedure enhancement. Common procedures discussed are the suprascapular nerve at the suprascapular notch, deep branch of the radial nerve at the supinator, median nerve at the pronator teres and carpal tunnel, lateral cutaneous nerve of the thigh, superficial fibular nerve at the leg, tibial nerve at the ankle, and interdigital neuroma. For each procedure, the indications, relevant anatomy, preprocedural scanning technique, and injection procedure itself are detailed. PMID:27468673

  2. Radial artery cannulation. Potential hazard in patients with acromegaly.

    Science.gov (United States)

    Campkin, T V

    1980-10-01

    Using Allen's test, impaired ulnar artery circulation to one or both hands was detected pre-operatively in five out of ten acromegalic patients scheduled for transphenoidal hypophysectomy. Three of these patients also had symptoms of compression of the median nerve at the wrist (carpal tunnel syndrome). If ulnar flow is considered to be inadequate cannulation of a dorsalis pedis artery provides one possible alternative route for continuous measurement of the blood pressure during induced hypotension. In the three patients in this report in whom this vessel was cannulated no ischaemic complications in the foot were seen.

  3. Multichannel recording of median nerve somatosensory evoked potentials

    NARCIS (Netherlands)

    van de Wassenberg, W.; van der Hoeven, J.; Leenders, K.; Maurits, N.

    2008-01-01

    Objectives. -Clinical applications of multichannel (>= 64 electrodes) electroencephalography (EEG) have been limited so far. Amplitude variability of evoked potentials in healthy subjects is large, which limits their diagnostic applicability. This amplitude variability may be partially due to spatia

  4. A CASE REPORT OF MULTIPLE ARTERIAL ANOMALIES IN A CADAVE R

    Directory of Open Access Journals (Sweden)

    Anbumani

    2015-03-01

    Full Text Available During routine dissection in our department, multiple arterial variations were observed in a cadaver. The following arterial variations are present. They are, superficial brachioulnar artery, which originated at the level of junction of upper and middle th ird of arm. It runs a superficial course anterior to median nerve in the arm and terminates in the formation of superficial palmar arch. The brachial artery terminated as radial and common interosseous artery. Subscapular artery and circumflex humeral arte ry arose as a common trunk from the third part of axillary artery. The circumflex humeral artery later divides into anterior circumflex humeral and posterior circumflex humeral arteries. The right common carotid artery bifurcated into internal carotid arte ry anteromedially and external carotid artery posterolaterally at the level of upper lamin a of th yroid cartilage. A proper knowledge of variations in the arterial pattern is a must for a good treatment outcome, especially in the fields like vascular surge ry, reconstructive surgery, cardiac surgery, angiogram, arterial cannulation, arterio - venous fistula for renal dialysis. etc.

  5. Dissecção robótica da artéria torácica interna direita por esternotomia mediana Robotic dissection of the right internal thoracic artery through median sternotomy

    Directory of Open Access Journals (Sweden)

    Fabio Biscegli Jatene

    2010-06-01

    Full Text Available A utilização de sistemas robóticos em cirurgia cardíaca visa à diminuição do trauma operatório. A revascularização do miocárdio totalmente endoscópica, assistida por robô DaVinci (Intuitive Surgical, Sunnyvale, Califórnia é factível e seu aprendizado deve ser realizado em etapas. O primeiro passo é o preparo da artéria torácica interna esquerda, já por via totalmente endoscópica. O caso apresentado propõe a dissecção da artéria torácica interna direita por esternotomia completa. Propõe um novo passo rumo ao procedimento completamente endoscópico, visando à diminuição de lesões decorrentes da curva de aprendizado.The use of robotic systems in cardiac surgeries aims at decreasing the surgical trauma.The use of robotic systems in cardiac surgeries aims at decreasing the surgical trauma. The totally endoscopic myocardial revascularization, assisted by the DaVinci robot (Intuitive Surgical, Sunnyvale, California is feasible and the learning process must be carried out in steps. The first step is the preparation of the left internal thoracic artery, through the totally endoscopic approach. The case presented here proposes the dissection of the right internal thoracic artery through complete sternotomy. It proposes a new step directed at the totally endoscopic procedure, aiming at decreasing the injuries caused by the learning curve.

  6. Sosiaalisen median merkitys maisemasuunnittelutoimiston markkinoinnissa

    OpenAIRE

    Holmstén, Salla

    2013-01-01

    Sosiaalisen median merkitys on kasvanut nopeasti viime vuosien aikana ja nykyään myös moni yritys on lähtenyt hyödyntämään sen palveluita. Tässä opinnäytetyössä käsitellään sosiaalisen median merkitystä maisemasuunnittelutoimistoille tänä päivänä. Työn tavoitteena on selvittää, millainen merkitys sosiaalisen median palveluilla on yritysten markkinoinnissa yleisesti. Käytetäänkö sosiaalisen median palveluita, entä miksi jätetään käyttämättä? Onko käytöstä koettu olevan hyötyä, entä haittaa? Ta...

  7. The Diagnostic Value of Nerve Ultrasound in an Atypical Palmar Cutaneous Nerve Lesion.

    Science.gov (United States)

    Zanette, Giampietro; Tamburin, Stefano

    2016-07-01

    Detailed knowledge of the fascicular anatomy of peripheral nerves is important for microsurgical repair and functional electrostimulation.We report a patient with a lesion on the left palmar cutaneous branch of the median nerve (PCBMN) and sensory signs expanding outside the PCBMN cutaneous innervation territory. Nerve conduction study showed the absence of left PCBMN sensory nerve action potential, but apparently, no median nerve (MN) involvement. Nerve ultrasound documented a neuroma of the left PCBMN and a coexistent lateral neuroma of the left MN in the carpal tunnel after the PCBMN left the main nerve trunk.Nerve ultrasound may offer important information in patients with peripheral nerve lesions and atypical clinical and/or nerve conduction study findings. The present case may shed some light on the somatotopy of MN fascicles at the wrist. PMID:26945219

  8. CROSSING ANASTOMOSIS OF NERVE BUNDLES NEAR INNERVATED ORGANS TO TREAT IRREPARABLE NERVE INJURIES

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective To study the therapeutical effects of crossing anastomosis of nerve on the peripheral and central nerve injuries.Methods Twelve kinds of central and peripheral nerve disorders and their complications were treated with 11 kinds of crossing anastomosis of nerve bundles near the innervated organs. After nerve injury and repair, somatosensory evoked potentials (SEPs) and horseradish peroxidase (HRP) retrograde tracing studies were used to investigate the rabbit's nerve function and morphology.Results The ulcers of all patients healed. Sensation, voluntary movement, and joint function recovered. Four weeks after the anastomosis of distal stump of radialis superficialis nerve and median nerve, pain sensation regained and SEPs appeared. HRP retrograde tracing studies demonstrated sensory nerve ending of medial nerve formed new connection with the body of neuron.Conclusion Crossing anastomosis of nerve is an effective method to treat peripheral and central nerve injuries.

  9. Nerve biopsy

    Science.gov (United States)

    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 ...

  10. Non-Local Euclidean Medians.

    Science.gov (United States)

    Chaudhury, Kunal N; Singer, Amit

    2012-11-01

    In this letter, we note that the denoising performance of Non-Local Means (NLM) can be improved at large noise levels by replacing the mean by the Euclidean median. We call this new denoising algorithm the Non-Local Euclidean Medians (NLEM). At the heart of NLEM is the observation that the median is more robust to outliers than the mean. In particular, we provide a simple geometric insight that explains why NLEM performs better than NLM in the vicinity of edges, particularly at large noise levels. NLEM can be efficiently implemented using iteratively reweighted least squares, and its computational complexity is comparable to that of NLM. We provide some preliminary results to study the proposed algorithm and to compare it with NLM.

  11. Celiac Artery Compression Syndrome

    Directory of Open Access Journals (Sweden)

    Mohammed Muqeetadnan

    2013-01-01

    Full Text Available Celiac artery compression syndrome is a rare disorder characterized by episodic abdominal pain and weight loss. It is the result of external compression of celiac artery by the median arcuate ligament. We present a case of celiac artery compression syndrome in a 57-year-old male with severe postprandial abdominal pain and 30-pound weight loss. The patient eventually responded well to surgical division of the median arcuate ligament by laparoscopy.

  12. 颈总动脉交感神经网剥脱术治疗脑性瘫痪的探讨%Discussion of common carotid artery sympathetic nerve net exfoliation therapy treating cerebral palsy

    Institute of Scientific and Technical Information of China (English)

    尹彪中; 李如求; 成顺成

    2002-01-01

    Objective To discuss mechanism of common carotid artery sympathetic nerve net exfoliation therapy treating sequela of cerebral palsy. Methods Examing and assessing before and after operation, curative effect analysis, Wals value assay and 1 year follow up to 124 patients. Result Score of patients in this group reached excellent 1 week after operation, reached good 1 year after operation, Wals value measure P≤ 0.05. Conclusion This operation had an effect on the promotion of mixed type; athetosis type cerebral palsy, upper limb function disorder and malfunction.

  13. Magnetic resonance neurography of median neuropathies proximal to the carpal tunnel

    Energy Technology Data Exchange (ETDEWEB)

    Thawait, Gaurav K. [Johns Hopkins Hospital, The Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States); The Johns Hopkins Hospital, Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States); Subhawong, Ty K.; Eng, John; Carrino, John A.; Chhabra, Avneesh [Johns Hopkins Hospital, The Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States); Thawait, Shrey K. [Yale University, Bridgeport Hospital, Department of Radiology, Bridgeport, CT (United States); Andreisek, Gustav [University Hospital Zurich, Department of Radiology, Zurich (Switzerland); Belzberg, Alan J. [Johns Hopkins Hospital, Department of Neurosurgery, Baltimore, MD (United States)

    2012-06-15

    This review provides magnetic resonance neurography (MRN) imaging appearances of median neuropathy proximal to the carpal tunnel. Carpal tunnel syndrome (CTS) and its imaging have been extensively described in the literature; however, there is a relative paucity of information on the MR imaging appearances of different pathologies of the median nerve proximal to the carpal tunnel. (orig.)

  14. Sosiaalisen median opas pienille hotelleille

    OpenAIRE

    Lohtander, Annukka

    2014-01-01

    Tämä työ on produktityyppinen opinnäytetyö, joka koostuu tietoperustasta ja tuotoksesta. Tuotos on sosiaalisen median opas pienille suomalaisille hotelleille. Sosiaalisesta mediasta on tullut osa lähes jokaisen yrityksen toimintaa. Majoitusalalla tärkeimpiä alustoja ovat Facebook, TripAdvisor, Twitter, Foursquare, keskustelufoorumit, blogit sekä kuva- ja videopalvelut. Osassa näistä alustoista on syytä olla mukana niin sisällön tuottajana kuin sen seuraajana ja reagoijanakin. Osa...

  15. 缝合神经的指固有动脉背支血管链皮瓣修复指远端皮肤缺损%Repair of fingertip defect with proper digital artery lateral cutaneous branch-chain flap accompanied with dorsal digital nerve or dorsal branch of proper digital nerve coaptation

    Institute of Scientific and Technical Information of China (English)

    孙涛; 魏鹏; 周丹亚; 胡瑞斌; 滕晓峰; 陈宏

    2011-01-01

    Objective To explore the effect of using proper digital artery lateral cutaneous branch-chain flap with dorsal digital nerves or dorsal branch of proper digital nerye for repairing of fingertip defect.Methods From December 2008 to November 2009, 24 cases (26 digits) of fingertip defect were treated with proper digital artery lateral cutaneous branch-chain flap.The flap was designed on the lateral side of the proximal phalanx of the injured finger with its long axis running on the lateral midline of the finger.The vascular pedicle was 0.8 to 1.0 cm wide.The pivot point was at the distal 1/3 of the middle phalanx upon which the flap was reversed to repair the defect of the fingertip.The dorsal digital nerve or dorsal branch of proper digital nerve was included in the flap and coapted with the nerve in the wound to reconstruct sensation of the injured finger.Results All 26 flaps survived.Postoperative follow-up period was 6 to 8 months.All these flaps recovered with satisfying and quality, excellent sensation with 4 to 8 mm two-point discrimination.ROM of the interphalangeal joint of the injured finger was good.Conclusion Proper digital artery lateral cutaneous branchchain flap transfer with nerve coaptation is an ideal method for repairing fingertip defect.The surgery is simple.Reliable blood supply can be achieved without sacrificing the proper digital artery.Coaptation of the nerve restores sensation at the fingertip.There is minor donor site damage and very few complications.%目的 探讨缝合神经的指固有动脉背支血管链皮瓣修复指远端皮肤缺损的疗效.方法 2008年12月至2009年11月,对24例26指指远端皮肤缺损患者,以指固有动脉背侧支形成的血管链为血供,于近节指体侧方设计皮瓣,皮瓣轴线为指体侧方中线,皮瓣蒂宽0.8~1.0cm,皮瓣转折点为中节指体中远端,逆行转移修复指远端皮肤缺损,皮瓣携带指固有神经背侧支或指背神经与创面指神经断端进行缝合

  16. Peripheral nerve involvement in Bell's palsy

    Directory of Open Access Journals (Sweden)

    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.

  17. Clinical application of first dorsal metacarpal artery radial cutaneous branch and superficial radial nerve flap%第一掌骨背动脉桡侧皮支蒂桡神经浅支皮瓣的临床应用

    Institute of Scientific and Technical Information of China (English)

    沈小芳; 芮永军; 许亚军; 糜菁熠; 赵刚

    2012-01-01

    目的 介绍应用第一掌骨背动脉桡侧皮支蒂桡神经浅支皮瓣修复拇指软组织缺损的体会.方法 2006年6月至2009年8月,对9例拇指桡侧软组织缺损患者,应用以第一掌骨背动脉桡侧皮支为轴心血管并携带桡神经浅支皮瓣进行修复,切取面积4.0 cm×2.0cm~7.0 cm× 3.5 cm.结果 术后9例皮瓣全部存活,6例获得随访,3例失访,随访时间为11~34个月.皮瓣质地良好,感觉恢复至S2~S3+,供区植皮愈合良好,轻度色素沉着,无痛性神经瘤发生.结论 第一掌骨背动脉桡侧皮支蒂桡神经浅支皮瓣血供可靠,成活率高,方法简单,可修复拇指全指腹缺损,是修复拇指软组织缺损的方法之一.%Objective To explore the clinical outcomes of applying first dorsal metacarpal artery radial cutaneous branch and superficial radial nerve flap to repair soft tissue defects of the thumb. Methods Nine cases of soft tissue defects in the thumb were treated from June 2006 to August 2009 with a flap using the first dorsal metacarpal artery radial cutaneous branch as the axial vessel and including the superficial radial nerve.The size of the raised flaps ranged from 4.0 cm× 2.0 cm to 7.0 cm× 3.5 cm. Results All the flaps survived after the surgery.Follow-up time ranged from 11 to 34 months in 6 cases.Three cases were lost to follow-up.The flaps had good texture.Protective sensation was restored from S2 to S3 +.The donor site skin graft healed well with slight pigmentation.There were on painful neuroma in these 6 cases. Conclusion First dorsal metacarpal artery radial cutaneous branch and superficial radial nerve flap has a high survival rate and reliable blood supply.It is easy to operate and can cover large defects.This flap is an ideal flap for repair of soft tissue defects in the thumb.

  18. Rare anatomical variation of the musculocutaneous nerve - case report

    Directory of Open Access Journals (Sweden)

    Sergio Ricardo Rios Nascimento

    2016-06-01

    Full Text Available ABSTRACT The clinical and surgical importance of anatomical knowledge of the musculocutaneous nerve and its variations is due to the fact that one of the complications in many upper-limb surgical procedures involves injury to this nerve. During routine dissection of the right upper limb of a male cadaver, we observed an anatomical variation of this nerve. The musculocutaneous nerve originated in the lateral cord and continued laterally, passing under the coracobrachialis muscle and then continuing until its first branch to the biceps brachialis muscle. Just after this, it supplied another two branches, i.e. the lateral cutaneous nerve of the forearm and a branch to the brachialis muscle, and then it joined the median nerve. The median nerve followed the arm medially to the region of the cubital fossa and then gave rise to the anterior intermediate nerve of the forearm. The union between the musculocutaneous nerve and the median nerve occurred approximately at the midpoint of the arm and the median nerve. Given that either our example is not covered by the classifications found in the literature or that it fits into more than one variation proposed, without us finding something truly similar, we consider this variation to be rare.

  19. Stimuli of sensory-motor nerves terminate arterial contractile effects of endothelin-1 by CGRP and dissociation of ET-1/ET(A)-receptor complexes

    DEFF Research Database (Denmark)

    Meens, Merlijn J P M T; Compeer, Matthijs G; Hackeng, Tilman M;

    2010-01-01

    BACKGROUND: Endothelin-1 (ET-1), a long-acting paracrine mediator, is implicated in cardiovascular diseases but clinical trials with ET-receptor antagonists were not successful in some areas. We tested whether the quasi-irreversible receptor-binding of ET-1 (i) limits reversing effects of the...... antagonists and (ii) can be selectively dissociated by an endogenous counterbalancing mechanism. METHODOLOGY/PRINCIPAL FINDINGS: In isolated rat mesenteric resistance arteries, ET(A)-antagonists, endothelium-derived relaxing factors and synthetic vasodilators transiently reduced contractile effects of ET-1...

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

    Institute of Scientific and Technical Information of China (English)

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

    2010-01-01

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

  1. Nerve transfer helps repair brachial plexus injury by increasing cerebral cortical plasticity

    Institute of Scientific and Technical Information of China (English)

    Guixin Sun; Zuopei Wu; Xinhong Wang; Xiaoxiao Tan; Yudong Gu

    2014-01-01

    In the treatment of brachial plexus injury, nerves that are functionally less important are trans-ferred onto the distal ends of damaged crucial nerves to help recover neuromuscular function in the target region. For example, intercostal nerves are transferred onto axillary nerves, and accessory nerves are transferred onto suprascapular nerves, the phrenic nerve is transferred onto the musculocutaneous nerves, and the contralateral C7 nerve is transferred onto the median or radial nerves. Nerve transfer has become a major method for reconstructing the brachial plexus after avulsion injury. Many experiments have shown that nerve transfers for treatment of brachi-al plexus injury can help reconstruct cerebral cortical function and increase cortical plasticity. In this review article, we summarize the recent progress in the use of diverse nerve transfer methods for the repair of brachial plexus injury, and we discuss the impact of nerve transfer on cerebral cortical plasticity after brachial plexus injury.

  2. Advanced median method for timing jitter compensation

    Institute of Scientific and Technical Information of China (English)

    Wang Chen; Zhu Jiangmiao; Jan Verspecht; Liu Mingliang; Li Yang

    2008-01-01

    Timing jitter is one of the main factors that influence on the accuracy of time domain precision measurement. Timing jitter compensation is one of the problems people concern. Because of the flaws of median method, PDF deconvolution method and synthetic method, we put forward a new method for timing jitter compensation, which is called advanced median method. The theory of the advanced median method based on probability and statistics is analyzed, and the process of the advanced median method is summarized in this paper. Simulation and experiment show that compared with other methods, the new method could compensate timing jitter effectively.

  3. Microsurgical anatomy of the abducens nerve.

    Science.gov (United States)

    Joo, Wonil; Yoshioka, Fumitaka; Funaki, Takeshi; Rhoton, Albert L

    2012-11-01

    The aim of this study is to demonstrate and review the detailed microsurgical anatomy of the abducens nerve and surrounding structures along its entire course and to provide its topographic measurements. Ten cadaveric heads were examined using ×3 to ×40 magnification after the arteries and veins were injected with colored silicone. Both sides of each cadaveric head were dissected using different skull base approaches to demonstrate the entire course of the abducens nerve from the pontomedullary sulcus to the lateral rectus muscle. The anatomy of the petroclival area and the cavernous sinus through which the abducens nerve passes are complex due to the high density of critically important neural and vascular structures. The abducens nerve has angulations and fixation points along its course that put the nerve at risk in many clinical situations. From a surgical viewpoint, the petrous tubercle of the petrous apex is an intraoperative landmark to avoid damage to the abducens nerve. The abducens nerve is quite different from the other nerves. No other cranial nerve has a long intradural path with angulations and fixations such as the abducens nerve in petroclival venous confluence. A precise knowledge of the relationship between the abducens nerve and surrounding structures has allowed neurosurgeon to approach the clivus, petroclival area, cavernous sinus, and superior orbital fissure without surgical complications. PMID:22334502

  4. LOCAL MEDIAN ESTIMATION OF VARIANCE FUNCTION

    Institute of Scientific and Technical Information of China (English)

    杨瑛

    2004-01-01

    This paper considers local median estimation in fixed design regression problems. The proposed method is employed to estimate the median function and the variance function of a heteroscedastic regression model. Strong convergence rates of the proposed estimators are obtained. Simulation results are given to show the performance of the proposed methods.

  5. Coronary Artery Bypass

    Directory of Open Access Journals (Sweden)

    Kadri Ceberut

    2011-01-01

    Full Text Available Ancient schwannoma is a rare variant of neural tumors though rarely seen in the thorax. The combination with coronary artery diseases is also rare. Here we describe a 66 year-old male who had undergone one-stage combined surgery for thoracic ancient schwannomas removal and coronary artery disease. The masses were, respectively, 13 cm in the middle mediastinum and 5 cm in diameter originating from the intercostal nerve. The tumors were successfully removed using sternotomy, and then a coronary artery bypass grafting was performed. Here we discuss this rare tumor in relation to the relevant literature.

  6. Median Approximations for Genomes Modeled as Matrices.

    Science.gov (United States)

    Zanetti, Joao Paulo Pereira; Biller, Priscila; Meidanis, Joao

    2016-04-01

    The genome median problem is an important problem in phylogenetic reconstruction under rearrangement models. It can be stated as follows: Given three genomes, find a fourth that minimizes the sum of the pairwise rearrangement distances between it and the three input genomes. In this paper, we model genomes as matrices and study the matrix median problem using the rank distance. It is known that, for any metric distance, at least one of the corners is a [Formula: see text]-approximation of the median. Our results allow us to compute up to three additional matrix median candidates, all of them with approximation ratios at least as good as the best corner, when the input matrices come from genomes. We also show a class of instances where our candidates are optimal. From the application point of view, it is usually more interesting to locate medians farther from the corners, and therefore, these new candidates are potentially more useful. In addition to the approximation algorithm, we suggest a heuristic to get a genome from an arbitrary square matrix. This is useful to translate the results of our median approximation algorithm back to genomes, and it has good results in our tests. To assess the relevance of our approach in the biological context, we ran simulated evolution tests and compared our solutions to those of an exact DCJ median solver. The results show that our method is capable of producing very good candidates. PMID:27072561

  7. Clinical and radiologic review of uncommon cause of profound iron deficiency anemia: Median arcuate ligament syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Gunduz, Yasemin; Asil, Kiyasrttin; Aksoy, Yakup Ersel; Ayhan, Lacin Tatli [Dept. of Radiology, Sakarya University Medical Faculty, Sakarya (Turkmenistan)

    2014-08-15

    Median arcuate ligament syndrome is an anatomic and clinical entity characterized by dynamic compression of the proximal celiac artery by the median arcuate ligament, which leads to postprandial epigastric pain, vomiting, and weight loss. These symptoms are usually nonspecific and are easily misdiagnosed as functional dyspepsia, peptic ulcer disease, or gastropathy. In this report, we presented a 72-year-old male patient with celiac artery compression syndrome causing recurrent abdominal pain associated with gastric ulcer and iron deficiency anemia. This association is relatively uncommon and therefore not well determined. In addition, we reported the CT angiography findings and three-dimensional reconstructions of this rare case.

  8. 伴动眼神经麻痹的未破裂后交通动脉动脉瘤的形态和血流动力学特点分析%Analysis of morphological and hemodynamic characteristics of unruptured posterior communicating artery aneurysms with oculomotor nerve paralysis

    Institute of Scientific and Technical Information of China (English)

    张莹; 荆林凯; 张倩倩; 刘健; 张义森; 王坤; 穆士卿; 杨新健

    2016-01-01

    目的 分析伴动眼神经麻痹的未破裂后交通动脉(PCoA)动脉瘤的形状及血流动力学特点.方法 回顾性研究首都医科大学附属北京天坛医院神经介入科2014年1月至2015年6月收治的未破裂单发PCoA动脉瘤患者70例.按照其主要临床症状分为无症状组、动眼神经麻痹组、其他临床症状组.对患者个体化的三维DSA图像进行数值模拟分析,对比各组形状和血流动力学参数的区别.结果 (1)动眼神经麻痹组的平均径颈比为1.75 ±0.46,高于无症状组的1.15±0.44及其他临床症状组的1.20±0.42,差异有统计学意义(P<0.01);而3组间动脉瘤的侧壁/分叉分型、是否带子瘤、最大径、瘤颈宽度、表面积及体积差异均无统计学意义(P>0.05).(2)动眼神经麻痹组的平均壁面切应力为0.48±0.21,低于无症状组的0.68±0.24和其他临床症状组的0.82 ±0.22,差异有统计学意义(P<0.01);动眼神经麻痹组的低壁面切应力面积百分比的中位数(四分位间距)为3.77%(1.48%,27.16%),高于无症状组的0.15% (0.00%,1.07%)及其他临床症状组的0.03% (0.00%,0.44%),差异有统计学意义(P<0.01);3组之间壁面切应力震荡因子的对比差异无统计学意义(P =0.420).结论 伴动眼神经麻痹的未破裂PCoA动脉瘤,具有高径颈比及低壁面切应力,可能是未破裂PCoA动脉瘤中的高风险类型.%Objective To analyze the morphological and hemodynamic characteristics of unruptured posterior communicating artery aneurysms (PCoA) with oculomotor nerve paralysis.Methods Seventy patients with unruptured single PCoA aneurysm admitted to the Department of Neural Interventional Radiology,Beijing Tiantan Hospital,Capital Medical University from January 2014 to June 2015 were studied retrospectively.According to their main clinical symptoms,they were divided into 3 groups:asymptomatic group (including mild headache and dizziness),oculomotor nerve palsy group

  9. Median topographic maps for biomedical data sets

    CERN Document Server

    Hammer, Barbara; Rossi, Fabrice; 10.1007/978-3-642-01805-3_6

    2009-01-01

    Median clustering extends popular neural data analysis methods such as the self-organizing map or neural gas to general data structures given by a dissimilarity matrix only. This offers flexible and robust global data inspection methods which are particularly suited for a variety of data as occurs in biomedical domains. In this chapter, we give an overview about median clustering and its properties and extensions, with a particular focus on efficient implementations adapted to large scale data analysis.

  10. Cutaneous nerve entrapment syndrome

    Institute of Scientific and Technical Information of China (English)

    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.

  11. Nerve biopsy (image)

    Science.gov (United States)

    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 ...

  12. ANATOMICAL PRINCIPLES BEHIND PRESERVATION OF LARYNGEAL NERVES DURING THYROIDECTOMY

    Directory of Open Access Journals (Sweden)

    O. Fabian

    2011-08-01

    Full Text Available This paper presents the anatomical principles behind preservation of inferior laryngeal nerve and of the external branch of superior laryngeal nerve during thyroidectomy. The embryological development of thyroid and recurrent laryngeal nerves explains the constant relationship between Zuckerkandl’s tuberculum and the recurrent laryngeal nerve, while anomalies in development of the aortic arches explain the presence of rare anatomical variants, with a high risk of nerve injury, of non-recurrent course of the inferior laryngeal nerve. Good knowledge of the relationship between the external branch of superior laryngeal nerve and the superior thyroid artery makes possible to avoid transection of this branch during ligature around superior thyroid artery and vein. Anatomical landmarks used to identify the recurrent laryngeal nerve (tracheo-oesophageal sulcus, the cross-over with the inferior thyroid artery, Berry’s ligament, Zuckerkandl’s tuberculum and variations in the extra-laryngeal branching of the nerve are discussed based on data from the literature. The anatomical variants when the inferior laryngeal nerve doesn’t have a recurrent course are also discussed

  13. Monitoring Median Queries over Moving Objects

    Institute of Scientific and Technical Information of China (English)

    XU Hu; LU Yan-sheng; LI Zhi-cheng

    2010-01-01

    The k-median problem has attracted a number of researchers. However, few of them have considered both the dynamic environment and the issue of accuracy. In this paper, a new type of query is studied, called continuous median monitoring (CMM) query. It considers the k-median problem under dynamic environment with an accuracy guarantee. A continuous group nearest neighbor based (CGB) algorithm and an average distance medoid (ADM) algorithm are proposed to solve the CMM problem. ADM is a hill climbing schemed algorithm and achieves a rapid converging speed by checking only qualified candidates. Experiments show that ADM is more efficient than CGB and outperforms the classical PAM (partitioning around medoids) and CLARANS (clustering large applications based on randomized search) algorithms with various parameter settings.

  14. Switching non-local vector median filter

    Science.gov (United States)

    Matsuoka, Jyohei; Koga, Takanori; Suetake, Noriaki; Uchino, Eiji

    2016-04-01

    This paper describes a novel image filtering method that removes random-valued impulse noise superimposed on a natural color image. In impulse noise removal, it is essential to employ a switching-type filtering method, as used in the well-known switching median filter, to preserve the detail of an original image with good quality. In color image filtering, it is generally preferable to deal with the red (R), green (G), and blue (B) components of each pixel of a color image as elements of a vectorized signal, as in the well-known vector median filter, rather than as component-wise signals to prevent a color shift after filtering. By taking these fundamentals into consideration, we propose a switching-type vector median filter with non-local processing that mainly consists of a noise detector and a noise removal filter. Concretely, we propose a noise detector that proactively detects noise-corrupted pixels by focusing attention on the isolation tendencies of pixels of interest not in an input image but in difference images between RGB components. Furthermore, as the noise removal filter, we propose an extended version of the non-local median filter, we proposed previously for grayscale image processing, named the non-local vector median filter, which is designed for color image processing. The proposed method realizes a superior balance between the preservation of detail and impulse noise removal by proactive noise detection and non-local switching vector median filtering, respectively. The effectiveness and validity of the proposed method are verified in a series of experiments using natural color images.

  15. Sosiaalisen median toimintasuunnitelma, case Guild Travel Ltd

    OpenAIRE

    Vanhanen, Anni

    2014-01-01

    Tämän työn tarkoituksena on luoda käyttökelpoinen sosiaalisen median markkinointi-suunnitelma lontoolaiselle matkatoimistolle, joka myy matkoja Suomeen. Työn toimek-siantaja on Guild Travel Ltd. Työ toteutettiin vuoden 2014 keväällä. Työssä esitellään toimeksiantaja matkailualan toimijana ja perehdytään markkinoinnin teoriaan. Käsittelyssä ovat useat eri markkinoinnin teoriat, kuten SOSTAC, SMART ja marketing mix. Näitä malleja hyödyntäen luodaan yrityksen sosiaalisen median toimin-tasuun...

  16. Anatomic Study of Different Way to Cutting Superficial Radial Nerve Transplanting to Repair Peripheral Nerve Defection and Functional Reconstruction of Donor Site%桡神经浅支的功能解剖学观察

    Institute of Scientific and Technical Information of China (English)

    李高峰; 田德虎; 董海涛; 刁雪鸥; 于光辉; 梁立伟

    2011-01-01

    Objective In order to provide anatomic basis for clinic using of different way of cutting superficial radial nerve transplantation and reconstructing the function of the donor site. Methods We have investigated 30 adult cadaveric upper limbs (left 15 and right 15) that fixed by Formaldehyde. Then measured the data following:the length of the superficial radial nerve ,the length of deep the superficial radial nerve ,the vertical dimension from bifurcation of superficial radial nerve to lateral antebrachial cutaneous nerve and the vertical dimension to the median nerve. Eight fresh cadaveric upper limbs were selected to perform HE staining to count nerve-tract numbers of the same horizontal of cutaneous antebrachii lateralis nerve and median nerve under a microscope. 8 cephalic vein of fresh cadaveric upper limbs were perfused with polyvinyl chloride cyclohexanone solution,then the relation of little branches of cephalic vein and superficial radial nerve was observed. Red emulsion was perfused to arteries of 8 upper limb specimen,then the length and blood supply of median nerve were observed. Results The length of radial deep the superficial radial nerve is (124.89+10. 52) mm,the length of the superficial radial nerve is (31.87+12.54) mm ,The vertical dimension from bifurcation of superficial radial nerve is to lateral antebrachial cutaneous nerve is (5. 99+1.50) mm. and the vertical dimension to the median nerve is (35.66+2.82) mm. Conclusion The superficial radial nerve not only using free grafting with blood vessel or not with blood vessel,but also using to rebuild aesthema of operating antebrachial flap. After cutting superficial radial nerve ,we can reconstruct sensory function of the donor by way of end-to-side anastomosis between far broken ends of superficial radial nerve and median nerve or and lateral antebrachial cutaneous nerve. The superficial radial nerve is a better donator nerve for curing neurologic defect.%目的 对桡神经浅支进行功能解

  17. Reflex effects of aerosolized histamine on phrenic nerve activity.

    OpenAIRE

    Pack, A I; Hertz, B C; Ledlie, J F; Fishman, A. P.

    1982-01-01

    Studies were conducted in anesthetized, paralyzed dogs on the effect of aerosolized histamine on phrenic nerve activity. The paralyzed dogs were ventilated in phase with their recorded phrenic nerve activity at a constant inspiratory flow-rate, using a cycle-triggered ventilator. Phrenic nerve activity was measured before and during administration of aerosolized histamine while the inspiratory flow-rate and arterial blood gases were kept constant. In addition, before and after histamine, phre...

  18. The morphological substrate for Renal Denervation : Nerve distribution patterns and parasympathetic nerves. A post-mortem histological study

    NARCIS (Netherlands)

    van Amsterdam, Wouter A C; Blankestijn, Peter J; Goldschmeding, Roel; Bleys, Ronald L A W

    2015-01-01

    BACKGROUND: Renal Denervation as a possible treatment for hypertension has been studied extensively, but knowledge on the distribution of nerves surrounding the renal artery is still incomplete. While sympathetic and sensory nerves have been demonstrated, there is no mention of the presence of paras

  19. Functional outcome after peroneal nerve injury

    NARCIS (Netherlands)

    de Bruijn, I.; Geertzen, J.H.; Dijkstra, P.U.

    2007-01-01

    The objective of this study was to describe muscle strength, ankle-foot orthosis (AFO) use, walking ability, participation and quality of life in patients with peroneal nerve injury. A historic cohort study (n = 27) was performed with a median follow-up time of 61 months (inter quartile range 37-91)

  20. The median forehead flap reviewed: a histologic study on vascular anatomy.

    Science.gov (United States)

    Skaria, A M

    2015-05-01

    Local skin flaps can be divided into two types: random flaps and axial flaps. An axial flap is defined as a flap containing a named artery in its pedicle. For the paramedian forehead flap (PMFF) a lot of surgeons insist on the point that the pedicle must contain the supratrochlear artery. To demonstrate that median forehead flaps (MFF) need not contain a named artery, we selected first 8 patients with a PMFF and further 12 patients who had undergone reconstructive surgery using a MFF. After division, we analysed the pedicle of the flap histologically and measured the diameter of the arteries or arterioles and compared them to anatomical descriptions of the frontal arteries. In none of the 12 cases could we find a functional artery of approximately 1 mm in diameter that could correspond to the supratrochlear artery. The MFF is an axial flap but not in accordance with the current definition of this term. In contrast to published literature, we show that only in a part of cases a named artery was present in the pedicle. Despite this fact, the MFF is a secure flap for full thickness defect repair on the nose. PMID:24756613

  1. Median sternotomy closure: review and update research

    Institute of Scientific and Technical Information of China (English)

    Hua Kun; Yang Xiubin

    2009-01-01

    Cardiac surgery is a very common operation nowadays all over the world. Median stemotomy is a routine procedure required for cardiac access during open heart surgery. The complications of this procedure after the cardiac surgery range from 0.7% to 1.5% of all cases, and bear a high mortality rate if they occur. Every individual surgeon must pay great attention on every detail during the sternal closure. This article shows the details as to conventional information and updated progress on median sternotomy closure. The update contents involve in biomechanics, number of wires twists, biomaterial and so on.According to our experience, we recommend four peristernal single/double steel wires for sternal closure as our optimal choice.

  2. Microdissection of distal artery perforator of the medial leg and design of skin flap pedicled with nutrient vessels of the saphenous nerve%小腿内侧远端动脉穿支显微解剖与隐神经营养血管皮瓣设计

    Institute of Scientific and Technical Information of China (English)

    张发惠; 郑和平; 张国栋

    2007-01-01

    以胫后动脉肌间隙支、内踝前动脉穿支和以踝管区动脉穿支血管蒂的3种隐神经-大隐静脉营养血管远端蒂皮瓣或复合瓣,旋转轴点在内踝平面,适宜小腿远段、踝足部及其远侧的组织缺损修复.%BACKGROUND: The distally based skin flap pedicled with nutrient vessels of saphenous nerve has provided a method with higher achievement ratio to repair the tissue defect of ankle and foot, due to its high rotation point, lacking of distributive characteristics of distally pedicled vessels description for the specific operations, so it is still difficult in clinical application.OBJECTIVE: To investigate the distal artery perforators of medial leg, so as to suggest an anatomical theory for the reasonable design of the distally based compound flap pedicled with nutrient vessels of saphenous nerve-great saphenous vein.DESIGN: A single sample experiment.SETTING: Researching Center of Clinical Anatomy, Military Institute of Orthopaedics, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA.MATERIALS: The experiment was carried out in the Researching Center of Clinical Anatomy, Military Institute of Orthopaedics, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA from May to October, 2004.Thirty-four adult specimens perfused with red emulsion at lateral arteries of upper lower limbs were provided by the Researching Center of Clinical Anatomy, Military Institute of Orthopaedics, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA.METHODS: Specimens of the distal medial legs were dissected with microscope taking the most prominent point of medial malleolus as the pivot point.MAIN OUTCOME MEASURES: ① Distal artery perforators of medial leg; ② Distal nutrient vessels of saphenous nerve-great saphenous vein; ③ Blood supply correlation of nutrient vessel with neighboring muscle, bone and skin.RESULTS: ① The distal artery perforators of medial leg derived from 9 main

  3. COLOUR IMAGE STEGANOGRAPHY USING MEDIAN MAINTENANCE

    Directory of Open Access Journals (Sweden)

    S. Arivazhagan

    2011-08-01

    Full Text Available Steganographic algorithms in the recent past have been producing stego images with perceptual invisibility, better secrecy and certain robustness against attacks like cropping, filtering etc. Recovering a good quality secret from a good quality stego image may not always be possible. The method proposed in this paper works in transform domain and attempts to extract the secret almost as same as the embedded one maintaining minimal changes to the cover image by using techniques like median maintenance, offset and quantization.

  4. Ultrasound in the diagnosis of a median neuropathy in the forearm: case report

    Directory of Open Access Journals (Sweden)

    Yoon Joon-Shik

    2007-12-01

    Full Text Available Abstract Background Electrodiagnostic studies are traditionally used in the diagnosis of focal neuropathies, however they lack anatomical information regarding the nerve and its surrounding structures. The purpose of this case is to show that high-resolution ultrasound used as an adjunct to electrodiagnostic studies may complement this lack of information and give insight to the cause. Case presentation A 60-year-old male patient sustained a forearm traction injury resulting in progressive weakness and functional loss in the first three digits of the right hand. High-resolution ultrasound showed the presence of an enlarged nerve and a homogenous soft-tissue structure appearing to engulf the nerve. The contralateral side was normal. Surgery revealed fibrotic bands emanating from the flexor digitorum profundus muscle compressing the median nerve thus confirming the ultrasound findings. Conclusion A diagnostically challenging case of median neuropathy in the forearm is presented in which high-resolution ultrasound was valuable in establishing an anatomic etiology and directing appropriate management.

  5. Portfolio optimization using median-variance approach

    Science.gov (United States)

    Wan Mohd, Wan Rosanisah; Mohamad, Daud; Mohamed, Zulkifli

    2013-04-01

    Optimization models have been applied in many decision-making problems particularly in portfolio selection. Since the introduction of Markowitz's theory of portfolio selection, various approaches based on mathematical programming have been introduced such as mean-variance, mean-absolute deviation, mean-variance-skewness and conditional value-at-risk (CVaR) mainly to maximize return and minimize risk. However most of the approaches assume that the distribution of data is normal and this is not generally true. As an alternative, in this paper, we employ the median-variance approach to improve the portfolio optimization. This approach has successfully catered both types of normal and non-normal distribution of data. With this actual representation, we analyze and compare the rate of return and risk between the mean-variance and the median-variance based portfolio which consist of 30 stocks from Bursa Malaysia. The results in this study show that the median-variance approach is capable to produce a lower risk for each return earning as compared to the mean-variance approach.

  6. Facial nerve paralysis after cervical traction.

    Science.gov (United States)

    So, Edmund Cheung

    2010-10-01

    Cervical traction is a frequently used treatment in rehabilitation clinics for cervical spine problems. This modality works, in principle, by decompressing the spinal cord or its nerve roots by applying traction on the cervical spine through a harness placed over the mandible (Olivero et al., Neurosurg Focus 2002;12:ECP1). Previous reports on treatment complications include lumbar radicular discomfort, muscle injury, neck soreness, and posttraction pain (LaBan et al., Arch Phys Med Rehabil 1992;73:295-6; Lee et al., J Biomech Eng 1996;118:597-600). Here, we report the first case of unilateral facial nerve paralysis developed after 4 wks of intermittent cervical traction therapy. Nerve conduction velocity examination revealed a peripheral-type facial nerve paralysis. Symptoms of facial nerve paralysis subsided after prednisolone treatment and suspension of traction therapy. It is suspected that a misplaced or an overstrained harness may have been the cause of facial nerve paralysis in this patient. Possible causes were (1) direct compression by the harness on the right facial nerve near its exit through the stylomastoid foramen; (2) compression of the right external carotid artery by the harness, causing transient ischemic injury at the geniculate ganglion; or (3) coincidental herpes zoster virus infection or idiopathic Bell's palsy involving the facial nerve.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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

  9. 手掌部浅血管神经层与屈肌支持带关系的观测%Observation on the Relationship between the Layer of Superficial Vessels and Nerves and Flexor Retinaculum in Palm of Hand

    Institute of Scientific and Technical Information of China (English)

    杨开明; 王勇; 杨新文

    2000-01-01

    目的:为腕管松解术及掌中间隙引流术提供解剖学基础。方法:18例(男12、女6)36侧成人固定上肢标本上对手掌部屈肌支持带、正中神经、尺神经在腕掌部分支点和掌浅弓最高点与屈肌支持带下缘的距离以及尺动脉终末支与正中神经间距观测。结果:正中神经掌部分支点距屈肌支持带下缘9±3mm。尺神经掌部分支点距屈肌支持带下缘5±2mm。正中神经干与尺动脉终末支间距为10±2mm。结论:在手掌部掌长肌腱与第三指蹼尺侧缘连线尺侧1.0cm,腕横韧带下缘远侧2.5cm内确有无血管、神经的相对安全区。%Objective: To provide the anatomy basis for the carpal canal released and the middle palamar space drainaged. Methods: We observed the support points of the flexor retinacultm, median nerve and ulnar nerve in palm of hand, the distance between the top of superficial plamar arch and the low edge of flexor retinaculum, and the distance between the ulnar artery endness branch and median nerve in 18 cases of adult specimens (male 12,female 6) Results: The distance between median nerve ramis point in palm of hand and the low edge of flexor retinaculum was 9.0 ±+ 3.0 mm. The distance between ulnar nerve ramis point in palm of hand and the low edge of flexor retinaculum was 5.0±+ 2.0. The distance between median nerve trunk and ulnar artery endness branch was 10.0 + 2.0. Conclusions: There is a security related territory where is situated between long palmar muscle tendon and lunar interior of the third digit about 1.0 crm, distal 2.5 cm of flexor retinaculum lacking of vessels and nerves in the palm of hand.

  10. Local Sympathetic Denervation of Femoral Artery in a Rabbit Model by Using 6-Hydroxydopamine In Situ

    Directory of Open Access Journals (Sweden)

    Yufei Jin

    2014-01-01

    Full Text Available Both artery bundle and sympathetic nerve were involved with the metabolism of bone tissues. Whether the enhancing effects of artery bundle result from its accompanying sympathetic nerve or blood supply is still unknown. There is no ideal sympathetic nerve-inhibited method for the in situ denervation of artery bundle. Therefore, we dipped the femoral artery in the 6-hydroxydopamine (6-OHDA locally and observed its effect. Compared with control group, the in situ treatment of 6-OHDA did not damage the normal structure of vascular bundle indicated by hematoxylin-eosin (HE staining. However, the functions of sympathetic nerve was completely inhibited for more than 2 weeks, and only a few function of sympathetic nerve resumed 4 weeks later, evidenced by glyoxylic acid staining and the expression of tyrosine hydroxylase (TH and nerve peptide Y (NPY. Thus, 6-OHDA is promising as an ideal reagent for the local denervation of sympathetic nerve from artery system.

  11. Solitary median maxillary central incisor (SMMCI) syndrome

    OpenAIRE

    Hall Roger K

    2006-01-01

    Abstract Solitary median maxillary central incisor syndrome (SMMCI) is a complex disorder consisting of multiple, mainly midline defects of development resulting from unknown factor(s) operating in utero about the 35th–38th day(s) from conception. It is estimated to occur in 1:50,000 live births. Aetiology is uncertain. Missense mutation in the SHH gene (I111F) at 7q36 may be associated with SMMCI. The SMMCI tooth differs from the normal central incisor, in that the crown form is symmetric; i...

  12. Giant Serpentine Internal Carotid Artery Aneurysm: Endovascular Parent Artery Occlusion: A Pediatric Case Report

    OpenAIRE

    Prochazka, V.; Chmelova, J.; Cizek, V.; Skoloudik, D.; Hrbac, T.

    2007-01-01

    We report on a case of a 14-year-old boy with a giant serpentine aneurysm of the left internal carotid artery cavernous segment with symptoms of acute mass-effect cranial nerve dysfunction. After a balloon occlusion test of the collateral circulation, the patient underwent parent artery occlusion with platinum Guglielmi detachable coils and fibered coils. An optimal angiographic result and successful clinical outcome were achieved with resolution of IIIrd, IVth and Vlth cranial nerve ischemic...

  13. Isolated abducens nerve palsy with hyperhomocysteinemia: Association and outcomes

    Directory of Open Access Journals (Sweden)

    Virender Sachdeva

    2013-01-01

    Full Text Available Ischemic abducens nerve palsy usually presents as isolated cranial nerve palsy in the middle aged and elderly patients with known risk factors such as diabetes mellitus, hypertension, dyslipidemia, carotid artery disease, etc., In this report, we describe four patients with isolated abducens nerve palsy who presented with an acute onset diplopia whose detailed history and examination were suggestive of an ischemic etiology. Detailed systemic and laboratory evaluation revealed hyperhomocysteinemia as the only potential risk factor. To the best of our knowledge this is the first report of association of hyperhomocysteinemia and isolated abducens nerve palsy.

  14. Dorsal penile nerves and primary premature ejaculation

    Institute of Scientific and Technical Information of China (English)

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

    2009-01-01

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

  15. Effect of local anesthetics on perioperative oxidative stress injury and nerve conduction function in diabetic or non-diabetic patients

    Institute of Scientific and Technical Information of China (English)

    Dong-Yang Zhu; Ping Li

    2016-01-01

    Objective:To study the effect of local anesthetics on perioperative oxidative stress injury and nerve conduction function in diabetic or non-diabetic patients.Methods:A total of 100 c diabetic patients and 100 non-diabetic patients who received selective surgery under intraspinal block anesthesia were selected as the research subjects, diabetic patients were selected as observation group, non-diabetic patients were selected as control group, serum and urine were collected respectively before and after operation, and reactive oxygen species (ROS), malondialdehyde (MDA), superoxide dismutase (SOD), 8-hydroxy-2 deoxyguanosine (8-OHdG) levels were determined; electromyography was carried out, and the motor nerve conduction velocity of median nerve and common peroneal nerve as well as sensory nerve conduction velocity of median nerve and superficial peroneal nerve were determined.Results:One day before operation and 1 day after operation, serum ROS and MDA levels and urine 8-OHdG levels of observation group were significantly higher than those of control group, and serum SOD levels were significantly lower than those of control group; ROS, MDA, SOD and 8-OHdG levels of observation group before and after operation changed more significantly than those of control group. 1 week after operation, MNCV of median nerve and common peroneal nerve as well as SNCV of median nerve and superficial peroneal nerve of observation group were significantly lower than those before operation, and MNCV of median nerve and common peroneal nerve as well as SNCV of median nerve and superficial peroneal nerve of control group were not significantly different from those before operation.Conclusions: Local anesthetics can cause peripheral nerve conduction function impairment in diabetic patients, and the possible molecular mechanism is that local anesthetics activate perioperative oxidative stress more significantly in diabetic patients than in non-diabetic patients.

  16. Ultra Low-Power Analog Median Filters

    Directory of Open Access Journals (Sweden)

    A. Diaz-Sanchez

    2013-09-01

    Full Text Available The design and implementation of three analog median filter topologies, whose transistors operate in the deep weak-inversion region, is described. The first topology is a differential pairs array, in which drain currents are driven into two nodes in a differential fashion, while the second topology is based on a wide range OTA, which is used to maximize the dynamic range. Finally, the third topology uses three range-extended OTAs. The proposed weak-inversion filters were designed and fabricated in ON Semiconductor 0.5 micrometer technology through MOSIS. Experimental results of three-input fabricated prototypes for all three topologies are show, where power consumptions of 90nW in the first case, and 270nW in the other two cases can be noticed. A dual power supply +/-1.5 Volts were used.

  17. Sosiaalisen median paikallismarkkinointisuunitelma : case: Lahden Kellokeskus Oy

    OpenAIRE

    Hiukka, Piia

    2015-01-01

    Tämä opinnäytetyö käsittelee markkinointiviestinnän tehokkuutta ja siihen liittyviä ilmiöitä sosiaalisessa mediassa. Työn tavoitteena oli löytää vaikuttavimmat sisällöt, joiden avulla case-yritys Lahden Kellokeskus voi parantaa paikallista näkyvyyttään Facebookissa. Opinnäytetyössä ei puututtu erilaisten sosiaalisen median kanavien teknisiin ominaisuuksiin tai niiden hyödyntämiseen, vaan tavoittena oli löytää tehokkaimmat markkinointiviestinnän sisällöt, joita voidaan julkaista sähköisesti. ...

  18. Changes in retinal nerve fiber layer thickness after spinal surgery in the prone position: a prospective study

    Directory of Open Access Journals (Sweden)

    Baran Gencer

    2015-02-01

    Full Text Available BACKGROUND AND OBJECTIVES: Changes in ocular perfusion play an important role in the pathogenesis of ischemic optic neuropathy. Ocular perfusion pressure is equal to mean arterial pressure minus intraocular pressure. The aim of this study was to evaluate the changes in the intraocular pressure and the retinal nerve fiber layer thickness in patients undergoing spinal surgery in the prone position. METHODS: This prospective study included 30 patients undergoing spinal surgery. Retinal nerve fiber layer thickness were measured one day before and after the surgery by using optical coherence tomography. Intraocular pressure was measured by tonopen six times at different position and time-duration: supine position (baseline; 10 min after intubation (Supine 1; 10 (Prone 1, 60 (Prone 2, 120 (Prone 3 min after prone position; and just after postoperative supine position (Supine 2. RESULTS: Our study involved 10 male and 20 female patients with the median age of 57 years. When postoperative retinal nerve fiber layer thickness measurements were compared with preoperative values, a statistically significant thinning was observed in inferior and nasal quadrants (p = 0.009 and p = 0.003, respectively. We observed a statistically significant intraocular pressure decrease in Supine 1 and an increase in both Prone 2 and Prone 3 when compared to the baseline. Mean arterial pressure and ocular perfusion pressure were found to be significantly lower in Prone 1, Prone 2 and Prone 3, when compared with the baseline. CONCLUSIONS: Our study has shown increase in intraocular pressure during spinal surgery in prone position. A statistically significant retinal nerve fiber layer thickness thinning was seen in inferior and nasal quadrants one day after the spinal surgery.

  19. Pain Catastrophizing predicts Pain Intensity during a Neurodynamic Test for the Median Nerve in Healthy Participants

    OpenAIRE

    Beneciuk, Jason M.; Bishop, Mark D; George, Steven Z.

    2010-01-01

    Psychological factors within the Fear-Avoidance Model of Musculoskeletal Pain (FAM) predict clinical and experimental pain in both symptomatic and asymptomatic individuals. Clinicians routinely examine individuals with provocative testing procedures that evoke symptoms. The purpose of this study was to investigate which FAM factors were associated with evoked pain intensity, non-painful symptom intensity, and range of motion during an upper-limb neurodynamic test. Healthy participants (n = 62...

  20. Magnetic resonance imaging and T2 relaxometry of human median nerve at 7 Tesla.

    NARCIS (Netherlands)

    Gambarota, G.; Veltien, A.A.; Klomp, D.W.J.; Alfen, N. van; Mulkern, R.V.; Heerschap, A.

    2007-01-01

    Measurements of T2 relaxation times in tissues have provided a unique, noninvasive method to investigate the microenvironment of water molecules in vivo. As more clinical imaging is performed at higher field strengths, tissue relaxation times need to be reassessed in order to optimize tissue contras

  1. Ulnar Nerve Tendon Transfers for Pinch.

    Science.gov (United States)

    Cook, Shane; Gaston, R Glenn; Lourie, Gary M

    2016-08-01

    Power and tip pinch are an integral part of intrinsic hand function that can be significantly compromised with dysfunction of the ulnar nerve. Loss of power pinch is one component that can significantly affect an individual's ability to perform simple daily tasks. Tip pinch is less affected, as this task has significant contributions from the median nerve. To restore power pinch, the primary focus must be on restoring the action of the adductor pollicis primarily, and if indicated the first dorsal interosseous muscle and flexor pollicis brevis. PMID:27387080

  2. Hyperdensity of the Basilar Artery on Postmortem CT: A Potential Indicator for Basilar Artery Thrombosis.

    Science.gov (United States)

    Garland, Jack; Tse, Rexson; Beh, Raymond J; Lyons, Timothy J; Cala, Allan D

    2016-06-01

    Basilar artery thrombosis constitutes 1% of all types of stroke, carries a mortality rate of up to 90%, and is one of the rarer causes of sudden death. It leads to brain stem ischemia and commonly presents with impaired consciousness, cranial nerve palsy, hemiplegia or quadriplegia, and sudden collapse. Clinically, the diagnosis of basilar artery thrombosis is made on clinical symptoms, along with a hyperdense basilar artery in antemortem computed tomography (CT) scan. To our knowledge, whether a hyperdense basilar artery indicates basilar artery thrombosis on postmortem CT scan is not documented in the literature. We present a case report of a 55-year-old man who on postmortem CT scan showed a hyperdense basilar artery and was subsequently confirmed to be a fatal basilar artery thrombosis. We suggest that a hyperdense basilar artery on postmortem CT should prompt the pathologist to consider basilar artery thrombosis. PMID:27049662

  3. Gestational pulmonary arterial hypertension

    OpenAIRE

    Moll, Matthew; Payne, Julie G.; Tukey, Melissa H.; Farber, Harrison W.

    2015-01-01

    Pulmonary arterial hypertension (PAH) is a progressive disease marked by the irreversible pulmonary vascular changes of vasoconstriction, thrombosis, and proliferation of smooth muscle and endothelial cells. The untreated clinical course is characterized by progressive dyspnea and a median survival of less than 3 years. Many of these patients are of child-bearing age; however, pregnancy leads to physiologic changes that are particularly poorly tolerated in PAH, conferring a 30%–56% mortality....

  4. Complete oculomotor palsy caused by persistent trigeminal artery.

    Science.gov (United States)

    Bosco, Domenico; Consoli, Domenico; Lanza, Pier Luigi; Plastino, Massimiliano; Nicoletti, Francesco; Ceccotti, Claudio

    2010-10-01

    Primitive trigeminal artery (PTA) is the most frequent embryonic communication between the carotid and vertebro-basilar system. PTA is a pathophysiology phenomenon which has been implicated as a rare cause of cranial nerve dysfunction. We report the case of a 40-year-old woman who developed a complete oculomotor nerve palsy caused by a persistent ecstatic trigeminal artery. Brain MRI and MRA studies documented a neurovascular conflict between the oculomotor nerve and a PTA. To the best of our knowledge there is no report about complete third cranial nerve palsy NC due to a PTA. A role of this rare vascular condition is discussed. PMID:20552240

  5. Duration of symptomatology and median segmental sensory latency in 993 carpal tunnel syndrome hands (668 cases

    Directory of Open Access Journals (Sweden)

    KOUYOUMDJIAN JOAO ARIS

    1999-01-01

    Full Text Available According to median sensory nerve action potential onset-latency to index finger in a 140 mm fixed distance, 993 carpal tunnel syndrome (CTS hands from 668 patients were grouped into MIld (3.0 to 3.5 ms, 384 hands, MOderate (3.6 to 4.4 ms, 332 hands, SEvere (> 4.4 ms, 135 hands and UNrecordable (142 hands and correlated with CTS symptomatology duration. All patients have sensory antidromic median-radial latency difference (MRD e > or = 1.0 ms without any doubt about CTS diagnosis. Patients with systemic disease, trauma or previous surgery were excluded. There is a remarkable cumulative percentage increase from 1 to 12 months in group UN (3.5% to 38.7%, 11 folds, much less than the group MI (13.8% to 54.6%, 3.9 folds. There is also a remarkable non-cumulative percentage increase in group UN, from 1 to 4-12 months; the group MI had a relatively uniform distribution in all symptomatic duration groups from 1 to > 60 months. The conclusion is that median nerve compression at carpal tunnel can lead to unrecordable potentials in a relatively short period from 1 to 12 months of evolution, suggesting acute/subacute deterioration. Electrophysiological evaluation must be done periodically in patients that underwent clinical treatment, since cumulative 38.7% of group UN was found in 12 months period.

  6. Relationships between the Brook Street Terrane and Median Tectonic Zone (Median Batholith) : evidence from Jurassic conglomerates

    International Nuclear Information System (INIS)

    U-Pb zircon ages of 237-180 Ma and c. 280 Ma of seven granitoid clasts from the Rainy River Conglomerate which lies within the eastern Median Tectonic Zone (Median Batholith) in Nelson, and the Barretts Formation of the Brook Street Terrane in Southland, constrain the depositional ages of both units to be no older than c. 180-200 Ma (Early Jurassic). The minimum age of the Rainy River Conglomerate is constrained by the 147 +2 -1 Ma (Latest Jurassic) emplacement age of the One Mile Gabbronorite (new name: previously western Buller Diorite). The ages and chemistry of five of the granitoid clasts are broadly compatible with derivation from rocks that are now represented by Triassic plutons of the Median Tectonic Zone (Median Batholith), although ages as young as 180 Ma are slightly outside the range of the latter as currently exposed in New Zealand. The age (273-290 Ma, 237 +/- 3 Ma) and chemistry of the other two clasts (one each from Rainy River Conglomerate and Barretts Formation) suggest derivation from the Brook Street Terrane. Similarity in stratigraphic age, depositional characteristics, granitoid clast ages and composition between Rainy River Conglomerate and Barretts Formation suggests that they are broadly correlative and collectively overlapped a combined Brook Street Terrane - Median Batholith (MTZ) before the Late Jurassic (147 +2 -1 Ma). Sedimentary overlap may also have continued across to Middle Jurassic conglomeratic strata in the Murihiku Terrane to the east of the Brook Street Terrane. A U-Pb zircon age of 261 +/- 2 Ma is reported for Pourakino Trondhjemite of the Brook Street Terrane. (author). 56 refs., 10 figs., 4 tabs

  7. Retrobulbar diameter of optic nerve in glaucoma

    Directory of Open Access Journals (Sweden)

    Stefanović Ivan

    2009-01-01

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

  8. Circle of Willis variant analogous to fetal type primitive trigeminal artery

    International Nuclear Information System (INIS)

    Primitive caroticobasilar anastomoses are uncommon embryonic arterial connections between the carotid (anterior) and vertebrobasilar (posterior) circulations. With the exception of extracranial proatlantal intersegmental arteries, these embryonic arterial anastomoses are named according to the cranial nerves which they parallel. In this report, a previously undescribed variant circle of Willis with supraclinoid caroticobasilar anastomosis, functionally equivalent to a fetal type primitive trigeminal artery, is presented. (orig.)

  9. Occupational exposure to pesticides and nerve conduction studies among Korean farmers.

    Science.gov (United States)

    Park, Su Kyeong; Kong, Kyoung Ae; Cha, Eun Shil; Lee, Young Joo; Lee, Gyu Taek; Lee, Won Jin

    2012-01-01

    This study aimed to determine whether occupational exposure to pesticides was associated with decreased nerve conduction studies among farmers. On 2 separate occasions, the authors performed a cross-sectional study of a group of 31 male farmers who periodically applied pesticides. The study included questionnaire interviews and nerve conduction studies on the median, ulnar, posterior tibial, peroneal, and sural nerves. Although all mean values remained within laboratory normal limits, significant differences between the first and second tests were found in sensory conduction velocities on the median and sural nerves, and motor conduction velocities on the posterior tibial nerve. Lifetime days of pesticide application was negatively associated with nerve conduction velocities at most nerves after adjusting for potential confounders. These findings may reflect a link between occupational pesticide exposure and peripheral neurophysiologic abnormality that deserves further evaluation.

  10. Morphological Assessment of Cadaveric Radial, Brachial and Subclavian Arteries: A Neurointerventional Approach

    Science.gov (United States)

    Yilmaz, Ali; Ozkul, Ayca; Shin, Dong Seong; Im, Soo-Bin; Yoon, Seok-Mann

    2015-01-01

    Objective The transradial catheterization (TRC) is becoming widespread, primarily for neurointerventions. Therefore, the evaluation of radial artery puncture in clinical practice and a better understanding of the anatomy are important to improve the safety of neuroendovascular surgery. Methods Ten formalin-fixed adult Korean cadavers were dissected to expose radial artery (RA), brachial artery (BrA) and subclvian artery (ScA), bilaterally. Vessel lengths and diameters were meaured using a caliper and distance between the specific point of vessels and the anatomical landmarks including the radial styloid process, the medial epicondyle of the humerus, the sternoclavicular joint, and the vertebral artery orifice were also measured. Results The average length between the radial (RAPS) and the BrA puncture sites (BrAPS) and between the vertebral artery orifice (VAO) and the BrA bifurcation (BrAB) did not differ between sides (p>0.05). The average length between the radial styloid process (RSP) and the RAPS was 13.41±2.19 mm, and the RSP was 26.85±2.47 mm from the median nerve (MN). The mean length between the medial epicondyle (ME) and the BrAPS as 44.23±5.47 mm, whereas the distance between the ME and the MN was 42.23±4.77 mm. The average VAO-ScA angle was 70.94±6.12°, and the length between the ScA junction (SCJ) and the VAO was 60.30±8.48 mm. Conclusion This study provides basic anatomical information about the radial artery and the brachial route and can help improving new techniques, selection of size and shape of catheters for TRC. This can help neurointerventionists who adopt a transradial neuroendovascular approach and offers comprehensive and safe care to their patients. PMID:26819682

  11. Recurrent ulnar nerve entrapment at the elbow: Correlation of surgical findings and 3-Tesla magnetic resonance neurography

    OpenAIRE

    Chhabra, Avneesh; Wadhwa, Vibhor; Thakkar, Rashmi S; John A Carrino; Dellon, A. Lee

    2013-01-01

    The authors describe the correlation between 3-Tesla magnetic resonance neurography (MRN) and surgical findings in two patients who underwent multiple previous failed ulnar nerve surgeries. MRN correctly localized the site of the abnormality. Prospectively observed MRN findings of perineural fibrosis, ulnar nerve re-entrapment abnormalities, medial antebrachial cutaneous neuroma and additional median nerve entrapment were confirmed surgically.

  12. Solitary median maxillary central incisor (SMMCI) syndrome.

    Science.gov (United States)

    Hall, Roger K

    2006-01-01

    Solitary median maxillary central incisor syndrome (SMMCI) is a complex disorder consisting of multiple, mainly midline defects of development resulting from unknown factor(s) operating in utero about the 35th-38th day(s) from conception. It is estimated to occur in 1:50,000 live births. Aetiology is uncertain. Missense mutation in the SHH gene (I111F) at 7q36 may be associated with SMMCI. The SMMCI tooth differs from the normal central incisor, in that the crown form is symmetric; it develops and erupts precisely in the midline of the maxillary dental arch in both primary and permanent dentitions. Congenital nasal malformation (choanal atresia, midnasal stenosis or congenital pyriform aperture stenosis) is positively associated with SMMCI. The presence of an SMMCI tooth can predict associated anomalies and in particular the serious anomaly holoprosencephaly. Common congenital anomalies associated with SMMCI are: severe to mild intellectual disability, congenital heart disease, cleft lip and/or palate and less frequently, microcephaly, hypopituitarism, hypotelorism, convergent strabismus, oesophageal and duodenal atresia, cervical hemivertebrae, cervical dermoid, hypothyroidism, scoliosis, absent kidney, micropenis and ambiguous genitalia. Short stature is present in half the children. Diagnosis should be made by eight months of age, but can be made at birth and even prenatally at 18-22 weeks from the routine mid-trimester ultrasound scan. Management depends upon the individual anomalies present. Choanal stenosis requires emergency surgical treatment. Short stature may require growth hormone therapy. SMMCI tooth itself is mainly an aesthetic problem, which is ideally managed by combined orthodontic, prosthodontic and oral surgical treatment; alternatively, it can be left untreated. PMID:16722608

  13. Solitary median maxillary central incisor (SMMCI syndrome

    Directory of Open Access Journals (Sweden)

    Hall Roger K

    2006-04-01

    Full Text Available Abstract Solitary median maxillary central incisor syndrome (SMMCI is a complex disorder consisting of multiple, mainly midline defects of development resulting from unknown factor(s operating in utero about the 35th–38th day(s from conception. It is estimated to occur in 1:50,000 live births. Aetiology is uncertain. Missense mutation in the SHH gene (I111F at 7q36 may be associated with SMMCI. The SMMCI tooth differs from the normal central incisor, in that the crown form is symmetric; it develops and erupts precisely in the midline of the maxillary dental arch in both primary and permanent dentitions. Congenital nasal malformation (choanal atresia, midnasal stenosis or congenital pyriform aperture stenosis is positively associated with SMMCI. The presence of an SMMCI tooth can predict associated anomalies and in particular the serious anomaly holoprosencephaly. Common congenital anomalies associated with SMMCI are: severe to mild intellectual disability, congenital heart disease, cleft lip and/or palate and less frequently, microcephaly, hypopituitarism, hypotelorism, convergent strabismus, oesophageal and duodenal atresia, cervical hemivertebrae, cervical dermoid, hypothyroidism, scoliosis, absent kidney, micropenis and ambiguous genitalia. Short stature is present in half the children. Diagnosis should be made by eight months of age, but can be made at birth and even prenatally at 18–22 weeks from the routine mid-trimester ultrasound scan. Management depends upon the individual anomalies present. Choanal stenosis requires emergency surgical treatment. Short stature may require growth hormone therapy. SMMCI tooth itself is mainly an aesthetic problem, which is ideally managed by combined orthodontic, prosthodontic and oral surgical treatment; alternatively, it can be left untreated.

  14. ELECTRODIAGNOSTIC ASSESSMENT OF PERIPHERAL NERVE INJURIES IN KICK-BOXERS

    Directory of Open Access Journals (Sweden)

    M.R EMAD

    2002-06-01

    Full Text Available Introducti0n. Peripheral nerve injuries are one of the common traumas in various sport fields. Nowadays, thera are a growing tendency to Martial arts among young people. Insufficient knowlodage about the biomechanics and true skills in these sports can expose the athletes to many neuromusculoskeletal injuries including peripheral nerve injuries. The aim of this study was assessment of peripheral nerve injuries among Kick-boxers. Methods. The research was done on 30 male kick-boxers Aged between 17-28 years. Ulnar, tibial and median nerves were studied for the presence of unlar nerve entrapment on elbow, trasal tunnel syndrom and carpal tunnel syndrom. Results. Ulnar neuropathy was observed in 12 cases. Tibial entrapment was detected in 13 cases. No median nerve intrapment of CTS was detected. There was a significant correlation between the age of the participants and nerve entrapment. Discussion. Peripheral nerve injuries should be considered in athletes and should be trained to apply preventive and thrapeutic procedures.

  15. Popliteal Artery Pseudoaneurysm Following Primary Total Knee Arthroplasty

    OpenAIRE

    Shin, Young-Soo; Hwang, Yeok-Gu; Savale, Abhijit Prakash; Han, Seung-Beom

    2014-01-01

    An early diagnosis of popliteal artery pseudoaneurysm-a sequela of popliteal artery trauma-is difficult owing to its late presentation following total knee arthroplasty. The incidence of a popliteal artery pseudoaneurysm with a hematoma presenting only a peripheral nerve injury after total knee arthroplasty is also uncommon in the absence of common diagnostic features such as a pulsatile swelling with an audible bruit on auscultation. In the present report, we describe popliteal artery pseudo...

  16. Treatment of kid foot soft tissue defect with reverse flap with cutaneous branch of fibular artery combine with sural nerve nutritional vessel axial%腓动脉皮支与腓肠神经联合远端蒂皮瓣修复小儿足踝部皮肤缺损

    Institute of Scientific and Technical Information of China (English)

    喻伟光; 邵新中; 吕莉; 苏晓清; 石硕

    2010-01-01

    Objective To investigate the clinical efficiency of kid foot soft tissue defect with reverse flap with cutaneous branch of fibular artery combine with sural nerve nutritional vessel axial. Methods From Feb. 2006 to Feb. 2009, according to the position and size of the soft tissue defects, the sural nerve nutritional vessel flap combine with the cutaneous branch of the peroneal artery were desingned and obtained to repair the 5 cases soft tissue defects of the foot. The flap size ranged from 8 cm × 7 cm to 18 cm × 10 cm. The vessel pedicle of cutaneous branches ranged from 1.7 cm to 3.0 cm. The distribution of the vessel pedicle of cutaneous branches ranged from 4.5 cm to 8.0 cm on the lateral malleolus. Results All flaps survived completely in 6 cases. The outline and function were satisfactory during 6-18 months follow-up. Among of 6 cases, the sural nerve were anastomosed with the acceptor sensory nerve in all cases. The skin sense were sat-isfactory after 1 year of operation and 2-point discrimination was 10-13 mm. Conclusion The blood supply of this flap is reliable without sacrifice of major arteries. Flap elevation is easy. It can reverse to a long dis-tance and can repair large skin defects. Especially this flap could have some sensory nerve. It is very useful in repairing kid foot large soft tissue defect.%目的 探讨腓动脉皮支与腓肠神经营养血管联合远端蒂皮瓣逆行修复小儿足踝部皮肤缺损的临床应用效果.方法 根据缺损部位及大小设计以腓动脉下段皮支与腓肠神经营养血管的联合远端蒂及旋转点,沿腓肠神经营养血管轴线切取皮瓣,逆行移位修复小儿足踝部皮肤软组织缺损6例.皮瓣切取范围8.0 cm × 7.0 cm~18.0 cm×10.0 cm,联合血管蒂长1.7~3.0 cm,血管蒂发出部位位于外踝上4.0~8.0 cm.结果 术后6例皮瓣其中5例完全成活,创面Ⅰ期愈合.1例远端1.0 cm发生干性坏死,面积约2.0 cm×1.0 cm,经换药后愈合.随访6~18个月,

  17. Nerve conduction velocity

    Science.gov (United States)

    ... to measure the speed of the nerve signals. Electromyography (recording from needles placed into the muscles) is ... Often, the nerve conduction test is followed by electromyography (EMG). In this test, needles are placed into ...

  18. Common peroneal nerve dysfunction

    Science.gov (United States)

    ... toe-out movements Tests of nerve activity include: Electromyography (EMG, a test of electrical activity in muscles) Nerve ... Peroneal neuropathy. In: Preston DC, Shapiro BE, eds. Electromyography and Neuromuscular Disorders . 3rd ed. Philadelphia, PA: Elsevier; ...

  19. Pulmonary Artery Denervation Reduces Pulmonary Artery Pressure and Induces Histological Changes in an Acute Porcine Model of Pulmonary Hypertension

    OpenAIRE

    Rothman, A.M.K.; Arnold, N D; Chang, W.; Watson, O.; Swift, A J; Condliffe, R; Elliot, C A; Kiely, D. G.; Suvarna, S K; Gunn, J.; Lawrie, A.

    2015-01-01

    Background— Pulmonary arterial hypertension is a devastating disease with high morbidity and mortality and limited treatment options. Recent studies have shown that pulmonary artery denervation improves pulmonary hemodynamics in an experimental model and in an early clinical trial. We aimed to evaluate the nerve distribution around the pulmonary artery, to determine the effect of radiofrequency pulmonary artery denervation on acute pulmonary hypertension induced by vasoconstriction, and to de...

  20. Epicardial ultrasound in coronary artery bypass surgery

    OpenAIRE

    Budde, R.P.J.

    2005-01-01

    Chapter 1 Coronary artery bypass surgery (CABG) is traditionally performed via a median sternotomy approach on cardiopulmonary bypass (arrested heart). Since the mid 1990ties, beating heart, minimally invasive and even totally endoscopic CABG are (re)explored. In all approaches to CABG, the surgeon may face several intraoperative difficulties: 1. Localization of the target coronary artery for bypass grafting. 2. Selection of the optimal anastomotic site on the target coronary artery. 3. Asses...

  1. Chitosan crosslinked flat scaffolds for peripheral nerve regeneration.

    Science.gov (United States)

    Fregnan, F; Ciglieri, E; Tos, P; Crosio, A; Ciardelli, G; Ruini, F; Tonda-Turo, C; Geuna, S; Raimondo, S

    2016-01-01

    Chitosan (CS) has been widely used in a variety of biomedical applications, including peripheral nerve repair, due to its excellent biocompatibility, biodegradability, readily availability and antibacterial activity. In this study, CS flat membranes, crosslinked with dibasic sodium phosphate (DSP) alone (CS/DSP) or in association with the γ-glycidoxypropyltrimethoxysilane (CS/GPTMS_DSP), were fabricated with a solvent casting technique. The constituent ratio of crosslinking agents and CS were previously selected to obtain a composite material having both adequate mechanical properties and high biocompatibility. In vitro cytotoxicity tests showed that both CS membranes allowed cell survival and proliferation. Moreover, CS/GPTMS_DSP membranes promoted cell adhesion, induced Schwann cell-like morphology and supported neurite outgrowth from dorsal root ganglia explants. Preliminary in vivo tests carried out on both types of nerve scaffolds (CS/DSP and CS/GPTMS_DSP membranes) demonstrated their potential for: (i) protecting, as a membrane, the site of nerve crush or repair by end-to-end surgery and avoiding post-operative nerve adhesion; (ii) bridging, as a conduit, the two nerve stumps after a severe peripheral nerve lesion with substance loss. A 1 cm gap on rat median nerve was repaired using CS/DSP and CS/GPTMS_DSP conduits to further investigate their ability to induce nerve regeneration in vivo. CS/GPTMS_DSP tubes resulted to be more fragile during suturing and, along a 12 week post-operative lapse of time, they detached from the distal nerve stump. On the contrary CS/DSP conduits promoted nerve fiber regeneration and functional recovery, leading to an outcome comparable to median nerve repaired by autograft. PMID:27508969

  2. Estimulação elétrica nervosa transcutânea após cirurgia de revascularização miocárdica Transcutaneous electrical nerve stimulation after coronary artery bypass graft surgery

    Directory of Open Access Journals (Sweden)

    Paula Monique Barbosa Lima

    2011-12-01

    Full Text Available INTRODUÇÃO: Após a cirurgia cardíaca, os pacientes apresentam limitação na força muscular respiratória, o que favorece a instalação de complicações pulmonares. OBJETIVO: Analisar a eficácia da estimulação elétrica nervosa transcutânea sobre o processo doloroso e força muscular respiratória em pacientes submetidos à cirurgia de revascularização do miocárdio (CRM. MÉTODOS: Foram inclusos pacientes em pós-operatório de CRM por meio de esternotomia, com uso de circulação extracorpórea, anestesia geral, sem estar sob efeito de bloqueio neuromuscular, uso de drenos de tórax e mediastino, extubados até 6 horas pós-procedimento e apresentando índice igual ou superior a três na escala analógica visual da dor (EVA, estando no primeiro dia de pós-operatório (1º DPO. Foram recrutados 20 pacientes, divididos em dois grupos, sem predomínio de sexo: Grupo Controle (n=10, que recebeu terapia analgésica mais fisioterapia; e Grupo TENS, que recebeu terapia analgésica, fisioterapia e TENS. A TENS foi aplicada por 30 minutos, três vezes ao dia, num intervalo de 3 horas cada aplicação. RESULTADOS: Para o grau de dor, houve uma média inicial e final, respectivamente, de 7,0 e 1,0 para o Grupo TENS e 7,0 e 8,0 para o Grupo Controle. Para a Pimáx, a média inicial e final foi de, respectivamente, -102,5 cmH2O e -141,17 cmH2O para o Grupo TENS e -97,0 cmH2O e -100,3 cmH2O para o Controle. Quanto a Pemáx, a média inicial e final foi de, respectivamente, 63 cmH2O e 125 cmH2O para o Grupo TENS e 55,3 cmH2O e 53,2 cmH2O para o Grupo Controle. CONCLUSÃO: A TENS demonstrou eficácia significativa na redução da algia e no aumento das forças musculares respiratórias no 1º DPO de CRM.INTRODUCTION: After cardiac surgery, patients have a limitation in respiratory muscle strength, which favors the appearing of pulmonary complications. OBJECTIVE: To evaluate the effectiveness of transcutaneous electrical nerve stimulation (TENS

  3. Optic Nerve Pit

    Science.gov (United States)

    ... 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 ...

  4. The Heterogeneous P-Median Problem for Categorization Based Clustering

    Science.gov (United States)

    Blanchard, Simon J.; Aloise, Daniel; DeSarbo, Wayne S.

    2012-01-01

    The p-median offers an alternative to centroid-based clustering algorithms for identifying unobserved categories. However, existing p-median formulations typically require data aggregation into a single proximity matrix, resulting in masked respondent heterogeneity. A proposed three-way formulation of the p-median problem explicitly considers…

  5. EMG MEDIAN POWER FREQUENCY IN AN EXHAUSTING EXERCISE

    NARCIS (Netherlands)

    AMENT, W; BONGA, GJJ; HOF, AL; VERKERKE, GJ

    1993-01-01

    EMG median power frequency of the calf muscles was investigated during an exhausting treadmill exercise. This exercise was an uphill run, the average endurance time was 1.5 min. Median power frequency of the calf muscles declined by more than 10% during this exercise. In addition EMG median power fr

  6. The superficial ulnar artery: development and clinical significance Artéria ulnar superficial: desenvolvimento e relevância clínica

    Directory of Open Access Journals (Sweden)

    Srinivasulu Reddy

    2007-09-01

    Full Text Available The principal arteries of the upper limb show a wide range of variation that is of considerable interest to orthopedic surgeons, plastic surgeons, radiologists and anatomists. We present here a case of superficial ulnar artery found during the routine dissection of right upper limb of a 50-year-old male cadaver. The superficial ulnar artery originated from the brachial artery, crossed the median nerve anteriorly and ran lateral to this nerve and the brachial artery. The superficial ulnar artery in the arm gave rise to a narrow muscular branch to the biceps brachii. At the elbow level the artery ran superficial to the bicipital aponeurosis where it was crossed by the median cubital vein. It then ran downward and medially superficial to the forearm flexor muscles, and then downward to enter the hand. At the palm, it formed the superficial and deep palmar arches together with the branches of the radial artery. The presence of a superficial ulnar artery is clinically important when raising forearm flaps in reconstructive surgery. The embryology and clinical significance of the variation are discussed.As principais artérias do membro superior apresentam uma ampla variação, que é relativamente importante a cirurgiões ortopédicos e plásticos, radiologistas e anatomistas.Apresentamosumcaso de artéria ulnar superficial encontrada durante dissecção de rotina de membro superior direito de um cadáver masculino de 50 anos de idade.Aartéria ulnar superficial originava-se da artéria braquial, cruzava o nervo mediano anteriormente e percorria lateralmente esse nervo e a artéria braquial. A artéria ulnar superficial no braço deu origem a um ramo muscular estreito do músculo bíceps braquial. Ao nível do cotovelo, a artéria percorria superficialmente a aponeurose bicipital, onde era cruzada pela veia cubital mediana. Percorria, então, em sentido descendente e medialmente superficial aos músculos flexores do antebraço, e então descendia para

  7. Stretch-induced nerve injury: a proposed technique for the study of nerve regeneration and evaluation of the influence of gabapentin on this model

    Directory of Open Access Journals (Sweden)

    J.A. Machado

    2013-11-01

    Full Text Available The rat models currently employed for studies of nerve regeneration present distinct disadvantages. We propose a new technique of stretch-induced nerve injury, used here to evaluate the influence of gabapentin (GBP on nerve regeneration. Male Wistar rats (300 g; n=36 underwent surgery and exposure of the median nerve in the right forelimbs, either with or without nerve injury. The technique was performed using distal and proximal clamps separated by a distance of 2 cm and a sliding distance of 3 mm. The nerve was compressed and stretched for 5 s until the bands of Fontana disappeared. The animals were evaluated in relation to functional, biochemical and histological parameters. Stretching of the median nerve led to complete loss of motor function up to 12 days after the lesion (P<0.001, compared to non-injured nerves, as assessed in the grasping test. Grasping force in the nerve-injured animals did not return to control values up to 30 days after surgery (P<0.05. Nerve injury also caused an increase in the time of sensory recovery, as well as in the electrical and mechanical stimulation tests. Treatment of the animals with GBP promoted an improvement in the morphometric analysis of median nerve cross-sections compared with the operated vehicle group, as observed in the area of myelinated fibers or connective tissue (P<0.001, in the density of myelinated fibers/mm2 (P<0.05 and in the degeneration fragments (P<0.01. Stretch-induced nerve injury seems to be a simple and relevant model for evaluating nerve regeneration.

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

    Institute of Scientific and Technical Information of China (English)

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

    2008-01-01

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

  9. Optic nerve oxygenation

    DEFF Research Database (Denmark)

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

    2005-01-01

    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...... 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......-oxygenase inhibitor, indomethacin, which indicates that prostaglandin metabolism plays a role. Laboratory studies suggest that carbonic anhydrase inhibitors might be useful for medical treatment of optic nerve and retinal ischemia, potentially in diseases such as glaucoma and diabetic retinopathy. However, clinical...

  10. Optic nerve oxygenation

    DEFF Research Database (Denmark)

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

    2005-01-01

    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......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...... 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...

  11. THE USE OF PROTECTOR MADE OF REPEREN IN MICROVASCULAR DECOMPRESSION OF TRIGEMINAL NERVE

    OpenAIRE

    Sheludyakov А.Y.; Tikhomirov S.Е.; Stupak Y.А.

    2014-01-01

    For the first time there was used an isolating protector made of Reperen aiming to resolve a neurovascular conflict between superior cerebellar artery and trigeminal nerve root — a leading cause of trigeminal neuralgia.

  12. The Use of Protector Made of Reperen in Microvascular Decompression of Trigeminal Nerve

    Directory of Open Access Journals (Sweden)

    Sheludyakov А.Y.

    2014-03-01

    Full Text Available For the first time there was used an isolating protector made of Reperen aiming to resolve a neurovascular conflict between superior cerebellar artery and trigeminal nerve root — a leading cause of trigeminal neuralgia.

  13. Arterial Ageing

    OpenAIRE

    Lee, Seung-Jun; Park, Sung-Ha

    2013-01-01

    Arterial ageing is characterized by age associated degeneration and sclerosis of the media layer of the large arteries. However, besides ageing, clinical conditions, which enhance oxidative stress and inflammation act to accelerate the degree of arterial ageing. In this review, we summarized the pathophysiology and contributing factors that accelerate arterial ageing. Among them, we focused on hypertension, the renin-angiotensin-aldosterone system and vascular inflammation which are modifiabl...

  14. Association between internal carotid artery dissection and arterial tortuosity

    Energy Technology Data Exchange (ETDEWEB)

    Saba, Luca; Piga, Mario [Azienda Ospedaliero Universitaria (A.O.U.), Department of Radiology, Monserrato, Cagliari (Italy); Argiolas, Giovanni Maria; Siotto, Paolo [Azienda Ospedaliero Brotzu (A.O.B.), Department of Radiology, di Cagliari (Italy); Sumer, Suna; Wintermark, Max [Neuroradiology Division, Neuroradiology, UVA Department of Radiology, Charlottesville, VA (United States); Raz, Eytan [New York University School of Medicine, Department of Radiology, New York, NY (United States); Sapienza University of Rome, Department of Neurology and Psychiatry, Rome (Italy); Sanfilippo, Roberto; Montisci, Roberto [Azienda Ospedaliero Universitaria (A.O.U.), Department of Vascular Surgery, di Cagliari (Italy)

    2014-10-18

    Carotid artery dissection is an important cause of ischemic stroke in all age groups, particularly in young patients. The purpose of this work was to assess whether there is an association between the presence of an internal carotid artery dissection (ICAD) and the arterial tortuosity. This study considered 124 patients (72 males and 52 females; median age 57 years) with CT/MR diagnosis of ICAD of the internal carotid artery were considered in this multi-centric retrospective study. The arterial tortuosity was evaluated and, when present, was categorized as elongation, kinking, or coiling. For each patient, both the right and left sides were considered for a total number of 248 arteries in order to have the same number of cases and controls. Fisher's exact test was applied to test the association between elongation, kinking, coiling, dissection, and the side affected by CAD. Fisher's exact test showed a statistically significant association between the ICAD and kinking (p = 0.0089) and coiling (p = 0.0251) whereas no statistically significant difference was found with arterial vessel elongation (p = 0.444). ICAD was more often seen on the left side compared to the right (p = 0.0001). These results were confirmed using both carotid arteries of the same patient as dependent parameter with p = 0.0012, 0.0129, and 0.3323 for kinking, coiling, and elongation, respectively. The presence of kinking and coiling is associated with ICAD. (orig.)

  15. Imaging the trigeminal nerve

    Energy Technology Data Exchange (ETDEWEB)

    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.

  16. Imaging the trigeminal nerve

    International Nuclear Information System (INIS)

    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.

  17. Semi-skeletonized Internal Mammary Grafts and Phrenic Nerve Injury: Cause-and-effect analysis

    Institute of Scientific and Technical Information of China (English)

    DENG Yongzhi; SUN Zongquan; MA Jie; Hugh S PATERSON

    2006-01-01

    Phrenic nerve injury after cardiac surgery increases postoperative pulmonary complications. The purpose of this study was to analyze the causes and effects of phrenic nerve injury after cardiac surgery. Prospectively collected data on 2084 consecutive patients who underwent cardiac surgery from Jan. 1995 to Feb. 2002 were analyzed. Twenty-eight preoperative and operation related variables were subjected to logistic analysis with the end point being phrenic nerve injury. Then phrenic nerve injury and 6 perioperative morbidities were included in the analysis as variables to determine their independent predictive value for perioperative pulmonary morbidity. An identical approach was used to identify the independent risk factors for perioperative mortality. There were 53 phrenic nerve injuries (2.5 %). There was no phrenic nerve injury in non-coronary surgery or coronary surgery using conduits other than the internal mammary artery. The independent risk factors for phrenic nerve injury were the use of internal mammary artery (Odds ratio (OR)=14.5) and the presence of chronic obstructive pulmonary disease (OR=2.9). Phrenic nerve injury was an independent risk factor (OR=8.1) for perioperative pulmonary morbidities but not for perioperative mortality. Use of semi-skeletonized internal mammary artery harvesting technique and drawing attention to possible vascular or mechanical causes of phrenic nerve injury may reduce its occurrence. Unilateral phrenic nerve injury, although rarely life-threatening, is an independent risk factor for postoperative respiratory complications. When harvesting internal mammary arteries, it should be kept in mind avoiding stretching, compromising, or inadvertently dissecting phrenic nerve is as important as avoiding damage of internal mammary artery itself.

  18. Benign anatomical mistakes: the correct anatomical term for the recurrent laryngeal nerve.

    Science.gov (United States)

    Mirilas, Petros; Skandalakis, John E

    2002-01-01

    The term recurrent laryngeal nerve has been adopted by Nomina Anatomica (1989) and Terminologia Anatomica (1998) to describe this vagus branch from its origin, its turn dorsally around the subclavian artery and the aortic arch, and its cranial pathway until it reaches its terminal organs in the neck. However, there is still much confusion, and either the terms inferior and recurrent laryngeal nerve are used interchangeably or inferior laryngeal nerve is considered the terminal branch of the recurrent laryngeal nerve. We hereby feel that it is necessary to reassess the term and we propose the term inferior laryngeal nerve for the entire nerve under consideration, from its origin from the vagus nerve to its destinations, including tracheal, esophageal, and pharyngeal branches. If the term superior laryngeal nerve is a given, standard and accepted term in the anatomical terminology, then logically the term inferior laryngeal nerve should also be accepted, as opposed to it. Of course the upward travel of the inferior laryngeal nerve is "recurrent". When nonrecurrence is encountered together with an arteria lusoria, a retroesophageal right subclavian artery or a right aortic arch, we consider that the term nonrecurrent inferior laryngeal nerve should be used to describe the deviation from the normal.

  19. Fusiform aneurysm of a persistent trigeminal artery associated with rare intracranial arterial variations and subarachnoid hemorrhage.

    Science.gov (United States)

    Kimball, David; Ples, Horia; Kimball, Heather; Miclaus, Gratian D; Matusz, Petru; Loukas, Marios

    2015-01-01

    The trigeminal artery is one of four primitive anastomoses between the internal carotid artery and vertebrobasilar system that regresses in the sixth week of fetal development. A persistent trigeminal artery (PTA) is generally an incidental finding but may also be associated with intracranial vascular pathologies such as aneurysms, arteriovenous malformations, and cranial nerve compression syndromes. We present an extremely rare case of a right PTA with an associated bleeding fusiform aneurysm located in the carotidian (lateral) part of the PTA. In addition, this rare anatomic variation was associated with bilateral absence of the posterior communicating arteries, a left posterior cerebral artery originating from the left internal carotid artery, and agenesis of the A1 segment of the left anterior cerebral artery. PMID:25053265

  20. Facial Nerve Neuroma Management

    OpenAIRE

    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...

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

    Directory of Open Access Journals (Sweden)

    Straschill Max

    2006-10-01

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

  2. Paralisia de prega vocal esquerda secundária à lesão do nervo laríngeo recorrente após cirurgia de ligadura do canal arterial: relato de caso Parálisis de pliegue vocal izquierdo secundario a la lesión del nervio laríngeo recurrente después de cirugía de ligadura del canal arterial: relato de caso Paralysis of the left vocal cord secondary to left recurrent nerve lesion following surgery for ligation of the arterial canal: case report

    Directory of Open Access Journals (Sweden)

    Marcius Vinícius M. Maranhão

    2002-07-01

    .800 g, sometida a cirugía para ligadura del canal arterial. Recibió como medicación pré-anestésica, midazolam (0,8 mg.kg-1, sesenta minutos antes de la cirugía. La inducción y la manutención de la anestesia fueron hechas con sevoflurano, alfentanil y pancuronio. La disección del canal arterial fue realizada con dificultad. En el 4º día del pós-operatorio presentó disfonia persistente. La videolarin- goscopia mostró parálisis de pliegue vocal izquierdo y pequeña abertura paramediana. CONCLUSIONES: Por su íntima relación con el canal arterial, el nervio laríngeo recurrente izquierdo puede ser lesionado, durante la cirugía correctiva, principalmente cuando existen dificultades en la disección y ligadura del canal arterial. Diferentemente de las disfonias decurrentes de la intubación y extubación traqueal, surgen más tardíamente y permanecen por largos períodos, pudiendo inclusive ser irreversibles.BACKGROUND AND OBJECTIVES: Postoperative dysphonia is commonly associated to tracheal intubation and extubation complications, but other causal factors may be involved, including surgical procedures. This article aimed at reporting a late postoperative dysphonia as a consequence of left vocal cord paralysis secondary to left recurrent laryngeal nerve injury during ductus arteriosus ligation procedure. CASE REPORT: Female patient, 6 years old, physical status ASA II, 18.8 kg, submitted to ductus arteriosus ligation. Patient was premedicated with oral midazolam (0.8 mg.kg-1 60 minutes before surgery. Anesthesia was induced and maintained with sevoflurane, alfentanil and pancuronium. The ductus arteriosus was difficult to dissect. In the 4th postoperative day, patient presented with persistent dysphonia. Videolaryngoscopy has evidenced paralysis of the left vocal cord and a small paramedian gap. CONCLUSIONS: For its close relationship with the ductus arteriosus, the left recurrent laryngeal nerve may be damaged during corrective procedures, especially when

  3. Superselective arterial infusion and concomitant radiotherapy for advanced head and neck cancer

    International Nuclear Information System (INIS)

    Superselective arterial infusion for patients with advanced head and neck cancer has increasingly been applied in Japan. We analyzed our experiences and evaluated the efficacy and safety of this treatment. Forty-four patients, who were considered contraindicated for surgery or rejected radical surgery, received superselective intra-arterial infusion therapy of cisplatin (100-120 mg/m2/week) with simultaneous intravenous infusion of thiosulfate to neutralize cisplatin toxicity, and conventional concomitant extrabeam radiotherapy (65 Gy/26 f/6.5 weeks). During the median follow-up period of 17 months, 2-year progression-free survival rate of primary lesion was 66.9%, and that of patients with T4b diseases 57%. The 2-year overall survival rate was 52.4%. Although acute toxic effects were considered acceptable, severe toxic events occurred in some cases, namely, cranial nerve palsy, Methicillin-resistant Staphylococcus aureus (MRSA) pneumonia, sepsis, and osteoradionecrosis. We confirmed the high effectiveness of superselective arterial infusion and concomitant radiotherapy, which can concentrate the attack of decadose cisplatin on locoregional disease. Moreover, even patients with unresectable disease can be cured. We must clarify the treatment results and late side effects, and establish the indications for this treatment. (author)

  4. A theoretical analysis of the median LMF adaptive algorithm

    DEFF Research Database (Denmark)

    Bysted, Tommy Kristensen; Rusu, C.

    1999-01-01

    the speed of convergence, no analytical studies have yet been made to prove this. In order to enhance the usability, this paper presents a convergence and steady-state analysis of the median LMF adaptive algorithm. As expected this proves that the median LMF has a slower convergence and a lower steady...

  5. NORMATIVE DATA OF UPPER LIMB NERVE CONDUCTION IN YOUNG POPULATION IN AND AROUND BARPETA TOWN, ASSAM

    Directory of Open Access Journals (Sweden)

    Dipti

    2015-12-01

    Full Text Available INTRODUCTION Goal of our work was to establish the data of normal nerve conduction velocity (NCV for the median and the ulnar nerves in normal healthy adults in Barpeta town area, Assam, India. METHODS Nerve conduction studies were performed prospectively in the upper limbs of 100 carefully screened, healthy individuals of either sex, who were between the ages of 20 and 60 years, by using a standardized technique. RESULTS: MOTOR STUDIES The median distal latency (DL in men was 3.48 (0.26 ms, the amplitude (CMAPA was 9.86 (1.92 mV, the conduction velocity (MNCV was 55.94 (2.94 m/s and the F-wave (min latency was 26.86 (2.12 minute. In the ulnar nerve, the motor DL was 2.3 (0.26 ms, the amplitude (CMAPA was 9.97 (3.90 mV, MNCV was 62.97 (3.90 m/s and the F-Wave (min latency was 25.98±2.41. In the sensory studies, the median nerve DL was 1.89 (0.25 ms, SNCV was 53.14±3.80 m/s and the amplitude (SNAPA was 42.69 (20.48 μV for was. For the ulnar nerve the DL was 1.89 (0.36 ms, SNCV was 56.86 (6.23 m/s and the amplitude (SNAPA was 40.92 (168.4 μV. CONCLUSION The normative conduction parameters of the commonly tested nerves in the upper limb were established in research laboratory of physiology department of our institute. The mean motor nerve conduction parameters for the median and the ulnar nerves correlated favorably with the existing literature data. However, for the sensory nerves, a higher value for the nerve action potential amplitude was demonstrated in this study.

  6. Applied anatomy of the cervical region of the recurrent laryngeal nerve

    Institute of Scientific and Technical Information of China (English)

    Changchu Wu; Xing Guo; Yanwei Li

    2008-01-01

    BACKGROUND AND OBJECTIVE: To avoid recurrent laryngeal nerve (RLN) injury during thyroid surgery, it is important to identify the nerve and to follow its projection carefully to discriminate it from the inferior thyroid artery. DESIGN, TIME AND SETTING: All studies were performed at the Anatomy Division of Shaoyang Medical College from May 2003 to May 2004 with repeated measurement design. MATERIALS: Fifty embalmed adult corpses, comprising 20 females and 30 males, were obtained by donation. METHODS AND MAIN OUTCOME MEASURES: The projection, branches, and the relationship of the RLN to the inferior thyroid artery were observed. RESULTS: The RLN in all cases ascended through the tracheoesophageal groove at the isthmus superior levels of the thyroid gland. However, the RLN in 14 cases were situated inferior to the isthmus of the thyroid gland; 11 cases were to the right side and 2 cases to the left side, projected in the tracheoesophageal groove, and ascended away from the groove after 4.5-6.5 mm. The RLN typically ramified at the thyroid isthmus plane (44 cases, 44% of all cases). The RLN branches were variable. Type 2 rami were most common in the RLN, accounting for 55%; the second most common was RLN branches with no rami. RLN braches with type 3 rami, 4 rami, and 5 rami were less common. Approximately 54% of nerves were situated behind the main branch artery. The nerves located adjacent to the arteries, and between the arterial branches, were similar; the former applied to 19 cases, accounting for 19%, whereas the latter applied to 18 cases, accounting for 18%. Left nerves behind the artery, and right nerves before the artery, were more common. There were significant differences between the left and right nerves (P<0.01). CONCLUSION: There was not a significant difference in the projection of the RLN, while a significant difference in the number of RLN branches existed. In addition, the anatomical relationship of the RLN and the inferior thyroid artery exhibited

  7. Head rotation and sound image localization in the median plane

    Institute of Scientific and Technical Information of China (English)

    RAO Dan; XIE Bosun

    2005-01-01

    The effect of head rotation on median plane sound source (or image) localization is studied. It is suggested that, at low frequency, the change of interaural time difference (ITD) caused by head rotation supplies information for determining sound source direction in the median plane. Based on the suggestion, the summed sound image localization equations for multiple loudspeakers arranged in the median plane are derived. Especially, for a pair of loudspeakers arranged front-back symmetrically in the median plane, the localization equations are similar to that of stereophonic sound in horizontal plane. A sound image localization experiment was carried out to prove the theoretical analysis. The results of this paper are not only available to virtual spatial auditory, but also supply a quantitative validation of the hypothesis that head rotation is a cue for sound source localization in the median plane at low frequency.

  8. Adaptive Threshold Median Filter for Multiple-Impulse Noise

    Institute of Scientific and Technical Information of China (English)

    JIANG Bo; HUANG Wei

    2007-01-01

    Attenuating the noises plays an essential role in the image processing. Almost all the traditional median filters concern the removal of impulse noise having a single layer, whose noise gray level value is constant. In this paper, a new adaptive median filter is proposed to handle those images corrupted not only by single layer noise. The adaptive threshold median filter(ATMF) has been developed by combining the adaptive median filter (AMF) and two dynamic thresholds. Because of the dynamic threshold being used, the ATMF is able to balance the removal of the multiple-impulse noise and the quality of image. Comparison of the proposed method with traditional median filters is provided. Some visual examples are given to demonstrate the performance of the proposed Filter.

  9. Peripheral nerve disease

    Institute of Scientific and Technical Information of China (English)

    1992-01-01

    920745 Experimental reconstruction of in-trinsic hand muscle function by anteriorinterosseous nerve transference. HUANGGang(黄钢), et al. Dept Orthopaedics, GeneralHosp, PLA, Beijing, 100853. Natl, Med J Chin1992; 72(5): 269-272. The anterior interosseous nerve was transferred

  10. Fractionated Stereotactic Radiotherapy for Facial Nerve Schwannomas.

    Science.gov (United States)

    Shi, Wenyin; Jain, Varsha; Kim, Hyun; Champ, Colin; Jain, Gaurav; Farrell, Christopher; Andrews, David W; Judy, Kevin; Liu, Haisong; Artz, Gregory; Werner-Wasik, Maria; Evans, James J

    2016-02-01

    Purpose Data on the clinical course of irradiated facial nerve schwannomas (FNS) are lacking. We evaluated fractionated stereotactic radiotherapy (FSRT) for FNS. Methods Eight consecutive patients with FNS treated at our institution between 1998 and 2011 were included. Patients were treated with FSRT to a median dose of 50.4 Gy (range: 46.8-54 Gy) in 1.8 or 2.0 Gy fractions. We report the radiographic response, symptom control, and toxicity associated with FSRT for FNS. Results The median follow-up time was 43 months (range: 10-75 months). All patients presented with symptoms including pain, tinnitus, facial asymmetry, diplopia, and hearing loss. The median tumor volume was 1.57 cc. On the most recent follow-up imaging, five patients were noted to have stable tumor size; three patients had a net reduction in tumor volume. Additionally, six patients had improvement in clinical symptoms, one patient had stable clinical findings, and one patient had worsened House-Brackmann grade due to cystic degeneration. Conclusion FSRT treatment of FNS results in excellent control of growth and symptoms with a small rate of radiation toxicity. Given the importance of maintaining facial nerve function, FSRT could be considered as a primary management modality for enlarging or symptomatic FNS. PMID:26949592

  11. Spontaneous internal carotid artery dissection.

    Science.gov (United States)

    Khimenko, L P; Esham, H R; Ahmed, W

    2000-10-01

    Once considered uncommon, spontaneous dissection of the carotid artery is an increasingly recognized cause of stroke, headache, cranial nerve palsy, or ophthalmologic events, especially in young adults. Even in the presence of existing signs and symptoms, the diagnosis can be missed by experienced physicians of all specialties. We report a case of spontaneous internal carotid artery dissection in a 38-year-old woman with a cortical stroke and visual disturbances as initial symptoms. The diagnosis was confirmed by magnetic resonance imaging/angiography and by angiography. Prompt anticoagulation was instituted, and the patient had complete resolution of symptoms. Cervicocephalic arterial dissection should be included in the differential diagnosis of the causes of cerebrovascular events.

  12. From basilar artery dolichoectasia to basilar artery aneurysm: natural history in images.

    Science.gov (United States)

    Zis, Panagiotis; Fragkis, Stylianos; Lykouri, Maria; Bageris, Ioannis; Kolovos, Georgios; Angelidakis, Panagiotis; Tavernarakis, Antonios

    2015-05-01

    Dolichoectasia is a medical term used to describe elongated and dilated vessels that follow a tortuous and windy course with frequent loops and curves. We are presenting the natural history in images of a normal basilar artery becoming dolichoectatic, followed by the formation of an aneurysm, over a period of many years, in 60-year-old Caucasian man with a long history of secondary progressive multiple sclerosis and uncontrolled arterial hypertension, who was diagnosed with dolichoectasia of basilar artery in 2008. Although relatively stable at this point, eventually his mobility deteriorated and signs from the cranial nerves, such as trigeminal neuralgia and bilateral palsy of the VI and the VII nerves were added in the clinical picture. In 2014, both computed tomography and magnetic resonance imaging of the brain revealed the formation of an unruptured aneurysm of the basilar artery. PMID:25765208

  13. Biological and artificial nerve conduit for repairing peripheral nerve defect

    Institute of Scientific and Technical Information of China (English)

    Xuetao Xie; Changqing Zhang

    2006-01-01

    OBJECTIVE: Recently, with the development of biological and artificial materials, the experimental and clinical studies on application of this new material-type nerve conduit for treatment of peripheral nerve defect have become the hotspot topics for professorial physicians.DATA SOURCES: Using the terms "nerve conduits, peripheral nerve, nerve regeneration and nerve transplantation" in English, we searched Pubmed database, which was published during January 2000 to June 2006, for the literatures related to repairing peripheral nerve defect with various materials. At the same time, we also searched Chinese Technical Scientific Periodical Database at the same time period by inputting" peripheral nerve defect, nerve repair, nerve regeneration and nerve graft" in Chinese.STUDY SELECTION: The materials were firstly selected, and literatures about study on various materials for repairing peripheral nerve defect and their full texts were also searched. Inclusive criteria: nerve conduits related animal experiments and clinical studies. Exclusive criteria: review or repetitive studies.DATA EXTRACTION: Seventy-nine relevant literatures were collected and 30 of them met inclusive criteria and were cited.DATA SYNTHESTS: Peripheral nerve defect, a commonly seen problem in clinic, is difficult to be solved. Autogenous nerve grafting is still the gold standard for repairing peripheral nerve defect, but because of its application limitation and possible complications, people studied nerve conduits to repair nerve defect. Nerve conduits consist of biological and artificial materials.CONCLUSION: There have been numerous reports about animal experimental and clinical studies of various nerve conduits, but nerve conduit, which is more ideal than autogenous nerve grafting, needs further clinical observation and investigation.

  14. UNILATERAL VARIATION IN THE BRANCHING PATTERN OF RIGHT AXILLARY ARTERY: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    A.K.Manicka Vasuki

    2015-09-01

    Full Text Available Axillary artery and its branches are prone to have variations in their course. Knowledge about such variations are important for Radiologists in imaging techniques, Surgeons,Orthopedicians and Anesthetists in performing surgeries in the axilla and giving regional nerve blocks in the axilla.During dissection of a cadaver in the department of Anatomy, PSG IMS &R, Coimbatore, We observed a variation in the third part of right Axillary artery. From the common trunk, Subscapular artery, Anterior and Posterior circumflex humeral arteries and Profunda brachii artery arose. Third part of Axillary artery continued down as brachial artery. We are highlighting the variation in this study.

  15. Neurophysiological approach to disorders of peripheral nerve

    DEFF Research Database (Denmark)

    Crone, Clarissa; Krarup, Christian

    2013-01-01

    Disorders of the peripheral nerve system (PNS) are heterogeneous and may involve motor fibers, sensory fibers, small myelinated and unmyelinated fibers and autonomic nerve fibers, with variable anatomical distribution (single nerves, several different nerves, symmetrical affection of all nerves...

  16. Partial oculomotor nerve palsy in a 7-year-old child

    Science.gov (United States)

    Israni, Anil; Chakrabarty, Biswaroop; Kumar, Atin; Gulati, Sheffali

    2016-01-01

    Oculomotor nerve palsy can be due to varied causes that include diabetic neuropathy, myasthenia gravis, brainstem infarction, demyelinating conditions, and cerebral aneurysms. Among the aneurysmal causes of oculomotor nerve palsy, aneurysm of the posterior communicating artery has been observed to be the most common. Pupillary dysfunction is considered to be an important feature of aneurysmal oculomotor nerve paresis. A case of a 7-year-old boy with partial oculomotor nerve palsy with pupillary sparing is being reported here, the etiology of which is tortuous and ectatic distal internal carotid artery. This is a rare cause of oculomotor nerve paresis and to the best of our knowledge has not yet been reported in children. Ischemia rather than compression seems to be the most plausible cause in this case.

  17. Radial Nerve Tendon Transfers.

    Science.gov (United States)

    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

  18. Changes in nerve microcirculation following peripheral nerve compression

    Institute of Scientific and Technical Information of China (English)

    Yueming Gao; Changshui Weng; Xinglin Wang

    2013-01-01

    Following peripheral nerve compression, peripheral nerve microcirculation plays important roles in regulating the nerve microenvironment and neurotrophic substances, supplying blood and oxygen and maintaining neural conduction and axonal transport. This paper has retrospectively analyzed the articles published in the past 10 years that addressed the relationship between peripheral nerve compression and changes in intraneural microcirculation. In addition, we describe changes in different peripheral nerves, with the aim of providing help for further studies in peripheral nerve microcirculation and understanding its protective mechanism, and exploring new clinical methods for treating peripheral nerve compression from the perspective of neural microcirculation.

  19. An exact solver for the DCJ median problem.

    Science.gov (United States)

    Zhang, Meng; Arndt, William; Tang, Jijun

    2009-01-01

    The "double-cut-and-join" (DCJ) model of genome rearrangement proposed by Yancopoulos et al. uses the single DCJ operation to account for all genome rearrangement events. Given three signed permutations, the DCJ median problem is to find a fourth permutation that minimizes the sum of the pairwise DCJ distances between it and the three others. In this paper, we present a branch-and-bound method that provides accurate solution to the multichromosomal DCJ median problems. We conduct extensive simulations and the results show that the DCJ median solver performs better than other median solvers for most of the test cases. These experiments also suggest that DCJ model is more suitable for real datasets where both reversals and transpositions occur.

  20. Median Analysis on the TNCs Financial Characteristics of China

    Directory of Open Access Journals (Sweden)

    LU Diqian

    2012-04-01

    Full Text Available The purpose of this empirical study is to study the basic characteristics of Chinese TNCs in the background of economic globalization. Based on the theory of modern TNCs, with data of Chinese listed companies financial statements in 2009, we constructed quantitative analysis system by using more steady statistics which included median, Median Average Difference (MAD, median average difference of dispersion coefficient and median regression model fitted by two-stage least absolute derivation. Then empirical study was carried out on financial characteristics of Chinese TNCs. The results show that Chinese TNCs have advantages relative to other types of companies, ultra big company size is Chinese TNCs' essential requirements, fast capital expansion is Chinese TNCs salient feature and concept of financial management lag is Chinese TNCs' major defect and so on.

  1. An approximate algorithm for median graph computation using graph embedding

    OpenAIRE

    Ferrer Sumsi, Miquel; Valveny, Ernest; Serratosa Casanelles, Francesc; Riesen, Kaspar; Bunke, Horst

    2008-01-01

    Graphs are powerful data structures that have many attractive properties for object representation. However, some basic operations are difficult to define and implement, for instance, how to obtain a representative of a set of graphs. The median graph has been defined for that purpose, but existing algorithms are computationally complex and have a very limited applicability. In this paper we propose a new approach for the computation of the median graph based on graph embedding in vector spac...

  2. Testing the gravity p-median model empirically

    Directory of Open Access Journals (Sweden)

    Kenneth Carling

    2015-12-01

    Full Text Available Regarding the location of a facility, the presumption in the widely used p-median model is that the customer opts for the shortest route to the nearest facility. However, this assumption is problematic on free markets since the customer is presumed to gravitate to a facility by the distance to and the attractiveness of it. The recently introduced gravity p-median model offers an extension to the p-median model that account for this. The model is therefore potentially interesting, although it has not yet been implemented and tested empirically. In this paper, we have implemented the model in an empirical problem of locating vehicle inspections, locksmiths, and retail stores of vehicle spare-parts for the purpose of investigating its superiority to the p-median model. We found, however, the gravity p-median model to be of limited use for the problem of locating facilities as it either gives solutions similar to the p-median model, or it gives unstable solutions due to a non-concave objective function.

  3. EFFECT OF FOLIC ACID SUPPLEMENTATION ON RECOVERY OF NERVE FUNCTION IN RATS WITH MIDDLE CEREBRAL ARTERY OCCLUSION%补充叶酸对脑梗死大鼠神经功能恢复的影响

    Institute of Scientific and Technical Information of China (English)

    曹家松; 秦善春; 张海红; 刘欢; 黄国伟

    2013-01-01

    目的 探讨叶酸干预对脑梗死大鼠脑脊液(cerebrospinal fluid,CSF)、血清叶酸及神经功能的影响.方法 40只SD大鼠随机分为四组:假手术组(Sham)、中动脉栓塞组(MCAO)、单纯叶酸补充组(Sham-FA)和叶酸补充中动脉栓塞组(FA-MCAO).叶酸以0.8mg/kg bw·d灌胃,对照组给予等量生理盐水;4w后线栓法制备MCAO模型,术后1d及21d行GarciaJH评分;化学免疫发光法测定CSF及血清叶酸.结果 MCAO组大鼠梗死后CSF及血清叶酸均较造模前显著降低(P<0.05);叶酸干预(4w)下FA-MCAO组梗死前后CSF及血清叶酸均高于MCAO组(P<0.05),且脑梗死后CSF叶酸高于对照Sham-FA组,差异有统计学意义(P<0.05),FA-MCAO组的Garcia JH评分较MCAO组显著增加(P<0.05).结论 脑梗死可降低SD大鼠CSF及血清叶酸水平.补充叶酸可显著提高并维持损伤后CSF叶酸高水平,促进神经功能恢复.%Objective To investigate the dynamic changes ofcerebrospinal fluid (CSF) and serum folic acid and the neurological function in middle cerebral artery occlusion model rats with folic acid supplementation.Methods Forty SD rats stratified by weight were randomly divided into four groups:sham group (Sham),middle cerebral artery occlusion group (MCAO),simple folic acid supplemented group (Sham-FA) and folic acid supplemented plus middle cerebral artery occlusion group (FA-MCAO).Sham-FA and FA-MCAO rats were intervened continuously by 0.8 mg/kg·d bw doses of folic acid,and animals of control groups with same volume of saline.The left MCAO rats were modeled by thread occlusion method and neurological defects were scored in postoperative 1d and 21d.The CSF and serum folic acid was determined by immuno chemiluminescence method.Results CSF and serum folic acid of MCAO rats was significantly decreased as compared to the normal (P<0.05).CSF and serum folic acid in FA-MCAO group (4w) was statistically increased,especially the CSF folic acid rapidly increased in FA-MCAO group

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

    Science.gov (United States)

    Patterson, Jennifer Megan M

    2016-05-01

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

  5. Clinical application of branch artery of the sural medial gastrocnemius muscle flap combine with sural nerve nutritional vessel axial%腓肠肌内侧头穿支动脉与腓肠神经营养血管联合蒂肌皮瓣的临床应用

    Institute of Scientific and Technical Information of China (English)

    邵新中; 喻伟光; 王巧君; 王英彩; 吕莉; 王立; 孙建涛

    2011-01-01

    Objective To investigate the clinical efficiency of branch artery of the sural medial gastrocnemius muscle flap combine with sural nerve nutritional vessel axial.Methods From February 2006to March 2010,according to the position and size of the soft tissue defects,the muscle flap combined with branch artery of the sural medial gastrocnemius and sural nerve nutritional vessel axial were desingned and obtained to repair 7 cases of sofi tissue defects of the upper-region of the tibial.The flap size ranged from 8.0 cm × 8.0 cm to 12.0 cm × 10.0 cm.The vessel pedicle of branches ranged from 1.8-3.0 cm.The distribution of the vessel pedicle of branches ranged from 10.0-17.0 cm on the distant popliteal fossa,and ranged from 2.0-5.0 cm on the back of medial line.Results The outline and function were satisfactory during 6-15 months follow-up.Conclusion The blood supply of this flap is reliable without sacrifice of major arteries.Flap elevation is easy.It can transfer to a long distance and can repair large skin defects.It is very useful in repairing upper-region of the tibial large soft tissue defect.%目的 探讨腓肠肌内侧头穿支动脉与腓肠神经营养血管联合蒂肌皮瓣的临床应用效果.方法 自2006年2月至2010年3月,根据缺损部位及大小设计以腓肠肌内侧头穿支动脉与腓肠神经营养血管轴的联合蒂,沿腓肠肌内侧头血管轴切取皮瓣,顺行移位修复膑前及胫骨上段皮肤及软组织缺损7例.皮瓣切取范围8.0 cm×8.0 cm~12.0 cm×10.0 cm,联合血管蒂长1.8~3.0 cm,联合血管蒂发出位于腘褶皱以远10.0 ~ 17.0 cm,距后正中线2.0~5.0 cm的范围内.结果 6例伤口一期愈合.1例发生皮瓣远端表浅干性坏死,面积约1 cm×2 cm,经换药后逐渐愈合.随访6~ 15个月,无任何并发症,肌皮瓣质地优良,外观满意.结论 腓肠肌内侧头穿支动脉与腓肠神经营养血管联合蒂肌皮瓣手术操作简便,血供可靠且不牺牲主要动脉,切取面

  6. Diabetic Nerve Problems

    Science.gov (United States)

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

  7. Damaged axillary nerve (image)

    Science.gov (United States)

    Conditions associated with axillary nerve dysfunction include fracture of the humerus (upper arm bone), pressure from casts or splints, and improper use of crutches. Other causes include systemic disorders that cause neuritis (inflammation of ...

  8. Sacral nerve stimulation.

    Science.gov (United States)

    Matzel, K E; Stadelmaier, U; Besendörfer, M

    2004-01-01

    The current concept of recruiting residual function of an inadequate pelvic organ by electrostimulation involves stimulation of the sacral spinal nerves at the level of the sacral canal. The rationale for applying SNS to fecal incontinence was based on clinical observations of its effect on bowel habits and anorectal continence function in urologic patients (increased anorectal angulation and anal canal closure pressure) and on anatomic considerations: dissection demonstrated a dual peripheral nerve supply of the striated pelvic floor muscles that govern these functions. Because the sacral spinal nerve site is the most distal common location of this dual nerve supply, stimulating here can elicit both functions. Since the first application of SNS in fecal incontinence in 1994, this technique has been improved, the patient selection process modified, and the spectrum of indications expanded. At present SNS has been applied in more than 1300 patients with fecal incontinence limited.

  9. Diabetes and nerve damage

    Science.gov (United States)

    Diabetic neuropathy; Diabetes - neuropathy; Diabetes - peripheral neuropathy ... In people with diabetes, the body's nerves can be damaged by decreased blood flow and a high blood sugar level. This condition is ...

  10. Degenerative Nerve Diseases

    Science.gov (United States)

    Degenerative nerve diseases affect many of your body's activities, such as balance, movement, talking, breathing, and heart function. Many of these diseases are genetic. Sometimes the cause is a medical ...

  11. Dopamine D1 and D2 receptor immunoreactivities in the arcuate-median eminence complex and their link to the tubero-infundibular dopamine neurons

    Directory of Open Access Journals (Sweden)

    W. Romero-Fernandez

    2014-07-01

    Full Text Available Dopamine D1 and D2 receptor immunohistochemistry and Golgi techniques were used to study the structure of the adult rat arcuate-median eminence complex, and determine the distribution of the dopamine D1 and D2 receptor immunoreactivities therein, particularly in relation to the tubero-infundibular dopamine neurons. Punctate dopamine D1 and D2 receptor immunoreactivities, likely located on nerve terminals, were enriched in the lateral palisade zone built up of nerve terminals, while the densities were low to modest in the medial palisade zone. A codistribution of dopamine D1 receptor or dopamine D2 receptor immunoreactive puncta with tyrosine hydroxylase immunoreactive nerve terminals was demonstrated in the external layer. Dopamine D1 receptor but not dopamine D2 receptor immnunoreactivites nerve cell bodies were found in the ventromedial part of the arcuate nucleus and in the lateral part of the internal layer of the median eminence forming a continuous cell mass presumably representing neuropeptide Y immunoreactive nerve cell bodies. The major arcuate dopamine/ tyrosine hydroxylase nerve cell group was found in the dorsomedial part. A large number of tyrosine hydroxylase immunoreactive nerve cell bodies in this region demonstrated punctate dopamine D1 receptor immunoreactivity but only a few presented dopamine D2 receptor immunoreactivity which were mainly found in a substantial number of tyrosine hydroxylase cell bodies of the ventral periventricular hypothalamic nucleus, also belonging to the tubero-infundibular dopamine neurons. Structural evidence for projections of the arcuate nerve cells into the median eminence was also obtained. Distal axons formed horizontal axons in the internal layer issuing a variable number of collaterals classified into single or multiple strands located in the external layer increasing our understanding of the dopamine nerve terminal networks in this region.  Dopamine D1 and D2 receptors may therefore directly

  12. Optic nerve oxygen tension

    DEFF Research Database (Denmark)

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

    2000-01-01

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

  13. Side-to-side range of movement variability in variants of the median and radial neurodynamic test sequences in asymptomatic people.

    Science.gov (United States)

    Stalioraitis, Vaidas; Robinson, Kim; Hall, Toby

    2014-08-01

    Side-to-side discrepancy in range of motion (ROM) during upper limb neurodynamic testing is used in part to identify abnormal peripheral nerve mechanosensitivity and is one of three factors to consider in determining a positive test. Large side-to-side variability is reported for some variants of the upper limb neurodynamic test sequences, however discrepancies for other test variants are unknown. Hence the purpose of this study was to evaluate side-to-side discrepancy in elbow flexion ROM during two variants of upper limb neurodynamic test sequence for the median and radial nerves. 51 asymptomatic subjects (26 females, mean age 29.69 years) were evaluated. A uniaxial electrogoniometer was used to measure elbow flexion ROM at onset of resistance (R1) and onset of discomfort (P1) during the median and radial neurodynamic tests on each side. Reliability was determined by testing 20 subjects twice and was found to be good (ICC greater than 0.88 and SEM less than 4.02°). There was no significant difference in mean ROM between sides. Lower-bound scores indicate that intra-individual, inter-limb differences of more than 15° for the median nerve and 11° for the radial nerve exceeds the range of normal ROM asymmetry on neurodynamic testing at R1 and P1. Correlation of ROM between limbs was significant with R(2) values of 0.62 and 0.85 for the median and radial nerves respectively. These finding provide clinicians with information regarding normal side-to-side variability in ROM during two commonly used variants of neurodynamic tests. PMID:24703935

  14. EFFECTS OF PROTEIN ENERGY MALNUTRITION ON PERIPHERAL NERVE CONDUCTION IN CHILDREN

    Directory of Open Access Journals (Sweden)

    Rubha S, Vinodha R

    2015-11-01

    Full Text Available Background: Peripheral nerve conduction changes caused by malnutrition can be shown clinically and electrophysiologically. They are produced mainly due to deficiency of micro and macronutrients like vitamins, minerals, protein, fat & Carbohydrate Aim : Protein energy malnutrition (PEM affects the myelination and growth of the nervous system. The aim of this study was to assess the effects of PEM on peripheral nerve conduction in children. Materials & Methods: Study group includes 40 malnourished children of 5 – 10 years of age from Raja Mirasudar Hospital, Thanjavur based on Indian Academy of Paediatrics & WHO classification for malnutrition. Control group consists of 40 normal children of same age group. Nerve conduction study for median nerve was performed using eight channel digital polygraph. Nerve conduction velocity was evaluated. Results were analysed statistically using unpaired student ‘t’ test. Results : Nerve conduction study (NCS showed reduced motor and sensory nerve conduction velocity ( p < 0.05 in children with Grade III malnutrition. Children with Grade I, II malnutrition showed reduced sensory nerve conduction velocity ( p < 0.05 . Conclusion: The present study shows significant reduction in nerve conducion velocity in children with malnutrition which may be due to nutritional deficiency affecting myelination of peripheral nerves which depends on duration and severity of malnutrition. So nerve conduction study can be used to detect malnutrition at its early stage.

  15. Assessment of the trauma degree and spinal cord function of para-median minimally invasive and open TLIF for single segmental lumbar degenerative disease

    Institute of Scientific and Technical Information of China (English)

    Zheng Bo-long; He Bao-rong; Yang Xiao-bin; Yang Ming; Yan Liang; Bai Xiao-fan; Hao Ding-jun

    2016-01-01

    Objective:To study the trauma degree of para-median minimally invasive and open TLIF for single segmental lumbar degenerative disease and the effect on spinal cord function.Methods:A total of 78 cases of patients with single segmental lumbar disc herniation who received TLIF treatment in our hospital were selected as the research subjects and randomly divided into two groups, minimally invasive group received para-median minimally invasive TLIF and open group received open TLIF. Perioperative serum levels of oxidative stress indicators and pain mediators as well as spinal cord function were compared between two groups.Results: 1 d and 3 d after operation, serum SOD, GSH-Px and SP levels of minimally invasive group were significantly higher than those of open group, and MDA, AOPP, NO,β-EP, PGE2 and CGRP levels were significantly lower than those of open group; 1 week after operation, NCV and DL of common peroneal nerve and tibial nerve of two groups were not different from those before operation; 4 weeks and 16 weeks after operation, NCV of common peroneal nerve and tibial nerve of both groups were higher than those before operation while DL were lower than those before operation, and NCV of common peroneal nerve and tibial nerve of minimally invasive group were significantly higher than those of open group while DL were significantly lower than those of open group.Conclusion:The trauma degree of para-median minimally invasive TLIF for single segmental lumbar degenerative disease is less and the postoperative spinal cord function recovery is more ideal.

  16. Management of Trigeminal Neuralgia Caused by an Intraneural Spiral Trigeminocerebellar Artery: A Case Report

    OpenAIRE

    WAKUTA, Naoki; Abe, Hiroshi; NONAKA, Masani; Higashi, Toshio; UEBA, Tetsuya; Inoue, Tooru

    2015-01-01

    The trigeminocerebellar artery (TCA) is a branch of the basilar artery that may have an intraneural course and may cause trigeminal neuralgia. We report a case of trigeminal neuralgia with right vertebral artery aneurysm caused by an intraneural TCA that compressed the trigeminal nerve in multiple places. We performed proximal trapping for the fusiform aneurysm with extra-intracranial bypass to preserve flow of the posterior inferior cerebellar artery, followed by microvascular decompression ...

  17. [Biophysics of nerve excitation].

    Science.gov (United States)

    Kol'e, O R; Maksimov, G V

    2010-01-01

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

  18. Study of the anatomical position of the femoral nerve by magnetic resonance imaging in patients with fractured neck of femur: relevance to femoral nerve block.

    LENUS (Irish Health Repository)

    Mehmood, Shehzad

    2012-01-31

    STUDY OBJECTIVE: To determine the anatomical location of the femoral nerve in patients who have sustained fracture of the neck of femur, and its relevance to femoral nerve block technique. DESIGN: Prospective, observational clinical study. SETTING: Orthopedic and Radiology departments of a regional hospital. SUBJECTS: 10 consecutive adult ASA physical status II and III patients (mean age, 78.5 yrs) and 4 adult healthy volunteers. INTERVENTIONS: A T1 magnetic resonance imaging scan was performed of both upper thighs in patients and healthy volunteers successfully. MEASUREMENTS: The distance (mm) between the midpoint of the femoral artery and the midpoint of the femoral nerve, and the distance of the femoral nerve from the skin was measured at the mid-inguinal ligament, the pubic tubercle, and at the mid-inguinal crease. Data are shown as means (SD). Differences between both sides were compared using paired Student\\'s t-tests. P < 0.05 was significant. MAIN RESULTS: In patients the mean distance (mm) between the midpoint of the femoral nerve from the midpoint of femoral artery at the mid-inguinal crease on the fractured and non-fractured sides was 10.7 and 11.0, respectively (P = 0.87). The mean distance (mm) between the midpoint of the femoral nerve from the midpoint of the femoral artery at the mid-inguinal ligament on the fractured and non-fractured sides was 9.64 and 12.5, respectively (P = 0.03). The mean distance (mm) between the midpoint of the femoral nerve from the midpoint of the femoral artery at the pubic tubercle on the fractured and non-fractured sides was 8.74 and 10.49, respectively (P = 0.18). CONCLUSIONS: Blockade of the femoral nerve may be easier to perform at the mid-inguinal crease in patients with fractured neck of femur.

  19. Sosiaalinen media markkinoinnin kanavana : suunnitelma Lycka Reklamin sosiaalisen median aktivoimiseen

    OpenAIRE

    Tuomenoksa, Michaela

    2016-01-01

    Tämä opinnäytetyö käsittelee sosiaalista mediaa yrityksen näkökulmasta. Miten yritys voi hyödyntää sosiaalista mediaa toiminnassaan ja markkinoinnissa? Mitä eroa on sosiaalisen median kanavissa ja mitä kanavat mahdollistavat? Pohdin myös, minkälainen sisältö on kiinnostavaa ja mitä asioita pitää ottaa huomioon sosiaalisen median viestinnässä. Opinnäytetyössäni pureudun myös yksinomaisesti Lycka Reklamin sosiaalisen median käyttöön – mitkä kanavat ovat hyödyll...

  20. Enhancement of the facial nerve at MR imaging

    International Nuclear Information System (INIS)

    In the few cases studied, normal facial nerves are reported to show no MR enhancement. Because this did not fit clinical experience, the authors designed a retrospective imaging review with anatomic correlation. Between June 1989 and June 1990, 175 patients underwent focused temporal bone MR imaging before and after administration of intravenous gadopentetate dimeglumine (0.1 mmol/kg). Exclusion criteria for the study included facial nerve dysfunction (subjective or objective); facial nerve mass; central nervous system infection, inflammation, or trauma; neurofibromatosis; or previous cranial surgery of any type. The following sequences were reviewed: GE 1.5-T axial spin-echo TR 567 msec, TE 20 msec, 256 x 192, 2.0 excitations, 20-cm field of view, 3-mm section thickness. Imaging analysis was a side-by side comparison of the images and region-of-interest quantified signal intensity. Anatomic correlation included a comparison with dissection and axial histologic sections. Ninety-three patients (aged 15-75 years) were available for imaging analysis after the exclusionary criteria were applied. With 46 patients (92 facial nerves) analyzed, they found that 76 nerves (83%) showed easily visible gadopentetate dimeglumine enhancement, especially about the geniculate ganglia. Sixteen (17%) of the 92 nerves did not show visible enhancement, but region-of-interest analysis showed increased intensity after gadopentetate dimeglumine administration. Sixteen patients (42%) showed right-to-left asymmetry in facial nerve enhancement. The facial nerves showed enhancement in the geniculate, tympanic, and fallopian portions; the facial nerve within the IAC showed no enhancement. This corresponded exactly with the topographic features of a circummeural arterial/venous plexus seen on the anatomic preparations

  1. The role of sensory nerve conduction study of the palmar cutaneous nerve in the diagnosis of carpal tunnel syndrome in patients with polyneuropathy

    Directory of Open Access Journals (Sweden)

    Ayse Tokcaer

    2007-01-01

    Full Text Available Background: Conventional methods in the diagnosis of carpal tunnel syndrome (CTS in patients with polyneuropathy (PNP are insufficient. Aims: We suggest that the comparison of the conduction of the median nerve with that of the neighboring peripheral nerves may be more beneficial in the diagnosis of entrapment neuropathy. Setting and Design: The median nerve sensory conduction in healthy volunteers, in cases of CTS, PNP cases without CTS and in cases of PNP in whom clinical findings point to CTS, were compared by palmar cutaneous nerve (PCN sensory conduction. Materials and Methods: Comparative parameters were difference of PCN-1st digits′ nerve conduction velocities (NCV, PCN/1st digit NCVs ratio, difference of 5th-2nd digits′ NCVs and 5th/2nd digits′ NCVs ratio. Statistical Analysis: The statistical analysis was performed by the SPSS package for statistics. Student t test and receiver operating characteristic were used. Results: Although the ratio of PCN-1st digit did not differ significantly between the control group and the polyneuropathy group, there was a significant difference between CTS and PNP+CTS groups and the control group ( P < 0.001 and P < 0.001, respectively. The ratio of PCN-1st digit nerve conduction velocity was also significantly different between polyneuropathy and PNP+CTS groups ( P < 0.001. Conclusion: To diagnose CTS on a background of polyneuropathy in mild cases in which sensory conduction is preserved, the ratio of sensory nerve conduction velocities of the palmar cutaneous nerve and the median nerve 1st digit-wrist segment may be a criterion.

  2. Otic artery: a review of normal and pathological features.

    Science.gov (United States)

    Vasović, Ljiljana; Arsić, Stojanka; Vlajković, Slobodan; Jovanović, Ivan; Jovanović, Predrag; Ugrenović, Sladjana; Andjelković, Zlatibor

    2010-05-01

    Three primitive arteries - the trigeminal, otic and hypoglossal take the names according to their close relation with the V, VIII and XII cranial nerves, while at the cervical level, the first segmental artery is named the primitive proatlantal intersegmental artery. When the human embryo is 4 mm long, these arteries serve as transitory anastomoses between primitive internal carotid arteries and bilateral longitudinal neural arterial plexus, which is the precursor of future basilar artery. Normal and/or abnormal morphofunctional aspects of the prenatal and postnatal forms of the otic artery are described according to the personal and literature data. Many (ab) normal arteries are also noted in differential diagnosis of the otic artery. Postnatally, individual incidence rates of the carotid-vertebrobasilar anastomoses have been found to be inversely related to their order of disappearance. The persistent trigeminal artery has a reported incidence from 0.06-0.6%, whereas the persistent primitive otic artery has been convincingly documented only in minor rates. Persistent carotid-vertebrobasilar anastomoses between the anterior and posterior cranial circulation are important to recognize during angiography for endovascular and surgical planning. Most frequently, the otic artery was an incidental finding. PMID:20424561

  3. Somesoppa : Sosiaalisen median kehittämissuunnitelma ravintola Rustikille

    OpenAIRE

    Hartikainen, Lotta

    2016-01-01

    Tämän opinnäytetyön tarkoituksena oli tehdä Ravintola Rustikille sosiaalisen median kehittämissuunnitelma. Kehittämissuunnitelmaa varten ideoita ja kehittämiskohtia kerättiin kolmen eri keinon avulla. Ensimmäiseksi tehtiin vertaileva kirjoituspöytätutkimus neljän muun ravintolan toiminnasta sosiaalisessa mediassa ja etsittiin muiden toiminnasta vinkkejä Rustikia varten. Seuraavaksi tehtiin kartoitus Rustikin toiminnasta sosiaalisessa mediassa. Rustikin käyttämät sosiaalisen median alustat ova...

  4. Morphological and Median Adaptive Filters Based on LCBP Rank Filter

    Directory of Open Access Journals (Sweden)

    D. Prokin

    2013-11-01

    Full Text Available The presented median and morphological (min and max filters based on low complexity bit-pipeline (LCBP rank filter provide reduced complexity of required processing hardware, due to similar pipeline stages and the complete absence of sorting networks in comparison with other solutions. FPGA realization of bit-pipeline median and morphological filter and adaptive bit-pipeline rank filter according to this paper provides significantly higher maximum operating frequency and much smaller used chip resources in comparison with state-of-the-art sorting methods.

  5. Sosiaalisen median käyttö matkan eri vaiheissa

    OpenAIRE

    Nuottimäki, Iina

    2015-01-01

    Tämä opinnäytetyö on tehty toimeksiantona suomalaiselle matkailumedialle Rantapallo Oy:lle. Opinnäytetyö kartoitti matkaprosessin eri vaiheissa käytettyjä sosiaalisen median kanavia sekä niiden käyttötarkoitusta. Vastaajilta kysyttiin myös, kuinka paljon sosiaalisesta mediasta hankittu tieto vaikuttaa heidän ostopäätöksiinsä ja mitä matkailutiedon lähteitä sekä sosiaalisen median kanavia he pitävät luotettavimpina lähteinä matkan suunnittelussa. Tutkimukseen sisältyi yhteensä 11 suosittua sos...

  6. [Nitroxidergic nerve fibers of intracerabral blood vessels].

    Science.gov (United States)

    Kotsiuba, A E; Kotsiuba, E P; Chertok, V M

    2009-01-01

    Methods of light and electron microscopic histochemistry were applied to study the structure and distribution of NADPH-diaphorase-positive neurons and processes in the parietal area of rat cerebral cortex. It was found that the most of the neurons displayed close connections with the intracerebral vessels. In the cerebral cortex, the smallest distance between the axonal plasma membrane and smooth muscle cells of the intracerebral arteries was found to be no less than 0.3-0.5 microm. Neuronal cell bodies were located in the functionally important areas of the vessels (in the areas of lateral trunk branching and in arteriolar sources), while their processes accompanied the vessels, tightly embracing them with their branches. Quite often, the neurons, the dendrites of which make contacts with the bodies or processes of over- or underlying neurons, sent their nerve fibers to the arteries, veins and capillaries. Thus, nitroxidergic neurons or their groups may control the blood flow in the different areas of vascular bed, performing the functions of the local nerve center.

  7. Dog sciatic nerve gap repaired by artificial tissue nerve graft

    Institute of Scientific and Technical Information of China (English)

    GU Xiaosong; ZHANG Peiyun; WANG Xiaodong; DING Fei; PENG Luping; CHENG Hongbing

    2003-01-01

    The feasibility of repairing dog sciatic nerve damage by using a biodegradable artificial tissue nerve graft enriched with neuroregenerating factors is investigated. The artificial nerve graft was implanted to a 30 mm gap of the sciatic nerve damage in 7 dogs. The dogs with the same nerve damage that were repaired by interposition of the autologous nerve or were given no treatment served as control group 1 or 2, respectively. The observations include gross and morphological observations, immune reaction, electrophysiological examination, fluorescence tracing of the neuron formation and the number of the neurons at the experimental sites, etc. Results showed that 6 months after the implantation of the graft, the regenerated nerve repaired the damage of the sciatic nerve without occurrence of rejection and obvious inflammatory reaction in all 7 dogs, and the function of the sciatic nerve recovered with the nerve conduction velocity of (23.91±11.35)m/s. The regenerated neurons and the forming of axon could be observed under an electron microscope. This proves that artificial tissue nerve graft transplantation can bridge the damaged nerve ends and promote the nerve regeneration.

  8. Carotid artery surgery

    Science.gov (United States)

    Carotid endarterectomy; CAS surgery; Carotid artery stenosis - surgery; Endarterectomy - carotid artery ... through the catheter around the blocked area during surgery. Your carotid artery is opened. The surgeon removes ...

  9. Trigeminal neuralgia caused by the vertebral artery associated with primitive trigeminal artery and agenesis of the internal carotid artery.

    Science.gov (United States)

    Fukuda, M; Kameyama, S; Takahashi, H; Tanaka, R

    1998-06-01

    A 69-year-old female presented with trigeminal neuralgia caused by tortuous vertebrobasilar artery associated with primitive trigeminal artery (PTA) and agenesis of the ipsilateral internal carotid artery (ICA). Left vertebral angiography showed marked elongation of the left vertebral artery and filling of the left ICA via the PTA. Bone window computed tomography suggested agenesis of the left ICA. Intraoperative findings showed that the vertebrobasilar junction had compressed the root entry zone of the trigeminal nerve. The neuralgia improved immediately after microvascular decompression. There has been no recurrence for 20 months. Trigeminal neuralgia may be caused by a tortuous vertebrobasilar system due to hemodynamic stress associated with PTA and agenesis of the ICA. PMID:9689822

  10. Epicardial ultrasound in coronary artery bypass surgery

    NARCIS (Netherlands)

    Budde, R.P.J.

    2005-01-01

    Chapter 1 Coronary artery bypass surgery (CABG) is traditionally performed via a median sternotomy approach on cardiopulmonary bypass (arrested heart). Since the mid 1990ties, beating heart, minimally invasive and even totally endoscopic CABG are (re)explored. In all approaches to CABG, the surgeo

  11. Neuromuscular ultrasound of cranial nerves.

    Science.gov (United States)

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

    2015-04-01

    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 reference textbooks available in the field. This review article focuses on ultrasound scanning techniques of the 4 accessible cranial nerves: optic, facial, vagus and spinal accessory nerves. The relevant literatures and potential future applications are discussed.

  12. Management of sternal osteomyelitis and mediastinal infection following median sternotomy

    Institute of Scientific and Technical Information of China (English)

    GAO Ju; WANG Wen-zhang; WANG You-li; LU Shu-qiang; CAI Ai-bing; YANG Zhi-fu; HAN Zhi-yi; LI Jiu-jiang; WEN Yu-ming; GENG Feng-yong

    2010-01-01

    Background Median sternotomy is considered the most usually performed procedure in cardiac operations. This study aimed to assess clinical effectiveness of bilateral pectoralis major muscle flaps (BPMMF) for management of sternal osteomyelitis and mediastinal infection following median sternotomy.Methods Clinical data were collected and retrospectively analyzed from twelve patients who underwent the BPMMF transposition for management of sternal osteomyelitis and mediastinal infection following median sternotomy from January 2006 to June 2009. Procedure consisted of rigorous debridement of necrotic tissues, dead space obliteration using the BPMMF, and placement of drainage tubes connected to a negative pressures generator for adequate drainage.Results No patients died of drainage, and all 12 patients had viable BPMMF when discharged from hospital. At 1 week post discharge, 2 patients presented with sternal infection but recovered following local debridement and medication. No patients showed infection recurrence during the follow-up period over 10 months.Conclusions Sternal osteomyelitis and mediastinal infection following median sternotomy may be effectively managed through rigorous debridement of infected soft tissues, resection of the damaged stermal segment, transposition of the BPMMF to fill the damaged sternum resulting from debridement, and adequate postoperative drainage.

  13. Mean, Median and Mode from a Decision Perspective

    Science.gov (United States)

    Holt, Melinda Miller; Scariano, Stephen M.

    2009-01-01

    The classroom activity described here allows mathematically mature students to explore the role of mean, median and mode in a decision-making environment. While students discover the importance of choosing a measure of central tendency, their understanding of probability distributions, maximization, and prediction is reinforced through active…

  14. A novel image inpainting technique based on median diffusion

    Indian Academy of Sciences (India)

    Rajkumar L Biradar; Vinayadatt V Kohir

    2013-08-01

    Image inpainting is the technique of filling-in the missing regions and removing unwanted objects from an image by diffusing the pixel information from the neighbourhood pixels. Image inpainting techniques are in use over a long time for various applications like removal of scratches, restoring damaged/missing portions or removal of objects from the images, etc. In this study, we present a simple, yet unexplored (digital) image inpainting technique using median filter, one of the most popular nonlinear (order statistics) filters. The median is maximum likelihood estimate of location for the Laplacian distribution. Hence, the proposed algorithm diffuses median value of pixels from the exterior area into the inner area to be inpainted. The median filter preserves the edge which is an important property needed to inpaint edges. This technique is stable. Experimental results show remarkable improvements and works for homogeneous as well as heterogeneous background. PSNR (quantitative assessment) is used to compare inpainting results.

  15. Brain malformation in single median maxillary central incisor

    DEFF Research Database (Denmark)

    Kjaer, I; Wagner, Aa; Thomsen, L L;

    2009-01-01

    Clinical and radiographic examinations and MR scan of a 12-year-old girl with SMMCI (single median maxillary central incisor) showed impaired growth and a midline defect involving the central incisor, cranium and the midline structures in the brain, falx cerebri and pituitary gland. She had a...

  16. Estimation of Transition Probabilities Using Median Absolute Deviations

    OpenAIRE

    Kim, C. S.; Schaible, Glenn D.

    1988-01-01

    The probability-constrained minimum absolute deviations (MAD) estimator appears to be superior to the probability-constrained quadratic programming estimator in estimating transition probabilities with limited aggregate time series data Futhermore, one can reduce the number of columns in the probability-constrained MAD simplex tableau by adopting the median property

  17. Ultrasonographic reference values for assessing normal radial nerve ultrasonography in the normal population

    Institute of Scientific and Technical Information of China (English)

    Jun Chen; Shan Wu; Jun Ren

    2014-01-01

    High-resolution ultrasound has been used recently to characterize median and ulnar nerves, but is seldom used to characterize radial nerves. The radial nerve is more frequently involved in en-trapment syndromes than the ulnar and median nerves. However, the reference standard for nor-mal radial nerves has not been established. Thus, this study measured the cross-sectional areas of radial nerves of 200 healthy male or female volunteers, aged 18 to 75, using high-resolution ultrasound. The results showed that mean cross-sectional areas of radial nerves at 4 cm upon the lateral epicondyle of the humerus and mid-humerus (midpoint between the elbow crease and axilla) were 5.14 ± 1.24 and 5.08 ± 1.23 mm2, respectively. The age and the dominant side did not affect the results, but the above-mentioned cross-sectional areas were larger in males (5.31 ± 1.25 and 5.19 ± 1.23 mm2) than in females (4.93 ± 1.21 and 4.93 ± 1.23 mm2, respective-ly). In addition, the cross-sectional areas of radial nerves were positively correlated with height and weight (r = 0.38, 0.36, respectively, bothP < 0.05). These data provide basic clinical data for the use of high-resolution ultrasound for the future diagnosis, treatment, and prognostic evalua-tion of peripheral neuropathies.

  18. Diffusion tensor imaging of peripheral nerve in patients with chronic inflammatory demyelinating polyradiculoneuropathy: a feasibility study

    Energy Technology Data Exchange (ETDEWEB)

    Kakuda, Takako; Fukuda, Hiroshi; Tanitame, Keizo; Takasu, Miyuki; Date, Shuji; Awai, Kazuo [Hiroshima University, Department of Diagnostic Radiology, Graduate School of Biomedical Sciences, Hiroshima (Japan); Ochi, Kazuhide; Ohshita, Tomohiko; Matsumoto, Masayasu [Hiroshima University, Department of Clinical Neuroscience and Therapeutics, Graduate School of Biomedical Science, Hiroshima (Japan); Kohriyama, Tatsuo [Department of Neurology, Hiroshima City Hospital, Hiroshima (Japan); Ito, Katsuhide [Department of Radiology, Onomichi General Hospital, Onomichi, Hiroshima-ken (Japan)

    2011-12-15

    The purpose of this study was to assess the clinical feasibility of diffusion tensor imaging (DTI) for the evaluation of peripheral nerves in patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Using a 3-T magnetic resonance imaging scanner, we obtained DTI scans of the tibial nerves of 10 CIDP patients and 10 sex- and age-matched healthy volunteers. We prepared fractional anisotropy (FA) maps, measured the FA values of tibial nerves, and compared these values in the two study groups. In nine patients, we also performed tibial nerve conduction studies and analyzed the correlation between the FA values and parameters of the nerve conduction study. The tibial nerve FA values in CIDP patients (median 0.401, range 0.312-0.510) were significantly lower than those in healthy volunteers (median 0.530, range 0.469-0.647) (Mann-Whitney test, p < 0.01). They were significantly correlated with the amplitude of action potential (Spearman correlation coefficient, p = 0.04, r = 0.86) but not with nerve conduction velocity (p = 0.79, r = 0.11). Our preliminary data suggest that the noninvasive DTI assessment of peripheral nerves may provide useful information in patients with CIDP. (orig.)

  19. Unusual Origin of a Double Upper Subscapular Nerve from the Suprascapular Nerve and the Posterior Division of the Upper Trunk of the Brachial Plexus: A Case Report.

    Science.gov (United States)

    Paraskevas, George; Koutsouflianiotis, Konstantinos; Iliou, Kalliopi; Bitsis, Theodosios; Kitsoulis, Panagiotis

    2016-06-01

    A double upper subscapular nerve on the right side was detected in a male cadaver, with the proximal one arising from the suprascapular nerve and the distal one from the posterior division of the upper trunk of the brachial plexus. Both of them penetrated and supplied the uppermost portion of the right subscapularis muscle. That anatomic variation was associated with a median nerve formed by two lateral roots. The origin and pattern of the upper subscapular nerve displays high variability, however the presented combination of the variable origin of a double upper subscapular nerve has rarely been described in the literature. The knowledge of such an anatomic variation is essential for the surgeon operating in the region especially in instances of brachial plexus' repair after any traumatic injury. Moreover, the awareness of the precise origin and topography of these nerves is important for the physician attempting to block these nerves or utilizing these nerves as grafts for neurotization of adjacent damaged nerves of the brachial plexus. PMID:27504272

  20. Diagnostic signs of motor neuropathy in MR neurography: Nerve lesions and muscle denervation

    Energy Technology Data Exchange (ETDEWEB)

    Schwarz, Daniel; Pham, Mirko; Bendszus, Martin; Baeumer, Philipp [Heidelberg University Hospital, Department of Neuroradiology, Heidelberg (Germany); Weiler, Markus [Heidelberg University Hospital, Department of Neurology, Heidelberg (Germany); German Cancer Research Center (DKFZ), Clinical Cooperation Unit Neurooncology, Heidelberg (Germany); Heiland, Sabine [Heidelberg University Hospital, Section of Experimental Radiology, Department of Neuroradiology, Heidelberg (Germany)

    2015-05-01

    To investigate the diagnostic contribution of T2-w nerve lesions and of muscle denervation in peripheral motor neuropathies by magnetic resonance neurography (MRN). Fifty-one patients with peripheral motor neuropathies underwent high-resolution MRN by large coverage axial T2-w sequences of the upper arm, elbow, and forearm. Images were evaluated by two blinded readers for T2-w signal alterations of median, ulnar, and radial nerves, and for denervation in respective target muscle groups. All 51 patients displayed nerve lesions in at least one of three nerves, and 43 out of 51 patients showed denervation in at least one target muscle group of these nerves. In 21 out of 51 patients, the number of affected nerves matched the number of affected target muscle groups. In the remaining 30 patients, T2-w lesions were encountered more frequently than target muscle group denervation. In 153 nerve-muscle pairs, 72 showed denervation, but only one had increased muscle signal without a lesion in the corresponding nerve. MRN-based diagnosis of peripheral motor neuropathies is more likely by visualization of peripheral nerve lesions than by denervation in corresponding target muscles. Increased muscular T2-w signal without concomitant nerve lesions should raise suspicion of an etiology other than peripheral neuropathy. (orig.)

  1. Tumors of the optic nerve

    DEFF Research Database (Denmark)

    Lindegaard, Jens; Heegaard, Steffen

    2009-01-01

    A variety of lesions may involve the optic nerve. Mainly, these lesions are inflammatory or vascular lesions that rarely necessitate surgery but may induce significant visual morbidity. Orbital tumors may induce proptosis, visual loss, relative afferent pupillary defect, disc edema and optic...... atrophy, but less than one-tenth of these tumors are confined to the optic nerve or its sheaths. No signs or symptoms are pathognomonic for tumors of the optic nerve. The tumors of the optic nerve may originate from the optic nerve itself (primary tumors) as a proliferation of cells normally present...... in the nerve (e.g., astrocytes and meningothelial cells). The optic nerve may also be invaded from tumors originating elsewhere (secondary tumors), invading the nerve from adjacent structures (e.g., choroidal melanoma and retinoblastoma) or from distant sites (e.g., lymphocytic infiltration and distant...

  2. Carotid Artery Screening

    Science.gov (United States)

    ... Resources Professions Site Index A-Z Carotid Artery Screening What is carotid artery screening? Who should consider ... about carotid artery screening? What is carotid artery screening? Screening examinations are tests performed to find disease ...

  3. The new technique of using the epigastric arteries in renal transplantation with multiple renal arteries

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Amirzargar

    2013-01-01

    Full Text Available The most common anatomic variant seen in the donor kidneys for renal transplantation is multiple renal arteries (MRA, which can cause an increased risk of complications. We describe the long-term outcomes of 16 years of experience in 76 kidney transplantations with MRAs. In a new reconstruction technique, we remove arterial clamps after anastomosing the donor to the recipient′s main renal vessels, which cause backflow from accessory arteries to prevent thrombosis. By this technique, we reduce the ischemic times as well as the operating times. Both in live or cadaver donor kidneys, lower polar arteries were anastomosed to the inferior epigastric artery and upper polar arteries were anastomosed to the superior epigastric arteries. Injection of Papaverine and ablation of sympathic nerves of these arteries dilate and prevent them from post-operative spasm. Follow-up DTPA renal scan in all patients showed good perfusion and function of the transplanted kidney, except two cases of polar arterial thrombosis. Mean creatinine levels during at least two years of follow-up remained acceptable. Patient and graft survival were excellent. No cases of ATN, hypertension, rejection and urologic complications were found. In conclusion, this technique can be safely and successfully utilized for renal transplantation with kidneys having MRAs, and may be associated with a lower complication rate and better graft function compared with the existing techniques.

  4. Feasibility and safety of ultrasound-guided nerve block for management of limb injuries by emergency care physicians

    Directory of Open Access Journals (Sweden)

    Sanjeev Bhoi

    2012-01-01

    Full Text Available Background: Patients require procedural sedation and analgesia (PSA for the treatment of acute traumatic injuries. PSA has complications. Ultrasound (US guided peripheral nerve block is a safe alternative. Aim: Ultrasound guided nerve blocks for management of traumatic limb emergencies in Emergency Department (ED. Setting and Design: Prospective observational study conducted in ED. Materials and Methods: Patients above five years requiring analgesia for management of limb emergencies were recruited. Emergency Physicians trained in US guided nerve blocks performed the procedure. Statistical analysis: Effectiveness of pain control, using visual analogue scale was assessed at baseline and at 15 and 60 minutes after the procedure. Paired t test was used for comparison. Results: Fifty US guided nerve blocks were sciatic- 4 (8%, femoral-7 (14%, brachial- 29 (58%, median -6 (12%, and radial 2 (4% nerves. No patients required rescue PSA. Initial median VAS score was 9 (Inter Quartile Range [IQR] 7-10 and at 1 hour was 2(IQR 0-4. Median reduction in VAS score was 7.44 (IQR 8-10(75%, 1-2(25% (P=0.0001. Median procedure time was 9 minutes (IQR 3, 12 minutes and median time to reduction of pain was 5 minutes (IQR 1,15 minutes. No immediate or late complications noticed at 3 months. Conclusion: Ultrasound-guided nerve blocks can be safely and effectively performed for upper and lower limb emergencies by emergency physicians with adequate training.

  5. COMPARISON OF NERVE CONDUCTION VELOCITY IN TEENAGERS WITH DIFFERENT IQ

    OpenAIRE

    Khosravi, S

    2002-01-01

    Introduction. Correlation between nerve conduction velocity (NCV) in peripheral and central nervous systems and intelligence has been investigated during recent years with different results. To determine whether there is any correlation between peripheral NCV and IQ, we tested median and ulnar NCV in three groups of teenagers with different IQs. Methods. 144 normal subjects aged between 12-17 years were studied in three groups. Group I, with IQ more than 120 (measured with the Wechsler i...

  6. Identification of a persistent primitive trigeminal artery following the transposition technique for trigeminal neuralgia: A case report

    Science.gov (United States)

    Kato, Naoki; Tanaka, Toshihide; Sakamoto, Hiroki; Arai, Takao; Hasegawa, Yuzuru; Abe, Toshiaki

    2011-01-01

    A patient who presented with trigeminal neuralgia associated with a persistent primitive trigeminal artery (PPTA) is presented. A 62-year-old woman suffering from right orbital pain was admitted to the hospital. Medical treatment for three months was ineffective, and her neuralgia had deteriorated and gradually spread in the maxillary division. Magnetic resonance imaging demonstrated the flow void signal attached to the right trigeminal nerve. Thus, microvascular decompression was performed. The superior cerebellar artery was the responsible artery, and it was transposed to decompress the trigeminal nerve. After this manoeuvre, an artery was identified running parallel to the trigeminal nerve toward Meckel’s cave. The artery, which turned out to be a PPTA, communicated with the basilar artery. The PPTA was carefully observed, and it was found not to be the artery causing the neuralgia because it did not compress the nerve at surgical observation. No additional procedure between the PPTA and the trigeminal nerve was performed. The patient’s symptom improved dramatically following surgery, and her postoperative course was uneventful. Postoperative three-dimensional computed tomography showed the PPTA. The findings in the present case suggest that transposition of the responsible artery effectively decompresses the root entry zone and assists in determining whether the PPTA is affecting the trigeminal nerve. PMID:22059208

  7. Identification of a persistent primitive trigeminal artery following the transposition technique for trigeminal neuralgia: a case report.

    Science.gov (United States)

    Kato, Naoki; Tanaka, Toshihide; Sakamoto, Hiroki; Arai, Takao; Hasegawa, Yuzuru; Abe, Toshiaki

    2011-01-01

    A patient who presented with trigeminal neuralgia associated with a persistent primitive trigeminal artery (PPTA) is presented. A 62-year-old woman suffering from right orbital pain was admitted to the hospital. Medical treatment for three months was ineffective, and her neuralgia had deteriorated and gradually spread in the maxillary division. Magnetic resonance imaging demonstrated the flow void signal attached to the right trigeminal nerve. Thus, microvascular decompression was performed. The superior cerebellar artery was the responsible artery, and it was transposed to decompress the trigeminal nerve. After this manoeuvre, an artery was identified running parallel to the trigeminal nerve toward Meckel's cave. The artery, which turned out to be a PPTA, communicated with the basilar artery. The PPTA was carefully observed, and it was found not to be the artery causing the neuralgia because it did not compress the nerve at surgical observation. No additional procedure between the PPTA and the trigeminal nerve was performed. The patient's symptom improved dramatically following surgery, and her postoperative course was uneventful. Postoperative three-dimensional computed tomography showed the PPTA. The findings in the present case suggest that transposition of the responsible artery effectively decompresses the root entry zone and assists in determining whether the PPTA is affecting the trigeminal nerve. PMID:22059208

  8. 颈总动脉周围交感神经网剥脱切除术治疗脑性瘫痪患儿的效果及对其认知功能的影响%Effect of excision of peripheral sympathetic nerve network in common carotid artery in children with cerebral palsy and its effect on their cognitive function

    Institute of Scientific and Technical Information of China (English)

    赵家鹏; 王家勤; 常崇旺; 王玉峰; 马世江; 冯宇飞

    2015-01-01

    Objective To explore the clinical effect of excision of peripheral sympathetic nerve network in common carotid artery on children with cerebral palsy (CP)and the effect on their cognitive function. Methods A ret-rospective study method was admitted to preschool children with CP in 69 cases in Center of Brain Disease,the Third Hospital Affiliated to Xinxiang Medical University from July 2008 to August 2014, the common carotid artery sympathetic with the surrounding network stripping off resection treatment of 43 cases ( surgery group) ,without the use of surgery in the treatment of children with 26 cases ( no operation group) . The muscle tension improved, movement to improve the ability of 2 groups before and after treatment 6 months were detected and compared. Developmental quotient ( DQ) ,intelligence quotient ( IQ) ,bilateral middle cerebral artery ( MCA) hemodynamic index difference were deter-mined between 2 groups before and after treatment 6 months. Results After treatment 6 months,the muscle tension score and walking ability score of the surgery group were significantly better than those of no operation group [(2. 2± 1. 1) scores vs (4. 5±0. 6)scores,(3. 5±0. 7) scores vs (2. 7±0. 8) scores,all P<0. 05],and significantly improved compared with before treatment[(4. 8±0. 6)scores,(2. 2±0. 9)scores,all P<0. 05]. After treatment 6 months,the IQ score,fine motor, social adaptation, personal social, language score and MCA mean velocity ( MV ) , peak velocity ( PV) ,resistance index ( RI) ,pulsatility index ( PI) determination value of the surgery group were significantly higher than those of no operation group and before treatment (all P<0. 05). Conclusions Excision of peripheral sympathetic nerve network on common carotid artery has a good clinical effect in the treatment of CP , and can significantly improve the cognitive function of children with CP .%目的:探讨颈总动脉周围交感神经网剥脱切除术治疗脑性瘫痪( CP )患儿的临床

  9. Optic nerve oxygen tension

    DEFF Research Database (Denmark)

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

    2004-01-01

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

  10. Innervation of the human middle meningeal artery

    DEFF Research Database (Denmark)

    Edvinsson, L; Gulbenkian, S; Barroso, C P;

    1998-01-01

    The majority of nerve fibers in the middle meningeal artery and branching arterioles are sympathetic, storing norepinephrine and neuropeptide Y (NPY). A sparse supply of fibers contain acetylcholinesterase activity and immunoreactivity toward vasoactive intestinal peptide (VIP), peptidine histidine...... methionine (PHM), and calcitonin gene-related peptide (CGRP). Only few substance P and neuropeptide K immunoreactive fibers are noted. Electronmicroscopy shows axons and terminals at the adventitial medial border of the human middle meningeal artery, with a fairly large distance to the smooth muscle cells...

  11. Progress of peripheral nerve repair

    Institute of Scientific and Technical Information of China (English)

    陈峥嵘

    2002-01-01

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

  12. Delayed appearance of hypaesthesia and paralysis after femoral nerve block

    Directory of Open Access Journals (Sweden)

    Stefan Landgraeber

    2012-03-01

    Full Text Available We report on a female patient who underwent an arthroscopy of the right knee and was given a continuous femoral nerve block catheter. The postoperative course was initially unremarkable, but when postoperative mobilisation was commenced, 18 hours after removal of the catheter, the patient noticed paralysis and hypaesthesia. Examination confirmed the diagnosis of femoral nerve dysfunction. Colour duplex sonography of the femoral artery and computed tomography of the lumbar spine and pelvis yielded no pathological findings. Overnight the neurological deficits decreased without therapy and were finally no longer detectable. We speculate that during the administration of the local anaesthetic a depot formed, localised in the medial femoral intermuscular septa, which was leaked after first mobilisation. To our knowledge no similar case has been published up to now. We conclude that patients who are treated with a nerve block should be informed and physician should be aware that delayed neurological deficits are possible.

  13. Solitary median maxillary central incisor: a report of 2 cases.

    Science.gov (United States)

    Sekerci, Ahmet Ercan; Uçar, Faruk Izzet; Gümüş, Hüsniye; Aydınbelge, Mustafa; Sisman, Yildiray

    2012-01-01

    A single median maxillary central incisor (SMMCI) is a rare dental anomaly that may occur alone or be associated with growth deficiency or other systemic abnormalities. The best known association is with holoprosencephaly (HPE). HPE is a complex brain malformation that affects both the forebrain and the face. Early diagnosis of SMMCI is important, since it may be a sign of other severe congenital or developmental abnormalities. Therefore, systematic follow-up and close monitoring of the growth and development of SMMCI patients is crucial. The purpose of this paper was to report the cases of 2 children, each with a single median maxillary central incisor, and describe important symptoms of this syndrome that have not yet been reported. PMID:22583889

  14. The median recoil direction as a WIMP directional detection signal

    CERN Document Server

    Green, Anne M

    2010-01-01

    Direct detection experiments have reached the sensitivity required to detect dark matter WIMPs. Demonstrating that a putative signal is due to WIMPs, and not backgrounds, is a major challenge however. The direction dependence of the WIMP scattering rate provides a potential WIMP `smoking gun'. If the WIMP distribution is predominantly smooth, the Galactic recoil distribution is peaked in the direction opposite to the direction of Solar motion. Previous studies have found that, for an ideal detector, of order 10 WIMP events would be sufficient to reject isotropy, and rule out an isotropic background. We examine how the median recoil direction could be used to confirm the WIMP origin of an anisotropic recoil signal. Specifically we determine the number of events required to reject the null hypothesis that the median direction is random (corresponding to an isotropic Galactic recoil distribution) at 95% confidence. We find that for zero background 31 events are required, a factor of roughly 2 more than are requi...

  15. Lapset median käyttäjinä

    OpenAIRE

    Jalonen, Taru; Suomela, Sonja

    2010-01-01

    Laurea-ammattikorkeakoulu Tiivistelmä Hyvinkää Sosiaali-, terveys- ja liikunta-ala Hoitotyön koulutusohjelma Terveydenhoitaja AMK Sairaanhoitaja AMK Taru Jalonen, Sonja Suomela Lapset median käyttäjinä Vuosi ‎2010‎ Sivumäärä ‎63‎ Tämän opinnäytetyön tarkoituksena oli selvittää lasten tottumuksia ja kokemuksia mediasta sekä ‎niiden herättämiä tunteita. Lisäksi selvitimme lasten käyttämiä mediaympäristöjä sekä median ‎näkymistä lasten leikeissä. Tämä työ on os...

  16. Functional mapping of the cardiorespiratory effects of dorsal and median raphe nuclei in the rat

    Directory of Open Access Journals (Sweden)

    R.M. Alvarenga

    2005-11-01

    Full Text Available The dorsal (DRN and median (MRN raphe nuclei are important sources of serotonergic innervation to the forebrain, projecting to sites involved in cardiovascular regulation. These nuclei have been mapped using electrical stimulation, which has the limitation of stimulating fibers of passage. The present study maps these areas with chemical stimulation, investigating their influence on cardiorespiratory parameters. Urethane-anesthetized (1.2 g/kg, iv male Wistar rats (280-300 g were instrumented for pulsatile and mean blood pressure (MBP, heart rate, renal nerve activity, and respiratory frequency recordings. Microinjections of L-glutamate (0.18 M, 50-100 nl with 1% Pontamine Sky Blue were performed within the DRN or the MRN with glass micropipettes. At the end of the experiments the sites of microinjection were identified. The majority of sites within the MRN (86.1% and DRN (85.4% evoked pressor responses when stimulated (DRN: deltaMBP = +14.7 ± 1.2; MRN: deltaMBP = +13.6 ± 1.3 mmHg. The changes in renal nerve activity and respiratory rate caused by L-glutamate were +45 ± 11 and +42 ± 9% (DRN; P < 0.05%, +40 ± 10 and +29 ± 7% (MRN, P < 0.05, respectively. No significant changes were observed in saline-microinjected animals. This study shows that: a the blood pressure increases previously observed by electrical stimulation within the raphe are due to activation of local neurons, b this pressor effect is due to sympathoexcitation because the stimulation increased renal sympathetic activity but did not produce tachycardia, and c the stimulation of cell bodies in these nuclei also increases the respiratory rate.

  17. Nonrecurrent inferior laryngeal nerves and anatomical findings during thyroid surgery: report of three cases.

    Science.gov (United States)

    Kato, Kumiko; Toriumi, Yasuo; Kamio, Makiko; Nogi, Hiroko; Shioya, Hisashi; Takeyama, Hiroshi

    2016-12-01

    A nonrecurrent inferior laryngeal nerve (NRILN) is found more frequently on the right side than on the left, and it is closely associated with an aberrant right subclavian artery. The presence of the aberrant right subclavian artery on preoperative computed tomography (CT) scan suggests NRILN; however, different types of branching locations and pathways exist. Here, we report three NRILN cases with different pathways where the vagus nerve arises more medial than usual and a review of the literature. Case 1: A 30-year-old Japanese female presented with papillary thyroid carcinoma. Preoperative CT scan revealed an aberrant right subclavian artery, and an operation was performed under suspicion of NRILN. During the operation, the vagus nerve was found to arise more medially than usual and two NRILNs originated from it at the level of the cricoid cartilage and at a more caudal position; the two NRILNs were preserved. Case 2: A 33-year-old Japanese female with a thyroid nodule of increased size underwent surgery. Preoperative CT scan revealed an aberrant right subclavian artery, which suggested NRILN. During the operation, the vagus nerve was identified to run more medially than usual and NRILN was found to originate at the level of the cricoid cartilage; NRILN was preserved. Case 3: A 78-year-old Japanese female underwent an operation with a diagnosis of papillary thyroid carcinoma. Preoperative CT scan showed an aberrant right subclavian artery. During the operation, NRILN was found to originate from the vagus nerve at the level of the lower pole of the thyroid gland, and the vagus nerve ran medial to the common carotid artery at the caudal level. PMID:27188389

  18. The median Genocchi numbers, Q-analogues and continued fractions

    OpenAIRE

    Feigin, Evgeny

    2011-01-01

    The goal of this paper is twofold. First, we review the recently developed geometric approach to the combinatorics of the median Genocchi numbers. The Genocchi numbers appear in this context as Euler characteristics of the degenerate flag varieties. Second, we prove that the generating function of the Poincar\\' e polynomials of the degenerate flag varieties can be written as a simple continued fraction. As an application we prove that the Poincar\\' e polynomials coincide with the $q$-version ...

  19. Quadratic Assignment of Hubs in p-Hub Median Problem

    DEFF Research Database (Denmark)

    Gelareh, Shahin

    We introduce Generalized p-Hub Median Problem (GpHMP) that seeks to locate p hub nodes and install p distinct hub facilities/operators on the hubs while discount factor resulted by consolidation of flow on the hub links depends on the facilities/operators that are installed/operating on both hub ......-points. The mathematical model is presented and numerical results on the instances of CAB and AP data sets are reported....

  20. Educational system, income inequality and growth: the median voter's decision

    Directory of Open Access Journals (Sweden)

    Joilson Dias

    2005-03-01

    Full Text Available I analyze a long run educational policy as a mechanism to close the income gap among low, median and high-income families. If the choice is made endogenous by the use of the median voter theorem, the results are as follow: i public education system guarantees income convergence, however the income growth rate of the median voter is smaller; ii the combination public and private (hybrid educational system allows faster income growth rate, but income inequality is almost the natural outcome. The ending result is that the combination public and private system will prevail, since the income growth rate of the median voter is higher in this system. This might explain the persistence and differences of income inequality among the economies.O objetivo deste artigo é analisar a utilização da política educacional no longo prazo como mecanismo para a redução da desigualdade de renda entre famílias de renda baixa, mediana e alta. Se a decisão sobre a política for endogeneizada, de acordo com o teorema do eleitor mediano, os resultados são os seguintes: i o sistema educacional público para todos, apesar de garantir convergência de renda, produz uma menor taxa de crescimento da renda do eleitor mediano; ii a combinação público-privado (sistema educacional híbrido permite uma maior taxa de crescimento da renda do eleitor mediano, no entanto a desigualdade de renda é inerente a este sistema. Como resultado final, o eleitor mediano irá escolher o sistema público-privado, pois o crescimento da sua renda é maior, o que pode explicar a persistência e as diferenças na desigualdade de renda das economias.

  1. Outcome of free digital artery perforator flap transfer for reconstruction of fingertip defects

    Directory of Open Access Journals (Sweden)

    Lei Zhu

    2014-01-01

    Full Text Available Background: Fingertip defect can be treated with many flaps such as random pattern abdominal flap, retrograde digital artery island flap, V-Y advancement flap, etc. However, swelling in the fingertip, dysfunction of sensation, flexion and extension contracture or injury in the hemi-artery of the finger usually occurs during the recovery phase. Recently, digital artery perforator flaps have been used for fingertip reconstructions. With the development of super microsurgery techniques, free flaps can be more effective for sensory recovery and durability of the fingertip. Materials and Methods: Six cases (six fingers of fingertip defects were treated with free digital artery perforator flaps of appropriate size and shape from the proximal phalanx. During surgery, the superficial veins at the edge of flap were used as reflux vessels and the branches of the intrinsic nerve and dorsal digital nerve toward the flap were used as sensory nerves. The proximal segment of the digital artery (cutaneous branches towards the flap was cut off to form the pedicled free flap. The fingertips were reconstructed with the free flap by anastomosing the cutaneous branches of digital artery in the flap with the distal branch or trunk of the digital artery, the flap nerve with the nerve stump and the veins of the flap with the digital artery accompanying veins or the superficial veins in the recipient site. Results: Six flaps survived with successful skin grafting. Patients were followed up for 6-9 months. The appearance and texture of the flaps was satisfactory. The feeling within the six fingers recovered to S4 level (BMRC scale and the two point discrimination was 3-8 mm. Conclusion: Free digital artery perforator flap is suitable for repairing fingertip defect, with good texture, fine fingertip sensation and without sacrificing the branch of the digital artery or nerve.

  2. Median Robust Extended Local Binary Pattern for Texture Classification.

    Science.gov (United States)

    Liu, Li; Lao, Songyang; Fieguth, Paul W; Guo, Yulan; Wang, Xiaogang; Pietikäinen, Matti

    2016-03-01

    Local binary patterns (LBP) are considered among the most computationally efficient high-performance texture features. However, the LBP method is very sensitive to image noise and is unable to capture macrostructure information. To best address these disadvantages, in this paper, we introduce a novel descriptor for texture classification, the median robust extended LBP (MRELBP). Different from the traditional LBP and many LBP variants, MRELBP compares regional image medians rather than raw image intensities. A multiscale LBP type descriptor is computed by efficiently comparing image medians over a novel sampling scheme, which can capture both microstructure and macrostructure texture information. A comprehensive evaluation on benchmark data sets reveals MRELBP's high performance-robust to gray scale variations, rotation changes and noise-but at a low computational cost. MRELBP produces the best classification scores of 99.82%, 99.38%, and 99.77% on three popular Outex test suites. More importantly, MRELBP is shown to be highly robust to image noise, including Gaussian noise, Gaussian blur, salt-and-pepper noise, and random pixel corruption. PMID:26829791

  3. Male median raphe cysts: serial retrospective analysis and histopathological classification

    Directory of Open Access Journals (Sweden)

    Shao I-Hung

    2012-09-01

    Full Text Available Abstract Background To review the clinical and pathological characteristics of median raphe cysts and to classify the lesions according to pathogenesis and histopathological findings. Methods The medical records of patients who were diagnosed with median raphe cysts between 2001 and 2010 were reviewed to document the clinical presentation and pathological findings of the cysts. Results Most patients were asymptomatic; however, 9 patients had inflammatory or infectious cysts that were tender or painful. Four patients who had cysts on the parameatus and distal prepuce had difficulty voiding. Hematuria and hematospermia were noted in 2 cases. Thirty-one cysts were lined with an urothelium-like epithelium, and a squamous epithelium lining was found in 3 cases. In 2 cases, a well-formed mucinous glandular structure was observed. The other 20 cysts consisted of mixed epithelia. After excision of the cysts under local or general anesthesia, an urethral fistula developed as a complication in only 1 case. Conclusions Median raphe cysts are benign lesions formed due to tissue trapping during the development of urethral folds. The cysts can be defined into 4 types based on pathological findings: urethral, epidermoid, glandular, and mixed. The associated symptoms and signs should be taken into consideration when determining the treatment for the cysts. Virtual slides The virtual slide(s for this article can be found here: http//http://www.diagnosticpathology.diagnomx.eu/vs/7727074877500751

  4. Deficiency in monocarboxylate transporter 1 (MCT1) in mice delays regeneration of peripheral nerves following sciatic nerve crush

    KAUST Repository

    Morrison, Brett M.

    2015-01-01

    Peripheral nerve regeneration following injury occurs spontaneously, but many of the processes require metabolic energy. The mechanism of energy supply to axons has not previously been determined. In the central nervous system, monocarboxylate transporter 1 (MCT1), expressed in oligodendroglia, is critical for supplying lactate or other energy metabolites to axons. In the current study, MCT1 is shown to localize within the peripheral nervous system to perineurial cells, dorsal root ganglion neurons, and Schwann cells by MCT1 immunofluorescence in wild-type mice and tdTomato fluorescence in MCT1 BAC reporter mice. To investigate whether MCT1 is necessary for peripheral nerve regeneration, sciatic nerves of MCT1 heterozygous mice are crushed and peripheral nerve regeneration was quantified electrophysiologically and anatomically. Compound muscle action potential (CMAP) recovery is delayed from a median of 21. days in wild-type mice to greater than 38. days in MCT1 heterozygote mice. In fact, half of the MCT1 heterozygote mice have no recovery of CMAP at 42. days, while all of the wild-type mice recovered. In addition, muscle fibers remain 40% more atrophic and neuromuscular junctions 40% more denervated at 42. days post-crush in the MCT1 heterozygote mice than wild-type mice. The delay in nerve regeneration is not only in motor axons, as the number of regenerated axons in the sural sensory nerve of MCT1 heterozygote mice at 4. weeks and tibial mixed sensory and motor nerve at 3. weeks is also significantly reduced compared to wild-type mice. This delay in regeneration may be partly due to failed Schwann cell function, as there is reduced early phagocytosis of myelin debris and remyelination of axon segments. These data for the first time demonstrate that MCT1 is critical for regeneration of both sensory and motor axons in mice following sciatic nerve crush.

  5. Phorbol esters potentiate rapid dopamine release from median eminence and striatal synaptosomes

    International Nuclear Information System (INIS)

    In the present study, we investigated the ability of phorbol esters to potentiate Ca2+-dependent depolarization-induced release of tritium-labeled dopamine ([3H]DA) from median eminence and striatal synaptosomes. Phorbol esters potentiated [3H]DA release in a concentration-dependent manner in both kinds of dopaminergic nerve terminals and with a potency series similar to that reported for stimulation of protein kinase-C (PKC) activity in other cell systems. Evoked [3H]DA release was increased by 12-O-tetradecanoylphorbol-13-acetate (TPA; 10(-7) M) after 1, 3, 5, and 10 sec of depolarization. The effect of TPA was suppressed by sphingosine, a PKC inhibitor. TPA enhanced [3H]DA release evoked by high K+, veratridine or the Ca2+ ionophore A23187. Phorbol ester potentiation was found to be depolarization dependent, as it was present from 30-75 mM, but not at 5-20 mM external K+. Potentiation was seen at all external Ca2+ concentrations studied between 0.01-3 mM. However, in the absence of external free Ca2+ (i.e. with 0.1 mM EGTA), the phorbol effect was not present. These data indicate that an increase in intrasynaptosomal Ca2+ concentration is necessary for the enhancement of [3H]DA release by phorbol esters to occur. The combination of TPA and the Ca2+ ionophore A23187 does not show the marked synergism observed in some other systems, that is maximal release was not reinstated. This suggests that in dopaminergic nerve terminals, activation of PKC has a modulatory, rather than a mediating, effect on release. Recently, we have shown that hyperprolactinemia stimulated [3H]DA release from median eminence synaptosomes by an external Ca2+-independent mechanism which might involve the PKC pathway. However, in the present work we found that the TPA and PRL effects on evoked [3H]DA release were additive, suggesting that two independent mechanisms are involved

  6. Phorbol esters potentiate rapid dopamine release from median eminence and striatal synaptosomes

    Energy Technology Data Exchange (ETDEWEB)

    Shu, C.; Selmanoff, M.

    1988-06-01

    In the present study, we investigated the ability of phorbol esters to potentiate Ca2+-dependent depolarization-induced release of tritium-labeled dopamine ((3H)DA) from median eminence and striatal synaptosomes. Phorbol esters potentiated (3H)DA release in a concentration-dependent manner in both kinds of dopaminergic nerve terminals and with a potency series similar to that reported for stimulation of protein kinase-C (PKC) activity in other cell systems. Evoked (3H)DA release was increased by 12-O-tetradecanoylphorbol-13-acetate (TPA; 10(-7) M) after 1, 3, 5, and 10 sec of depolarization. The effect of TPA was suppressed by sphingosine, a PKC inhibitor. TPA enhanced (3H)DA release evoked by high K+, veratridine or the Ca2+ ionophore A23187. Phorbol ester potentiation was found to be depolarization dependent, as it was present from 30-75 mM, but not at 5-20 mM external K+. Potentiation was seen at all external Ca2+ concentrations studied between 0.01-3 mM. However, in the absence of external free Ca2+ (i.e. with 0.1 mM EGTA), the phorbol effect was not present. These data indicate that an increase in intrasynaptosomal Ca2+ concentration is necessary for the enhancement of (3H)DA release by phorbol esters to occur. The combination of TPA and the Ca2+ ionophore A23187 does not show the marked synergism observed in some other systems, that is maximal release was not reinstated. This suggests that in dopaminergic nerve terminals, activation of PKC has a modulatory, rather than a mediating, effect on release. Recently, we have shown that hyperprolactinemia stimulated (3H)DA release from median eminence synaptosomes by an external Ca2+-independent mechanism which might involve the PKC pathway. However, in the present work we found that the TPA and PRL effects on evoked (3H)DA release were additive, suggesting that two independent mechanisms are involved.

  7. Celiac artery stenosis/occlusion treated by interventional radiology

    Energy Technology Data Exchange (ETDEWEB)

    Ikeda, Osamu [Department of Diagnostic Radiology, Kumamoto University Graduate School of Medical and Pharmaceutical Sciences, 1-1-1, Honjo Kumamoto 860-8505 (Japan)], E-mail: osamu-3643ik@do9.enjoy.ne.jp; Tamura, Yoshitaka; Nakasone, Yutaka; Yamashita, Yasuyuki [Department of Diagnostic Radiology, Kumamoto University Graduate School of Medical and Pharmaceutical Sciences, 1-1-1, Honjo Kumamoto 860-8505 (Japan)

    2009-08-15

    Severe stenosis/occlusion of the proximal celiac trunk due to median arcuate ligament compression (MALC), arteriosclerosis, pancreatitis, tumor invasion, and celiac axis agenesis has been reported. However, clinically significant ischemic bowel disease attributable to celiac axis stenosis/occlusion appears to be rare because the superior mesenteric artery (SMA) provides for rich collateral circulation. In patients with celiac axis stenosis/occlusion, the most important and frequently encountered collateral vessels from the SMA are the pancreaticoduodenal arcades. Patients with celiac artery stenosis/occlusion are treated by interventional radiology (IR) via dilation of the pancreaticoduodenal arcade. In patients with dilation of the pancreaticoduodenal arcade on SMA angiograms, IR through this artery may be successful. Here we provide several tips on surmounting these difficulties in IR including transcatheter arterial chemoembolization for hepatocellular carcinoma, an implantable port system for hepatic arterial infusion chemotherapy to treat metastatic liver tumors, coil embolization of pancreaticoduodenal artery aneurysms, and arterial stimulation test with venous sampling for insulinomas.

  8. Celiac artery stenosis/occlusion treated by interventional radiology

    International Nuclear Information System (INIS)

    Severe stenosis/occlusion of the proximal celiac trunk due to median arcuate ligament compression (MALC), arteriosclerosis, pancreatitis, tumor invasion, and celiac axis agenesis has been reported. However, clinically significant ischemic bowel disease attributable to celiac axis stenosis/occlusion appears to be rare because the superior mesenteric artery (SMA) provides for rich collateral circulation. In patients with celiac axis stenosis/occlusion, the most important and frequently encountered collateral vessels from the SMA are the pancreaticoduodenal arcades. Patients with celiac artery stenosis/occlusion are treated by interventional radiology (IR) via dilation of the pancreaticoduodenal arcade. In patients with dilation of the pancreaticoduodenal arcade on SMA angiograms, IR through this artery may be successful. Here we provide several tips on surmounting these difficulties in IR including transcatheter arterial chemoembolization for hepatocellular carcinoma, an implantable port system for hepatic arterial infusion chemotherapy to treat metastatic liver tumors, coil embolization of pancreaticoduodenal artery aneurysms, and arterial stimulation test with venous sampling for insulinomas.

  9. Pathology of the vestibulocochlear nerve

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-05-15

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

  10. Trigeminal neuralgia and persistent trigeminal artery

    OpenAIRE

    Conforti, Renata; Parlato, Raffaele Stefano; De Paulis, Danilo; Cirillo, Mario; Marrone, Valeria; Cirillo, Sossio; Moraci, Aldo; Parlato, Ciro

    2012-01-01

    We report a case of trigeminal neuralgia caused by persistent trigeminal artery (PTA) associated with asymptomatic left temporal cavernoma. Our patient presented unstable blood hypertension and the pain of typical trigeminal neuralgia over the second and third divisions of the nerve in the right side of the face. The attacks were often precipitated during physical exertion. MRI and Angio-MRI revealed the persistent carotid basilar anastomosis and occasionally left parietal cavernoma. After dr...

  11. Social Security: a financial appraisal for the median voter.

    Science.gov (United States)

    Galasso, V

    Several explanations have been proposed for why voters continue to support unfunded social security systems. Browning (1975) suggests that the extremely large unfunded pension systems of most democracies depend on the existence of a voting majority composed of middle-aged and older people who fail to fully internalize the cost of financing the system. In fact, when voting, economically rational workers consider only their current and future contributions to the system and their expected pension benefits--not their past contributions, which they regard as sunk costs. If, for a majority of voters, the expected continuation return from social security exceeds the return from alternative assets, an unfunded social security system is politically sustainable. This article explores the validity of Browning's proposition by quantifying the returns that U.S. voters in presidential elections from 1964 to 1996 have obtained, or expect to obtain, from Social Security. Did "investments" in Social Security outperform alternative forms of investment, such as mutual funds or pension funds, for a majority of the voters? What can be expected for the future? The U.S. Social Security system redistributes income within age cohorts on the basis of sex, income, and marital status. To account for some of these features, the median voter is represented by a family unit whose members--a husband who accounts for 70 percent of household earnings and a wife who accounts for 30 percent--make joint economic and voting decisions. Thus, retirement and survival benefits paid out to the spouse of an insured worker can be included in the calculation of Social Security returns. Interval estimates of voters' family incomes from the U.S. Census Bureau were used to obtain the median voter's household earnings. The median voter's age is derived from the ages of those who voted in presidential elections, not from the ages of the entire electorate. The median voter's contributions to Social Security are the

  12. Progesterone and peripheral nerve regeneration

    Institute of Scientific and Technical Information of China (English)

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

    2006-01-01

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

  13. Nerve sonography in multifocal motor neuropathy and chronic inflammatory demyelinating polyneuropathy

    Directory of Open Access Journals (Sweden)

    D. S. Druzhinin

    2016-01-01

    Full Text Available The quantitative ultrasound characteristics (USC of the median, ulnar nerve at different levels and the spinal nerves in patients with multifocal motor neuropathy (MMN; n=13; 40,4 ± 12,6 years old and chronic inflammatory demyelinating polyneuropathy (CIDP; n = 7; 47,3 ± 11,2 year old did not reveal statistical difference in cross sectional area (CSA between analyzed groups. Patients with MMN have more pronounced asymmetry of CSA in comparison with CIDP patients which have a symmetrical pattern of diffuse nerve involvement. Quantitative USC has shown to be not informative enough in differentiation of MMN and CIDP. The qualitative analysis (QA according to 3 described types of nerve changes has shown that CIDP is characterized by the prevalence of type 3 pattern (85.8 % while MMN – by type 2 (69.2 %. The sensitivity and specificity of proposed QA patterns in nerve USC need to be analyzed in additional investigations. 

  14. Short-interval intracortical inhibition is modulated by high-frequency peripheral mixed nerve stimulation.

    Science.gov (United States)

    Murakami, Takenobu; Sakuma, Kenji; Nomura, Takashi; Nakashima, Kenji

    2007-06-01

    Cortical excitability can be modulated by manipulation of afferent input. We investigated the influence of peripheral mixed nerve stimulation on the excitability of the motor cortex. Motor evoked potentials (MEPs), short-interval intracortical inhibition (SICI) and intracortical facilitation (ICF) in the right abductor pollicis brevis (APB), extensor carpi radialis (ECR) and first dorsal interosseous (FDI) muscles were evaluated using paired-pulse transcranial magnetic stimulation (TMS) before and after high-frequency peripheral mixed nerve stimulation (150 Hz, 30 min) over the right median nerve at the wrist. The MEP amplitude and SICI of the APB muscle decreased transiently 0-10 min after the intervention, whereas the ICF did not change. High-frequency peripheral mixed nerve stimulation reduced the excitability of the motor cortex. The decrement in the SICI, which reflects the function of GABA(A)ergic inhibitory interneurons, might compensate for the reduced motor cortical excitability after high-frequency peripheral mixed nerve stimulation.

  15. Ultrasonographic evaluation of the iatrogenic peripheral nerve injuries in upper extremity

    International Nuclear Information System (INIS)

    The aim of our study is to assess the efficiency of the ultrasonography (US) in the diagnosis of peripheral nerve injury. This study includes nine patients (six radial, one median and two posterior interosseous (PIO) nerves) with peripheral nerve injury diagnosed by clinical and electrophysiological methods in the last 3 years. Preoperatively, an ultrasonographic examination was performed and correlated with physical exam and surgical findings. Five patients, who were diagnosed as peripheral nerve transection by US, underwent surgery. The ultrasonographic findings were concordant with the intraoperative findings. Axonal swelling alone was found in the remaining three patients, who were treated conservatively because of preserved nerve continuity without display of nerve compression. In one patient, we were unable to visualize the nerve due to obesity and soft tissue edema. High-resolution US provide morphological information about the exact location, intensity and extent of the nerve injuries, facilitating the preoperative diagnosis. Thus, US may be a useful method for planning optimal treatment strategy in especially iatrogenic nerve injuries.

  16. Vascularized peripheral nerve trunk autografted in the spinal cord: a new experimental model in adult rats

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: To investigate the effect of vascularized peripheral nerve trunk autografted in spinal cord. Methods: With modern microsurgical technique,vascularized peripheral median and ulnar nerve trunk autografted in the upper thoracic region of the spinal cord were established in 20 female adult rats. The origin and the termination of axons in the graft were studied by retrograde neuronal labeling with horseradish peroxidase (HRP).Cord, nerve grafts and some normal median and ulnar nerves in the right upper limb were removed and sectioned for Bielschowsky's silver stain and haematoxylin and eosin (H&E) stain. Light and electron microscopic examination and electrophysiological examination were applied.Results: The grafts were innervated by many new fibers. Studies with HRP indicated that new axons in graft were originated from intrinsic central nervous system (CNS) neurons with their cell bodies from brain stem to sacral segments of spinal cord. Other axons arose from dorsal root ganglia at the level of graft and at least 19 distal segments to them. Together with electron microscopy, electrophysiological examination, silver and H&E stain, the results demonstrated that vascularized peripheral nerve trunk grafted in spinal cord attracted many neurons to grow into the nerve grafts.Conclusions: The findings implicate that CNS is able to regenerate much better in vascularized nerve autografted in spinal cord.

  17. [Techniques of autonomic nerve preservation in laparoscopic radical resection for rectal cancer].

    Science.gov (United States)

    Wei, Hongbo; Zheng, Zongheng

    2015-06-01

    Pelvic autonomic nerve is a three-dimensional structure surrounding the rectum. There are several key points related to nerve injury during laparoscopic radical resection for rectal cancer. Hypogastric nerve has close relation with the upper and middle part of the rectum. Combined with S2-S4 pelvic splanchnic nerve, hypogastric nerve forms pelvic plexus. Incorrect operation in pelvic parietal peritoneum during dissection of upper rectum will lead to nerve injury. When performing dissection of inferior mesenteric artery, bilateral nerve tracts should be pushed to posterior abdominal wall and anterior fascia of the abdominal aorta should be well protected to avoid nerve injury. Pelvic plexus fibers located lateral to the rectum of pelvic floor, as well as neurovascular bundle closed to Denonvillier's fascia, also have close relations with nerve injury. Dissection of either lateral or anterior wall of rectum should be performed behind the Denonvillier's fascia and in front of the proper fascia of rectum. Sharp dissection should be performed closed to the mesorectum to protect branches of pelvic plexus.

  18. Pseudoaneurysm of the Posterior Tibial Artery After Posterior Tibial Tendon Transfer.

    Science.gov (United States)

    Elabdi, Monsef; Roukhsi, Redouane; Tijani, Youssef; Chtata, Hassan; Jaafar, Abdeloihab

    2016-01-01

    Pseudoaneurysm of the posterior tibial artery is an uncommon condition that, left untreated, can lead to hemorrhage, thrombosis, or emboli. We present the case of a 54-year-old male who developed pseudoaneurysm of the posterior tibial artery 4 months after undergoing tibialis posterior tendon transfer for management of peroneal nerve palsy, which had developed as a complication of hip arthroplasty. PMID:26972754

  19. Optic nerve hypoplasia

    Directory of Open Access Journals (Sweden)

    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.

  20. Peripheral nerve hyperexcitability syndromes.

    Science.gov (United States)

    Küçükali, Cem Ismail; Kürtüncü, Murat; Akçay, Halil İbrahim; Tüzün, Erdem; Öge, Ali Emre

    2015-01-01

    Peripheral nerve hyperexcitability (PNH) syndromes can be subclassified as primary and secondary. The main primary PNH syndromes are neuromyotonia, cramp-fasciculation syndrome (CFS), and Morvan's syndrome, which cause widespread symptoms and signs without the association of an evident peripheral nerve disease. Their major symptoms are muscle twitching and stiffness, which differ only in severity between neuromyotonia and CFS. Cramps, pseudomyotonia, hyperhidrosis, and some other autonomic abnormalities, as well as mild positive sensory phenomena, can be seen in several patients. Symptoms reflecting the involvement of the central nervous system occur in Morvan's syndrome. Secondary PNH syndromes are generally seen in patients with focal or diffuse diseases affecting the peripheral nervous system. The PNH-related symptoms and signs are generally found incidentally during clinical or electrodiagnostic examinations. The electrophysiological findings that are very useful in the diagnosis of PNH are myokymic and neuromyotonic discharges in needle electromyography along with some additional indicators of increased nerve fiber excitability. Based on clinicopathological and etiological associations, PNH syndromes can also be classified as immune mediated, genetic, and those caused by other miscellaneous factors. There has been an increasing awareness on the role of voltage-gated potassium channel complex autoimmunity in primary PNH pathogenesis. Then again, a long list of toxic compounds and genetic factors has also been implicated in development of PNH. The management of primary PNH syndromes comprises symptomatic treatment with anticonvulsant drugs, immune modulation if necessary, and treatment of possible associated dysimmune and/or malignant conditions. PMID:25719304

  1. Optic nerve hypoplasia.

    Science.gov (United States)

    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

  2. Trigeminal neuralgia: how often are trigeminal nerve-vessel contacts found by MRI in normal volunteers

    International Nuclear Information System (INIS)

    Purpose: To assess prospectively how often contacts are found between the trigeminal nerve and arteries or veins in the perimesencephalic cistern via MRI in normal volunteers. Materials and methods: 48 volunteers without a history of trigeminal neuralgia were examined prospectively (MRI at 1.5T; T2-CISS sequence, coronal orientation, 0.9 mm slice thickness). Two radiologists decided by consensus whether there was a nerve-vessel contact in the perimesencephalic cistern. Results: In 27% of the volunteers, no contact was found between the trigeminal nerve and regional vessels, while in 73%, such a contact was present. In 61% of the cases, the offending vessel was an artery, in 39%, it was a vein. In 2 volunteers, a deformation of the nerve was noted. Conclusion: Contrary to what has been suggested by retrospective studies, the majority of normal volunteers, if studied prospectively, do show a contact between the trigeminal nerve and local vessels. A close proximity between the nerve and regional vessels is thus normal and is not necessarily proof of a pathological nerve-vessel conflict. (orig.)

  3. Robust optic nerve segmentation on clinically acquired CT

    Science.gov (United States)

    Panda, Swetasudha; Asman, Andrew J.; DeLisi, Michael P.; Mawn, Louise A.; Galloway, Robert L.; Landman, Bennett A.

    2014-03-01

    The optic nerve is a sensitive central nervous system structure, which plays a critical role in many devastating pathological conditions. Several methods have been proposed in recent years to segment the optic nerve automatically, but progress toward full automation has been limited. Multi-atlas methods have been successful for brain segmentation, but their application to smaller anatomies remains relatively unexplored. Herein we evaluate a framework for robust and fully automated segmentation of the optic nerves, eye globes and muscles. We employ a robust registration procedure for accurate registrations, variable voxel resolution and image fieldof- view. We demonstrate the efficacy of an optimal combination of SyN registration and a recently proposed label fusion algorithm (Non-local Spatial STAPLE) that accounts for small-scale errors in registration correspondence. On a dataset containing 30 highly varying computed tomography (CT) images of the human brain, the optimal registration and label fusion pipeline resulted in a median Dice similarity coefficient of 0.77, symmetric mean surface distance error of 0.55 mm, symmetric Hausdorff distance error of 3.33 mm for the optic nerves. Simultaneously, we demonstrate the robustness of the optimal algorithm by segmenting the optic nerve structure in 316 CT scans obtained from 182 subjects from a thyroid eye disease (TED) patient population.

  4. Mustavaaran sosiaalisen median viestintästrategia ja -suunnitelma

    OpenAIRE

    Parkkinen, Erkka

    2015-01-01

    Tämän opinnäytetyön toimeksiantona oli luoda sosiaalisen median viestintästrategian ja -suunnitelman pohja sekä niiden kehittämiseen tarvittavat elementit laskettelukeskusta Mustavaaralle. Työssäni paneudun digitaalisen viestinnän mahdollisuuksia ja suunnittelen kanavia markkinointiviestinnän kehittämiseksi Mustavaaralle tulevaisuudessa. Opinnäytetyö yhdistelee tutkimuksellisia ja toiminnallisia toimenpiteitä. Opinnäytetyössä lähteinä käytetään kirjallisia ja nettipohjaisia lähteitä sekä omaa...

  5. Kansallisteatterin somelainen viestintätiimi : Sosiaalisen median integrointi arkirutiineihin

    OpenAIRE

    Helstelä, Kirsi

    2015-01-01

    Kansallisteatterin somelainen viestintätiimi on Kansallisteatterille tehty kehittämistyö, jonka tarkoitus on kehittää Kansallisteatterin viestintää sosiaalisessa mediassa ja sujuvoittaa sosiaalisen median sisällöntuotantorutiineja Kansallisteatterin viestintätiimissä, joka jakaantuu tiedotus-, markkinointi- ja myyntitiimeihin. Säilyttääksensä elinvoimaisuutensa Kansallisteatterin on houkuteltava jatkuvasti uusia yleisöjä ja pidettävä kiinni nykyisistä katsojistaan yhä tiiviimmin. Tässä tehtäv...

  6. The p-median Facility Location Problem and Solution Approaches

    Directory of Open Access Journals (Sweden)

    Mehmet BASTI

    2012-05-01

    Full Text Available In today’s globalized and increasingly competitive environment, organizations’ need to implement successful strategies for supply chain management has become indispensable. Transportation costs within the supply chain comprise an important part of the organizations’ expenses. For this reason, the strategic selection of location is an issue that directly affects supply chain performance and costs. At this stage, it becomes very important to apply the latest and the best methods to the facility location problem. The focus of this study is the p-median problem and its solution techniques, one of the location allocation problems aimed at minimizing the costs arising from shipments between facilities and demand points.

  7. Biofabrication and testing of a fully cellular nerve graft

    International Nuclear Information System (INIS)

    Rupture of a nerve is a debilitating injury with devastating consequences for the individual's quality of life. The gold standard of repair is the use of an autologous graft to bridge the severed nerve ends. Such repair however involves risks due to secondary surgery at the donor site and may result in morbidity and infection. Thus the clinical approach to repair often involves non-cellular solutions, grafts composed of synthetic or natural materials. Here we report on a novel approach to biofabricate fully biological grafts composed exclusively of cells and cell secreted material. To reproducibly and reliably build such grafts of composite geometry we use bioprinting. We test our grafts in a rat sciatic nerve injury model for both motor and sensory function. In particular we compare the regenerative capacity of the biofabricated grafts with that of autologous grafts and grafts made of hollow collagen tubes by measuring the compound action potential (for motor function) and the change in mean arterial blood pressure as consequence of electrically eliciting the somatic pressor reflex. Our results provide evidence that bioprinting is a promising approach to nerve graft fabrication and as a consequence to nerve regeneration. (paper)

  8. A novel GABA-mediated corticotropin-releasing hormone secretory mechanism in the median eminence.

    Science.gov (United States)

    Kakizawa, Keisuke; Watanabe, Miho; Mutoh, Hiroki; Okawa, Yuta; Yamashita, Miho; Yanagawa, Yuchio; Itoi, Keiichi; Suda, Takafumi; Oki, Yutaka; Fukuda, Atsuo

    2016-08-01

    Corticotropin-releasing hormone (CRH), which is synthesized in the paraventricular nucleus (PVN) of the hypothalamus, plays an important role in the endocrine stress response. The excitability of CRH neurons is regulated by γ-aminobutyric acid (GABA)-containing neurons projecting to the PVN. We investigated the role of GABA in the regulation of CRH release. The release of CRH was impaired, accumulating in the cell bodies of CRH neurons in heterozygous GAD67-GFP (green fluorescent protein) knock-in mice (GAD67(+/GFP)), which exhibited decreased GABA content. The GABAA receptor (GABAAR) and the Na(+)-K(+)-2Cl(-) cotransporter (NKCC1), but not the K(+)-Cl(-) cotransporter (KCC2), were expressed in the terminals of the CRH neurons at the median eminence (ME). In contrast, CRH neuronal somata were enriched with KCC2 but not with NKCC1. Thus, intracellular Cl(-) concentrations ([Cl(-)]i) may be increased at the terminals of CRH neurons compared with concentrations in the cell body. Moreover, GABAergic terminals projecting from the arcuate nucleus were present in close proximity to CRH-positive nerve terminals. Furthermore, a GABAAR agonist increased the intracellular calcium (Ca(2+)) levels in the CRH neuron terminals but decreased the Ca(2+) levels in their somata. In addition, the increases in Ca(2+) concentrations were prevented by an NKCC1 inhibitor. We propose a novel mechanism by which the excitatory action of GABA maintains a steady-state CRH release from axon terminals in the ME. PMID:27540587

  9. A novel GABA-mediated corticotropin-releasing hormone secretory mechanism in the median eminence

    Science.gov (United States)

    Kakizawa, Keisuke; Watanabe, Miho; Mutoh, Hiroki; Okawa, Yuta; Yamashita, Miho; Yanagawa, Yuchio; Itoi, Keiichi; Suda, Takafumi; Oki, Yutaka; Fukuda, Atsuo

    2016-01-01

    Corticotropin-releasing hormone (CRH), which is synthesized in the paraventricular nucleus (PVN) of the hypothalamus, plays an important role in the endocrine stress response. The excitability of CRH neurons is regulated by γ-aminobutyric acid (GABA)–containing neurons projecting to the PVN. We investigated the role of GABA in the regulation of CRH release. The release of CRH was impaired, accumulating in the cell bodies of CRH neurons in heterozygous GAD67-GFP (green fluorescent protein) knock-in mice (GAD67+/GFP), which exhibited decreased GABA content. The GABAA receptor (GABAAR) and the Na+-K+-2Cl− cotransporter (NKCC1), but not the K+-Cl− cotransporter (KCC2), were expressed in the terminals of the CRH neurons at the median eminence (ME). In contrast, CRH neuronal somata were enriched with KCC2 but not with NKCC1. Thus, intracellular Cl− concentrations ([Cl−]i) may be increased at the terminals of CRH neurons compared with concentrations in the cell body. Moreover, GABAergic terminals projecting from the arcuate nucleus were present in close proximity to CRH-positive nerve terminals. Furthermore, a GABAAR agonist increased the intracellular calcium (Ca2+) levels in the CRH neuron terminals but decreased the Ca2+ levels in their somata. In addition, the increases in Ca2+ concentrations were prevented by an NKCC1 inhibitor. We propose a novel mechanism by which the excitatory action of GABA maintains a steady-state CRH release from axon terminals in the ME. PMID:27540587

  10. An investigation of an autonomic innervation of the vertebral artery using monoamine histofluorescence

    Directory of Open Access Journals (Sweden)

    JA Mitchell

    2009-06-01

    Full Text Available Blood flow to the hindbrain, via the paired vertebral arteries, must be uncompromised for adequate neurological functioning of its vital centres. Therefore, it would seem unlikely that the intracranial vertebral artery would need to vasoconstrict, thus reducing its blood flow. In order to investigate the existence and location of a noradrenaline-mediated constrictor mechanism in the wall of the intracranial vertebral artery, transverse sections of ten baboon and ten monkey vessels were stained with sucrose-potassium phosphate-glyoxylic acid (counterstained with malachite-green. This method allows the visualisation of catecholaminergic nerves when the sections are exposed to ultraviolet light. In this study of primate vascular tissue, however, none of the monkey or baboon vertebral artery sections showed the presence of noradrenergic nerves in the tunica media – tunica adventitia junction or penetrating the tunica media of the arteries. These findings indicate that the intracranial vertebral artery does not have a neurogenic vasomotor function in primates.

  11. [Two cases of solitary median maxillary central incisor syndrome].

    Science.gov (United States)

    Catania, P; Conti, C; Poggi, G M; Bardelli, T; Lasagni, D; De Martino, M

    2010-02-01

    Solitary median maxillary central incisor syndrome (SMMCI) syndrome is a unique developmental abnormality arising from an unknown event occurring between the 35th and 38th days in utero, and involving mieline structure of the head including the cranial bones, the maxilla and its container dentition (specifically the central incisor tooth germ), together with other midline structures of the body. The SMMCI tooth may be possibly occur as an isolated trait or in association with many other midline developmental anomalies. It is estimated to occur in 1:50000 live births. There is a wide variability in the phenotypic spectrum. SMMCI is considered one of the most minimal expressions of the holoprosencephaly spectrum. Mutation in the Sonic Hedgehog homolog (SHH) gene may be associated with SSMMCI, but recent studies suggests the existence of several other candidate genes. We described two patients with SMMCI. They presented a solitary median maxillary incisor, short stature, hipotelorism and corpus callosus anomalies found on magnetic resonance imaging (MRI). They also present severe hiponatremia. At the best of our knowledge, this is the first report of cases of SMMCI with hiponatremia. We suggest that the sodium disorder may be secondary to syndrome of inappropriate secretion of antidiuretic hormone (SIADH). PMID:20212404

  12. ACTIVE PRINCIPLES AND MEDIAN LETHAL DOSE OF CURCUMA LONGA LINN.

    Directory of Open Access Journals (Sweden)

    Pandey Govind

    2011-05-01

    Full Text Available The present study aimed to determine the active principles and median lethal dose (LD50 of Curcuma longa (Haldi by conducting phytochemical and toxicity (acute and chronic studies. The hydroalcoholic extract (HAE of haldi was prepared and its extractability was calculated as 35.9%. The chemical tests revealed the presence of many active principles (phytoconstituents such as alkaloids, glycosides, reducing sugars, tannins, resins, saponins, sterols and fixed oils. For acute toxicity, including median lethal dose (LD50 of C. longa, its HAE was administered @ 250, 500 and 1000 mg/kg body weight to female albino rats of groups 2 to 4, respectively. Rats of group 1 were administered with normal saline to serve as control. No mortality in any group of rats was found up to 48 hr, thus this drug has the LD50 above 1000 mg/kg. For chronic toxicity of C. longa HAE, similar drug dosage schedule was applied in groups 1 to 4 of rats as used for acute toxicity study; however, the drug-extract was given for 3 weeks. During both acute and chronic toxicity studies, C. longa HAE @ 1000 mg/kg elicited some gross observational effects like initial excitement, followed by mild depression, dullness, decreased respiration and reduced spontaneous motor activity (SMA. The results suggest that although haldi contains many pharmacologically important active principles but its higher dose (1000 mg/kg is slightly toxic.

  13. Radiographic signs of open median sternotomy in neonates and infants

    Energy Technology Data Exchange (ETDEWEB)

    Wu, George [Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); Geisinger Medical Center, Danville, PA (United States); Jaimes, Camilo; Markowitz, Richard I. [Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); Gaynor, J.W. [The Children' s Hospital of Philadelphia, Department of Surgery, Philadelphia, PA (United States)

    2012-06-15

    Leaving the median sternotomy wound open following cardiac surgery is employed to avoid cardiovascular compression. Horizontal struts can be used. Radiologists interpreting portable radiographs might be unaware of the open median sternotomy (OMS). To describe the frequency of radiographic signs of OMS and to increase awareness among radiologists to prevent misdiagnosis of pneumothorax and pneumomediastinum. Radiographs of 41 infants (17 girls/24 boys) with OMS were studied (age range 2 days to 8 months, mean 33 days). Central lucency and sternal edges were noted. Interclavicular distances before and after sternotomy were compared. Central lucency was seen in 25/41 (61%) children. Sternal struts were apparent in 27 (66%). In 14 without struts, central lucency was present in 8 (57%). In 27 children with struts, central lucency was present in 17 (63%) and absent in 10 (37%). Split sternal centers were identified in 6/41 (15%). The mean interclavicular distance was 23.5 mm (SD = 4.39) before sternotomy and 38.2 mm (SD = 7.0 mm) after sternotomy (P < 0.001). OMS has characteristic signs in the majority of cases. Recognition of these findings is useful and can prevent misinterpretation. (orig.)

  14. Renal nerves and nNOS

    DEFF Research Database (Denmark)

    Kompanowska-Jezierska, Elzbieta; Wolff, Helle; Kuczeriszka, Marta;

    2008-01-01

    It was hypothesized that renal sympathetic nerve activity (RSNA) and neuronal nitric oxide synthase (nNOS) are involved in the acute inhibition of renin secretion and the natriuresis following slow NaCl loading (NaLoad) and that RSNA participates in the regulation of arterial blood pressure (MABP......). This was tested by NaLoad after chronic renal denervation with and without inhibition of nNOS by S-methyl-thiocitrulline (SMTC). In addition, the acute effects of renal denervation on MABP and sodium balance were assessed. Rats were investigated in the conscious, catheterized state, in metabolic cages...... of acutely and chronically denervated rats were less than control (15% and 9%, respectively, P renal denervation (14.5 +/- 0.2 vs. 19.3 +/- 1.3 mIU/l, P

  15. [Electrical nerve stimulation for plexus and nerve blocks].

    Science.gov (United States)

    Birnbaum, J; Klotz, E; Bogusch, G; Volk, T

    2007-11-01

    Despite the increasing use of ultrasound, electrical nerve stimulation is commonly used as the standard for both plexus and peripheral nerve blocks. Several recent randomized trials have contributed to a better understanding of physiological and clinical correlations. Traditionally used currents and impulse widths are better defined in relation to the distance between needle tip and nerves. Commercially available devices enable transcutaneous nerve stimulation and provide new opportunities for the detection of puncture sites and for training. The electrically ideal position of the needle usually is defined by motor responses which can not be interpreted without profound anatomical knowledge. For instance, interscalene blocks can be successful even after motor responses of deltoid or pectoral muscles. Infraclavicular blocks should be aimed at stimulation of the posterior fascicle (extension). In contrast to multiple single nerve blocks, axillary single-shot blocks more commonly result in incomplete anaesthesia. Blockade of the femoral nerve can be performed without any nerve stimulation if the fascia iliaca block is used. Independently of the various approaches to the sciatic nerve, inversion and plantar flexion are the best options for single-shot blocks. Further clinical trials are needed to define the advantages of stimulating catheters in continuous nerve blocks.

  16. Distribution and property of nerve fibers in human long bone tissue

    Institute of Scientific and Technical Information of China (English)

    CHEN Bin; PEI Guo-xian; JIN Dan; WEI Kuan-hai; QIN Yu; LIU Qing-si

    2007-01-01

    Objective:To observe the distribution of the nerve fibers in the bone tissue and the entry points of these fibers into the bone. Methods:The adult tibia was used for the ground sections which were afterwards made into the slice sections by decalcification in ethylenediamine tetraacetic acid (EDTA).The ground sections were stained in silver and the slice sections were stained in silver and haematoxylin and eosin (HE) respectively.Then,the samples of the transmission electron microscope and the atomic force microscope were made and observed. Results:In the human long bone tissue,many nerve fibers were distributed in the membrane,cortical bone,cancellous bone and marrow.The nerve fibers entered the bone from the nutrient foramen,and passed through the nutrient canal,Haversian's canal and Volkmann's canal,and finally into the bone marrow.In the nutrient canal,the nerve fibers,mainly the medullary nerve fibers,followed the blood vessel into the bone.In the cortical bone,the nerve fibers also followed the blood vessels and were mainly distributed along Haversian's canal and Volkmann's canal.In the bone trabecular and bone marrow,there were many nerve fiber endings arranged around the blood vessels,mainly around the tunica media of medium-size arteries in the marrow and around capillary blood vessels,and a few scattered in the bone marrow. There were sporadic nerve endings in epiphyseal plate and no nerve fibers permeated epiphysis to diaphysis.No distribution of nerve fibers could be found in cartilaginous part.Conclusions:There are many nerve fibers in bone and the nerve passageway is nutrient foramen,Volkman's canal,Haversian's canal and bone marrow.

  17. Angioplasty and stent placement -- peripheral arteries

    Science.gov (United States)

    Percutaneous transluminal angioplasty - peripheral artery; PTA - peripheral artery; Angioplasty - peripheral arteries; Iliac artery -angioplasty; Femoral artery - angioplasty; Popliteal artery - angioplasty; Tibial ...

  18. Persistent primitive trigeminal artery associated with cerebrovascular diseases and other cerebrosis

    International Nuclear Information System (INIS)

    Persistent primitive trigeminal artery (PPTA) is the most common permanent abnormal vascular anastomosis between carotid artery and basilar artery. PPTA is a rare cerebrovascular variation and is often associated with cerebrovascular disease (CVD). Clinically, PPTA manifests itself in symptoms such as trigeminal neuralgia, oculomotor paralysis, abducens nerve paralysis, subarachnoid hemorrhage, etc. This paper aims to review 116 PPTA cases with CVD and other cerebrosis, which have ever been reported since 1983 in English or Chinese medical literature. (authors)

  19. Resolution of trigeminal neuralgia by coil embolization of a persistent primitive trigeminal artery aneurysm

    OpenAIRE

    Ladner, Travis R; Ehtesham, Moneeb; Davis, Brandon J; Khan, Imad S; Ghiassi, Mayshan; Ghiassi, Mahan; Singer, Robert J

    2013-01-01

    The persistent primitive trigeminal artery (PTA) is a rare anastomosis between the carotid artery and basilar artery. While most PTAs are asymptomatic, lateral variants can occasionally compress the trigeminal nerve and precipitate trigeminal neuralgia. Aneurysms of the PTA are exceptionally rare in the literature and have not previously been associated with trigeminal neuralgia. We present the first case of an aneurysm of the PTA causing trigeminal neuralgia. The patient underwent coil embol...

  20. Effect of low-frequency pulse percutaneous electric stimulation on peripheral nerve injuries at different sites

    Institute of Scientific and Technical Information of China (English)

    Jinwu Wang; Liye Chen; Qi Li; Weifeng Ni; Min Zhang; Shangchun Guo; Bingfang Zeng

    2006-01-01

    BACKGROUND: The postoperative recovery of nerve function in patients with peripheral nerve injury is always an important problem to solve after treatment. The electric stimulation induced electromagnetic field can nourish nerve, postpone muscular atrophy, and help the postoperative neuromuscular function.OBJECTIVE: To observe the effects of low-frequency pulse percutaneous electric stimulation on the functional recovery of postoperative patients with peripheral nerve injury, and quantitatively evaluate the results of electromyogram (EMG) examination before and after treatment.DESIGN: A retrospective case analysis.SETTING: The Sixth People's Hospital affiliated to Shanghai Jiaotong University.PARTICIPANTS: Nineteen postoperative inpatients with peripheral nerve injury were selected from the Department of Orthopaedics, the Sixth People's Hospital affiliated to Shanghai Jiaotong University from June 2005 to January 2006, including 13 males and 6 females aged 24-62 years with an average of 36 years old.There were 3 cases of brachial plexus nerve injury, 3 of median nerve injury, 7 of radial nerve injury, 3 of ulnar nerve injury and 3 of common peroneal nerve injury, and all the patients received probing nerve fiber restoration. Their main preoperative manifestations were dennervation, pain in limbs, motor and sensory disturbances. All the 19 patients were informed with the therapeutic program and items for evaluation.METHODS : ① Low-frequency pulse percutaneous electric stimulation apparatus: The patients were given electric stimulation with the TERESA cantata instrument (TERESA-0, Shanghai Teresa Health Technology, Co.,Ltd.). The patients were stimulated with symmetric square waves of 1-111 Hz, and the intensity was 1.2-5.0 mA, and it was gradually adjusted according to the recovered conditions of neural regeneration following the principle that the intensity was strong enough and the patients felt no obvious upset. They were treated for 4-24 weeks, 10-30 minutes

  1. Trigeminal Neuralgia Caused by Persistent Primitive Trigeminal Artery

    OpenAIRE

    Park, Chang Kyu; Choi, Hyuk Jai; Lee, Sung Ho; Rhee, Bong Arm

    2014-01-01

    A 66-year-old man presented with typical trigeminal neuralgia (TN). Magnetic resonance angiography (MRA) revealed a primitive trigeminal artery (PTA) that came into contact with the trigeminal nerve. Based on MRA, we performed microvascular decompression (MVD). In the operational field, we confirmed the PTA location and performed MVD successfully. Postoperatively, the patient's pain subsided without any complications.

  2. Trigeminal Neuralgia Caused by Persistent Primitive Trigeminal Artery

    Science.gov (United States)

    Park, Chang Kyu; Lee, Sung Ho; Rhee, Bong Arm

    2014-01-01

    A 66-year-old man presented with typical trigeminal neuralgia (TN). Magnetic resonance angiography (MRA) revealed a primitive trigeminal artery (PTA) that came into contact with the trigeminal nerve. Based on MRA, we performed microvascular decompression (MVD). In the operational field, we confirmed the PTA location and performed MVD successfully. Postoperatively, the patient's pain subsided without any complications. PMID:25368776

  3. Trigeminal neuralgia caused by persistent primitive trigeminal artery.

    Science.gov (United States)

    Park, Chang Kyu; Choi, Hyuk Jai; Lee, Sung Ho; Rhee, Bong Arm

    2014-09-01

    A 66-year-old man presented with typical trigeminal neuralgia (TN). Magnetic resonance angiography (MRA) revealed a primitive trigeminal artery (PTA) that came into contact with the trigeminal nerve. Based on MRA, we performed microvascular decompression (MVD). In the operational field, we confirmed the PTA location and performed MVD successfully. Postoperatively, the patient's pain subsided without any complications. PMID:25368776

  4. Chronic nerve root entrapment: compression and degeneration

    Science.gov (United States)

    Vanhoestenberghe, A.

    2013-02-01

    Electrode mounts are being developed to improve electrical stimulation and recording. Some are tight-fitting, or even re-shape the nervous structure they interact with, for a more selective, fascicular, access. If these are to be successfully used chronically with human nerve roots, we need to know more about the possible damage caused by the long-term entrapment and possible compression of the roots following electrode implantation. As there are, to date, no such data published, this paper presents a review of the relevant literature on alternative causes of nerve root compression, and a discussion of the degeneration mechanisms observed. A chronic compression below 40 mmHg would not compromise the functionality of the root as far as electrical stimulation and recording applications are concerned. Additionally, any temporary increase in pressure, due for example to post-operative swelling, should be limited to 20 mmHg below the patient’s mean arterial pressure, with a maximum of 100 mmHg. Connective tissue growth may cause a slower, but sustained, pressure increase. Therefore, mounts large enough to accommodate the root initially without compressing it, or compliant, elastic, mounts, that may stretch to free a larger cross-sectional area in the weeks after implantation, are recommended.

  5. Applied anatomical study of the vascularized ulnar nerve and its blood supply for cubital tunnel syndrome at the elbow region

    Institute of Scientific and Technical Information of China (English)

    Mei-xiu-li Li; Qiong He; Zhong-lin Hu; Sheng-hua Chen; Yun-cheng Lv; Zheng-hai Liu; Yong Wen; Tian-hong Peng

    2015-01-01

    Cubital tunnel syndrome is often accompanied by paresthesia in ulnar nerve sites and hand muscle atrophy. When muscle weakness occurs, or after failure of more conservative treatments, anterior transposition is used. In the present study, the ulnar nerve and its blood vessels were examined in the elbows of 18 adult cadavers, and the external diameter of the nutrient vessels of the ulnar nerve at the point of origin, the distances between the origin of the vessels and the medial epicondyle of the humerus, and the length of the vessels accompanying the ulnar nerve in the superior ulnar collateral artery, the inferior ulnar collateral artery, and the posterior ulnar recurrent artery were measured. Anterior transposition of the vascularized ulnar nerve was per-formed to treat cubital tunnel syndrome. The most appropriate distance that the vascularized ulnar nerve can be moved to the subcutaneous tissue under tension-free conditions was 1.8 ± 0.6 cm (1.1–2.5 cm), which can be used as a reference value during the treatment of cubital tunnel syndrome with anterior transposition of the vascularized ulnar nerve.

  6. Sosiaalisen median merkitys mikroyrityksille - Case: TallFits Oy

    OpenAIRE

    Nousiainen, Ari; Koskivuori, Timo

    2011-01-01

    Tämän opinnäytetyön aiheena on sosiaalinen media mikroyritysten näkökulmasta. Työssä käsi-tellään sosiaalista mediaa ja markkinoinnissa tapahtunutta muutosta sekä niitä toimintatapoja, joita interaktiivinen mediaympäristö yrityksille ja sen asiakkaille tarjoaa. Työn tavoitteena on tuottaa tietoa sosiaalisen median hyödyistä ja haasteista mikroyrityksille ja lisätä koh-deyrityksemme TallFits Oy:n myyntiä ja löydettävyyttä. Tavoitteiden saavuttamiseksi opinnäytetyömme tarkoituksena oli tehd...

  7. Fingerprint image enhancement method using directional median filter

    Science.gov (United States)

    Wu, Chaohong; Shi, Zhixin; Govindaraju, Venu

    2004-08-01

    The performance of any fingerprint recognizer highly depends on the fingerprint image quality. Different types of noises in the fingerprint images pose greater difficulty for recognizers. Most Automatic Fingerprint Identification Systems (AFIS) use some form of image enhancement. Although several methods have been described in the literature, there is still scope for improvement. In particular, effective methodology of cleaning the valleys between the ridge contours are lacking. We observe that noisy valley pixels and the pixels in the interrupted ridge flow gap are "impulse noises". Therefore, this paper describes a new approach to fingerprint image enhancement, which is based on integration of Anisotropic Filter and directional median filter(DMF). Gaussian-distributed noises are reduced effectively by Anisotropic Filter, "impulse noises" are reduced efficiently by DMF. Usually, traditional median filter is the most effective method to remove pepper-and-salt noise and other small artifacts, the proposed DMF can not only finish its original tasks, it can also join broken fingerprint ridges, fill out the holes of fingerprint images, smooth irregular ridges as well as remove some annoying small artifacts between ridges. The enhancement algorithm has been implemented and tested on fingerprint images from FVC2002. Images of varying quality have been used to evaluate the performance of our approach. We have compared our method with other methods described in the literature in terms of matched minutiae, missed minutiae, spurious minutiae, and flipped minutiae(between end points and bifurcation points). Experimental results show our method to be superior to those described in the literature.

  8. Carotid Artery Disease

    Science.gov (United States)

    ... brain with blood. If you have carotid artery disease, the arteries become narrow, usually because of atherosclerosis. ... one of the causes of stroke. Carotid artery disease often does not cause symptoms, but there are ...

  9. Peripheral arterial line (image)

    Science.gov (United States)

    A peripheral arterial line is a small, short plastic catheter placed through the skin into an artery of the arm or leg. The purpose of a peripheral arterial line is to allow continuous monitoring of ...

  10. CT appearance of a patent impar umbilical artery in an adult woman and related anomalies: a case report and review of the literature

    OpenAIRE

    Glodny, Bernhard; Henninger, Benjamin; Hofmann, Karin; Trieb, Thomas; Petersen, Johannes; Rehder, Peter

    2009-01-01

    Background We report on a case of an impar umbilical artery (IUA) in an 18-year-old woman. Case presentation The aorta branched off at level L2 into a ventral IUA and a dorsal aorta. The strong IUA produced the inferior mesenteric artery (IMA), the renal artery of a left-sided duplex kidney, and the right-sided ovarian artery before it turned to the right to merge into the right common iliac artery. From the aorta arose the lumbar arteries, the median sacral artery, lateral sacral arteries, a...

  11. Axonal degeneration of the ulnar nerve secondary to carpal tunnel syndrome: fact or fiction?

    Institute of Scientific and Technical Information of China (English)

    Radwa Mahmoud Azmy; Amira Ahmed Labib; Saly Hassan Elkholy

    2013-01-01

    The distribution of sensory symptoms in carpal tunnel syndrome is strongly dependent on the degree of electrophysiological dysfunction of the median nerve. The association between carpal tunnel syndrome and ulnar nerve entrapment is still unclear. In this study, we measured ulnar nerve function in 82 patients with carpal tunnel syndrome. The patients were divided into group I with minimal carpal tunnel syndrome (n = 35) and group II with mild to moderate carpal tunnel syndrome (n = 47) according to electrophysiological data. Sixty-one age- and sex-matched subjects without carpal tunnel syndrome were used as a control group. There were no significant differences in ulnar sensory nerve peak latencies or conduction velocities from the 4th and 5th fingers between patients with carpal tunnel syndrome and the control group. The ulnar sensory nerve action potential amplitudes from the 4th and 5th fingers were lower in patients with carpal tunnel syndrome than in the control group. The ratios of the ulnar sensory nerve action potential amplitudes from the 4th and 5th fingers were almost the same in patients with carpal tunnel syndrome as in the control group. These findings indicate that in patients with minimal to moderate carpal tunnel syndrome, there is some electrophysiological evidence of traction on the adjacent ulnar nerve fibers. The findings do not indicate axonal degeneration of the ulnar nerve.

  12. Unusual bilateral origins of the deep artery of thigh and associated variations

    Directory of Open Access Journals (Sweden)

    Shankar N

    2009-08-01

    Full Text Available During routine dissection of a middle aged male cadaver, an unusual origin of the deep artery of thigh was observed bilaterally. It arose from the femoral artery less than 1 cm distal to the inguinal ligament. On both sides, its diameter was greater than that of the femoral artery. An unusually distal origin of the lateral circumflex femoral artery was observed bilaterally. An unnamed branch from the deep artery of thigh on the left side was seen coursing superolaterally towards the anterior superior iliac spine. The deep external pudendal artery arose from the medial circumflex femoral artery on either side. On the right side, the femoral nerve emerged in the femoral triangle by piercing the iliacus muscle. As the deep artery of thigh is often used in vascular reconstructive procedures and is frequently visualized by various radiological imaging techniques, anatomical variations of itself as well as its branches have significant clinical implications.

  13. Ischemic preconditioning reduces the severity of ischemia-reperfusion injury of peripheral nerve in rats

    Directory of Open Access Journals (Sweden)

    Kurutas Ergul

    2006-09-01

    Full Text Available Abstract Background and aim Allow for protection of briefly ischemic tissues against the harmful effects of subsequent prolonged ischemia is a phenomennon called as Ischemic Preconditioning (IP. IP has not been studied in ischemia-reperfusion (I/R model of peripheral nerve before. We aimed to study the effects of acute IP on I/R injury of peripheral nerve in rats. Method 70 adult male rats were randomly divided into 5 groups in part 1 experimentation and 3 groups in part 2 experimentation. A rat model of severe nerve ischemia which was produced by tying iliac arteries and all idenfiable anastomotic vessels with a silk suture (6-0 was used to study the effects of I/R and IP on nerve biochemistry. The suture technique used was a slip-knot technique for rapid release at time of reperfusion in the study. Cytoplasmic vacuolar degeneration was also histopathologically evaluated by light microscopic examination in sciatic nerves of rats at 7th day in part 2 study. Results 3 hours of Reperfusion resulted in an increase in nerve malondialdehyde levels when compared with ischemia and non-ischemia groups (p 0.05. There was also a significant decrease in vacoular degeneration of sciatic nerves in IP group than I/R group (p Conclusion IP reduces the severity of I/R injury in peripheral nerve as shown by reduced tissue MDA levels at 3 th hour of reperfusion and axonal vacoulization at 7 th postischemic day.

  14. Maxillary artery: functional and imaging anatomy for safe and effective transcatheter treatment.

    Science.gov (United States)

    Tanoue, Shuichi; Kiyosue, Hiro; Mori, Hiromu; Hori, Yuzo; Okahara, Mika; Sagara, Yoshiko

    2013-01-01

    The maxillary artery is a terminal branch of the external carotid artery. Although the main maxillary artery trunk and most of its branches course within the extracranial space and supply the organs and muscles of the head and neck, other surrounding soft tissues, and the oral and rhinosinusal cavities, other branches supply the dura mater and cranial nerve and can anastomose to the internal carotid artery (ICA). Various pathologic conditions of the intracranial, head, and neck regions can involve the branches of the maxillary artery. Many of these diseases can be treated with endovascular approaches; however, there is a potential risk of complications in the brain parenchyma and cranial nerves related to the meningoneuronal arterial supply and anastomoses to the ICA. Therefore, familiarity with the functional and imaging anatomy of the maxillary artery is essential. In the past, conventional angiography has been the standard imaging technique for depicting the maxillary artery anatomy and related pathologic findings. However, recent advances in computed tomographic, magnetic resonance, and rotational angiography have further elucidated the maxillary artery anatomy by means of three-dimensional representations. Understanding the functional and imaging anatomy of the maxillary artery allows safe and successful transcatheter treatment of pathologic conditions in the maxillary artery territories. PMID:24224604

  15. Does retraction of the sternum during median sternotomy result in brachial plexus injuries?

    Science.gov (United States)

    Healey, Scott; O'Neill, Bridie; Bilal, Haris; Waterworth, Paul

    2013-07-01

    A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was 'does retraction of the sternum during median sternotomy result in brachial plexus injuries or peripheral neuropathies?' Altogether 58 papers were found using the reported search, of which 12 represented the best evidence to answer the question. The authors, date, journal and country of publication, patient group studied, study type, relevant outcomes and results of these papers were tabulated. Caudal placement of the retractor or relieving the pressure superiorly by removing the upper blades of a retractor (P = 0.02) and use of a caudally placed symmetrical retractor has been shown to reduce neuropathy. Positioning of the patient with 'hands up' positioning showed significant reduction in the incidence of brachial plexus injuries. Furthermore, how wide the retractor is opened and use of an asymmetrical retractor for internal mammary artery (IMA) harvesting are also important factors in quantifying risk of postoperative neuropathy. Wider sternal retraction and longer bypass time did increase the risk of developing postoperative neuropathy. Three asymmetrical retractors were looked at that demonstrates the Delacroix-Chevalier to be the safest (P retractor and using a caudally placed retractor.

  16. Reliability of clinical tests to evaluate nerve function and mechanosensitivity of the upper limb peripheral nervous system

    Directory of Open Access Journals (Sweden)

    Bachmann Lucas M

    2009-01-01

    Full Text Available Abstract Background Clinical tests to assess peripheral nerve disorders can be classified into two categories: tests for afferent/efferent nerve function such as nerve conduction (bedside neurological examination and tests for increased mechanosensitivity (e.g. upper limb neurodynamic tests (ULNTs and nerve palpation. Reliability reports of nerve palpation and the interpretation of neurodynamic tests are scarce. This study therefore investigated the intertester reliability of nerve palpation and ULNTs. ULNTs were interpreted based on symptom reproduction and structural differentiation. To put the reliability of these tests in perspective, a comparison with the reliability of clinical tests for nerve function was made. Methods Two experienced clinicians examined 31 patients with unilateral arm and/or neck pain. The examination included clinical tests for nerve function (sensory testing, reflexes and manual muscle testing (MMT and mechanosensitivity (ULNTs and palpation of the median, radial and ulnar nerve. Kappa statistics were calculated to evaluate intertester reliability. A meta-analysis determined an overall kappa for the domains with multiple kappa values (MMT, ULNT, palpation. We then compared the difference in reliability between the tests of mechanosensitivity and nerve function using a one-sample t-test. Results We observed moderate to substantial reliability for the tests for afferent/efferent nerve function (sensory testing: kappa = 0.53; MMT: kappa = 0.68; no kappa was calculated for reflexes due to a lack of variation. Tests to investigate mechanosensitivity demonstrated moderate reliability (ULNT: kappa = 0.45; palpation: kappa = 0.59. When compared statistically, there was no difference in reliability for tests for nerve function and mechanosensitivity (p = 0.06. Conclusion This study demonstrates that clinical tests which evaluate increased nerve mechanosensitivity and afferent/efferent nerve function have comparable moderate to

  17. The thickness of the retrobulbar portion of the optic nerve in Graves ophthalmopathy measured by ultrasound

    Directory of Open Access Journals (Sweden)

    Stefanović Ivan

    2009-01-01

    Full Text Available Introduction. The clinical diagnostic of Graves ophthalmopathy is based on the association of ocular signs and the disease of the thyroid gland. The evolution of the disease involves the development of eye globe protrusion, extraocular muscle thickening pressuring the optic nerve, which can result in its thickness. Objective. The aim of the paper is to find whether the retrobulbar optic nerve thickened and if there was a correlation between its possible thickening and the thickness of the muscles in Graves ophthalmopathy. We also wished to test the theory of compressive aetiology of such thickening using a 30-degree test. Methods. We examined 28 patients with Graves ophthalmopathy. The thickness of the retrobulbar optic nerve was measured by ultrasound on a B-scan using the Schraeder's method and by the largest thickness of the internal muscle. Results. The thickness of the retrobulbar portion of the optic nerve in the 52 analyzed eyes with signs of the disease ranged between 3.24 mm to 6.30 mm, with median of 5.13 mm, indicating that the majority of the patients had optic nerve thickening rating at this value. Forty-eight eyes had a marked retrobulbar optic nerve thickening, with the thickening over 4 mm, while in 4 eyes with signs of Graves ophthalmopathy the thickness of the optic nerve was within normal limits. We detected that 92.3% of the patients with muscular thickening also had a directly proportional thickening of the retrobulbar optic nerve. By using the 30-degree test we confirmed the diagnosis of compressive neuropathy. Conclusion. Patients with Graves ophthalmopathy and thickened muscles, also have a thickening of the retrobulbar optic nerve; the rate of the thickness directly depends on the degree of the muscular thickness. The word is of compressive neuropathy, i.e. the thickness of the optic nerve is the result of subarachnoid fluid stasis caused by the compression on the optic nerve.

  18. Fatigue testing of three peristernal median sternotomy closure techniques

    Directory of Open Access Journals (Sweden)

    Griffin Lanny V

    2008-09-01

    Full Text Available Abstract Background Failure of a sternotomy closure because of closure system fatigue is a complication that may result in dehiscence and put the individual at risk for serious complications. The purpose of this study was to assess the fatigue performance of three peristernal median sternotomy closure techniques (figure-of-eight stainless-steel wires, figure-of-eight stainless-steel cables, or Pectofix Dynamic Sternal Fixation [DSF] stainless-steel plates in order to quantify the potential risk of fatigue failure of these devices when subject to cyclic loads in physiologically relevant loading directions. Study Design All tests were conducted on polyurethane foam sternal models. A cardiothoracic surgeon divided each sternal model longitudinally and repaired it with a closure device. Tests were performed using a materials testing system that applied cyclic loading in a uniaxial direction until the test model catastrophically broke or data run-out occurred. For each loading direction (lateral distraction and longitudinal shear, five trials of each closure technique were tested. Life data and location of device failure (if present were evaluated. Statistical analysis was performed using regression with life data allowed for correlation between life data and the various closure techniques to develop risk assessment curves for each device. Results The data show that the figure-of-eight stainless-steel cable and the DSF plate systems are considerably less likely to fail under both lateral distraction and longitudinal shear cyclic loading conditions as compared to the figure-of-eight stainless-steel wire system. Moreover, the figure-of-eight stainless-steel cable system is the most resistant to failure, particularly for high cycle counts. Conclusion This study in addition to Cohen and Griffin's earlier published biomechanical comparison of the ultimate strength of these same three closure techniques provide extensive experimental evidence regarding the

  19. Giant early components of somatosensory evoked potentials to tibial nerve stimulation in cortical myoclonus.

    Science.gov (United States)

    Anzellotti, Francesca; Onofrj, Marco; Bonanni, Laura; Saracino, Antonio; Franciotti, Raffaella

    2016-01-01

    Enlarged cortical components of somatosensory evoked potentials (giant SEPs) recorded by electroencephalography (EEG) and abnormal somatosensory evoked magnetic fields (SEFs) recorded by magnetoencephalography (MEG) are observed in the majority of patients with cortical myoclonus (CM). Studies on simultaneous recordings of SEPs and SEFs showed that generator mechanism of giant SEPs involves both primary sensory and motor cortices. However the generator sources of giant SEPs have not been fully understood as only one report describes clearly giant SEPs following lower limb stimulation. In our study we performed a combined EEG-MEG recording on responses elicited by electric median and tibial nerve stimulation in a patient who developed consequently to methyl bromide intoxication CM with giant SEPs to median and tibial nerve stimuli. SEPs wave shapes were identified on the basis of polarity-latency components (e.g. P15-N20-P25) as defined by earlier studies and guidelines. At EEG recording, the SEP giant component did not appear in the latency range of the first cortical component for median nerve SEP (N20), but appeared instead in the range of the P37 tibial nerve SEP, which is currently identified as the first cortical component elicited by tibial nerve stimuli. Our MEG and EEG SEPs recordings also showed that components in the latency range of P37 were preceded by other cortical components. These findings suggest that lower limb P37 does not correspond to upper limb N20. MEG results confirmed that giant SEFs are the second component from both tibial (N43m-P43m) and median (N27m-P27m) nerve stimulation. MEG dipolar sources of these giant components were located in the primary sensory and motor area. PMID:27489768

  20. Effects of eugenol on nerve and vascular dysfunction in streptozotocin-diabetic rats.

    Science.gov (United States)

    Nangle, Matthew R; Gibson, T Michael; Cotter, Mary A; Cameron, Norman E

    2006-05-01

    Hyperglycaemia in diabetes mellitus results in oxidative stress and pro-inflammatory changes which contribute to vascular complications including endothelial dysfunction and peripheral neuropathy. The aim of this study was to examine whether treatment with the dominant ingredient of clove oil, eugenol, which has antioxidant and anti-inflammatory properties, could improve diabetic vascular and nerve function in streptozotocin-induced diabetic rats. Intervention treatment was given for 2 weeks following 6 weeks of untreated diabetes. Dose-ranging studies on diabetic deficits in sciatic nerve motor and saphenous nerve sensory nerve conduction velocities gave ED50 values of 28 mg/kg and 9 mg/kg, respectively, conduction velocity being within the non-diabetic range at a dose of 200 mg/kg. Sciatic nerve endoneurial blood flow was 49% reduced by diabetes and this was completely corrected by 200 mg/kg eugenol treatment. Gastric fundus maximum nitrergic nerve-mediated relaxation was 44% reduced by diabetes; eugenol corrected this deficit by 69%. For renal artery rings, maximum endothelium-dependent relaxation to acetylcholine was 51% reduced by diabetes; eugenol corrected this deficit by 60%, with improvements in both nitric oxide and endothelium-derived hyperpolarising factor (EDHF)-mediated vasorelaxation components. Diabetes increased renal artery sensitivity to phenylephrine-mediated contraction, however, this was unaffected by eugenol treatment. Thus, aspects of both vascular and neural complications in experimental diabetes are improved by eugenol, which could have potential therapeutic implications for diabetic neuropathy and vasculopathy. PMID:16773532

  1. MR imaging of the major nerves about the elbow: cadaveric study examining the effect of flexion and extension of the elbow and pronation and supination of the forearm

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Sook; Yeh, Lee Ren; Trudell, D.; Resnick, D. [Department of Radiology (114), Veterans Administration Medical Center, San Diego, CA (United States)

    1998-08-01

    Magnetic resonance (MR) imaging provides useful information in the evaluation of peripheral nerves. Recent advances in MR imaging allow for detailed depiction of the soft tissue structures of the elbow joint. Three major nerves are present about the elbow. Six cadaveric elbows were imaged to depict the normal anatomy of these nerves and to determine the best plane and position of the elbow for optimal visualization of each nerve. Axial images of the elbow in full extension with the forearm in supination allow identification of all major nerves. Axial images with the elbow in full flexion allow accurate assessment of the cubital tunnel and the ulner nerve. Axial images of the elbow in full extension with the forearm in pronation are helpful for assessment of the median and radial nerves in the forearm. (orig.) With 11 figs., 20 refs.

  2. Repeatability of nerve conduction measurements derived entirely by computer methods

    Directory of Open Access Journals (Sweden)

    Lesser Eugene A

    2009-11-01

    Full Text Available Abstract Background Nerve conduction studies are an objective, quantitative, and reproducible measure of peripheral nerve function and are widely used in the diagnosis of neuropathies. The purpose of this study is to determine the reliability of nerve conduction parameters derived entirely from computer based data acquisition and waveform cursor assignments and to quantify the relative contributions of test variability sources. Methods Thirty volunteers, some with symptoms suggestive of neuropathies; of these, 29 completed the study. The median, ulnar, deep peroneal, posterior tibial, and sural nerves were evaluated bilaterally at two test sessions 3-7 days apart. Within each session, nerves were tested twice within 10 minutes. The analyzed nerve conduction parameters include motor latencies, motor conduction velocity (CV, compound muscle action potential (CMAP amplitude, F-wave latencies (minimum, mean and maximum, sensory peak latency (DSL, sensory CV, and sensory nerve action potential (SNAP amplitude. The primary outcome measure is variance component analysis and the corresponding coefficient of variation (CoV. The between-session-test variance is the sum of within-session variance and between-session variance, quantifying the total variation between test sessions. Additional statistical measures include the intraclass correlation coefficient (ICC and relative interval variation (RIV. Results Motor and sensory latencies, CV and F-wave latency parameters have low between-session-test CoVs, ranging from 4.2% to 9.8%. Amplitude parameters have a higher between-session-test CoVs in the range of 15.6--19.8%. Between-test CoVs are about 30--80% lower than between-session CoVs with the exception of F-wave latency parameters. Between-test ICC values are 0.96 or above for all parameters. Between-session ICC ranges from 0.98 for F-wave latency to 0.77 for sural sensory CV. All latency-related between-session ICCs have a value 0.83 or above. The RIVs

  3. Autonomic and sensory nerve dysfunction in primary biliary cirrhosis

    Institute of Scientific and Technical Information of China (English)

    Katalin Keresztes; Ildikó Istenes; Aniko Folhoffer; Peter L Lakatos; Andrea Horvath; Timea Csak; Peter Varga; Peter Kempler; Ferenc Szalay

    2004-01-01

    AIM: Cardiovascular autonomic and peripheral sensory neuropathy is a known complication of chronic alcoholic and non-alcoholic liver diseases. We aimed to assess the prevalence and risk factors for peripheral sensory nerve and autonomic dysfunction using sensitive methods in patients with primary biliary cirrhosis (PBC).METHODS: Twenty-four AMA M2 positive female patients with clinical, biochemical and histological evidence of PBC and 20 age matched healthy female subjects were studied.Five standard cardiovascular reflex tests and 24-h heart rate variability (HRV) analysis were performed to define autonomic function. Peripheral sensory nerve function on median and peroneal nerves was characterized by current perception threshold (CPT), measured by a neuroselective diagnostic stimulator (Neurotron, Baltimore, MD).RESULTS: Fourteen of 24 patients (58%) had at least one abnormal cardiovascular reflex test and thirteen (54%)had peripheral sensory neuropathy. Lower heart rate response to deep breathing (P = 0.001), standing (P = 0.03)and Valsalva manoeuvre (P = 0.01), and more profound decrease of blood pressure after standing (P = 0.03) was found in PBC patients than in controls. As a novel finding we proved that both time domain and frequency domain parameters of 24-h HRV were significantly reduced in PBC patients compared to controls. Each patient had at least one abnormal parameter of HRV. Lower CPT values indicated hyperaesthesia as a characteristic feature at peroneal nerve testing at three frequencies (2000 Hz: P = 0.005;250 Hz: P = 0.002; 5 Hz: P = 0.004) in PBC compared to controls. Correlation of autonomic dysfunction with the severity and duration of the disease was observed. Lower total power of HRV correlated with lower CPT values at median nerve testing at 250 Hz (P = 0.0001) and at 5 Hz (P = 0.002), as well as with those at peroneal nerve testing at 2000 Hz (P = 0.01).CONCLUSION: Autonomic and sensory nerve dysfunctions are frequent in PBC. Twenty

  4. Isolated cranial nerve palsies in multiple sclerosis

    OpenAIRE

    Zadro, Ivana; Barun, Barbara; Habek, Mario; Brinar, Vesna V.

    1997-01-01

    During a 10 year period 24 patients with definite multiple sclerosis with isolated cranial nerve palsies were studied (third and fourth nerve: one patient each, sixth nerve: 12 patients, seventh nerve: three patients, eighth nerve: seven patients), in whom cranial nerve palsies were the presenting sign in 14 and the only clinical sign of an exacerbation in 10 patients. MRI was carried out in 20 patients and substantiated corresponding brainstem lesions in seven patients (...

  5. Ultrasonographic Evaluation of Peripheral Nerves.

    Science.gov (United States)

    Ali, Zarina S; Pisapia, Jared M; Ma, Tracy S; Zager, Eric L; Heuer, Gregory G; Khoury, Viviane

    2016-01-01

    There are a variety of imaging modalities for evaluation of peripheral nerves. Of these, ultrasonography (US) is often underused. There are several advantages of this imaging modality, including its cost-effectiveness, time-efficient assessment of long segments of peripheral nerves, ability to perform dynamic maneuvers, lack of contraindications, portability, and noninvasiveness. It can provide diagnostic information that cannot be obtained by electrophysiologic or, in some cases, magnetic resonance imaging studies. Ideally, the neurosurgeon can use US as a diagnostic adjunct in the preoperative assessment of a patient with traumatic, neoplastic, infective, or compressive nerve injury. Perhaps its most unique use is in intraoperative surgical planning. In this article, a brief description of normal US nerve anatomy is presented followed by a description of the US appearance of peripheral nerve disease caused by trauma, tumor, infection, and entrapment.

  6. GABAergic processes within the median preoptic nucleus promote NREM sleep.

    Science.gov (United States)

    Benedetto, Luciana; Chase, Michael H; Torterolo, Pablo

    2012-06-15

    GABAergic mechanisms in the preoptic region of the hypothalamus (POA) have been implicated in the generation and maintenance of NREM (quiet) sleep. We recently reported that neurons in the median peptic nucleus (MnPN) in the POA of the cat are selectively activated during NREM sleep. In the present study, we explored the hypothesis that NREM sleep is controlled by GABAergic mechanisms within the MnPN. Consequently, adult cats were utilized to determine GABA immunorreactivity within the MnPN and to examine the effects on sleep of the microinjection of a GABA(A) agonist (muscimol) and a GABA(A) antagonist (bicuculline) into this area. GABAergic neurons were present throughout the MnPN. Compared with control microinjections, after the application of muscimol, the time spent in NREM sleep (59.8±7.5 min) and REM sleep (6.9±4.7 min) decreased compared with control microinjections (103.8±5.2 and 20.2±4.3 min, respectively; P<0.005). In contrast, bicuculline microinjections increased only NREM sleep time (103.0±23.0 vs 77.7±23.7 min; P<0.05). These results demonstrate that GABAergic processes within the MnPN are involved in the generation and maintenance of sleep, especially NREM sleep. PMID:22483998

  7. Adipose derived stem cells and nerve regeneration

    Institute of Scientific and Technical Information of China (English)

    Alessandro Faroni; Richard JP Smith; Adam J Reid

    2014-01-01

    Injuries to peripheral nerves are common and cause life-changing problems for patients along-side high social and health care costs for society. Current clinical treatment of peripheral nerve injuries predominantly relies on sacriifcing a section of nerve from elsewhere in the body to pro-vide a graft at the injury site. Much work has been done to develop a bioengineered nerve graft, precluding sacriifce of a functional nerve. Stem cells are prime candidates as accelerators of re-generation in these nerve grafts. This review examines the potential of adipose-derived stem cells to improve nerve repair assisted by bioengineered nerve grafts.

  8. Peripheral Nerve Ultrasonography in Chronic Inflammatory Demyelinating Polyradiculoneuropathy and Multifocal Motor Neuropathy: Correlations with Clinical and Neurophysiological Data

    OpenAIRE

    Aristide Merola; Michela Rosso; Alberto Romagnolo; Erdita Peci; Dario Cocito

    2016-01-01

    Objective. This cross-sectional study analyzes the pattern of ultrasound peripheral nerve alterations in patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and multifocal motor neuropathy (MMN) at different stages of functional disability. Material and Methods. 22 CIDP and 10 MMN patients and a group of 70 healthy controls were evaluated with an ultrasound scan of the median, ulnar, peroneal, tibial, and sural nerves. Results were correlated with clinical disabilit...

  9. Peripheral nerve magnetic stimulation: influence of tissue non-homogeneity

    Directory of Open Access Journals (Sweden)

    Papazov Sava P

    2003-12-01

    Full Text Available Abstract Background Peripheral nerves are situated in a highly non-homogeneous environment, including muscles, bones, blood vessels, etc. Time-varying magnetic field stimulation of the median and ulnar nerves in the carpal region is studied, with special consideration of the influence of non-homogeneities. Methods A detailed three-dimensional finite element model (FEM of the anatomy of the wrist region was built to assess the induced currents distribution by external magnetic stimulation. The electromagnetic field distribution in the non-homogeneous domain was defined as an internal Dirichlet problem using the finite element method. The boundary conditions were obtained by analysis of the vector potential field excited by external current-driven coils. Results The results include evaluation and graphical representation of the induced current field distribution at various stimulation coil positions. Comparative study for the real non-homogeneous structure with anisotropic conductivities of the tissues and a mock homogeneous media is also presented. The possibility of achieving selective stimulation of either of the two nerves is assessed. Conclusion The model developed could be useful in theoretical prediction of the current distribution in the nerves during diagnostic stimulation and therapeutic procedures involving electromagnetic excitation. The errors in applying homogeneous domain modeling rather than real non-homogeneous biological structures are demonstrated. The practical implications of the applied approach are valid for any arbitrary weakly conductive medium.

  10. Combined Ipsilateral Oculomotor Nerve Palsy and Contralateral Downbeat Nystagmus in a Case of Cerebral Infarction

    Directory of Open Access Journals (Sweden)

    Kosuke Matsuzono

    2014-04-01

    Full Text Available We report a patient with acute cerebral infarction of the left paramedian thalamus, upper mesencephalon and cerebellum who exhibited ipsilateral oculomotor nerve palsy and contralateral downbeat nystagmus. The site of the infarction was considered to be the paramedian thalamopeduncular and cerebellar regions, which are supplied by the superior cerebellar artery containing direct perforating branches or both the superior cerebellar artery and the superior mesencephalic and posterior thalamosubthalamic arteries. Contralateral and monocular downbeat nystagmus is very rare. Our case suggests that the present downbeat nystagmus was due to dysfunction of cerebellar-modulated crossed oculovestibular fibers of the superior cerebellar peduncle or bilateral downbeat nystagmus with one-sided oculomotor nerve palsy.

  11. Triple Peripheral Nerve Injury Accompanying to Traumatic Brain Injury: A Case Report

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    Ižlknur Can

    2014-02-01

    Full Text Available Secondary injuries especially extremity fractures may be seen concurrently with traumatic brain injury (TBI. Peripheral nerve damages may accompany to these fractures and may be missed out, especially in acute stage. In this case report; damage of radial, ulnar and median nerves which was developed secondarily to distal humerus fracture that could not be detected in acute stage, in a patient who had motor vehicle accident (MVA. 29-year-old male patient was admitted with weakness in the right upper extremity. 9 months ago, he had traumatic brain injury because of MVA, and fracture of distal humerus was detected in follow-ups. Upon the suspect of the peripheral nerve injury, the diagnosis was confirmed with ENMG. The patient responded well to the rehabilitation program treatment. In a TBI patient, it must be kept in mind that there might be a secondary trauma and therefore peripheral nerve lesions may accompany to TBI.

  12. Effect of neurotrophic factor, MDP, on rats’ nerve regeneration

    Directory of Open Access Journals (Sweden)

    A.A. Fornazari

    2011-04-01

    Full Text Available Our objective was to determine the immune-modulating effects of the neurotrophic factor N-acetylmuramyl-L-alanyl-D-isoglutamine (MDP on median nerve regeneration in rats. We used male Wistar rats (120-140 days of age, weighing 250-332 g and compared the results of three different techniques of nerve repair: 1 epineural neurorrhaphy using sutures alone (group S - 10 rats, 2 epineural neurorrhaphy using sutures plus fibrin tissue adhesive (FTA; group SF - 20 rats, and 3 sutures plus FTA, with MDP added to the FTA (group SFM - 20 rats. Functional assessments using the grasp test were performed weekly for 12 weeks to identify recovery of flexor muscle function in the fingers secondary to median nerve regeneration. Histological analysis was also utilized. The total number and diameter of myelinated fibers were determined in each proximal and distal nerve segment. Two indices, reported as percentage, were calculated from these parameters, namely, the regeneration index and the diameter change index. By the 8th week, superiority of group SFM over group S became apparent in the grasping test (P = 0.005. By the 12th week, rats that had received MDP were superior in the grasping test compared to both group S (P < 0.001 and group SF (P = 0.001. Moreover, group SF was better in the grasping test than group S (P = 0.014. However, no significant differences between groups were identified by histological analysis. In the present study, rats that had received MDP obtained better function, in the absence of any significant histological differences.

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

    OpenAIRE

    Songtao Gao; Yan Zheng; Qiqing Cai; Zhansheng Deng; Weitao Yao; Jiaqiang Wang; Xin Wang; Peng Zhang

    2014-01-01

    Objective. To investigate the effect of tissue engineering nerve on repair of rat sciatic nerve defect. Methods. Forty-five rats with defective sciatic nerve were randomly divided into three groups. Rats in group A were repaired by acellular nerve grafts only. Rats in group B were repaired by tissue engineering nerve. In group C, rats were repaired by autogenous nerve grafts. After six and twelve weeks, sciatic nerve functional index (SFI), neural electrophysiology (NEP), histological and tra...

  14. Perinatal taurine exposure programs patterns of autonomic nerve activity responses to tooth pulp stimulation in adult male rats

    Science.gov (United States)

    Khimsuksri, Sawita; Wyss, J. Michael; Thaeomor, Atcharaporn; Paphangkorakit, Jarin; Jirakulsomchok, Dusit; Roysommuti, Sanya

    2016-01-01

    Perinatal taurine excess or deficit influences adult health and disease, especially relative to the autonomic nervous system. This study tests the hypothesis that perinatal taurine exposure influences adult autonomic nervous system control of arterial pressure in response to acute electrical tooth pulp stimulation. Female Sprague-Dawley rats were fed normal rat chow with 3% β-alanine (taurine depletion, TD), 3% taurine (taurine supplementation, TS) or water alone (control, C) from conception to weaning. Their male offspring were fed normal rat chow and tap water throughout the experiment. At 8–10 weeks of age, blood chemistry, arterial pressure, heart rate and renal sympathetic nerve activity were measured in anesthetized rats. Age, body weight, mean arterial pressure, heart rate, plasma electrolytes, blood urea nitrogen, plasma creatinine and plasma cortisol were not significantly different among the three groups. Before tooth pulp stimulation, low (0.3–0.5 Hz) and high frequency (0.5–4.0 Hz) power spectral densities of arterial pressure were not significantly different among groups, while the power spectral densities of renal sympathetic nerve activity were significantly decreased in TD compared to control rats. Tooth pulp stimulation did not change arterial pressure, heart rate, renal sympathetic nerve and arterial pressure power spectral densities in the 0.3–4.0 Hz spectrum or renal sympathetic nerve firing rate in any group. In contrast, perinatal taurine imbalance disturbed very low frequency power spectral densities of both arterial pressure and renal sympathetic nerve activity (below 0.1 Hz), both before and after the tooth pulp stimulation. The power densities of TS were most sensitive to ganglionic blockade and central adrenergic inhibition, while those of TD were sensitive to both central and peripheral adrenergic inhibition. The present data indicate that perinatal taurine imbalance can lead to aberrant autonomic nervous system responses in

  15. Schwannomatosis of the sciatic nerve

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, Tetsuji; Maruyama, Shigeki; Mizuno, Kosaku [Dept. of Orthopaedic Surgery, Kobe University School of Medicine (Japan)

    2001-02-01

    A 52-year-old woman with schwannomatosis in the left sciatic nerve is presented. The patient had no stigmata of neurofibromatosis (NF) type 1 or 2. Cutaneous or spinal schwannomas were not detected. Magnetic resonance (MR) imaging of the sciatic nerve revealed more than 15 tumors along the course of the nerve. Histological examination revealed schwannomas consisting of Antoni A and B areas. Immunohistochemical study showed most cells reacting intensely for S-100 protein. The patient underwent conservative follow-up treatment due to the minimal symptoms. The relationship of the disease with NF-2 and plexiform schwannoma is discussed. (orig.)

  16. Mobility-Related Consequences of Reduced Lower-Extremity Peripheral Nerve Function with Age: A Systematic Review.

    Science.gov (United States)

    Ward, Rachel E; Caserotti, Paolo; Cauley, Jane A; Boudreau, Robert M; Goodpaster, Bret H; Vinik, Aaron I; Newman, Anne B; Strotmeyer, Elsa S

    2016-08-01

    The objective of this study is to systematically review the relationship between lower-extremity peripheral nerve function and mobility in older adults. The National Library of Medicine (PubMed) was searched on March 23, 2015 with no limits on publication dates. One reviewer selected original research studies of older adults (≥65 years) that assessed the relationship between lower-extremity peripheral nerve function and mobility-related outcomes. Participants, study design and methods of assessing peripheral nerve impairment were evaluated and results were reported and synthesized. Eight articles were identified, including 6 cross-sectional and 2 longitudinal studies. These articles investigated 6 elderly cohorts (4 from the U.S. and 2 from Italy): 3 community-dwelling (including 1 with only disabled women and 1 without mobility limitations at baseline), 1 with both community-dwelling and institutionalized residents, 1 from a range of residential locations, and 1 of patients with peripheral arterial disease. Mean ages ranged from 71-82 years. Nerve function was assessed by vibration threshold (n=2); sensory measures and clinical signs and symptoms of neuropathy (n=2); motor nerve conduction (n=1); and a combination of both sensory measures and motor nerve conduction (n=3). Each study found that worse peripheral nerve function was related to poor mobility, although relationships varied based on the nerve function measure and mobility domain assessed. Six studies found that the association between nerve function and mobility persisted despite adjustment for diabetes. Evidence suggests that peripheral nerve function impairment at various levels of severity is related to poor mobility independent of diabetes. Relationships varied depending on peripheral nerve measure, which may be particularly important when investigating specific biological mechanisms. Future research needs to identify risk factors for peripheral nerve decline beyond diabetes, especially those

  17. Nerve Transfers for Treatment of Isolated Axillary Nerve Injuries

    OpenAIRE

    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...

  18. Capsaicin- resistant arterial baroreceptors

    Directory of Open Access Journals (Sweden)

    Andresen Michael C

    2006-05-01

    Full Text Available Abstract Background Aortic baroreceptors (BRs comprise a class of cranial afferents arising from major arteries closest to the heart whose axons form the aortic depressor nerve. BRs are mechanoreceptors that are largely devoted to cardiovascular autonomic reflexes. Such cranial afferents have either lightly myelinated (A-type or non-myelinated (C-type axons and share remarkable cellular similarities to spinal primary afferent neurons. Our goal was to test whether vanilloid receptor (TRPV1 agonists, capsaicin (CAP and resiniferatoxin (RTX, altered the pressure-discharge properties of peripheral aortic BRs. Results Periaxonal application of 1 μM CAP decreased the amplitude of the C-wave in the compound action potential conducting at 0.50 but completely inhibited discharge of an irregularly discharging BR (C-type. CAP at high concentrations (10–100 μM depressed BR sensitivity in regularly discharging BRs, an effect attributed to non-specific actions. RTX (≤ 10 μM did not affect the discharge properties of regularly discharging BRs (n = 7, p > 0.18. A CAP-sensitive BR had significantly lower discharge regularity expressed as the coefficient of variation than the CAP-resistant fibers (p Conclusion We conclude that functional TRPV1 channels are present in C-type but not A-type (A-δ myelinated aortic arch BRs. CAP has nonspecific inhibitory actions that are unlikely to be related to TRV1 binding since such effects were absent with the highly specific TRPV1 agonist RTX. Thus, CAP must be used with caution at very high concentrations.

  19. Stereotactic radiotherapy for malignancies involving the trigeminal and facial nerves.

    Science.gov (United States)

    Cuneo, K C; Zagar, T M; Brizel, D M; Yoo, D S; Hoang, J K; Chang, Z; Wang, Z; Yin, F F; Das, S K; Green, S; Ready, N; Bhatti, M T; Kaylie, D M; Becker, A; Sampson, J H; Kirkpatrick, J P

    2012-06-01

    Involvement of a cranial nerve caries a poor prognosis for many malignancies. Recurrent or residual disease in the trigeminal or facial nerve after primary therapy poses a challenge due to the location of the nerve in the skull base, the proximity to the brain, brainstem, cavernous sinus, and optic apparatus and the resulting complex geometry. Surgical resection caries a high risk of morbidity and is often not an option for these patients. Stereotactic radiosurgery and radiotherapy are potential treatment options for patients with cancer involving the trigeminal or facial nerve. These techniques can deliver high doses of radiation to complex volumes while sparing adjacent critical structures. In the current study, seven cases of cancer involving the trigeminal or facial nerve are presented. These patients had unresectable recurrent or residual disease after definitive local therapy. Each patient was treated with stereotactic radiation therapy using a linear accelerator based system. A multidisciplinary approach including neuroradiology and surgical oncology was used to delineate target volumes. Treatment was well tolerated with no acute grade 3 or higher toxicity. One patient who was reirradiated experienced cerebral radionecrosis with mild symptoms. Four of the seven patients treated had no evidence of disease after a median follow up of 12 months (range 2-24 months). A dosimetric analysis was performed to compare intensity modulated fractionated stereotactic radiation therapy (IM-FSRT) to a 3D conformal technique. The dose to 90% (D90) of the brainstem was lower with the IM-FSRT plan by a mean of 13.5 Gy. The D95 to the ipsilateral optic nerve was also reduced with IM-FSRT by 12.2 Gy and the D95 for the optic chiasm was lower with FSRT by 16.3 Gy. Treatment of malignancies involving a cranial nerve requires a multidisciplinary approach. Use of an IM-FSRT technique with a micro-multileaf collimator resulted in a lower dose to the brainstem, optic nerves and chiasm

  20. COMPARISON OF MOTOR AND SENSORY NERVE CONDUCTION IN UPPER LIMB OF DIABETICS AND NON DIABETICS

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    Ajay

    2015-01-01

    Full Text Available The physiological properties of nerve and muscle are usually modified due to patho physiological changes resulting from many diseases like diabetes. Impaired mobility and compromised dexterity leading to difficulties in daily life. Hand function in diabetes is affected mainly due to involvement of median nerve. Diabetic neuropathy the c ommon complication of diabetes can be assessed electro physiologically by nerve conduction studies. Therefore, we analyzed both motor and sensory nerve conduction on upper limb nerves. Distal latency, Amplitude and conduction velocity were measured in both upper limbs by using RMS EMG EP II machine with surface and ring electrodes. It was found that distal latencies of both nerves were higher in diabetics than non - diabetics. The difference was statistically significant. Motor responses are more reduced bel ow normal as compared with sensory responses in diabetics. Our study also revealed decreased amplitude and conduction velocity among cases. Our findings conclude that the nerve conduction studies are important in early detection of peripheral neuropathy so that prevention and management can be done in earliest possible way.

  1. Effect of skilled and unskilled training on nerve regeneration and functional recovery

    Directory of Open Access Journals (Sweden)

    A.S. Pagnussat

    2012-08-01

    Full Text Available The most disabling aspect of human peripheral nerve injuries, the majority of which affect the upper limbs, is the loss of skilled hand movements. Activity-induced morphological and electrophysiological remodeling of the neuromuscular junction has been shown to influence nerve repair and functional recovery. In the current study, we determined the effects of two different treatments on the functional and morphological recovery after median and ulnar nerve injury. Adult Wistar male rats weighing 280 to 330 g at the time of surgery (N = 8-10 animals/group were submitted to nerve crush and 1 week later began a 3-week course of motor rehabilitation involving either "skilled" (reaching for small food pellets or "unskilled" (walking on a motorized treadmill training. During this period, functional recovery was monitored weekly using staircase and cylinder tests. Histological and morphometric nerve analyses were used to assess nerve regeneration at the end of treatment. The functional evaluation demonstrated benefits of both tasks, but found no difference between them (P > 0.05. The unskilled training, however, induced a greater degree of nerve regeneration as evidenced by histological measurement (P < 0.05. These data provide evidence that both of the forelimb training tasks used in this study can accelerate functional recovery following brachial plexus injury.

  2. The role of ultrasound imaging in the evaluation of peripheral nerve in systemic sclerosis (scleroderma)

    Energy Technology Data Exchange (ETDEWEB)

    Tagliafico, Alberto, E-mail: atagliafico@sirm.org [Department of Radiology, University of Genova, Genova (Italy); Panico, Nicoletta [Division of Immunology, Department of Internal Medicine, University of Genoa, Genoa (Italy); Resmini, Eugenia [Department of Endocrinological and Medical Sciences (DiSEM), Center of Excellence for Biomedical Research, University of Genova, Genova (Italy); Derchi, Lorenzo E. [Department of Radiology, University of Genova, Genova (Italy); Ghio, Massimo [Division of Immunology, Department of Internal Medicine, University of Genoa, Genoa (Italy); Martinoli, Carlo [Department of Radiology, University of Genova, Genova (Italy)

    2011-03-15

    Background: Patients affected by scleroderma may complain of sensory disturbances especially in the hands. Purpose: To study the imaging features of upper limb nerves in patients affected by scleroderma (SSc). Materials and method: Twenty-five patients affected only by SSc were prospectively evaluated with high-resolution US and magnetic resonance (MRI) or computer tomography (CT) when necessary (2 patients). Median and ulnar nerves were evaluated bilaterally. Nerve conduction studies were performed in the symptomatic patients (n = 10). Results of imaging studies were correlated with disease duration, autoimmunity and immunosuppression. Nerves of SSc patients were compared with a control group of 90 patients matched for age and body mass index. Results: The prevalence of sensory disturbances revealed by clinical examination was 40%. In symptomatic SSc patients (n = 10) US evaluation revealed nerve abnormalities in 70% of cases (n = 7/10). n = 2 had a carpal tunnel syndrome. n = 5 had cubital tunnel syndrome. In two of them CT and MR were necessary to identify the compressed nerve at the level of the elbow due to the presence of calcifications. There was no association between the presence of an entrapment neuropathy and disease duration, autoantibodies and immunosuppression. Conclusion: Ultrasound, CT and MR may detect nerve abnormalities in 70% of SSc patients complaining of neurologic disturbances in the hands. The results of imaging studies support the hypothesis of a vascular dependent neuropathy in SSc.

  3. EXPRESSION OF CALCITONIN GENE-RELATED PEPTIDE IN FACIAL NERVE OF HEMIFACIAL SPASM

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    Objective To study the immunoreactivity of Calcitonin gene-related peptide (CGRP) in the facial nerve when Hemifacial Spasm is occurring. Methods The electrophysiological technique was used to explore abnormal muscle response (AMR) which was characteristic of Hemifacial Spasm.The animal models of Hemifacial Spasm in New Zealand white rabbits were established by compressing the main trunk of artificial demyelinated facial nerve with the temporal superficial artery. At 6 weeks after surgery, the facial nerves were taken from the experimental group and control one, the immunohistochemistry for CGRP using polyclonal antibody with ABC kit was performed in the facial nerves; at the same time, the observation for the facial nerves of light and transmission electron microscope was performed. Results The facial nerve demyelinated and the axons retrogressively changed, CGRP immunoreactive positive fibers were significantly detected in experimental groups; whereas this phenomenon was not found in control group. Conclusion CGRP can nutrien the injured facial nerve and plays an important role in the pathogenesis of Hemifacial Spasm.

  4. Influence of Different Geometric Representations of the Volume Conductor on Nerve Activation during Electrical Stimulation

    Directory of Open Access Journals (Sweden)

    José Gómez-Tames

    2014-01-01

    Full Text Available Volume conductor models with different geometric representations, such as the parallel layer model (PM, the cylindrical layer model (CM, or the anatomically based model (AM, have been employed during the implementation of bioelectrical models for electrical stimulation (FES. Evaluating their strengths and limitations to predict nerve activation is fundamental to achieve a good trade-off between accuracy and computation time. However, there are no studies aimed at clarifying the following questions. (1 Does the nerve activation differ between CM and PM? (2 How well do CM and PM approximate an AM? (3 What is the effect of the presence of blood vessels and nerve trunk on nerve activation prediction? Therefore, in this study, we addressed these questions by comparing nerve activation between CM, PM, and AM models by FES. The activation threshold was used to evaluate the models under different configurations of superficial electrodes (size and distance, nerve depths, and stimulation sites. Additionally, the influences of the sciatic nerve, femoral artery, and femoral vein were inspected for a human thigh. The results showed that the CM and PM had a high error rate, but the variation of the activation threshold followed the same tendency for electrode size and interelectrode distance variation as AM.

  5. Role of magnetic resonance imaging in entrapment and compressive neuropathy - what, where, and how to see the peripheral nerves on the musculoskeletal magnetic resonance image: Part 2. Upper extremity

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sungjun [Yonsei University, Department of Diagnostic Radiology, College of Medicine, Seoul (Korea); Hanyang University, Kuri Hospital, Department of Diagnostic Radiology, College of Medicine, Kuri City, Kyunggi-do (Korea); Choi, Jin-Young; Huh, Yong-Min; Song, Ho-Taek; Lee, Sung-Ah [Yonsei University, Department of Diagnostic Radiology, College of Medicine, Seoul (Korea); Kim, Seung Min [Yonsei University, Department of Neurology, College of Medicine, Seoul (Korea); Suh, Jin-Suck [Yonsei University, Department of Diagnostic Radiology, College of Medicine, Seoul (Korea); Yonsei University, Research Institute of Radiological Science, College of Medicine, Seoul (Korea)

    2007-02-15

    The diagnosis of nerve entrapment and compressive neuropathy has been traditionally based on the clinical and electrodiagnostic examinations. As a result of improvements in the magnetic resonance (MR) imaging modality, it plays not only a fundamental role in the detection of space-occupying lesions, but also a compensatory role in clinically and electrodiagnostically inconclusive cases. Although ultrasound has undergone further development in the past decades and shows high resolution capabilities, it has inherent limitations due to its operator dependency. We review the course of normal peripheral nerves, as well as various clinical demonstrations and pathological features of compressed and entrapped nerves in the upper extremities on MR imaging, according to the nerves involved. The common sites of nerve entrapment of the upper extremity are as follows: the brachial plexus of the thoracic outlet; axillary nerve of the quadrilateral space; radial nerve of the radial tunnel; ulnar nerve of the cubital tunnel and Guyon's canal; median nerve of the pronator syndrome, anterior interosseous nerve syndrome, and carpal tunnel syndrome. Although MR imaging can depict the peripheral nerves in the extremities effectively, radiologists should be familiar with nerve pathways, common sites of nerve compression, and common space-occupying lesions resulting in nerve compression in MR imaging. (orig.)

  6. Amplitude of sensory nerve action potential in early stage diabetic peripheral neuropathy:an analysis of 500 cases

    Institute of Scientific and Technical Information of China (English)

    Yunqian Zhang; Jintao Li; Tingjuan Wang; Jianlin Wang

    2014-01-01

    Early diagnosis of diabetic peripheral neuropathy is important for the successful treatment of diabetes mellitus. In the present study, we recruited 500 diabetic patients from the Fourth Afifl-iated Hospital of Kunming Medical University in China from June 2008 to September 2013: 221 cases showed symptoms of peripheral neuropathy (symptomatic group) and 279 cases had no symptoms of peripheral impairment (asymptomatic group). One hundred healthy control sub-jects were also recruited. Nerve conduction studies revealed that distal motor latency was longer, sensory nerve conduction velocity was slower, and sensory nerve action potential and amplitude of compound muscle action potential were signiifcantly lower in the median, ulnar, posterior tibial and common peroneal nerve in the diabetic groups compared with control subjects. More-over, the alterations were more obvious in patients with symptoms of peripheral neuropathy. Of the 500 diabetic patients, neural conduction abnormalities were detected in 358 cases (71.6%), among which impairment of the common peroneal nerve was most prominent. Sensory nerve abnormality was more obvious than motor nerve abnormality in the diabetic groups. The ampli-tude of sensory nerve action potential was the most sensitive measure of peripheral neuropathy. Our results reveal that varying degrees of nerve conduction changes are present in the early, as-ymptomatic stage of diabetic peripheral neuropathy.

  7. Sympathetically evoked Ca2+ signaling in arterial smooth muscle

    Institute of Scientific and Technical Information of China (English)

    Wei-jin ZANG; Joseph ZACHARIA; Christine LAMONT; Withrow Gil WIER

    2006-01-01

    The sympathetic nervous system plays an essential role in the control of total peripheral vascular resistance and blood flow, by controlling the contraction of small arteries. Perivascular sympathetic nerves release ATP, norepinephrine (NE) and neuropeptide Y. This review summarizes our knowledge of the intracellular Ca2+ signals that are activated by ATP and NE, acting respectively on P2X1 and α1 adrenoceptors in arterial smooth muscle. Each neurotransmitter produces a unique type of post-synaptic Ca2+ signal and associated contraction. The neural release of ATP and NE is thought to vary markedly with the pattern of nerve activity, probably reflecting both pre- and post-synaptic mechanisms. Finally, we show that Ca2+ signaling during neurogenic contractions activated by trains of sympathetic nerve fiber action potentials are in fact significantly different from that elicited by simple bath application of exogenous neurotransmitters to isolated arteries (a common experimental technique), and end by identifying important questions remaining in our understanding of sympathetic neurotransmission and the physiological regulation of contraction of small arteries.

  8. Nerve Disease and Bladder Control

    Science.gov (United States)

    ... Research Training & Career Development Grant programs for students, postdocs, and faculty Research at NIDDK Labs, faculty, and ... KB) Alternate Language URL Nerve Disease and Bladder Control Page Content On this page: What bladder control ...

  9. Sarcoidosis with Major Airway, Vascular and Nerve Compromise

    Directory of Open Access Journals (Sweden)

    Hiroshi Sekiguchi

    2013-01-01

    Full Text Available The present report describes a 60-year-old Caucasian woman who presented with progressive dyspnea, cough and wheeze. A computed tomography scan of the chest showed innumerable bilateral inflammatory pulmonary nodules with bronchovascular distribution and a mediastinal and hilar infiltrative process with calcified lymphadenopathy leading to narrowing of lobar bronchi and pulmonary arteries. An echocardiogram revealed pulmonary hypertension. Bronchoscopy showed left vocal cord paralysis and significant narrowing of the bilateral bronchi with mucosal thickening and multiple nodules. Transbronchial biopsy was compatible with sarcoidosis. Despite balloon angioplasty of the left lower lobe and pulmonary artery, and medical therapy with oral corticosteroids, her symptoms did not significantly improve. To the authors’ knowledge, the present report describes the first case of pulmonary sarcoidosis resulting in major airway, vascular and nerve compromise due to compressive lymphadenopathy and suspected concurrent granulomatous infiltration. Its presentation mimicked idiopathic mediastinal fibrosis.

  10. [Abnormal popliteal arteries].

    Science.gov (United States)

    Elbaz, C

    1975-01-01

    Arteriopathy restricted to the popliteal artery, except in cases of atheroma, must indicate three of four unusual diagnoses: the trapped popliteal artery and the dessicating haematoma are anatomo-clinical entities that have been identified only relatively recently. The popliteal artery may be trapped by the medial gastrocnomius muscle, round the tendon of which the artery passes (totally or partially). This results in compression of the artery and eventually in thrombosis. Clinically, intermittent claudication is seen that may deteriorate and lead to gangrene of the toes. Arteriography makes it possible to diagnose the condition as the condition as the artery is considerably displaced inwards. Surgical correction is simple: sectioning of the tendon and repositioning of the artery. Dessicating haematoma of the popliteal artery is due essentially to atheroma, associated with medianecrosis. A "egg-timer" stenosis is found by arteriography and this condition also progresses towards thrombosis. Arterial restoration is called for, usually by bridging. PMID:1230799

  11. Cranial nerve palsies in childhood

    OpenAIRE

    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. Median effective dose of remifentanil for awake laryngoscopy and intudation

    Institute of Scientific and Technical Information of China (English)

    XU Ya-chao; XUE Fu-shan; LUO Mad-ping; YANG Quan-yong; LIAO Xu; LU Yi; ZHANG Yan-ming

    2009-01-01

    Background Awake intubation requires an anesthetic management that provides sufficient patient safety and comfort, adequate intubating conditions, and stable hemodynamics. In this prospective clinical study, our aim was to determine the median effective dose (ED50) of remifentanil in combination with midazolam and airway topical anesthesia for awake laryngoscopy and intubation.Methods Thirty-six female adult patients, scheduled for elective plastic surgery under general anesthesia requiring orotracheal intubation were included in this study. Ten minutes after intravenous administration of midazolam 0.1 mg/kg, patients were assigned to receive remifentanil in bolus, followed by a continuous infusion. The bolus dose and infusion rate of remifentanil were adjusted by a modified Dixon's up-and-down method. Patient's reaction score at laryngoscopy and an Observer's Assessment of Alertness/Sedation Scale (OAA/S) were used to determine whether the remifentanil dosage regimen was accepted. During laryngoscopy, 2% lidocaine was sprayed into the airway to provide the topical anesthesia. EDso of remifentanil was calculated by the modified Dixon up-and-clown method, and the probit analysis was then used to confirm the results obtained from the modified Dixon's up-and-down method. In the patients who were scored as "accept", patient's OAA/S and reaction scores at different observed points, intubating condition score and patient's tolerance to the endotracheal tube after intubation were evaluated and recorded. Blood pressure and heart rate at different measuring points were also noted.Results ED50 of remifentanil for awake laryngoscopy and intubation obtained by the modified Dixon's up-and-down method was (0.62±0.02) pg/kg. Using probit analysis, ED50 and ED95 of remifentanil were 0.63 μg/kg (95% Cl, 0.54-0.70) and 0.83 μg/kg (95% Cl, 0.73-2.59), respectively. Nineteen patients who were scored as =accept" had an OAA/S of 15 and tolerated well laryngoscopy without significant

  13. Unilateral traumatic oculomotor nerve paralysis

    International Nuclear Information System (INIS)

    The present authors report a case of unilateral traumatic oculomotor nerve paralysis which shows interesting CT findings which suggest its mechanism. A 60-year-old woman was admitted to our hospital with a cerebral concussion soon after a traffic accident. A CT scan was performed soon after admission. A high-density spot was noted at the medial aspect of the left cerebral peduncle, where the oculomotor nerve emerged from the midbrain, and an irregular, slender, high-density area was delineated in the right dorsolateral surface of the midbrain. Although the right hemiparesis had already improved by the next morning, the function of the left oculomotor nerve has been completely disturbed for the three months since the injury. In our case, it is speculated that an avulsion of the left oculomotor nerve rootlet occurred at the time of impact as the mechanism of the oculomotor nerve paralysis. A CT taken soon after the head injury showed a high-density spot; this was considered to be a hemorrhage occurring because of the avulsion of the nerve rootlet at the medial surface of the cerebral peduncle. (J.P.N.)

  14. Trigeminal neuralgia and persistent trigeminal artery.

    Science.gov (United States)

    Conforti, Renata; Parlato, Raffaele Stefano; De Paulis, Danilo; Cirillo, Mario; Marrone, Valeria; Cirillo, Sossio; Moraci, Aldo; Parlato, Ciro

    2012-12-01

    We report a case of trigeminal neuralgia caused by persistent trigeminal artery (PTA) associated with asymptomatic left temporal cavernoma. Our patient presented unstable blood hypertension and the pain of typical trigeminal neuralgia over the second and third divisions of the nerve in the right side of the face. The attacks were often precipitated during physical exertion. MRI and Angio-MRI revealed the persistent carotid basilar anastomosis and occasionally left parietal cavernoma. After drug treatment of blood hypertension, spontaneous recovery of neuralgia was observed and we planned surgical treatment of left temporal cavernoma. PMID:22246457

  15. Comparison of the pulsed MIG welding process for different median current

    Institute of Scientific and Technical Information of China (English)

    Wen Yuanmei; Xue Jiaxiang; Yao Ping; Huang Shisheng

    2009-01-01

    Based on the high speed video system with electrical signals collecting and wavelet analyzing, the welding processes under three different median currents with the same median time were detected. The experimental results show that, when the median current is higher, the input peak energy is lower. And the droplet transfer is almost in spray mode. The welding process is the stablest.

  16. EFFECTS OF INTRAVENOUS FENTANYL ON SPONTANEOUS RENAL SYMPATHETIC NERVE ACTIVITY IN NORMAL AND VAGOTOMIZED RABBITS

    Institute of Scientific and Technical Information of China (English)

    Chen Wang; James G.Whitwam

    2004-01-01

    Objective To investigate the roles of sympathetic and vagus nerves in hypotension and bradycardia induced by fentanyl.Methods Fourteen rabbits were divided into 2 groups: normal and vagotomized rabbits. Rabbits were anesthetized,paralyzed, and artificial ventilated. Right renal sympathetic nerve was exposed and prepared for recording electrical activity.Fentanyl was injected intravenously in incremental doses of 1, 4, 15, 30, and 50 μg/kg at 10 minutes intervals.Results Fentanyl significantly reduced the spontaneous activity of renal sympathetic nerve, mean arterial pressure, and heart rate above a total dose of 20 μg/kg in both normal and vagotomized rabbits. However, normal rabbits spontaneous sympathetic nerve activity and mean arterial pressure were more depressed than vagotomized rabbits at total doses of 50 and 100 μg/kg. There were no significant difference in the reduction of heart rate between normal and vagotomized rabbits.Conclusion Fentanyl induction of bradycardia and hypotension in rabbits is mainly due to depression of sympathetic nerve activity.

  17. Coronary stent placement via radial artery for the treatment of circuitous hepatic artery stenosis after orthotopic liver transplantation

    International Nuclear Information System (INIS)

    Objective: To evaluate the feasibility and effectiveness of coronary stent placement via radial artery in the treatment of circuitous hepatic artery stenosis after orthotopic liver transplantation. Methods: Six patients with circuitous hepatic artery stenosis after orthotopic liver transplantation, encountered during the period of June 2006-Apr. 2008, were enrolled in this study. The stenosis occurred in 6-110 days (mean 47 days) after orthotopic liver transplantation. Stent placement through the left radial artery was carried out in 2 patients after the catheterization via the right femoral artery failed. Based on the preoperative CTA findings, stent placement through left radial artery was straightly performed in 4 patients. Thrombolytic therapy with 500,000 unit of urokinase was adopted in one patient with hepatic thrombus before stent placement. Percutaneous transhepatic biliary drainage (PTCD) was simultaneously performed with stent placement in two patients with dilated biliary tract. Results: The technical success rate was 100%. Thrombolytic therapy was successful in one patient with hepatic thrombus and PTCD had a curative effect on the biliary tract dilatation in two patients. During a follow-up period of 36-148 days (median 76 days), no stent stenosis was found on color Doppler ultrasonogram, the hepatic arteries remained patent in all patients. The hepatic functional parameters were improved in all cases. Conclusion: Coronary stent placement via radial artery is an effective treatment for circuitous hepatic artery stenosis after orthotopic liver transplantation. (authors)

  18. Histopathologic Evaluations of the Lingual Artery in Healthy Tongue of Adult Cadaver

    Science.gov (United States)

    Mun, Mi Jin; Lee, Chang-Hoon; Lee, Byung-Joo; Lee, Jin-Choon; Jang, Jeon Yeob; Jung, Sung Hoon; Wang, Soo-Geun

    2016-01-01

    Objectives. To clarify the anatomical distribution of the lingual artery in normal adult subjects through histopathologic evaluations. Methods. Eighteen healthy cadaveric tongues were used to produce 8 paraffin-embedded tissue sections each. Length from midline raphe, depth from dorsum of tongue and the whole transverse length tongue were measured. The lateral distance, depth, and proportion of lateral distance of deep lingual artery were determined from tip to base of tongue gradually. Lateral distance is length from median raphe to the center of deep lingual artery lumen. Depth is vertical distance from dorsal surface of tongue to the center of deep lingual artery. Proportion of lateral distance is obtained by dividing lateral distance with transverse length from median raphe to lateral border of tongue. The degree of symmetry between right and left sides and the difference between selected spots were evaluated. Results. Right and left sides of the lingual artery were symmetric. The lingual artery was lateralized as it run posterior. The lingual artery runs gradually deeper from the surface as it goes near the base of tongue. Both length and depth of the lingual artery gradually increased between 0%–75% of the mobile tongue, but 75%–100% zone of the lingual artery showed no significant difference. There was no anastomosis between right and left side of the lingual arteries. The lingual artery was located within 50% of the transverse length of tongue from median raphe. Conclusion. The present study reveals 3-dimensional information on the anatomical distributions of the lingual artery in normal adult subjects. These findings gives us beneficial information about the handling of the lingual artery during oral and base of tongue-related surgery. PMID:27334510

  19. Nerve sonography in multifocal motor neuropathy and chronic inflammatory demyelinating polyneuropathy

    OpenAIRE

    D. S. Druzhinin; Naumova, E. S.; S. S. Nikitin

    2016-01-01

    The quantitative ultrasound characteristics (USC) of the median, ulnar nerve at different levels and the spinal nerves in patients with multifocal motor neuropathy (MMN; n=13; 40,4 ± 12,6 years old) and chronic inflammatory demyelinating polyneuropathy (CIDP; n = 7; 47,3 ± 11,2 year old) did not reveal statistical difference in cross sectional area (CSA) between analyzed groups. Patients with MMN have more pronounced asymmetry of CSA in comparison with CIDP patients which have a symmetrical p...

  20. Electrophysiological evaluation of nerve function in inferior alveolar nerve injury: relationship between nerve action potentials and histomorphometric observations.

    Science.gov (United States)

    Murayama, M; Sasaki, K; Shibahara, T

    2015-12-01

    The objective of this study was to improve the accuracy of diagnosis of inferior alveolar nerve (IAN) injury by determining degrees of nerve disturbance using the sensory nerve action potential (SNAP) and sensory nerve conduction velocity (SCV). Crush and partial and complete nerve amputation injuries were applied to the IAN of rabbits, then SNAPs and histomorphometric observations were recorded at 1, 5, and 10 weeks. For crush injury, most nerves were smaller in diameter at 5 weeks than at 1 week, however after 10 weeks, extensive nerve regeneration was observed. The SNAP showed a decrease in SCV at weeks 1 and 5, followed by an increase at week 10. For partial nerve amputation, small to medium-sized nerve fibres were observed at weeks 1 and 5, then larger nerves were seen at week 10. Minimal changes in SCV were observed at weeks 1 and 5, however SCV increased at week 10. For complete nerve amputation, nerve fibres were sparse at week 1, but gradual nerve regeneration was observed at weeks 5 and 10. SNAPs were detectable from week 10, however the SCV was extremely low. This study showed SCV to be an effective factor in the evaluation of nerve injury and regeneration. PMID:26433750

  1. Lessons learned from a case of multivessel median arcuate ligament syndrome in the setting of an Arc of Buhler

    Directory of Open Access Journals (Sweden)

    Kevin O'Brien, M.D

    2016-09-01

    Full Text Available The median arcuate ligament (MAL can rarely compress both the celiac axis and superior mesenteric artery. We present a case of a 70-year male who presented with isolated episodes of upper abdominal pain and diarrhea associated with sweats and nausea. Angiography images demonstrated complete occlusion of the celiac axis and compression of the superior mesenteric artery during the expiration phases. The celiac axis was reconstituted distal to its origin by a patent Arc of Buhler. Other reported cases of multivessel MALs have produced severe symptoms in young adults requiring surgical and/or endovascular intervention. In this case, our patient's Arc of Buhler was protective against more severe chronic mesenteric ischemia. We suggest that a patent Arc of Buhler is protective against symptoms in a single vessel MALs patient. A significant percentage of patients receiving surgical intervention for MALs do not have relief of symptoms. There should be a search for an Arc of Buhler before surgical management of patients suspected to have single vessel MALs.

  2. Lessons learned from a case of multivessel median arcuate ligament syndrome in the setting of an Arc of Buhler.

    Science.gov (United States)

    O'Brien, Kevin; Ferral, Hector

    2016-09-01

    The median arcuate ligament (MAL) can rarely compress both the celiac axis and superior mesenteric artery. We present a case of a 70-year male who presented with isolated episodes of upper abdominal pain and diarrhea associated with sweats and nausea. Angiography images demonstrated complete occlusion of the celiac axis and compression of the superior mesenteric artery during the expiration phases. The celiac axis was reconstituted distal to its origin by a patent Arc of Buhler. Other reported cases of multivessel MALs have produced severe symptoms in young adults requiring surgical and/or endovascular intervention. In this case, our patient's Arc of Buhler was protective against more severe chronic mesenteric ischemia. We suggest that a patent Arc of Buhler is protective against symptoms in a single vessel MALs patient. A significant percentage of patients receiving surgical intervention for MALs do not have relief of symptoms. There should be a search for an Arc of Buhler before surgical management of patients suspected to have single vessel MALs. PMID:27594946

  3. VARIABILITY OF ORIGIN OF OBTURATOR ARTERY AND ITS CLINICAL SIGNIFICANCE

    Directory of Open Access Journals (Sweden)

    Sakthivel

    2015-12-01

    Full Text Available Background: Obturator artery is a branch of anterior division of internal iliac artery. It normally runs anteroinferiorly on the lateral wall of pelvis to the upper part of the obturator foramen and leaves the pelvis by passing through the obturator canal. On its course, the artery is accompanied by the obturator nerve and vein. It supplies the muscles of the medial compartment of the thigh. A severe and potentially lethal complication in pelvic injuries is arterial bleeding commonly involving the branches of the internal iliac artery, namely the lateral sacral, iliolumbar, obturator, vesical and inferior gluteal arteries. A sound knowledge of retro-pubic pelvic vascular anatomy is pivotal for successful performance of endoscopic procedures such as total extra-peritoneal inguinal hernioplasty or laparoscopic herniorraphy. The context and purpose of the study: This study is an attempt to analyse the origin, course, distribution of obturator artery in pelvis and their clinical implication. Result: out of 60 formalin fixed pelvic halves 36.6% of the specimens, (26.67% in males and 10% in females the origin of obturator artery was found to be normal from anterior division of internal iliac artery. About 63.63% from various other sources. Conclusion: This knowledge of variation in the origin of obturator artery is important while doing pelvic and groin surgeries requiring appropriate ligation. Such aberrant origins may be a significant source for persistent bleeding in the setting of acute trauma. Knowledge regarding the variations of obturator artery is useful during surgeries of fracture and direct or indirect inguinal, femoral and obturator hernias.

  4. A simple model of radial nerve injury in the rhesus monkey to evaluate peripheral nerve repair

    OpenAIRE

    Wang, Dong; Huang, Xijun; Fu, Guo; Gu, Liqiang; Liu, Xiaolin; WANG, HONGGANG; Hu, Jun; Yi, Jianhua; Niu, Xiaofeng; Zhu, Qingtang

    2014-01-01

    Current research on bone marrow stem cell transplantation and autologous or xenogenic nerve transplantation for peripheral nerve regeneration has mainly focused on the repair of peripheral nerve defects in rodents. In this study, we established a standardized experimental model of radial nerve defects in primates and evaluated the effect of repair on peripheral nerve injury. We repaired 2.5-cm lesions in the radial nerve of rhesus monkeys by transplantation of autografts, acellular allografts...

  5. Combination of Rare Right Arterial Variation with Anomalous Origins of the Vertebral Artery, Aberrant Subclavian Artery and Persistent Trigeminal Artery

    Science.gov (United States)

    Ishihara, H.; San Millán Ruíz, D.; Abdo, G.; Asakura, F.; Yilmaz, H.; Lovblad, K.O.; Rüfenacht, D.A.

    2011-01-01

    Summary A 32-year-old woman hospitalized for subarachnoid hemorrhage showed rare arterial variation on the right side with anomalous origins of the vertebral artery, aberrant subclavian artery and persistent trigeminal artery. Angiography showed the right vertebral artery to originate from the right common carotid artery, the right subclavian artery to arise separately from the descending aorta, and persistent trigeminal artery on the right side. The possible embryonic mechanism of this previously unreported variant combination is discussed. PMID:22005696

  6. On Renal Artery Stenosis

    OpenAIRE

    Eklöf, Hampus

    2005-01-01

    Renal artery stenosis (RAS) is a potentially curable cause of hypertension and azotemia. Besides intra-arterial renal angiography there are several non-invasive techniques utilized to diagnose patients with suspicion of renal artery stenosis. Removing the stenosis by revascularization to restore unobstructed blood flow to the kidney is known to improve and even cure hypertension/azotemia, but is associated with a significant complication rate. To visualize renal arteries with x-ray technique...

  7. Efficacy of regional renal nerve blockade in patients with chronic refractory heart failure

    Institute of Scientific and Technical Information of China (English)

    DAI Qi-ming; FEN Yi; LU Jing; MA Gen-shan

    2013-01-01

    Background Increased renal sympathetic nerve activity can result in diuretic resistance in patients with chronic congestive heart failure.We investigated the effect of regional renal nerve blockade on the patients with chronic refractory heart failure and diuretic resistance.Methods Eighteen patients with chronic refractory heart failure were enrolled (mean age (64±11) years).The patients were randomly divided into two groups (renal nerve blockade group and standard therapy group,n=9 each).Renal nerve blockade was performed by percutaneous injection of local anaesthetic under computed tomographic guidance.Heart rate,mean arterial blood pressure,plasma and urine electrolytes,neurohormones,factional excretion of sodium (FENa),24-hour urine volume were monitored at baseline and the first 24 hours after therapy.Dyspnea and oedema were also evaluated.The major adverse cardiovascular events (MACE),plasma brain natriuretic peptide (BNP) level and left ventricular ejection fraction (LVEF) were compared between the two groups during the 3-12 months follow-up period.Results No complication was observed during the acute phase of renal nerve blockade.After renal nerve blockade,the 24-hour urine volume and FENa were significantly increased,while the level of plasma rennin,angiotensin Ⅱ,aldosterone,BNP and atrial natriuretic peptide as well as dyspnea and oedema were significantly reduced in renal nerve blockade group compared with baseline and standard therapy group.During three to 12 months of follow-up,the rate of MACE and plasma BNP level were significantly lower,while LVEF was significantly higher in renal nerve blockade group than those in standard therapy group.Conclusion Regional renal nerve blockade may be a safe and effective treatment for patients with chronic refractory heart failure.

  8. Phrenic nerve transfer to the musculocutaneous nerve for the repair of brachial plexus injury: electrophysiological characteristics

    Directory of Open Access Journals (Sweden)

    Ying Liu

    2015-01-01

    Full Text Available Phrenic nerve transfer is a major dynamic treatment used to repair brachial plexus root avulsion. We analyzed 72 relevant articles on phrenic nerve transfer to repair injured brachial plexus that were indexed by Science Citation Index. The keywords searched were brachial plexus injury, phrenic nerve, repair, surgery, protection, nerve transfer, and nerve graft. In addition, we performed neurophysiological analysis of the preoperative condition and prognosis of 10 patients undergoing ipsilateral phrenic nerve transfer to the musculocutaneous nerve in our hospital from 2008 to 201 3 and observed the electromyograms of the biceps brachii and motor conduction function of the musculocutaneous nerve. Clinically, approximately 28% of patients had brachial plexus injury combined with phrenic nerve injury, and injured phrenic nerve cannot be used as a nerve graft. After phrenic nerve transfer to the musculocutaneous nerve, the regenerated potentials first appeared at 3 months. Recovery of motor unit action potential occurred 6 months later and became more apparent at 12 months. The percent of patients recovering ′excellent′ and ′good′ muscle strength in the biceps brachii was 80% after 18 months. At 12 months after surgery, motor nerve conduction potential appeared in the musculocutaneous nerve in seven cases. These data suggest that preoperative evaluation of phrenic nerve function may help identify the most appropriate nerve graft in patients with an injured brachial plexus. The functional recovery of a transplanted nerve can be dynamically observed after the surgery.

  9. Chitosan conduits combined with nerve growth factor microspheres repair facial nerve defects

    Institute of Scientific and Technical Information of China (English)

    Huawei Liu; Weisheng Wen; Min Hu; Wenting Bi; Lijie Chen; Sanxia Liu; Peng Chen; Xinying Tan

    2013-01-01

    Microspheres containing nerve growth factor for sustained release were prepared by a compound method, and implanted into chitosan conduits to repair 10-mm defects on the right buccal branches of the facial nerve in rabbits. In addition, chitosan conduits combined with nerve growth factor or normal saline, as wel as autologous nerve, were used as controls. At 90 days post-surgery, the muscular atrophy on the right upper lip was more evident in the nerve growth factor and normal sa-line groups than in the nerve growth factor-microspheres and autologous nerve groups. Electro-physiological analysis revealed that the nerve conduction velocity and amplitude were significantly higher in the nerve growth factor-microspheres and autologous nerve groups than in the nerve growth factor and normal saline groups. Moreover, histological observation il ustrated that the di-ameter, number, alignment and myelin sheath thickness of myelinated nerves derived from rabbits were higher in the nerve growth factor-microspheres and autologous nerve groups than in the nerve growth factor and normal saline groups. These findings indicate that chitosan nerve conduits com-bined with microspheres for sustained release of nerve growth factor can significantly improve facial nerve defect repair in rabbits.

  10. Chitosan conduits combined with nerve growth factor microspheres repair facial nerve defects.

    Science.gov (United States)

    Liu, Huawei; Wen, Weisheng; Hu, Min; Bi, Wenting; Chen, Lijie; Liu, Sanxia; Chen, Peng; Tan, Xinying

    2013-11-25

    Microspheres containing nerve growth factor for sustained release were prepared by a compound method, and implanted into chitosan conduits to repair 10-mm defects on the right buccal branches of the facial nerve in rabbits. In addition, chitosan conduits combined with nerve growth factor or normal saline, as well as autologous nerve, were used as controls. At 90 days post-surgery, the muscular atrophy on the right upper lip was more evident in the nerve growth factor and normal sa-line groups than in the nerve growth factor-microspheres and autologous nerve groups. physiological analysis revealed that the nerve conduction velocity and amplitude were significantly higher in the nerve growth factor-microspheres and autologous nerve groups than in the nerve growth factor and normal saline groups. Moreover, histological observation illustrated that the di-ameter, number, alignment and myelin sheath thickness of myelinated nerves derived from rabbits were higher in the nerve growth factor-microspheres and autologous nerve groups than in the nerve growth factor and normal saline groups. These findings indicate that chitosan nerve conduits bined with microspheres for sustained release of nerve growth factor can significantly improve facial nerve defect repair in rabbits. PMID:25206635

  11. Vertebral artery aneurysms.

    Directory of Open Access Journals (Sweden)

    Ravi Kumar C

    2000-04-01

    Full Text Available Vertebral artery (VA aneurysms are rare. We present our experience with three cases of VA aneurysms. Two aneurysms were located close to the origin of basilar artery while the third patient had a giant posterior inferior cerebellar artery aneurysm. These aneurysms were operated by the far lateral inferior suboccipital approach with good results.

  12. Retinal artery occlusion

    Science.gov (United States)

    ... artery occlusion; Branch retinal artery occlusion; CRAO; BRAO Images Retina References Sanborn GE, Magargal LE. Arterial obstructive disease ... A.M. Editorial team. Related MedlinePlus Health Topics ... audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among ...

  13. Cardiac autonomic nerve distribution and arrhythmia

    Institute of Scientific and Technical Information of China (English)

    Quan Liu; Dongmei Chen; Yonggang Wang; Xin Zhao; Yang Zheng

    2012-01-01

    OBJECTIVE: To analyze the distribution characteristics of cardiac autonomic nerves and to explore the correlation between cardiac autonomic nerve distribution and arrhythmia.DATA RETRIEVAL: A computer-based retrieval was performed for papers examining the distribution of cardiac autonomic nerves, using "heart, autonomic nerve, sympathetic nerve, vagus nerve, nerve distribution, rhythm and atrial fibrillation" as the key words.SELECTION CRITERIA: A total of 165 studies examining the distribution of cardiac autonomic nerve were screened, and 46 of them were eventually included.MAIN OUTCOME MEASURES: The distribution and characteristics of cardiac autonomic nerves were observed, and immunohistochemical staining was applied to determine the levels of tyrosine hydroxylase and acetylcholine transferase (main markers of cardiac autonomic nerve distribution). In addition, the correlation between cardiac autonomic nerve distribution and cardiac arrhythmia was investigated.RESULTS: Cardiac autonomic nerves were reported to exhibit a disordered distribution in different sites, mainly at the surface of the cardiac atrium and pulmonary vein, forming a ganglia plexus. The distribution of the pulmonary vein autonomic nerve was prominent at the proximal end rather than the distal end, at the upper left rather than the lower right, at the epicardial membrane rather than the endocardial membrane, at the left atrium rather than the right atrium, and at the posterior wall rather than the anterior wall. The main markers used for cardiac autonomic nerves were tyrosine hydroxylase and acetylcholine transferase. Protein gene product 9.5 was used to label the immunoreactive nerve distribution, and the distribution density of autonomic nerves was determined using a computer-aided morphometric analysis system.CONCLUSION: The uneven distribution of the cardiac autonomic nerves is the leading cause of the occurrence of arrhythmia, and the cardiac autonomic nerves play an important role in the

  14. Changes in the kinetics of [3H]dopamine release from median eminence and striatal synaptosomes during aging

    International Nuclear Information System (INIS)

    The release of preaccumulated tritium-labeled dopamine was examined in isolated nerve terminals prepared from the median eminence (ME) and corpus striatum (CS) of young, middle-aged, and old male rats. Fractional release of [3H]DA was measured over 1- to 10-sec time intervals under basal and depolarizing conditions in the presence of calcium. No differences in the rate of basal efflux between the age groups were observed in either ME or CS preparations. Fast-phase evoked [3H]DA release from CS synaptosomes was unchanged from young to middle-aged, but was decreased in old preparations. These data demonstrate that the nigrostriatal nerve terminal has a diminished ability to respond fully to depolarizing stimuli in advanced age. Mean serum PRL levels in old rats were 2.3-fold greater than those in both young and middle-aged rats, while serum LH levels were decreased 2.0-fold in middle-aged and old compared with those in young rats. The fact that LH levels were already decreased in middle-aged rats while PRL levels had not yet increased suggests that decreased gonadotropin titers in old rats do not result from the coincident hyperprolactinemia. In ME synaptosomes, depolarization-induced [3H]DA release was decreased at all time points in middle-aged preparations compared to that in young preparations. The reduced fractional release from the middle-aged ME synaptosomes was due to a depressed rate of release during the initial second of depolarization. Evoked release from ME terminals of old rats was comparable to that measured in the young group. Thus, there occurred an age-related biphasic change in the initial rate of evoked DA release from ME synaptosomes. Diminished response of ME dopaminergic terminals to depolarizing stimuli during middle age may be important in the later development of hyperprolactinemia in aging male rats

  15. Changes in the kinetics of ( sup 3 H)dopamine release from median eminence and striatal synaptosomes during aging

    Energy Technology Data Exchange (ETDEWEB)

    Gregerson, K.A.; Selmanoff, M. (Univ. of Maryland School of Medicine, Baltimore (USA))

    1990-01-01

    The release of preaccumulated tritium-labeled dopamine was examined in isolated nerve terminals prepared from the median eminence (ME) and corpus striatum (CS) of young, middle-aged, and old male rats. Fractional release of (3H)DA was measured over 1- to 10-sec time intervals under basal and depolarizing conditions in the presence of calcium. No differences in the rate of basal efflux between the age groups were observed in either ME or CS preparations. Fast-phase evoked (3H)DA release from CS synaptosomes was unchanged from young to middle-aged, but was decreased in old preparations. These data demonstrate that the nigrostriatal nerve terminal has a diminished ability to respond fully to depolarizing stimuli in advanced age. Mean serum PRL levels in old rats were 2.3-fold greater than those in both young and middle-aged rats, while serum LH levels were decreased 2.0-fold in middle-aged and old compared with those in young rats. The fact that LH levels were already decreased in middle-aged rats while PRL levels had not yet increased suggests that decreased gonadotropin titers in old rats do not result from the coincident hyperprolactinemia. In ME synaptosomes, depolarization-induced (3H)DA release was decreased at all time points in middle-aged preparations compared to that in young preparations. The reduced fractional release from the middle-aged ME synaptosomes was due to a depressed rate of release during the initial second of depolarization. Evoked release from ME terminals of old rats was comparable to that measured in the young group. Thus, there occurred an age-related biphasic change in the initial rate of evoked DA release from ME synaptosomes. Diminished response of ME dopaminergic terminals to depolarizing stimuli during middle age may be important in the later development of hyperprolactinemia in aging male rats.

  16. MR imaging findings of anterior interosseous nerve lesions

    Energy Technology Data Exchange (ETDEWEB)

    Dunn, Andrew J. [Royal Liverpool University Hospital, Department of Medical Imaging, Liverpool (United Kingdom); Salonen, David C. [University of Toronto, Toronto Western Hospital, Department of Medical Imaging, Toronto, Ontario (Canada); Anastakis, Dimitri J. [University of Toronto, Toronto Western Hospital, Division of Plastic Surgery, Toronto, Ontario (Canada)

    2007-12-15

    To study and characterise the MR imaging findings of lesions of the anterior interosseous nerve (AIN). Magnetic resonance imaging (MRI) findings of the forearm of ten patients referred to our institution with suspected AIN lesions were retrospectively studied. Five healthy volunteers with normal forearm MRI findings formed a control group. Two musculoskeletal radiologists assessed the forearm musculature for oedema in the distribution of the AIN, median, posterior interosseous and radial nerves on T2-weighted (T2W) fat-saturated sequences. T1-weighted (T1W) images were assessed and graded for the presence of muscle atrophy and fatty involution. Six patients had undergone surgical exploration; five of these had surgically confirmed AIN compression. Four patients had diagnoses other than AIN compression made on imaging features. Of the cases of proven AIN compression, oedema within the pronator quadratus (PQ) muscle was identified in all cases. PQ atrophy and fatty involution were seen in three (43%) surgically confirmed cases. Cases 2 and 3 also demonstrated oedema in the flexor digitorum profundus (FDP)1 and FDP2 muscles. These cases also showed oedema in the flexor-carpi radialis (FCR) and FDP3/FDP4 muscles, respectively. The four cases of non-AIN compression demonstrated muscle oedema patterns that were atypical for the AIN distribution. They included a rupture of the flexor pollicis longus (FPL) tendon, brachial neuritis, amyotrophic lateral sclerosis and compression of the proximal median nerve. MRI is a useful investigation in the diagnostic workup of AIN syndrome. AIN syndrome is likely when there is diffuse oedema of AIN innervated muscles on T2W fat-saturated images. The most reliable sign of an AIN lesion is oedema within the PQ. Oedema in the flexor carpi radialis, FDP3 and FDP4, although not in the classical distribution of the AIN, does not preclude the diagnosis of AIN syndrome. (orig.)

  17. Facial nerve paralysis in children.

    Science.gov (United States)

    Ciorba, Andrea; Corazzi, Virginia; Conz, Veronica; Bianchini, Chiara; Aimoni, Claudia

    2015-12-16

    Facial nerve palsy is a condition with several implications, particularly when occurring in childhood. It represents a serious clinical problem as it causes significant concerns in doctors because of its etiology, its treatment options and its outcome, as well as in little patients and their parents, because of functional and aesthetic outcomes. There are several described causes of facial nerve paralysis in children, as it can be congenital (due to delivery traumas and genetic or malformative diseases) or acquired (due to infective, inflammatory, neoplastic, traumatic or iatrogenic causes). Nonetheless, in approximately 40%-75% of the cases, the cause of unilateral facial paralysis still remains idiopathic. A careful diagnostic workout and differential diagnosis are particularly recommended in case of pediatric facial nerve palsy, in order to establish the most appropriate treatment, as the therapeutic approach differs in relation to the etiology.

  18. Improvement of mount preparations in showing myenteric nerve plexus from intestines of mice

    Institute of Scientific and Technical Information of China (English)

    王红; 张远强; 孙岚; 王春杨; 尹岭

    2003-01-01

    Objective: The whole mount preparations of digestive tract is an effective experimental way to study the appearance and distribution of nerve plexus in digestive tract. Although myentric nerve plexus preparations technique was reported very early. But we have done experiment over and over during our research work in order to improve this traditional method and to meet the needs of our research work, we made some progresses in regular mount preparations after many experiments, which helped offer better situation in observing myentric nerve plexus. Methods: Five healthy male adult Kunming mice (20-30 g in weight) were used in this study. After intraperitoneal injection of muscle relaxant, with dislocation of cervical vertebra method, the abdominal cavity was exposed through abdominal median incision. After several steps of mount preparations the mucous layer and longitudinal muscle layer mount preparations with myentric nerve plexus were stripped under anatomical microscope. Immunohistochemical staining was also used in our study. Results: The mount preparation samples with myentric nerve plexus from intestines of mice showed positive SP immunoreaction. The positive cells were dark brown. Many of the cytons appeared circular and oval, while some appeared triangular or irregular. Conclusion: Our improved method is really a good method to show enteric nerve plexus. The method has many advantages and is particularly applied to small animals such as Kunming mice and BALB/c mice, weighing from 20 g to 30 g.

  19. [Upper extremity arterial diseases].

    Science.gov (United States)

    Becker, F

    2007-02-01

    Compared to lower limb arterial diseases, upper limb arterial diseases look rare, heterogeneous with various etiologies and a rather vague clinical picture, but with a negligible risk of amputation. Almost all types of arterial diseases can be present in the upper limb, but the anatomical and hemodynamic conditions particular to the upper limb often confuse the issue. Thus, atherosclerosis affects mainly the subclavian artery in its proximal segment where the potential of collateral pathway is high making the symptomatic forms not very frequent whereas the prevalence of subclavian artery stenosis or occlusion is relatively high. The clinical examination and the etiologies are discussed according to the clinical, anatomical and hemodynamic context.

  20. The Use of Degradable Nerve Conduits for Human Nerve Repair: A Review of the Literature

    Directory of Open Access Journals (Sweden)

    M. F. Meek

    2005-01-01

    Full Text Available The management of peripheral nerve injury continues to be a major clinical challenge. The most widely used technique for bridging defects in peripheral nerves is the use of autologous nerve grafts. This technique, however, has some disadvantages. Many alternative experimental techniques have thus been developed, such as degradable nerve conduits. Degradable nerve guides have been extensively studied in animal experimental studies. However, the repair of human nerves by degradable nerve conduits has been limited to only a few clinical studies. In this paper, an overview of the available international published literature on degradable nerve conduits for bridging human peripheral nerve defects is presented for literature available until 2004. Also, the philosophy on the use of nerve guides and nerve grafts is given.

  1. Peripheral nerve conduits: technology update

    Directory of Open Access Journals (Sweden)

    Arslantunali D

    2014-12-01

    Full Text Available D Arslantunali,1–3,* T Dursun,1,2,* D Yucel,1,4,5 N Hasirci,1,2,6 V Hasirci,1,2,7 1BIOMATEN, Center of Excellence in Biomaterials and Tissue Engineering, Middle East Technical University (METU, Ankara, Turkey; 2Department of Biotechnology, METU, Ankara, Turkey; 3Department of Bioengineering, Gumushane University, Gumushane, Turkey; 4Faculty of Engineering, Department of Medical Engineering, Acibadem University, Istanbul, Turkey; 5School of Medicine, Department of Histology and Embryology, Acibadem University, Istanbul, Turkey; 6Department of Chemistry, Faculty of Arts and Sciences, METU, Ankara, Turkey; 7Department of Biological Sciences, Faculty of Arts and Sciences, METU, Ankara, Turkey *These authors have contributed equally to this work Abstract: Peripheral nerve injury is a worldwide clinical problem which could lead to loss of neuronal communication along sensory and motor nerves between the central nervous system (CNS and the peripheral organs and impairs the quality of life of a patient. The primary requirement for the treatment of complete lesions is a tension-free, end-to-end repair. When end-to-end repair is not possible, peripheral nerve grafts or nerve conduits are used. The limited availability of autografts, and drawbacks of the allografts and xenografts like immunological reactions, forced the researchers to investigate and develop alternative approaches, mainly nerve conduits. In this review, recent information on the various types of conduit materials (made of biological and synthetic polymers and designs (tubular, fibrous, and matrix type are being presented. Keywords: peripheral nerve injury, natural biomaterials, synthetic biomaterials

  2. Middle Cranial Fossa Transtemporal Approach to the Intrapetrous Internal Carotid Artery

    OpenAIRE

    Andrews, James C.; Martin, Neil A.; Black, Keith; Honrubia, Vincent F.; Becker, Donald P.

    1991-01-01

    Diseases involving the proximity of the internal carotid artery at the skull base require identification of this vessel in the temporal bone to gain vascular control for any maneuver in its vicinity. This article details the technique of surgical dissection and exposure of the internal carotid artery within the skull base through a transtemporal middle cranial fossa approach. The anatomic landmarks important in utilizing this procedure include the greater superficial petrosal nerve, the mandi...

  3. Repair of brachial plexus lower trunk injury by transferring brachialis muscle branch of musculocutaneous nerve:anatomic feasibility and clinical trials

    Institute of Scientific and Technical Information of China (English)

    ZHENG Xian-you; HOU Chun-lin; GU Yu-dong; SHI Qi-lin; GUAN Shi-bing

    2008-01-01

    Background There are few effective methods for treating injuries to the lower trunk of brachial plexus,and the curative effect is usually poor.The purpose of this study was to provide anatomic references for transferring the brachialis muscle branch of musculocutaneous nerve(BMBMCN)for selective neurotization of finger flexion in brachiaI plexus lower trunk injury,and to evaluate its clinical curative effects.Methods Microanatomy and measurement were done on 50 limbs from 25 adult human cadavers to obserye the origin,branch,type of the BMBMCN and median nerve,as well as their adjacent structures.Internal topographic features of the fascicular groups of the median nerve at the level of the BMBMCN were observed.In addition,the technique of BMBMCN transfer for selective neurotization of finger flexion of the median nerve was designed and tested in 6 fresh adult human cadavers.Acetylcholinesterase(AchE)staining of the BMBMCN and median nerve was done to observe the features of the nerve fibers.This technique was clinically tried to restore digital flexion in 6 cases of adult brachial plexus lower trunk injury.These cases were followed up for 3,6,9 and 12 months postoperatively.Recovery of function,grip strength,nerve electrophysiology and muscle power of the affected limbs were observed and measured.Results The brachialis muscle was totally innervated by the musculocutaneous nerve(MCN).Based on the Hunter's line,the Ievel of the origin of the BMBMCN was(13.18±2.77)cm.AchE histochemical staining indicated that the BMBMCN were totally made up of medullated nerve fibers.At the level of the BMBMCN,the median nerve consistently collected into three fascicular groups as shown by microanatomy in combination with AchE stain.The posterior fascicular group was mainly composed of anterior Interosseous nerves and branches to the palmaris longus.The technique was tested in six fresh cadavers successfully,except that stoma split occurred in one case.Five of the six cases recovered

  4. An experimental study of nerve bypass graft

    Institute of Scientific and Technical Information of China (English)

    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.

  5. Treadmill exercise induced functional recovery after peripheral nerve repair is associated with increased levels of neurotrophic factors.

    Directory of Open Access Journals (Sweden)

    Jae-Sung Park

    Full Text Available Benefits of exercise on nerve regeneration and functional recovery have been reported in both central and peripheral nervous system disease models. However, underlying molecular mechanisms of enhanced regeneration and improved functional outcomes are less understood. We used a peripheral nerve regeneration model that has a good correlation between functional outcomes and number of motor axons that regenerate to evaluate the impact of treadmill exercise. In this model, the median nerve was transected and repaired while the ulnar nerve was transected and prevented from regeneration. Daily treadmill exercise resulted in faster recovery of the forelimb grip function as evaluated by grip power and inverted holding test. Daily exercise also resulted in better regeneration as evaluated by recovery of compound motor action potentials, higher number of axons in the median nerve and larger myofiber size in target muscles. Furthermore, these observations correlated with higher levels of neurotrophic factors, glial derived neurotrophic factor (GDNF, brain derived neurotrophic factor (BDNF and insulin-like growth factor-1 (IGF-1, in serum, nerve and muscle suggesting that increase in muscle derived neurotrophic factors may be responsible for improved regeneration.

  6. Nerve lesioning with direct current

    Science.gov (United States)

    Ravid, E. Natalie; Shi Gan, Liu; Todd, Kathryn; Prochazka, Arthur

    2011-02-01

    Spastic hypertonus (muscle over-activity due to exaggerated stretch reflexes) often develops in people with stroke, cerebral palsy, multiple sclerosis and spinal cord injury. Lesioning of nerves, e.g. with phenol or botulinum toxin is widely performed to reduce spastic hypertonus. We have explored the use of direct electrical current (DC) to lesion peripheral nerves. In a series of animal experiments, DC reduced muscle force by controlled amounts and the reduction could last several months. We conclude that in some cases controlled DC lesioning may provide an effective alternative to the less controllable molecular treatments available today.

  7. Acute occlusion of the left subclavian artery with artery dissection

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    @@ Subclavian steal syndrome is cerebral or brain stem ischemia resulting from diversion of blood flow from the basilar artery to the subclavian artery, which is caused by occlusive disease of either the subclavian artery or the innominate artery before they branch off at the vertebral artery. In the patients with subclavian steal syndrome the subclavian artery is fed by retrograde flow from the vertebral artery via the carotids and the circle of Willis.

  8. A method for determining the median line of measured cylindrical and conical surfaces

    Science.gov (United States)

    Janecki, Dariusz; Zwierzchowski, Jarosław

    2015-08-01

    The paper presents a novel method for the determination of the median line of the cylindrical and conical surfaces. This method can be incorporated into virtually any cylindricity measurement strategy, including the bird-cage strategy and the helical line strategy. In the study, a median line was determined by minimizing the functional made up of two components. The form of the first component results from the classic definition of the median line provided in the corresponding standard. The other, termed the bending energy, is responsible for ensuring appropriate smoothness of the median line. In order to solve this variational problem, the median line was approximated by means of linear combination of cubic B-spline functions. A simulation and experiments were conducted to establish the suitability of the algorithm developed for the determination of the median line using the helical-line and the cross-section measurement strategy.

  9. Functional nerve recovery after bridging a 15 mm gap in rat sciatic nerve with a biodegradable nerve guide

    NARCIS (Netherlands)

    Meek, MF; Klok, F; Robinson, PH; Nicolai, JPA; Gramsbergen, A; van der Werf, J.F.A.

    2003-01-01

    Recovery of nerve function was evaluated after bridging a 15 mm sciatic nerve gap in 51 rats with a biodegradable poly(DL-lactide-epsilon-caprolactone) nerve guide. Recovery of function was investigated by analysing the footprints, by analysing video recordings of gait, by electrically eliciting the

  10. Two Cases of Bezold-Jarisch Reflex Induced by Intra-Arterial Nitroglycerin in Critical Left Main Coronary Artery Stenosis

    OpenAIRE

    Shah, Sachin P.; Waxman, Sergio

    2013-01-01

    The Bezold-Jarisch reflex, a well-described phenomenon, occurs upon the stimulation of intracardiac mechanoreceptors and is mediated by vagal afferent nerve fibers. Several factors can sensitize the cardiovascular system to develop this reflex, including acute myocardial ischemia, natriuretic peptides, and, rarely, nitroglycerin administration in the setting of acute myocardial infarction. The development of the Bezold-Jarisch reflex in the presence of severe coronary artery stenosis, specifi...

  11. Sosiaalisen median käytön esteet suomalaisissa matkailuyrityksissä

    OpenAIRE

    Makkonen, Marika

    2013-01-01

    Sosiaalinen media on vaikuttanut matkailuyritysten liiketoimintaan, ja yritykset ovat olleet innokkaita ottamaan sosiaalisen median osaksi markkinointistrategiaansa. Edelleen kuitenkin monet matkailuyritykset empivät sosiaalisen median käyttöönottoa. Sosiaalinen media vaikuttaa matkailijoiden päätöksentekoon yhä enemmän, ja tutki-mustulokset osoittavat sosiaalisen median strategisen tärkeyden matkailuyritysten kilpailukyvylle. Tämän tutkimuksen tavoitteena oli tutkia syitä, miksi osa suomalai...

  12. Diabetic Neuropathies: The Nerve Damage of Diabetes

    Science.gov (United States)

    ... Organizations (PDF, 293 KB). Alternate Language URL Español Diabetic Neuropathies: The Nerve Damage of Diabetes Page Content ... treated? Points to Remember Clinical Trials What are diabetic neuropathies? Diabetic neuropathies are a family of nerve ...

  13. Peripheral Nerve Diffusion Tensor Imaging: Assessment of Axon and Myelin Sheath Integrity.

    Directory of Open Access Journals (Sweden)

    A Heckel

    Full Text Available To investigate the potential of diffusion tensor imaging (DTI parameters as in-vivo biomarkers of axon and myelin sheath integrity of the median nerve in the carpal tunnel as validated by correlation with electrophysiology.MRI examinations at 3T including DTI were conducted on wrists in 30 healthy subjects. After manual segmentation of the median nerve quantitative analysis of fractional anisotropy (FA as well as axial, radial and mean diffusivity (AD, RD, and MD was carried out. Pairwise Pearson correlations with electrophysiological parameters comprising sensory nerve action potential (SNAP and compound muscle action potential (CMAP as markers of axon integrity, and distal motor latency (dml and sensory nerve conduction velocity (sNCV as markers of myelin sheath integrity were computed. The significance criterion was set at P=0.05, Bonferroni corrected for multiple comparisons.DTI parameters showed a distinct proximal-to-distal profile with FA, MD, and RD extrema coinciding in the center of the carpal tunnel. AD correlated with CMAP (r=0.50, p=0.04, Bonf. corr. but not with markers of myelin sheath integrity. RD correlated with sNCV (r=-0.53, p=0.02, Bonf. corr. but not with markers of axon integrity. FA correlated with dml (r=-0.63, p=0.002, Bonf. corr. and sNCV (r=0.68, p=0.001, Bonf. corr. but not with markers of axon integrity.AD reflects axon integrity, while RD (and FA reflect myelin sheath integrity as validated by correlation with electrophysiology. DTI parameters consistently indicate a slight decrease of structural integrity in the carpal tunnel as a physiological site of median nerve entrapment. DTI is particularly sensitive, since these findings are observed in healthy participants. Our results encourage future studies to evaluate the potential of DTI in differentiating axon from myelin sheath injury in patients with manifest peripheral neuropathies.

  14. Palsies of Cranial Nerves That Control Eye Movement

    Science.gov (United States)

    ... Medical News Palsies of Cranial Nerves That Control Eye Movement By Michael Rubin, MDCM NOTE: This is the ... Gaze Palsies Palsies of Cranial Nerves That Control Eye Movement Third Cranial Nerve (Oculomotor Nerve) Palsy Fourth Cranial ...

  15. Catecholamines in plasma from artery, cubital vein, and femoral vein in patients with cirrhosis. Significance of sampling site

    DEFF Research Database (Denmark)

    Henriksen, J H; Ring-Larsen, H; Christensen, N J

    1986-01-01

    The concentration of noradrenaline (NA) and adrenaline (A) was measured in arterial, cubital venous and femoral venous plasma in order to determine possible differences in different vascular beds in the peripheral circulation. In patients with cirrhosis, arterial plasma NA (median 2.54 nmol/l, n...

  16. Sosiaalisen median tunnettuus ja käyttö : Kohteena Kokkolan rovastikunnan seurakunnat

    OpenAIRE

    Kivelä, Irmeli

    2014-01-01

    Tämän opinnäytetyön tarkoituksena oli tutkia sosiaalisen median tunnettavuutta ja käyttöä Kokkolan rovastikunnan seurakunnissa. Opinnäytetyön tavoitteena oli selvittää sosiaalisen median hyödyntämistä seurakunnissa, työntekijöiden suhtautumista siihen ja sosiaalisen median vaikuttavuutta ulkoiseen viestintään. Opinnäytetyön teoriaosuus perustuu sosiaalisesta mediasta julkaistuun kirjallisuuteen ja sähköisiin aineistoihin. Sosiaalista median tarkastelussa on myös huomioitu Suomen evankelislut...

  17. Effect of experimental devascularization on peripheral nerves

    Directory of Open Access Journals (Sweden)

    Eros Abrantes Erhart

    1966-03-01

    Full Text Available In order to explore the functional importance of the vasa-nervorum and the nerve natural connective bed, fine nerve devascularizations were performed in ten adult dogs, using a dissecting microscope. 4 to 5 cm of the nerve vascularization and corresponding connective bed were injured. By this procedure it could be demonstrated, 30 days later, motor deficiencies and in the histological serial preparations a distad nerve degeneration, total in some fascicles and partial in others.

  18. Isolated trochlear nerve palsy with midbrain hemorrhage

    Directory of Open Access Journals (Sweden)

    Raghavendra S

    2010-01-01

    Full Text Available Midbrain hemorrhage causing isolated fourth nerve palsy is extremely rare. Idiopathic, traumatic and congenital abnormalities are the most common causes of fourth nerve palsy. We report acute isolated fourth nerve palsy in an 18-year-old lady due to a midbrain hemorrhage probably due to a midbrain cavernoma. The case highlights the need for neuroimaging in selected cases of isolated trochlear nerve palsy.

  19. Anaesthesia of the inferior alveolar and lingual nerves following subcondylar fractures of the mandible.

    Science.gov (United States)

    Politis, Constantinus; Sun, Yi; De Peuter, Bruno; Vandersteen, Marjan

    2013-10-01

    A retrospective chart review of 387 patients with condylar and subcondylar fractures revealed 2 cases of inferior alveolar nerve (IAN) and lingual nerve (LN) anaesthesia following the subcondylar fracture. Only 5 cases have been reported previously. The mechanism of action remains unknown but a review of the literature and an analysis of 120 dry human skulls supported the hypothesis that compression of the mandibular nerve at a high level, close to the foramen ovale, could cause anaesthesia. This complication is rare, because it requires compression at a particular angle. The antero-median angulation of the condyle must be close to the foramen ovale, and the fracture must be a unilaterally displaced fracture. The presence of an enlarged lateral pterygoid plate appeared to enhance the risk of compression. The IAN and LN anaesthesia could be resolved after open reduction of the fracture and IAN and LN anaesthesia constitute a strict indication for an early open fracture reduction. PMID:23453271

  20. Detergent-free Decellularized Nerve Grafts for Long-gap Peripheral Nerve Reconstruction

    Directory of Open Access Journals (Sweden)

    Srikanth Vasudevan, PhD

    2014-08-01

    Conclusions: This study describes a detergent-free nerve decellularization technique for reconstruction of long-gap nerve injuries. We compared DFD grafts with an established detergent processing technique and found that DFD nerve grafts are successful in promoting regeneration across long-gap peripheral nerve defects as an alternative to existing strategies.