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Sample records for chorda tympani nerve

  1. Shrinkage of ipsilateral taste buds and hyperplasia of contralateral taste buds following chorda tympani nerve transection

    Institute of Scientific and Technical Information of China (English)

    Yi-ke Li; Juan-mei Yang; Yi-bo Huang; Dong-dong Ren; Fang-lu Chi

    2015-01-01

    The morphological changes that occur in the taste buds after denervation are not well under-stood in rats, especially in the contralateral tongue epithelium. In this study, we investigated the time course of morphological changes in the taste buds following unilateral nerve transection. The role of the trigeminal component of the lingual nerve in maintaining the structural integrity of the taste buds was also examined. Twenty-four Sprague-Dawley rats were randomly divided into three groups:control, unilateral chorda tympani nerve transection and unilateral chorda tympani nerve transection+lingual nerve transection. Rats were allowed up to 42 days of re-covery before being euthanized. The taste buds were visualized using a cytokeratin 8 antibody. Taste bud counts, volumes and taste receptor cell numbers were quantiifed and compared among groups. No signiifcant difference was detected between the chorda tympani nerve transection and chorda tympani nerve transection+lingual nerve transection groups. Taste bud counts, vol-umes and taste receptor cell numbers on the ipsilateral side all decreased signiifcantly compared with control. On the contralateral side, the number of taste buds remained unchanged over time, but they were larger, and taste receptor cells were more numerous postoperatively. There was no evidence for a role of the trigeminal branch of the lingual nerve in maintaining the structural integrity of the anterior taste buds.

  2. Shrinkage of ipsilateral taste buds and hyperplasia of contralateral taste buds following chorda tympani nerve transection

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    Yi-ke Li

    2015-01-01

    Full Text Available The morphological changes that occur in the taste buds after denervation are not well understood in rats, especially in the contralateral tongue epithelium. In this study, we investigated the time course of morphological changes in the taste buds following unilateral nerve transection. The role of the trigeminal component of the lingual nerve in maintaining the structural integrity of the taste buds was also examined. Twenty-four Sprague-Dawley rats were randomly divided into three groups: control, unilateral chorda tympani nerve transection and unilateral chorda tympani nerve transection + lingual nerve transection. Rats were allowed up to 42 days of recovery before being euthanized. The taste buds were visualized using a cytokeratin 8 antibody. Taste bud counts, volumes and taste receptor cell numbers were quantified and compared among groups. No significant difference was detected between the chorda tympani nerve transection and chorda tympani nerve transection + lingual nerve transection groups. Taste bud counts, volumes and taste receptor cell numbers on the ipsilateral side all decreased significantly compared with control. On the contralateral side, the number of taste buds remained unchanged over time, but they were larger, and taste receptor cells were more numerous postoperatively. There was no evidence for a role of the trigeminal branch of the lingual nerve in maintaining the structural integrity of the anterior taste buds.

  3. The role of the chorda tympani nerve in the activation of the rat hypothalamic histaminergic system by leptin.

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    Morimoto-Ishizuka, T; Yamamoto, Y; Yamatodani, A

    2001-03-01

    A possible pathway through which leptin activates the histaminergic system was studied using in vivo microdialysis in rats. Intraperitoneal injection of leptin (1.3 mg/kg) caused a significant increase in hypothalamic histamine release, however, its intracerebroventricular injection (10 microg/rat) did not cause any significant changes in the release. Furthermore, leptin (1.3 mg/kg) had no effect on histamine release in rats whose chorda tympani nerves, a branch of the facial nerve which mediates taste information, were transected bilaterally. These findings indicate that leptin activates the histaminergic system by the peripheral signal inputs via the chorda tympani resulting in the suppression of food intake.

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

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    Toshiaki Yamanaka

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

  5. Influences of age, tongue region, and chorda tympani nerve sectioning on signal detection measures of lingual taste sensitivity.

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    Doty, Richard L; Heidt, Julie M; MacGillivray, Michael R; Dsouza, Merle; Tracey, Elisabeth H; Mirza, Natasha; Bigelow, Douglas

    2016-03-01

    Although the ability to taste is critical for ingestion, nutrition, and quality of life, a clear understanding of the influences of age, sex, and chorda tympani (CT) resection on taste function in different regions of the anterior tongue is generally lacking. In this study we employed criterion-free signal detection analysis to assess electric and chemical taste function on multiple tongue regions in normal individuals varying in age and sex and in patients with unilateral CT resections. The subjects were 33 healthy volunteers, ranging from 18 to 87 years of age, and 9 persons, 27 to 77 years of age, with unilateral CT lesions. The influences of age, sex, tongue region, and chorda tympani resections on signal detection sensitivity (d') and response bias (β) measures was assessed in 16 tongue regions to weak electric currents and solutions of sucrose, sodium chloride, and caffeine. Significant age-related decrements in d' were found for sucrose (p=0.012), sodium chloride (p=0.002), caffeine (p=0.006), and electric current (EC) (p=0.0001). Significant posterior to anterior, and medial to lateral, gradients of increasing performance were present for most stimuli. β was larger on the anterior than the posterior tongue for the electrical stimulus in the youngest subjects, whereas the opposite was true for sucrose in the oldest subjects. No sex differences were apparent. d' was depressed ipsilateral to the CT lesion side to varying degrees in all tongue regions, with the weakest influences occurring on the medial and anterior tongue. CT did not meaningfully influence β. This study is the first to employ signal detection analysis to assess the regional sensitivity of the tongue to chemical and electrical stimuli. It clearly demonstrates that tongue regions differ from one another in terms of their age-related sensitivity and their susceptibility to CT lesions.

  6. Comparison of the responses of the chorda tympani and glossopharyngeal nerves to taste stimuli in C57BL/6J mice

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    Hellekant Göran

    2003-03-01

    Full Text Available Abstract Background Recent progress in discernment of molecular pathways of taste transduction underscores the need for comprehensive phenotypic information for the understanding of the influence of genetic factors in taste. To obtain information that can be used as a base line for assessment of effects of genetic manipulations in mice taste, we have recorded the whole-nerve integrated responses to a wide array of taste stimuli in the chorda tympani (CT and glossopharyngeal (NG nerves, the two major taste nerves from the tongue. Results In C57BL/6J mice the responses in the two nerves were not the same. In general sweeteners gave larger responses in the CT than in the NG, while responses to bitter taste in the NG were larger. Thus the CT responses to cyanosuosan, fructose, NC00174, D-phenylalanline and sucrose at all concentrations were significantly larger than in the NG, whereas for acesulfame-K, L-proline, saccharin and SC45647 the differences were not significant. Among bitter compounds amiloride, atropine, cycloheximide, denatonium benzoate, L-phenylalanine, 6-n-propyl-2-thiouracil (PROP and tetraethyl ammonium chloride (TEA gave larger responses in the NG, while the responses to brucine, chloroquine, quinacrine, quinine hydrochloride (QHCl, sparteine and strychnine, known to be very bitter to humans, were not significantly larger in the NG than in the CT. Conclusion These data provide a comprehensive survey and comparison of the taste sensitivity of the normal C57BL/6J mouse against which the effects of manipulations of its gustatory system can be better assessed.

  7. Canal-wall-down mastoidectomy and tympanoplasty surgery preserving chorda tympani nerve integrality%保留鼓索神经的开放式乳突根治鼓室成形术

    Institute of Scientific and Technical Information of China (English)

    王林娥; 张汝祥; 张道行

    2012-01-01

    目的:报告开放式乳突根治鼓室成形术中寻找鼓索神经的方法和保留鼓索神经的意义.方法:66例慢性化脓性中耳炎或中耳胆脂瘤患者,术中以砧骨短突为标志,磨低外耳道后壁,沿面神经垂直段找到鼓索嵴(鼓索神经出骨管处),沿鼓索嵴找到游离于鼓室内的鼓索神经,仔细清理鼓索神经表面的病变组织,保持其完整性.结果:24例中耳胆脂瘤患者和42例慢性化脓性中耳炎患者鼓索神经表面胆脂瘤上皮及肉芽彻底清理,无一例鼓索神经断裂,患者术后味觉无明显变化.结论:开放式乳突根治鼓室成形术中彻底清理病变的同时保持鼓索神经的完整性,保留了鼓索神经的结构和功能,可以减低移植于镫骨头上的听小骨膺复物脱落的危险,且可对移植筋膜起支架作用.%Objective:To report the way for searching the chorda tympani nerve and the significance for preserving the chorda tympani nerve during canal'wall-down mastoidectomy and tympanoplasty surgery. Method:Sixty-six cases with chronic suppurative otitis media underwent canal-wall-down mastoidectomy and tympanoplasty surgery. According to the marker of the short crus of incus, the posterior wall of auditory canal was lowered and crista of the chorda tympani nerve was found through tracing the facial nerve contour. The chorda tympani nerve was preserved after clearing the surrounding tissue. Result: Among the 66 cases, 24 cases had middle ear chol-esteatoma,42 cases had granulation in middle ear. The cholesteatoma and granulation on the surface of the chorda tympani nerve were cleared thoroughly. No neurotmesis or obvious change of taste occurred after operation. Conclu sion: Canal-wall-down mastoidectomy and tympanoplasty surgery preserving chorda tympani nerve integrality may preserve the structure and function of the chorda tympani nerve , reduce the risk of ossicle extrusion above the head of stapes and serve as a frame for transplanting

  8. Changes of the Ultrastructure of Chorda Tympani Nerve in Chronic Otitis Media%慢性中耳炎患者鼓索神经超微结构的变化

    Institute of Scientific and Technical Information of China (English)

    胡正清; 王正敏

    2001-01-01

    Purpose To investigate the ultrastructure of the chorda tympani nerves in chronic otitis media. Methods The tympanic segments of chorda tympani nerves were collected for ultrastructural investigaions in 35 cases who underwent canal-wall-down tympanoplasty. All patients received a spatial (regional) taste test preoperatively and postoperatively. The extended Cochran-Mantel-Haenszel statistics was applied. Results There were obvious damages in all the chorda tympani nerves, such as swelling( 100 % ), disarrangement (100%), vacuoles formation (83%)of myelin, the edema of Schwann cell (91%), intracytoplasmic vacuoles in Schwann cell (89 % ) and the proliferation of the collagen tissue ( 97 % ). Five patients complained of taste change postoperatively. The gustation test showed that the taste intensities ipsilateral to the side of tympanoplasty were not statistically significant for each stimulus to all the loci( P > 0.05)comparing preoperative tests with postoperative tests. Conclusions This research implied that the chorda tympani nerves had pathological changes in ultrastructue in chronic otitis media who underwent canal wall-down tympanoplasty. The transection of chorda tympani nerve would not affect the function of taste in these patients.%目的研究慢性中耳炎患者鼓索神经的超微结构。方法取35例开放式鼓室成形术中所取的鼓室段 鼓索神经作透射电镜观察并进行区域性化学味阈的测定,统计方法为扩展Cochran-Mantel-Haenszel法。结果 35例慢性中耳炎患者鼓索神经的超微结构均有不同程度的变化,如有髓神经纤维髓鞘肿胀(100%)、排列紊乱 (100%)、空泡形成(83%)、Schwann细胞肿胀(91%)、细胞内空泡形成(89%)、髓鞘间胶原组织增生(97%)。35 例患者中5例术后发生味觉障碍,手术前后每一溶液于术侧舌部和软腭引起的味觉反应的差异在统计学上无显 著意义(P>0.05)。结论行开放式鼓室成形术患者鼓

  9. Scala tympani drill-out technique for oval window atresia with malformed facial nerve:A report of three cases

    Institute of Scientific and Technical Information of China (English)

    Yang Liu a; Feng Yang b

    2015-01-01

    Objective:To report a scala tympani drill-out technique for managing malformed facial nerve covering the entire oval window (OW). Methods:Data from three cases with OW atresia, malformed stapes and abnormal facial nerve courses were reported, in which a scala tympani drill-out technique was employed with a TORP between the tympanic membrane and scala tympani fenestration for hearing reconstruction. Results: Air conduction hearing improved in two of the three cases following surgery. In the third case, there was no improvement in air conduction hearing following a canal wall up mastoidectomy and tympanoplasty. There were no vertigo, tinnitus or sensorineural hearing loss in the three cases. Conclusion:The scala tympani drill-out technique, which is basically fenestration at the initial part of the basal turn, provides a choice in hearing reconstruction when the OW is completely covered by abarrently coursed facial nerve.

  10. Dissection and Exposure of the Whole Course of Deep Nerves in Human Head Specimens after Decalcification

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    Longping Liu

    2012-01-01

    Full Text Available The whole course of the chorda tympani nerve, nerve of pterygoid canal, and facial nerves and their relationships with surrounding structures are complex. After reviewing the literature, it was found that details of the whole course of these deep nerves are rarely reported and specimens displaying these nerves are rarely seen in the dissecting room, anatomical museum, or atlases. Dissections were performed on 16 decalcified human head specimens, exposing the chorda tympani and the nerve connection between the geniculate and pterygopalatine ganglia. Measurements of nerve lengths, branching distances, and ganglia size were taken. The chorda tympani is a very fine nerve (0.44 mm in diameter within the tympanic cavity and approximately 54 mm in length. The mean length of the facial nerve from opening of internal acoustic meatus to stylomastoid foramen was 52.5 mm. The mean length of the greater petrosal nerve was 26.1 mm and nerve of the pterygoid canal was 15.1 mm.

  11. [Neuroanatomy of the optic, trigeminal, facial, glossopharyngeal, vagus, accessory and hypoglossal nerves (author's transl)].

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    Lang, J

    1981-01-01

    1. The intracranial and intraorbital course of the optic nerve is described concisely, the intracanicular one in full details. Apart from the wide and small sections of the optic canal, its axis opposite to the cranial planes, the coating of the canal and the adjacency to the paranasal sinuses and arteries are exactly described. 2. At the trigeminal nerve the trigeminal ganglion, its roots and also the mandibular nerve have great importance in the practical medicine considering thermo-coagulation or surgery of the trigeminal nerve. This segments and also the adjacency of the fifth nerve to the internal carotid artery and subarachinoid brain vessels are exactly, the nuclei areas and central tracts are briefly explained. 3. The nuclei of the facial nerve the intracerebral and intracisternal course and its development, the facial canal and its narrow passes are described. Also the position of the internal acoustic pore in the skull, the dimensions of the internal acoustic meatus and the relations between nerves and vessels are explained. In addition to the geniculate ganglion and the chorda tympani the communications of the facial nerve inside the temporal bone, the tympanic intumescentia (ganglion) and the nervus intermedius, also the petrosal nerves are included in the description. The sheaths of the segments of the seventh cranial nerve and also the fasciculation are exactly, the somatotopic organization is briefly described. 4. The extracranial course of the glossopharyngeal nerve is briefly, its intracranial sections are included exactly in the investigation. 5. The nuclei of the vagus nerve and the intra- und extracranial course are described. 6. The accessory nerve, its nucleus and the intra- and extracranial course are concisely explained. 7. The hypoglossal nerve, its nucleus, the emergence of the fibres and also the relations of nerves and vessels in the posterior cranial fossa are described. The hypoglossal canal and also the extracranial course are

  12. Taste placodes are primary targets of geniculate but not trigeminal sensory axons in mouse developing tongue.

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    Mbiene, Joseph-Pascal

    2004-12-01

    Tongue embryonic taste buds begin to differentiate before the onset of gustatory papilla formation in murine. In light of this previous finding, we sought to reexamine the developing sensory innervation as it extends toward the lingual epithelium between E 11.5 and 14.5. Nerve tracings with fluorescent lipophilic dyes followed by confocal microscope examination were used to study the terminal branching of chorda tympani and lingual nerves. At E11.5, we confirmed that the chorda tympani nerve provided for most of the nerve branching in the tongue swellings. At E12.5, we show that the lingual nerve contribution to the overall innervation of the lingual swellings increased to the extent that its ramifications matched those of the chorda tympani nerve. At E13.0, the chorda tympani nerve terminal arborizations appeared more complex than those of the lingual nerve. While the chorda tympani nerve terminal branching appeared close to the lingual epithelium that of the trigeminal nerve remained rather confined to the subepithelial mesenchymal tissue. At E13.5, chorda tympani nerve terminals projected specifically to an ordered set of loci on the tongue dorsum corresponding to the epithelial placodes. In contrast, the lingual nerve terminals remained subepithelial with no branches directed towards the placodes. At E14.5, chorda tympani nerve filopodia first entered the apical epithelium of the developing fungiform papilla. The results suggest that there may be no significant delay between the differentiation of embryonic taste buds and their initial innervation.

  13. Chordae tendinae tumor as the cause of cardioembolic stroke.

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    Dafer, Rima M; Pasnoor, Mamatha; Gorton, Michael E; Gollub, Steven

    2006-01-01

    We describe the case of a chordae tendinae papillary fibroelastoma with patent foramen ovale and interatrial septal aneurysm in a healthy young woman who suffered from acute ischemic right middle cerebral artery infarction.

  14. Objective Tinnitus and the Tensor Tympani Muscle.

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    Rock

    1995-01-01

    Objective tinnitus (OT) may be caused by contraction of the tensor tympani muscle (TTM). The more forcefully the TTM contracts, the greater the intensity of the OT heard. Forceful closure of both eyelids can reflexively cause OT by contracting the TTM. The Forceful Eyelid Closure Syndrome (FECS) was reported at the Proceedings of the Second International Tinnitus Seminar in 1983.(1) FECS consists of several factors: (1) Objective tinnitus (2) An associated waning of hearing primarily of the lower frequencies, as much as 45 dB at 125 Hz, 30 to 40 dB at 250 Hz ascending to the patient's norm at 2000 Hz and approximately a 5 to 10 dB at 4000 Hz and 5 to 20 dB at 8000 Hz (3) Retraction of the manubrium and posterior mid-third of the tympanic membrane (TM) at the malleus-umbo area as seen under the otomicroscope (OM) in 25% (108) of 432 ears examined (4) These same ears were 75% (324) positive for increased impedance at maximum compliance with FEC. Of the patients studied, 25% had no response under the otomicroscope or by impedance audiometry.

  15. Effects of yohimbine on submaxillary salivation in dogs.

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    Montastruc, P.; Berlan, M.; Montastruc, J. L.

    1989-01-01

    1. The effects of yohimbine (0.5 mg kg-1 i.v.) on both resting and parasympathetic and sympathetic stimulation-induced submaxillary salivary responses were investigated in the anaesthetized dog. 2. Salivary secretion was increased significantly for a period of 45 min following an injection of yohimbine. 3. Sectioning of the chorda tympani (but not the cervical sympathetic) nerve abolished the yohimbine-induced increase in resting salivary secretion and potentiated that elicited by electrical stimulation of the chorda tympani nerve. 4. These results show that yohimbine increases submaxillary secretion by inhibition of presynaptic alpha 2-adrenoceptors located on the chorda tympani, which inhibit cholinergic transmission. PMID:2804539

  16. Restoration of quinine-stimulated Fos-immunoreactive neurons in the central nucleus of the amygdala and gustatory cortex following reinnervation or cross-reinnervation of the lingual taste nerves in rats.

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    King, Camille Tessitore; Garcea, Mircea; Spector, Alan C

    2014-08-01

    Remarkably, when lingual gustatory nerves are surgically rerouted to inappropriate taste fields in the tongue, some taste functions recover. We previously demonstrated that quinine-stimulated oromotor rejection reflexes and neural activity (assessed by Fos immunoreactivity) in subregions of hindbrain gustatory nuclei were restored if the posterior tongue, which contains receptor cells that respond strongly to bitter compounds, was cross-reinnervated by the chorda tympani nerve. Such functional recovery was not seen if instead, the anterior tongue, where receptor cells are less responsive to bitter compounds, was cross-reinnervated by the glossopharyngeal nerve, even though this nerve typically responds robustly to bitter substances. Thus, recovery depended more on the taste field being reinnervated than on the nerve itself. Here, the distribution of quinine-stimulated Fos-immunoreactive neurons in two taste-associated forebrain areas was examined in these same rats. In the central nucleus of the amygdala (CeA), a rostrocaudal gradient characterized the normal quinine-stimulated Fos response, with the greatest number of labeled cells situated rostrally. Quinine-stimulated neurons were found throughout the gustatory cortex, but a "hot spot" was observed in its anterior-posterior center in subregions approximating the dysgranular/agranular layers. Fos neurons here and in the rostral CeA were highly correlated with quinine-elicited gapes. Denervation of the posterior tongue eliminated, and its reinnervation by either nerve restored, numbers of quinine-stimulated labeled cells in the rostralmost CeA and in the subregion approximating the dysgranular gustatory cortex. These results underscore the remarkable plasticity of the gustatory system and also help clarify the functional anatomy of neural circuits activated by bitter taste stimulation.

  17. Tonic tensor tympani syndrome in tinnitus and hyperacusis patients: A multi-clinic prevalence study

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    Myriam Westcott

    2013-01-01

    Full Text Available Tonic tensor tympani syndrome (TTTS is an involuntary, anxiety-based condition where the reflex threshold for tensor tympani muscle activity is reduced, causing a frequent spasm. This can trigger aural symptoms from tympanic membrane tension, middle ear ventilation alterations and trigeminal nerve irritability. TTTS is considered to cause the distinctive symptoms of acoustic shock (AS, which can develop after exposure to an unexpected loud sound perceived as highly threatening. Hyperacusis is a dominant AS symptom. Aural pain/blockage without underlying pathology has been noted in tinnitus and hyperacusis patients, without wide acknowledgment. This multiclinic study investigated the prevalence of TTTS symptoms and AS in tinnitus and hyperacusis patients. This study included consecutive patients with tinnitus and/or hyperacusis seen in multiple clinics. Data collected: Symptoms consistent with TTTS (pain/numbness/burning in and around the ear; aural "blockage"; mild vertigo/nausea; "muffled" hearing; tympanic flutter; headache; onset or exacerbation from exposure to loud/intolerable sounds; tinnitus/hyperacusis severity. All patients were medically cleared of underlying pathology, which could cause these symptoms. 60.0% of the total sample (345 patients, 40.6% of tinnitus only patients, 81.1% of hyperacusis patients had ≥1 symptoms (P < 0.001. 68% of severe tinnitus patients, 91.3% of severe hyperacusis patients had ≥1 symptoms (P < 0.001. 19.7% (68/345 of patients in the total sample had AS. 83.8% of AS patients had hyperacusis, 41.2% of non-AS patients had hyperacusis (P < 0.001. The high prevalence of TTTS symptoms suggests they readily develop in tinnitus patients, more particularly with hyperacusis. Along with AS, they should be routinely investigated in history-taking.

  18. Fetal development of the pulley for muscle insertion tendons: A review and new findings related to the tensor tympani tendon.

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    Rodríguez-Vázquez, Jose Francisco; Honkura, Yohei; Katori, Yukio; Murakami, Gen; Abe, Hiroshi

    2017-01-01

    The existence of hard tissue pulleys that act to change the direction of a muscle insertion tendon is well known in the human body. These include (1) the trochlea for the extraocular obliquus superior muscle, (2) the pterygoid hamulus for the tensor veli palatini muscle, (3) the deep sulcus on the plantar aspect of the cuboid bone for the peroneus longus tendon, (4) the lesser sciatic notch for the obturator internus muscle, and (5) the bony trochleariformis process for the tensor tympani muscle tendon. In addition, (6) the stapedius muscle tendon shows a lesser or greater angulation at the pyramidal eminence of the temporal bone. Our recent studies have shown that the development of pulleys Nos. 1 and 2 can be explained by a change in the topographical relationship between the pulley and the tendon, that of pulley No. 3 by the rapidly growing calcaneus pushing the tendon, and that of pulley No. 4 by migration of the insertion along the sciatic nerve and gluteus medius tendon. Therefore, in Nos. 1-4, an initially direct tendon curves secondarily and obtains an attachment to the pulley. In case No. 6, the terminal part of the stapedius tendon originates secondarily from the interzone mesenchymal tissue of the incudostapedial joint. In the case of pulley No. 5, we newly demonstrated that its initial phase of development was similar to No. 6, but the tensor tympani tendon achieved a right-angled turn under guidance by a specific fibrous tissue and it migrated along the growing malleus manubrium.

  19. A study of fucoidan from the brown seaweed Chorda filum.

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    Chizhov, A O; Dell, A; Morris, H R; Haslam, S M; McDowell, R A; Shashkov, A S; Nifant'ev, N E; Khatuntseva, E A; Usov, A I

    1999-07-20

    Fucoidan fractions from the brown seaweed Chorda filum were studied using solvolytic desulfation. Methylation analysis and NMR spectroscopy were applied for native and desulfated polysaccharides. Homofucan sulfate from C. filum was shown to contain poly-alpha-(1-->3)-fucopyranoside backbone with a high degree of branching, mainly of alpha-(1-->2)-linked single units. Some fucopyranose residues are sulfated at O-4 (mainly) and O-2 positions. Some alpha-(1-->3)-linked fucose residues were shown by NMR to be 2-O-acetylated. The 1H and 13C NMR spectra of desulfated, deacetylated fucan were completely assigned. The spectral data obtained correspond to a quasiregular polysaccharide structure with a branched hexasaccharide repeating unit. Other fucoidan fractions from C. filum have more complex carbohydrate composition and give rather complex methylation patterns. [formula: see text

  20. Post-Traumatic Chordae Rupture of Tricuspid Valve

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    Kyomars Abbasi

    2015-10-01

    Full Text Available Blunt injury to the chest can affect any one or all components of the chest wall and thoracic cavity. The clinical presentation of patients with blunt chest trauma varies widely and ranges from minor reports of pain to florid shock. Traumatic tricuspid valve regurgitation is a rare cardiovascular complication of blunt chest trauma. Tricuspid valve regurgitation is usually begotten by disorders that cause the right ventricle to enlarge. Diagnosis is made by physical examination findings and is confirmed by echocardiography. We report two cases of severe tricuspid regurgitation secondary to the rupture of the chordae tendineae of the anterior leaflet following non-penetrating chest trauma. Both patients had uneventful postoperative courses.

  1. Ruptured chordae tendineae in acromegaly. An autopsy case.

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    Kaku, T; Nakashima, Y; Ichiyasu, H; Soejima, M; Baba, K; Kuroiwa, A

    1991-07-01

    A 57-year-old woman with acromegaly associated with mitral chordal rupture is reported. She was noted to have abnormal development in the size of her hands and feet in childhood. She occasionally suffered from shortness of breath on exertion and nocturnal dyspnea for several years, and was diagnosed and treated as having congestive heart failure due to valvular heart disease. On admission to our hospital, chordal rupture was suspected on the basis of M-mode and two-dimensional echocardiography. Seven years after discharge, she died of congestive heart failure. On autopsy, the heart weight and ventricular wall thickness were increased. Rupture of the posterior chordae was confirmed, but evidence of an old myocardial infarction was not found. There was severe interstitial fibrosis in the left ventricular wall. A possible etiology of the chordal rupture in this case was thought to be the excessive stretching caused by the disproportional visceromegaly of the heart.

  2. Surgical treatment of anterior mitral valve prolapse using artificial chordae loop

    Institute of Scientific and Technical Information of China (English)

    LI Ji-yong; ZHOU Qi-wen; ZHANG Jian-qun; ZHANG Fu-en; HE Yi-hua

    2010-01-01

    @@ Artificial chordae replacement with expanded polytetrafluoroethylene (ePTFE; Gore-Tex, W.L.Gore and Associates Inc., Flagstaff, AZ, USA) is an established technique for mitral valve repair with excellent long-term results.

  3. The use of a high-power laser on swine mitral valve chordae tendineae.

    Science.gov (United States)

    Pinto, Nathali Cordeiro; Chavantes, M Cristina; Zezell, Denise; Deana, Alessandro; Benetti, Carolina; Marcos, Rodrigo Labat; Lopes, Luciana Almeida; Martins, Rodrigo A B Lopes; Aiello, Vera Demarchi; Jatene, Fabio Biscegli; Pomerantzeff, Pablo M A

    2016-08-01

    Worldwide, rheumatic fever remains a significant cause of mitral valve insufficiency. It is responsible for approximately 90 % of early childhood valvular surgeries in Brazil. Elongated or flail chordae are frequently responsible and require surgical correction. The purpose of this study was to analyze and compare the histological tissues of the mitral valve chordae and the mechanical resistance generated by the chordae, both with and without the application of a high-power laser. Twenty normal porcine mitral valve chordae were measured and divided randomly into the following two groups: control group (not subjected to a high-power laser) and laser group (subjected to photonic irradiation). Laser surgery was performed under controlled conditions, using following parameters: λ = 980-nm wavelength, power = 3 W, and energy = 60 J. A mechanical test machine was used in combination with a subsequent histological study to measure chordae tensile properties. A histological analysis demonstrated a typical collagen bundle arrangement in the control group; however, under a particular reached temperature range (48), the collagen bundles assumed different arrangements in the laser group. Significant reductions in the chordae tendineae lengths and changes in their resistance in the laser group were observed, as these chordae exhibited less rigid fibers. The chordae tendineae of normal porcine valves subjected to a high-power laser exhibited its length reduction and less stiffness compared to the control group. A histological analysis of the laser treatment specimens demonstrated differences in collagen bundle spatial organization, following slight changes into tissue temperature.

  4. Short term and long term subjective taste disorder after middle ear cleft surgery

    Directory of Open Access Journals (Sweden)

    Ayaz Rehman

    2013-01-01

    Full Text Available Aim: The present study is a prospective study that looks into the prevalence of chorda tympani nerve injury and related symptoms following varying degrees of trauma to the nerve during four common types of middle-ear operations; namely, Tympanomastoid operations, myringoplasty, Tympanoplasty and Exploratory tympanotomy. Materials and Methods: 178 patients who underwent middle ear cleft surgery were included in this prospective study. Childrens below 20 years and patients with other potential cause of taste disturbance were excluded. Patients were given a single questionnaire, so as to assess their post-operative taste disturbance. Patient name, Age, Sex, Type of middle ear surgery, side of surgery were recorded. Any change in sense of taste immediately (after 2-4 weeks or delayed (2-3 yearswere recorded. Results: The number of patients with Chorda tympani nerve-related symptoms varied widely between these four groups. Increased occurrence of the nerve related symptoms were observed in Tympanomastoid and Myringoplasty, and a prolonged recovery time were observed in the tympanomastoid group. Stretching of the nerve produced more symptomatic cases than thermal injury or drying. Conclusion: It is important to inform patients about the possibility of Chorda Tympani Nerve injury during middle-ear operations, and it should also be emphasized that symptoms related to Chorda Tympani Nerve injury can occur irrespective of the type of damage to the nerve.

  5. Aortic valve repair via neo-chordae technique: mechanistic insight through numerical modelling.

    Science.gov (United States)

    Votta, Emiliano; Paroni, Luca; Conti, Carlo A; Pelosi, Alessandra; Mangini, Andrea; D'Alesio, Paolo; Vismara, Riccardo; Antona, Carlo; Redaelli, Alberto

    2012-05-01

    Recently, the neo-chordae technique (NCT) was proposed to stabilize the surgical correction of isolated aortic valve (AV) prolapse. Neo-chordae are inserted into the corrected leaflet to drive its closure by minimal tensions and prevent relapses. In a previous in vitro study we analysed the NCT effects on healthy aortic roots (ARs). Here we extend that analysis via finite element models (FEMs). After successfully replicating the experimental conditions for validation purposes, we modified our AR FEM, obtaining a continent AV with minor isolated prolapse, thus representing a realistic clinical scenario. We then simulated the NCT, and systematically assessed the acute effects of changing neo-chordae length, opening angle, asymmetry and insertion on the aorta. In the baseline configuration the NCT restored physiological AV dynamics and coaptation, without inducing abnormal leaflet stresses. This outcome was notably sensitive only to neo-chordae length, suggesting that the NCT is a potentially easy-to-standardize technique. However, this parameter is crucial: major shortenings (6 mm) prevent coaptation and increase leaflet stresses by 359 kPa, beyond the yield limit. Minor shortenings (2-4 mm) only induce a negligible stress increase and mild leaflet tethering, which however may hamper the long-term surgical outcome.

  6. Effects of stimulus duration on gustatory evoked potentials

    DEFF Research Database (Denmark)

    Rotvel, Camilla Arndal; Møller, Stine; Kivisaar, Kätlin

    sequence with 60 repetitions. The stimuli were delivered to the center of the tongue apex innervated by chorda tympani nerve. Brain response was recorded with 128 electrodes and the gustatory event related potential (GEP) was estimated by coherent averaging of all artefact free epochs. Focusing on the FC5...

  7. The Topography and Differentiation of Facial Nerve in Middle Ear Surgery%中耳炎手术中面神经定位和辨认的临床研究

    Institute of Scientific and Technical Information of China (English)

    赵东; 郭龙梅; 徐平

    2012-01-01

    Objective To investigate the topography and differentiation of the facial nerves in the middle car surgery. Methods From January 2008 to December 2010, radical mastoidectomy or tympanoplasty was administered in 185 patients with chronic otitis media and choicstcatoma otitis media, and analyzed the exploration of the surgery. Results 58 cases of exposed facial nerves were identified and the topography of the tympanic segments in facial nerve was located as the cochlcariform, odontoid, and proccssus brcvis incudis. 33 cochlcariform process disappeared, 25 odontoid process damaged, and 19 proccssus brcvis damaged or displatcd. 12 cochlcariform process and 14 digastric ridge damaged; chorda tympani nerve also could locate the facial nerves and 33 variations were noted. The relationship between facial nerves and granulation tissues indicated that there were 78 cases of the granulation tissue covering the surface of the nerve, 47 cases of the granulation tissue enclosing the nerve and 24 cases of the granulation tissue came from the facial nerve itself. Conclusion We can reduce and prevent the occurrence of facial nerve injuries by being familiar with the practices and variations of facial nerves within the normal temporal bones, and become skilled in basic operations%目的 探讨中耳炎手术中面神经的定位和辨认.方法 回顾性分析2008年1月~2010年12月185例行开放式乳突根治术或加鼓室成形术的慢性化脓性中耳炎及胆脂瘤中耳炎患者的手术资料,对术中面神经探查定位及辨认方法进行分析总结.结果 ①185例中,面神经探查发现58例面神经裸露;②面神经鼓室段定位标志为匙突、齿突、砧骨短突,185例中33例匙突消失,25例齿突遭到破坏,19例砧骨短突破坏或移位;乳突段定位标志为水平半规管、二腹肌脊,185例中12例水平半规管遭破坏,14例二腹肌脊被破坏;33例鼓索神经变异;③面神经与肉芽组织的关系为肉

  8. Effects of Sacrificing Tensor Tympani Muscle Tendon When Manubrium of Malleus Is Foreshortened in Type I Tympanoplasty

    Directory of Open Access Journals (Sweden)

    Sohil Vadiya

    2015-01-01

    Full Text Available The current study aims at observing effects of sacrificing the tensor tympani tendon when manubrium of malleus is foreshortened or retracted on graft uptake, hearing improvement, and occurrence of complications if any during type I tympanoplasty surgery for central perforations. 42 patients were included in group A where the tensor tendon was sectioned and 42 patients were included in group B where the tensor tympani tendon was retained and kept intact. Graft uptake rates are very good in both groups but hearing improvement was found significantly better in group A than group B. No unusual or undesired complications were seen in any of the cases. Sectioning of tensor tympani tendon is safe and effective procedure in cases where manubrium is foreshortened.

  9. Left atrial myxoma, ruptured chordae tendinae causing mitral regurgitation and coronary artery disease

    Directory of Open Access Journals (Sweden)

    Bhupesh Kumar

    2014-01-01

    Full Text Available Mitral regurgitation is uncommon with left atrial myxoma. The echocardiographic assessment of presence of mitral regurgitation and its severity are impaired by the presence of left atrial myxoma. We describe an uncommon association of left atrial myxoma with coronary artery disease and mitral regurgitation. MR was reported as mild on pre-operative transthoracic echocardiography but found to be severe due to ruptured chordae tendinae during intra-operative transesophageal echocardiography, which lead to change in the surgical plan to mitral valve replacement in addition to excision of myxoma.

  10. Ruptured chordae tendineae of the posterior leaflet of the tricuspid valve as a cause of tricuspid regurgitation following blunt chest trauma.

    Science.gov (United States)

    dos Santos, J; de Marchi, C H; Bestetti, R B; Corbucci, H A; Pavarino, P R

    2001-01-01

    A 12-year-old boy suffered a blunt chest trauma. Some hours later, a pulsatile bilateral jugular venous distension, a holosystolic murmur heard at the low parasternal border and hepatomegaly were observed. On echocardiography, ruptured chordae tendineae of the posterior leaflet of the tricuspid valve, as well as tricuspid regurgitation were detected. He remained asymptomatic during hospital stay and was discharged home in good condition. Thus, isolated ruptured chordae tendineae of the posterior leaflet of the tricuspid valve is another cause of tricuspid regurgitation following blunt chest trauma.

  11. 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 ...

  12. Simulation on Mechanical Properties of Triple -helix Artificial Chordae Structure%三螺旋人工腱索结构的力学性能仿真验证

    Institute of Scientific and Technical Information of China (English)

    常丽南; 宋成利; 沈桐; 梅举; 戴黄栋

    2015-01-01

    Bionic equivalent triple -helix artificial chordae structure was estabilished based on the structure of real heart mitral valve chordae.ABAQUS was applied to simulate the tensile tests.Simulation results were analyzed and compared with real chordae (marginal、basal and strut chordae)tensile properties to vertify feasibility and correctness of model.Results showed that the maximum stress of spiral chordae was consistent with the actual average maximum stress.Besides,force displacement curves of all kinds of chor-dae were basically in accordance with test curves.This proposed triple -helix equivalent model is closer to the real chordae’s proper-ties and can reduce stress concentration on mitral leaflets,which indicating a new direction to the structure improvements of artificial chordae materials and providing reference for finite element researches on soft tissue tensile properties module.%基于真实心脏二尖瓣腱索结构,利用仿生学类比方法提出整体三螺旋人工腱索等效替代模型,应用 ABAQUS 对其进行模拟拉伸测试,并与真实拉伸试验下猪心二尖瓣腱索(边缘腱索、基底腱索与支撑腱索)的力学性能进行对比分析,从而验证此等效模型的可行性与有效性。结果表明:三螺旋人工腱索结构所能承受的最大应力与实际试验中的平均最大应力一致,且相应腱索种类的拉力位移曲线与试验曲线基本相符。本研究提出的三螺旋人工腱索结构接近于真实腱索特性,可缓解二尖瓣膜上应力集中现象,为人工腱索材料的结构改进指明了新方向,同时,仿真过程对有限元模拟生物软组织拉伸性能模块提供了参考价值。

  13. Experimental induction of abdominal tympany, abomasitis, and abomasal ulceration by intraruminal inoculation of Clostridium perfringens type A in neonatal calves.

    Science.gov (United States)

    Roeder, B L; Chengappa, M M; Nagaraja, T G; Avery, T B; Kennedy, G A

    1988-02-01

    The etiologic role of Clostridum perfringens type A in the acute abdominal syndrome characterized by abomasal and rumen tympany, abomasitis, and abomasal ulceration was investigated in neonatal calves. Eight calves, 4 to 12 days old, were inoculated intraruminally with toxigenic C perfringens type A. Before and after C perfringens inoculation, blood samples were collected from all calves for blood gas and serum biochemical analysis and for determination of serum copper concentration; ruminal fluid was obtained for isolation of C perfringens. Calves were monitored daily for clinical signs of the syndrome and, depending on the severity of clinical signs, they were either euthanatized or redosed within 4 to 7 days. After necropsy, specimens obtained from the abomasum and rumen for macroscopic and microscopic examination and for anaerobic bacteriologic culture were processed in routine manner. Intraruminal inoculation of C perfringens type A into healthy calves induced anorexia, depression, bloat, diarrhea, and in some calves, death. Serum copper concentration was within normal range. Necropsy revealed variable degrees of abomasitis, petechial and ecchymotic hemorrhages, and ulcers (ranging from pinpoint to nearly perforate) in the abomasum. Seven of those calves also had multiple trichobezoars in the rumen. These necropsy findings were not seen in calves (controls) given distilled H2O only. In affected calves, acute abdominal syndrome was unrelated to copper deficiency, and C perfringens type A given intraruminally was able to induce clinical signs similar to those of the naturally acquired disease.

  14. Burning Mouth Syndrome and Other Oral Sensory Disorders: A Unifying Hypothesis

    Directory of Open Access Journals (Sweden)

    Miriam Grushka

    2003-01-01

    Full Text Available Burning Mouth Syndrome (BMS is a sensory disorder which results in constant, bilateral burning pain of the tongue, lips, and other oral mucous membranes. Atypical odontalgia (AO is another sensory disorder, usually defined as a toothache-like pain for which no dental cause can be identified. Previous literature has suggested that AO is often associated with a concomitant temporomandibular disorder (TMD. This hypothesis paper explores the possibility that BMS, AO and TMD can be related through hyperactivity of both the sensory and motor components of the trigeminal nerve following loss of central inhibition as a result of taste damage in the chorda tympani and/or the glossopharyngeal nerves.

  15. The accuracy of echocardiography versus surgical and pathological classification of patients with ruptured mitral chordae tendineae: a large study in a Chinese cardiovascular center

    Directory of Open Access Journals (Sweden)

    Bai Zhigang

    2011-07-01

    Full Text Available Abstract Background The accuracy of echocardiography versus surgical and pathological classification of patients with ruptured mitral chordae tendineae (RMCT has not yet been investigated with a large study. Methods Clinical, hemodynamic, surgical, and pathological findings were reviewed for 242 patients with a preoperative diagnosis of RMCT that required mitral valvular surgery. Subjects were consecutive in-patients at Fuwai Hospital in 2002-2008. Patients were evaluated by thoracic echocardiography (TTE and transesophageal echocardiography (TEE. RMCT cases were classified by location as anterior or posterior, and classified by degree as partial or complete RMCT, according to surgical findings. RMCT cases were also classified by pathology into four groups: myxomatous degeneration, chronic rheumatic valvulitis (CRV, infective endocarditis and others. Results Echocardiography showed that most patients had a flail mitral valve, moderate to severe mitral regurgitation, a dilated heart chamber, mild to moderate pulmonary artery hypertension and good heart function. The diagnostic accuracy for RMCT was 96.7% for TTE and 100% for TEE compared with surgical findings. Preliminary experiments demonstrated that the sensitivity and specificity of diagnosing anterior, posterior and partial RMCT were high, but the sensitivity of diagnosing complete RMCT was low. Surgical procedures for RMCT depended on the location of ruptured chordae tendineae, with no relationship between surgical procedure and complete or partial RMCT. The echocardiographic characteristics of RMCT included valvular thickening, extended subvalvular chordae, echo enhancement, abnormal echo or vegetation, combined with aortic valve damage in the four groups classified by pathology. The incidence of extended subvalvular chordae in the myxomatous group was higher than that in the other groups, and valve thickening in combination with AV damage in the CRV group was higher than that in the other

  16. Regional pulmonary edema caused by acute mitral insufficiency after rupture of chordae tendinae with prolaps of the posterior mitral valve; Regionales Lungenoedem bei akuter Mitralinsuffizienz nach Chordae-tendineae-Abriss mit Prolaps des posterioren Mitralsegels

    Energy Technology Data Exchange (ETDEWEB)

    Mauser, M.; Wiedemer, B.; Fleischmann, D. [Klinikum Lahr (Germany). Medizinische Klinik; Billmann, P. [Klinikum Lahr (Germany). Inst. fuer Radiologie; Ennker, J. [Herzzentrum Lahr/Baden (Germany). Abt. fuer Herzchirurgie

    2003-07-01

    An unilateral or predominantly lobar pulmonary edema is an unusual clinical or radiological finding, often misdiagnosed as one of the more common causes of focal lung disease. We report 2 cases of a regional pulmonary edema caused by the acute onset of a severe mitral insufficiency after the rupture of chordae tendinae resulting in a prolaps of the posterior mitral leaflet. In both cases the regional pulmonary edema was initially misdiagnosed as a pneumonic infiltration, which delayed the cardiological diagnostical procedures and the surgical intervention. The mechanism of the regional edema is an excentric regurgitation jet into the left atrium, which is usually directed to the orifice of the right upper lobe pulmonary vein which increases the hydrostatic vascular pressure in the corresponding lung segment. For the confirmation of the diagnosis, transesophageal echogradiographye is helpful in documenting the direction of the regurgitant flow and detecting differential gradients between the right and left pulmonary venous systems. The pulmonary infiltrations, which persisted for several weeks, dissappeared within a few days after surgical mitral-valve-reconstruction in both cases. (orig.) [German] Ein einseitiges oder ueberwiegend lobaeres Lungenoedem ist ein seltener klinischer und radiologischer Befund, der haeufig initial zur Fehldiagnose einer weitaus haeufigeren fokaleren Lungenerkrankung fuehrt. Wir berichten ueber 2 Faelle, bei denen nach Auftreten einer akuten Mitralinsuffizienz auf dem Boden eines Sehnenfadenabrisses am posterioren Mitralsegel ein regionales Lungenoedem zunaechst als pneumonisches Infiltrat fehlgedeutet wurde, was die weitere kardiologische Diagnostik und chirurgische Therapie verzoegerte. Wie in den wenigen in der Literatur beschriebenen Faellen findet sich hierbei ein exzentrischer Regurgitationsjet in den linken Vorhof, der ueblicherweise auf die Einmuendung der rechten oberen Pulmonalvene gerichtet ist und in dem dazugehoerigen

  17. 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.

  18. 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 ...

  19. Vagus Nerve Stimulation

    Science.gov (United States)

    Vagus nerve stimulation Overview By Mayo Clinic Staff Vagus nerve stimulation is a procedure that involves implantation of a device that stimulates the vagus nerve with electrical impulses. There's one vagus nerve on ...

  20. Ulnar nerve dysfunction

    Science.gov (United States)

    Neuropathy - ulnar nerve; Ulnar nerve palsy; Mononeuropathy; Cubital tunnel syndrome ... neuropathy occurs when there is damage to the ulnar nerve. This ... syndrome may result. When damage destroys the nerve covering ( ...

  1. Fetal Tendinous Connection Between the Tensor Tympani and Tensor Veli Palatini Muscles: A Single Digastric Muscle Acting for Morphogenesis of the Cranial Base.

    Science.gov (United States)

    Rodríguez-Vázquez, José Francisco; Sakiyama, Koji; Abe, Hiroshi; Amano, Osamu; Murakami, Gen

    2016-04-01

    Some researchers contend that in adults the tensor tympani muscle (TT) connects with the tensor veli palatini muscle (TVP) by an intermediate tendon, in disagreement with the other researchers. To resolve this controversy, we examined serial sections of 50 human embryos and fetuses at 6-17 weeks of development. At 6 weeks, in the first pharyngeal arch, a mesenchymal connection was found first to divide a single anlage into the TT and TVP. At and after 7 weeks, the TT was connected continuously with the TVP by a definite tendinous tissue mediolaterally crossing the pharyngotympanic tube. At 11 weeks another fascia was visible covering the cranial and lateral sides of the tube. This "gonial fascia" had two thickened borders: the superior one corresponded to a part of the connecting tendon between the TT and TVP; the inferior one was a fibrous band ending at the os goniale near the lateral end of the TVP. In association with the gonial fascia, the fetal TT and TVP seemed to provide a functional complex. The TT-TVP complex might first help elevate the palatal shelves in association with the developing tongue. Next, the tubal passage, maintained by contraction of the muscle complex, seems to facilitate the removal of loose mesenchymal tissues from the tympanic cavity. Third, the muscle complex most likely determined the final morphology of the pterygoid process. Consequently, despite the controversial morphologies in adults, the TT and TVP seemed to make a single digastric muscle acting for the morphogenesis of the cranial base.

  2. Recurrent hypogeusia in a patient with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP).

    Science.gov (United States)

    Kawaguchi, Norihiko; Sugeno, Naoto; Endo, Kaoru; Miura, Emiko; Misu, Tatsuro; Nakashima, Ichiro; Itoyama, Yasuto

    2012-04-01

    Hypogeusia, a condition with diminished sense of taste, is caused by several conditions, including zinc deficiency and as a side-effect of drugs, but is not common in neurological disorders. A 55-year-old Japanese man with a 30-year history of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) presented with hypogeusia during hospitalization for a recurrence of CIDP. The hypogeusia improved after treatment with high-dose intravenous methylprednisolone (HIMP). Two years later, hypogeusia developed again. A complete taste deficit was revealed by a filter paper test. Brain MRI showed enhancement of the bilateral facial nerve ganglia. Hypogeusia was partially ameliorated after extensive immunosuppressive therapy with repeated HIMP and plasma exchange. Improvement was more prominent in the area innervated by the chorda tympani nerve than that innervated by the glossopharyngeal nerve. To our knowledge, this is the first report of recurrent hypogeusia, which might be caused by cranial nerve injury associated with CIDP.

  3. Yohimbine increases submaxillary kallikrein release into the saliva in dogs: evidence for alpha 2-adrenoceptor-mediated inhibition of cholinergic pathways.

    Science.gov (United States)

    Girolami, J. P.; Bascands, J. L.; Pécher, C.; Berlan, M.; Montastruc, J. L.; Montastruc, P.

    1991-01-01

    1. The effects of the alpha 2-adrenoceptor antagonist, yohimbine (0.5 mg kg-1, i.v.) on basal, sympathetic and parasympathetic stimulation-induced submaxillary kallikrein release were investigated in the anaesthetized dog. Kallikrein was measured by its kininogenase activity before and after trypsin activation which also allowed a study of the proportion of active to total enzyme. 2. Yohimbine induced a rapid, three fold increase in basal kallikrein release correlated with an increase in salivary flow rate which lasted for 60 min following injection. 3. Sectioning the chorda tympani did not affect basal kallikrein release but abolished yohimbine-induced rise in salivary kallikrein secretion. 4. Parasympathetic stimulation alone induced a 3 to 4 fold increase in basal kallikrein release correlated with an increase in salivary flow rate. Yohimbine induced a significant additional increase in parasympathetic-stimulated kallikrein release. 5. When the cervical sympathetic nerve was sectioned the basal kallikrein release decreased by 30 to 40%. 6. Sympathetic stimulation alone also induced a 3 to 4 fold increase in basal kallikrein. This was not correlated with the salivary flow and unaffected by yohimbine. 7. The results indicate that yohimbine increases submaxillary kallikrein release into the saliva by inhibition of presynaptic alpha 2-adrenoceptors located on the chorda tympani nerve endings. PMID:1849766

  4. 鼓索神经切断导致味觉障碍药物治疗的效果观察

    Institute of Scientific and Technical Information of China (English)

    李栋; 杜欢乐; 尤慧华; 冯国飞

    2014-01-01

    目的:观察鼓室成形术中切断鼓索神经导致的味觉障碍患者应用药物干预的疗效,并分析常规中耳炎手术中有无保留鼓索神经的必要性。方法选取鼓室成形术中切断鼓索神经引起味觉障碍患者共60例,随机分为神经营养药(甲钴胺)及改善微循环药(复方丹参)治疗组和常用方法即随访观察味觉恢复组(对照组),各30例。结果所有患者均得到严格术后随访,随访均终止于术后12个月。参照味觉辨认三分法,治疗组味觉恢复26例,对照组17例,差异有统计学意义(P=0.01)。结论在鼓室成形术中切断鼓索神经导致的味觉障碍后,药物治疗有助于患者味觉的恢复;中耳手术中勿损伤鼓索神经,尤其是对于双侧中耳疾患的患者,保留鼓索神经有其必要性。%Objective The purpose of this study is to investigate whether clinical drug intervention is feasible and necessary for patients with dysgeusia caused by chorda tympani nerve transection in tympanoplasty,and to evaluate the necessity of preserving chorda tympani nerve in routine surgical procedure for otitis media. Methods Sixty patients with dysgeusia caused by chorda tympani nerve transection in tympanoplasty were divided into two groups,with 30 patients in each group. Patients in experimental group received drug treatment while those in control group did not receive any treatment. Results After follow up of 12 months,recovery from dysgeusia was found in 26 and 17 patients in experimental and control group respectively(P=0.01). Conclusions Drug treatment is feasible and necessary for patients with dysgeusia caused by chorda tympani nerve transection in tympanoplasty. Chorda tympani nerve injury should be avoided during middle ear operation,especially for patients with bilateral otitis media.

  5. 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 ...

  6. 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; ...

  7. The Physics of Nerves

    CERN Document Server

    Heimburg, Thomas

    2010-01-01

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

  8. Optic nerve oxygenation

    DEFF Research Database (Denmark)

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

    2005-01-01

    -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...... 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...

  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. 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.

  11. Imaging the hypoglossal nerve

    Energy Technology Data Exchange (ETDEWEB)

    Alves, Pedro [Department of Radiology, Centro Hospitalar de Lisboa Central-Hospital de Sao Jose, Rua Jose Antonio Serrano, 1150-199 Lisboa Codex (Portugal)], E-mail: tojais.pedro@gmail.com

    2010-05-15

    The hypoglossal nerve is a pure motor nerve. It provides motor control to the intrinsic and extrinsic tongue muscles thus being essential for normal tongue movement and coordination. In order to design a useful imaging approach and a working differential diagnosis in cases of hypoglossal nerve damage one has to have a good knowledge of the normal anatomy of the nerve trunk and its main branches. A successful imaging evaluation to hypoglossal diseases always requires high resolution studies due to the small size of the structures being studied. MRI is the preferred modality to directly visualize the nerve, while CT is superior in displaying the bony anatomy of the neurovascular foramina of the skull base. Also, while CT is only able to detect nerve pathology by indirect signs, such as bony expansion of the hypoglossal canal, MRI is able to visualize directly the causative pathological process as in the case of small tumors, or infectious/inflammatory processes affecting the nerve. The easiest way to approach the study of the hypoglossal nerve is to divide it in its main segments: intra-axial, cisternal, skull base and extracranial segment, tailoring the imaging technique to each anatomical area while bearing in mind the main disease entities affecting each segment.

  12. Suprascapular nerve palsy.

    Science.gov (United States)

    Moskowitz, E; Rashkoff, E S

    1989-11-01

    Isolated traumatic suprascapular nerve palsy without associated fracture is a rare occurrence. Localized segmental muscle atrophy limited to the supraspinatus and infraspinatus muscles associated with weakness in initiating abduction and in external rotation of the shoulder should suggest the diagnosis. Electromyography will confirm the diagnosis by excluding nerve root and brachial plexus involvement with denervation potentials limited to the supraspinatus and infraspinatus muscles.

  13. 22例保留前瓣叶的二尖瓣膜置换术疗效观察%The clinical observation of 22 preservation anterior leaflet with the chordae in mitral valve replacement

    Institute of Scientific and Technical Information of China (English)

    朱逸; 方良伟; 田小丰; 贡力

    2011-01-01

    Objective: To evaluate the effect of preservation anterior leaflet with the chordae to left ventricular function in mitral valve replacement. Methods: 48 patients in two groups were all performed mitral valve replacement under extracorporeal circulation, in which 22 cases reserved anterior leaflet with the chordae (observation group), and the other 26 cases were not reserved (control group). Then evaluated the change of LVEDV, LVESV and LVEF of two groups in pre-operation and 1 month after post-operation by echocardiography. Results: There were no early operative death in observation group,and only one operative death in control group. The echocardiography showed LVEDV and LVESV were decreased significantly, and LVEF was significantly enhanced than pre-operation in two groups (P<0.05). Conclusion: The preservation anterior leaflet with the chordae in mitral valve replacement can improve left ventricular function compared with the traditonal mitral valve replacement.%目的:评估二尖瓣置换术中保留前瓣叶及其腱索对左心室功能的影响.方法:48例患者均在体外循环下进行二尖瓣置换手术,其中22例保留了二尖瓣前叶及其腱索(观察组),26例未保留瓣叶及其腱索(对照组).采用超声心动图评估测量两组患者术前和术后1个月左心室舒张末容积(LVEDV)、左心室收缩末容积(LVESV)和左心室射血分数(LVEF)等变化.结果:观察组无手术早期死亡病例;对照组手术早期死亡1例(3.8%,1/26),超声心动图显示,两组LVEDV、LVESV均较术前明显缩小(P<0.05),LVEF较术前明显提高(P<0.05).结论:保留前瓣及其腱索的二尖瓣置换术对左心室功能的改善优于传统不保留瓣膜的二尖瓣置换术.

  14. 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.

  15. 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.

  16. 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....

  17. 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 ...

  18. 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 ...

  19. 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. ...

  20. 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 ...

  1. 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.

  2. Conjoined lumbosacral nerve roots

    Directory of Open Access Journals (Sweden)

    Atila Yılmaz

    2012-03-01

    Full Text Available Lumbosacral nerve root anomalies are a rare group ofcongenital anatomical anomalies. Various types of anomaliesof the lumbosacral nerve roots have been documentedin the available international literature. Ttheseanomalies may consist of a bifid, conjoined structure, ofa transverse course or of a characteristic anastomizedappearance. Firstly described as an incidental findingduring autopsies or surgical procedures performed forlumbar disk herniations and often asymptomatic, lumbosacralnerve root anomalies have been more frequentlydescribed in the last years due to the advances made inradiological diagnosis.

  3. Anatomical study of sciatic nerve and common peroneal nerve compression

    Institute of Scientific and Technical Information of China (English)

    Mingzhao Jia; Qing Xia; Jinmin Sun; Qiang Zhou; Weidong Wang

    2008-01-01

    BACKGROUND: Many diseases of the common peroneal nerve are a result of sciatic nerve injury. The present study addresses whether anatomical positioning of the sciatic nerve is responsible for these injuries. OBJECTIVE: To analyze anatomical causes of sciatic nerve and common peroneal nerve injury by studying the relationship between the sciatic nerve and piriformis. DESIGN, TIME AND SETTING: Observe and measure repeatedly. The experiment was conducted in the Department of Anatomy, Tianjin Medical College between January and June 2005. MATERIALS: Fifty-two adult cadavers 33 males and 19 females, with a total of 104 hemispheres, and fixed with formaldehyde, were provided by Tianjin Medical College and Tianjin Medical University. METHODS: A posterior cut was made from the lumbosacral region to the upper leg, fully exposing the piriformis and path of the sciatic nerve. MAIN OUTCOME MEASURES: (1) Anatomical characteristics of the tibial nerve and common peroneal nerve. (2) According to different areas where the sciatic nerve crosses the piriformis, the study was divided into two types--normal and abnormal. Normal is considered to be when the sciatic nerve passes through the infrapiriform foramen. Remaining pathways are considered to be abnormal. (3) Observe the relationship between the suprapiriform foramen, infrapiriform foramen, as well as the superior and inferior space of piriformis. RESULTS: (1) The nerve tract inside the common peroneal nerve is smaller and thinner, with less connective tissue than the tibial nerve. When pathological changes or variations of the piriformis, or over-abduction of the hip joint, occur, injury to the common peroneal nerve often arises due to blockage and compression. (2) A total of 76 hemispheres (73.08%) were normal, 28 were abnormal (26.92%). The piriformis can be injured, and the sciatic nerve can become compressed, when the hip joint undergoes intorsion, extorsion, or abduction. (3) The structures between the infrapiriform and

  4. 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.

  5. Repair of sciatic nerve defects using tissue engineered nerves*

    Institute of Scientific and Technical Information of China (English)

    Caishun Zhang; Gang Lv

    2013-01-01

    In this study, we constructed tissue-engineered nerves with acel ular nerve al ografts in Sprague-Dawley rats, which were prepared using chemical detergents-enzymatic digestion and mechanical methods, in combination with bone marrow mesenchymal stem cel s of Wistar rats cultured in vitro, to repair 15 mm sciatic bone defects in Wistar rats. At postoperative 12 weeks, electrophysiological detection results showed that the conduction velocity of regenerated nerve after repair with tis-sue-engineered nerves was similar to that after autologous nerve grafting, and was higher than that after repair with acel ular nerve al ografts. Immunohistochemical staining revealed that motor endplates with acetylcholinesterase-positive nerve fibers were orderly arranged in the middle and superior parts of the gastrocnemius muscle;regenerated nerve tracts and sprouted branches were connected with motor endplates, as shown by acetylcholinesterase histochemistry combined with silver staining. The wet weight ratio of the tibialis anterior muscle at the affected contralateral hind limb was similar to the sciatic nerve after repair with autologous nerve grafts, and higher than that after repair with acel ular nerve al ografts. The hind limb motor function at the affected side was significantly improved, indicating that acel ular nerve al ografts combined with bone marrow me-senchymal stem cel bridging could promote functional recovery of rats with sciatic nerve defects.

  6. 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.

  7. [Peripheral facial nerve palsy].

    Science.gov (United States)

    Pons, Y; Ukkola-Pons, E; Ballivet de Régloix, S; Champagne, C; Raynal, M; Lepage, P; Kossowski, M

    2013-06-01

    Facial palsy can be defined as a decrease in function of the facial nerve, the primary motor nerve of the facial muscles. When the facial palsy is peripheral, it affects both the superior and inferior areas of the face as opposed to central palsies, which affect only the inferior portion. The main cause of peripheral facial palsies is Bell's palsy, which remains a diagnosis of exclusion. The prognosis is good in most cases. In cases with significant cosmetic sequelae, a variety of surgical procedures are available (such as hypoglossal-facial anastomosis, temporalis myoplasty and Tenzel external canthopexy) to rehabilitate facial aesthetics and function.

  8. 面神经鼓乳段定位及术中面瘫预防%Location of tympanic segment and mastoid segment of facial nerve and prevention of prosopoplegia in operations

    Institute of Scientific and Technical Information of China (English)

    朱富高; 孙美红; 张俊瑶; 孙大为; 姜彦

    2011-01-01

    Objective:To study the location of facial nerve and prevent facial nerve injury in middle ear surgery according to dissection of temporal bone and experience of middle ear surgery.Method: Thirty sides of temporal bones were exposed tympanic and mastoid segment of facial nerve with facial nerve decompression.The course of facial nerve was located by the markers of middle ear.Result: Tympanic segment of facial nerve passed between horizontal semicircular canal and stapes,then superior and anterior to the cochleariform process.Mastoid segment of facial nerve located in posterior wall of tympanic cavity.The mastoid segment of facial nerve travelled below the level of horizontal semicircular canal and annulus membranae tympani, and the extension line of its posterior margin and posterior-one-third of horizontal semicircular canal intersected to form an included angle(117.04±2.42)°,.External genu of facial nerve located anterior and inferior to the horizontal semicircular canal.The shortest distance was(1.97±0.53) mm between middle point of horizontal semicircular canal and facial nerve, (1.03±0.29)mm between incus short process and facial nerve, (0.93 ± 0.25)mm between cochleariform process and facial nerve, (1.18±0.42)mm between head of stapes and facial nerve, (3.08±0.28)mm between tympani sulcus and facial nerve at the vestibule window level, and (2.13±0.34)mm between tympani sulcus and facial nerve at round window level,respectively.Conclusion: Horizontal semicircular canal carina, incus short process, stapes, annulus membranae tympani and cochleariform process are ideal landmarks of tympanic and mastoid segment of facial nerve, which are helpful in middle ear surgery.%目的:根据颞骨解剖结合中耳手术体会,探讨面神经走行定位,避免中耳手术中面神经损伤.方法:用30侧颞骨标本,模拟面神经减压术的手术步骤暴露面神经鼓乳段,确定面神经走行,用易见且恒定的标志进行面神经定位.结果:面神

  9. Bilateral eventration of sciatic nerve

    Directory of Open Access Journals (Sweden)

    T Sharma

    2010-12-01

    Full Text Available During routine dissection of a 60 years male cadaver, it was observed that the two divisions of sciatic nerve were separate in the gluteal region on both the sides with the tibial nerve passing below the piriformis and the common peroneal nerve piercing the piriformis muscle. The abnormal passage of the sciatic nerve (SN, the common peroneal nerve (CPN, and the tibial nerve (TN, either through the piriformis or below the superior gemellus may facilitate compression of these nerves. Knowledge of such patterns is also important for surgeons dealing with piriformis syndrome which affects 5-6% of patients referred for the treatment of back and leg pain. A high division may also account for frequent failures reported with the popliteal block. Keywords: eventration, piriformis muscle, piriformis syndrome, sciatic nerve

  10. 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...

  11. Nerve Injuries of the Upper Extremity

    Science.gov (United States)

    ... nerves do both of these things. Injury to nerves that carry motor signals causes some amount of weakness. Pain : This is frequently a symptom after nerve injury. The pain present after a nerve injury ...

  12. High division of sciatic nerve

    Directory of Open Access Journals (Sweden)

    Tripti Shrivastava

    2014-04-01

    Results: In all except two cadavers, the nerve divided at the apex of the popliteal fossa. In two cadavers the sciatic nerve divided bilaterally in the upper part of thigh. Conclusion: The high division presented in this study can make popliteal nerve blocks partially ineffective. The high division of sciatic nerve must always be borne in mind as they have important clinical implications. [Int J Res Med Sci 2014; 2(2.000: 686-688

  13. 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 block...

  14. 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.

  15. Imaging the ocular motor nerves.

    NARCIS (Netherlands)

    Ferreira, T.; Verbist, B.M.; Buchem, M. van; Osch, T. van; Webb, A.

    2010-01-01

    The ocular motor nerves (OMNs) comprise the oculomotor, trochlear and the abducens nerves. According to their course, they are divided into four or five anatomic segments: intra-axial, cisternal, cavernous and intra-orbital and, for the abducens nerve, an additional interdural segment. Magnetic reso

  16. Nerve growth factor and injured peripheral nerve regeneration

    Institute of Scientific and Technical Information of China (English)

    Endong Shi; Bingchen Wang; Qingshan Sun

    2008-01-01

    Nerve growth factor (NGF) exhibits many biological activities, such as supply of nutrients, neuroprotection, and the generation and rehabilitation of injured nerves. The neuroprotective and neurotrophic qualities of NGF are generally recognized. NGF may enhance axonal regeneration and myelination of peripheral nerves, as well as cooperatively promote functional recovery of injured nerves and limbs. The clinical efficacy of NGF and its therapeutic potentials are reviewed here. This paper also reviews the latest NGF research developments for repairing injured peripheral nerve, thereby providing scientific evidence for the appropriate clinical application of NGF.

  17. Delayed removal of maxillary third molar displaced into the infratemporal fossa

    Directory of Open Access Journals (Sweden)

    Bruno Tochetto Primo

    2014-04-01

    Full Text Available Third molar extraction is a common procedure and it is rarely associated with complications. One complication that may be associated with this procedure is displacement of the tooth into the infratemporal fossa, an anatomical structure that contains the temporalis muscle, medial and lateral pterygoid muscles, the pterygoid plexus, the maxillary artery and its branches, the mandibular nerve and its branches, and the chorda tympani. The present case report illustrates delayed surgical removal of a maxillary third molar that was displaced into the infratemporal fossa, via the intraoral access and under local anesthesia. Despite the rarity of this complication, oral and maxillofacial surgeons should be aware of its management and able to choose the optimal technique, taking into account the patient's signs and symptoms as well as the knowledge and experience of the surgeon.

  18. FGF21 Mediates Endocrine Control of Simple Sugar Intake and Sweet Taste Preference by the Liver

    DEFF Research Database (Denmark)

    von Holstein-Rathlou, Stephanie; BonDurant, Lucas D; Peltekian, Lila

    2016-01-01

    The liver is an important integrator of nutrient metabolism, yet no liver-derived factors regulating nutrient preference or carbohydrate appetite have been identified. Here we show that the liver regulates carbohydrate intake through production of the hepatokine fibroblast growth factor 21 (FGF21......), which markedly suppresses consumption of simple sugars, but not complex carbohydrates, proteins, or lipids. Genetic loss of FGF21 in mice increases sucrose consumption, whereas acute administration or overexpression of FGF21 suppresses the intake of both sugar and non-caloric sweeteners. FGF21 does...... not affect chorda tympani nerve responses to sweet tastants, instead reducing sweet-seeking behavior and meal size via neurons in the hypothalamus. This liver-to-brain hormonal axis likely represents a negative feedback loop as hepatic FGF21 production is elevated by sucrose ingestion. We conclude...

  19. 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.

  20. 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.

  1. Taste responses to neohesperidin dihydrochalcone in rats and baboon monkeys.

    Science.gov (United States)

    Naim, M; Rogatka, H; Yamamoto, T; Zehavi, U

    1982-06-01

    Preference-aversion behavior to solutions containing neohesperidin dihydrochalcone (NHDHC) was studied rats and baboon monkeys. Electrophysiological responses evoked by application of NHDHC solutions to taste receptors innervated by the chorda tympani and the glossopharyngeal nerves were also measured. As a group, rats were indifferent to solutions containing up to 1.2 x 10(-3) M NHDHC in short and long-term preference tests. A solution containing the very high concentration of 8.2 x 10(-3) M NHDHC was consumed less than water by all rats. The aversive behavior of rats to the 8.2 x 10(-3) M NHDHC solution appeared to be due to taste quality rather than olfaction. When percent preferences were calculated on an individual basis for the long-term preference tests, 59% of the rats were indifferent to solutions containing up to 1.2 x 10(-3) M NHDHC, 33% of the animals found this solution aversive and less than 8% showed preference. Behavioral responses to a solution of 3.4 x 10(-4) M aspartame also varied considerably among rats. The electrophysiological data were in line with the behavioral responses suggesting weak taste responses for NHDHC in rats. More pronounced responses observed in the glossopharyngeal nerve as compared to the chorda tympani. Baboon monkeys showed a strong preference for solutions containing 1.6 x 10(-5) M-1.6 x 10(-3) M NHDHC. A solution of 1.6 x 10(-2) M was consumed to a lesser extent than water. It is concluded that baboon monkeys present a better experimental model than rats for investigating the sweetness of NHDHC.

  2. Tissue engineering and peripheral nerve regeneration (III) -- Sciatic nerve regeneration with PDLLA nerve guide

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    The biodegradation rate and biocompatibility of poly(d, l -lactide) (PDLLA) in vivo were evaluated. The aim of this study was to establish a nerve guide constructed by the PDLLA with 3-D microenvironment and to repair a 10 mm of sciatic nerve gap in rats. The process of the nerve regeneration was investigated by histological assessment, electrophysiological examination, and determination of wet weight recovery rate of the gastrocnemius muscle. After 3 weeks, the nerve guide had changed from a transparent to an opaque status. The conduit was degraded and absorbed partly and had lost their strength with breakage at the 9th week of postoperation. At the conclusion of 12 weeks, proximal and distal end of nerves were anastomosed by nerve regeneration and the conduit vanished completely. The results suggest that PDLLA conduits may serve for peripheral nerve regeneration and PDLLA is a sort of hopeful candidate for tissue engineering.

  3. 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.

  4. [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.

  5. Acellular nerve allograft promotes selective regeneration

    Institute of Scientific and Technical Information of China (English)

    Haili Xin; Guanjun Wang; Xinrong He; Jiang Peng; Quanyi Guo; Wenjing Xu

    2011-01-01

    Acellular nerve allograft preserves the basilar membrane tube and extracellular matrix, which pro-motes selective regeneration of neural defects via bridging. In the present study, a Sprague Dawley rat sciatic nerve was utilized to prepare acellular nerve allografts through the use of the chemical extraction method. Subsequently, the allograft was transplanted into a 10-mm sciatic nerve defect in Wistar rats, while autologous nerve grafts from Wistar rats served as controls. Compared with autologous nerve grafts, the acellular nerve allografts induced a greater number of degenerated nerve fibers from sural nerves, as well as a reduced misconnect rate in motor fibers, fewer acetyl-choline esterase-positive sural nerves, and a greater number of carbonic anhydrase-positive senso-ry nerve fibers. Results demonstrated that the acellular nerve allograft exhibited significant neural selective regeneration in the process of bridging nerve defects.

  6. Diagnosis of Rupture of Mitral Chordae Tendinese by Color Doppler Eehocardiogrphy%二尖瓣腱索断裂的彩色多普勒超声心动图诊断

    Institute of Scientific and Technical Information of China (English)

    侯传举; 邓东安; 张玉威; 张仁福

    1996-01-01

    In 6016 patients of different cardiovascular diseases operated,5 cases with rupture of mitral chordae tendineae(RMCT)were detected by color Doppler eehocardiography(CDE).The accuracy rate of CDE was 100%.The ultrasonic manifeslations of RMCT in CDE were"flail shape" change of the mitral leaflets with ruptued ehordae tendineae in two-dimensional echocardiography (2DE)and a shade of multi-colored resurgitated jet of blood through mitral valve during systol in CDE.It is concluded that CDE has specific value in the diagnosis of RMCT and can replace the angiocardiography.It is necessary to differentiate RMCT from mitral valve prolapse(MVP)and mitral valve vegetation(MVV)by CDE.Surgical treatment should be done as soon as the diagnosis of RMCT iS confirmed.%应用彩色多普勒超声心动图(CDE)在已手术的6016例各种心血管疾病中检出5例二尖瓣腱索断裂(RMCT),CDE诊断准确率100%.本病的CDE表现是两维超声心动图(2DE)显示腱索断裂的二尖瓣叶呈"槤枷样"或"甩鞭样"改变,彩色多普勒(CD)显示收缩期过二尖瓣五彩相间返流束血流信号.结果表明CDE对本病有特异性诊断价值,可代替心血管造影检查.CDE诊断本病需与二尖瓣脱垂(MVP)和二尖瓣叶赘生物(MVV)相鉴别.一旦确诊应及早手术治疗.

  7. 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.

  8. 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.

  9. Peripheral nerve lengthening as a regenerative strategy

    Institute of Scientific and Technical Information of China (English)

    Kenneth M.Vaz; Justin M.Brown; Sameer B.Shah

    2014-01-01

    Peripheral nerve injury impairs motor, sensory, and autonomic function, incurring substantial ifnancial costs and diminished quality of life. For large nerve gaps, proximal lesions, or chronic nerve injury, the prognosis for recovery is particularly poor, even with autografts, the current gold standard for treating small to moderate nerve gaps. In vivo elongation of intact proximal stumps towards the injured distal stumps of severed peripheral nerves may offer a promising new strategy to treat nerve injury. This review describes several nerve lengthening strategies, in-cluding a novel internal ifxator device that enables rapid and distal reconnection of proximal and distal nerve stumps.

  10. Nanofibrous nerve conduit-enhanced peripheral nerve regeneration.

    Science.gov (United States)

    Jiang, Xu; Mi, Ruifa; Hoke, Ahmet; Chew, Sing Yian

    2014-05-01

    Fibre structures represent a potential class of materials for the formation of synthetic nerve conduits due to their biomimicking architecture. Although the advantages of fibres in enhancing nerve regeneration have been demonstrated, in vivo evaluation of fibre size effect on nerve regeneration remains limited. In this study, we analyzed the effects of fibre diameter of electrospun conduits on peripheral nerve regeneration across a 15-mm critical defect gap in a rat sciatic nerve injury model. By using an electrospinning technique, fibrous conduits comprised of aligned electrospun poly (ε-caprolactone) (PCL) microfibers (981 ± 83 nm, Microfiber) or nanofibers (251 ± 32 nm, Nanofiber) were obtained. At three months post implantation, axons regenerated across the defect gap in all animals that received fibrous conduits. In contrast, complete nerve regeneration was not observed in the control group that received empty, non-porous PCL film conduits (Film). Nanofiber conduits resulted in significantly higher total number of myelinated axons and thicker myelin sheaths compared to Microfiber and Film conduits. Retrograde labeling revealed a significant increase in number of regenerated dorsal root ganglion sensory neurons in the presence of Nanofiber conduits (1.93 ± 0.71 × 10(3) vs. 0.98 ± 0.30 × 10(3) in Microfiber, p regeneration. These results could provide useful insights for future nerve guide designs.

  11. Sensory nerve conduction studies in neuralgic amyotrophy.

    Science.gov (United States)

    van Alfen, Nens; Huisman, Willem J; Overeem, S; van Engelen, B G M; Zwarts, M J

    2009-11-01

    Neuralgic amyotrophy is a painful, episodic peripheral nerve disorder localized to the brachial plexus. Sensory symptoms occur in 80% of the patients. We assessed the frequency of abnormalities in sensory nerve conduction studies of the lateral and medial antebrachial cutaneous, radial sensory, median sensory, and ulnar sensory nerves in 112 patients. Sensory nerve conduction studies showed abnormalities in nerves, even when the nerve was clinically affected. The lateral and medial antebrachial cutaneous nerves were most often abnormal, in 15% and 17% of nerves. No correlation with the presence or localization of clinical deficits was found. Brachial plexus sensory nerve conduction studies seem to be of little diagnostic value in neuralgic amyotrophy. Our findings also indicate that some sensory lesions may be in the nerve roots instead of the plexus. An examination of normal sensory nerve conduction studies does not preclude neuralgic amyotrophy as a diagnosis.

  12. Functional assessment of sciatic nerve reconstruction : Biodegradable poly (DLLA-epsilon-CL) nerve guides versus autologous nerve grafts

    NARCIS (Netherlands)

    Meek, MF; Dijkstra, [No Value; Den Dunnen, WFA; Ijkema-Paassen, J; Schakenraad, JM; Gramsbergen, A; Robinson, PH

    1999-01-01

    The aim of this study was to compare functional nerve recovery after reconstruction with a biodegradable p(DLLA-epsilon-CL) nerve guide filled with modified denatured muscle tissue (MDMT), or an autologous nerve graft. We evaluated nerve recovery using walking track analysis (measurement of the scia

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

    NARCIS (Netherlands)

    den Dunnen, WFA; Meek, MF

    2001-01-01

    The aim of this study was to evaluate sensory nerve recovery and auto-mutilation after reconstruction of various lengths of nerve gaps in the sciatic nerve of the rat, using different techniques. Group 4, in which the longest nerve gap (15 mm) was reconstructed with a thin-walled p(DL-lactide-y-capr

  14. 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.)

  15. Factors that influence peripheral nerve regeneration

    DEFF Research Database (Denmark)

    Krarup, Christian; Archibald, Simon J; Madison, Roger D

    2002-01-01

    median nerve lesions (n = 46) in nonhuman primates over 3 to 4 years, a time span comparable with such lesions in humans. Nerve gap distances of 5, 20, or 50mm were repaired with nerve grafts or collagen-based nerve guide tubes, and three electrophysiological outcome measures were followed: (1) compound...

  16. Solitary fibrous tumour of the vagus nerve.

    Science.gov (United States)

    Scholsem, Martin; Scholtes, Felix

    2012-04-01

    We describe the complete removal of a foramen magnum solitary fibrous tumour in a 36-year-old woman. It originated on a caudal vagus nerve rootlet, classically described as the 'cranial' accessory nerve root. This ninth case of immunohistologically confirmed cranial or spinal nerve SFT is the first of the vagus nerve.

  17. Clinical significance of suprascapular nerve mobilization.

    Science.gov (United States)

    Bodily, Kale D; Spinner, Robert J; Shin, Alexander Y; Bishop, Allen T

    2005-11-01

    The anatomy of the suprascapular nerve is important to surgeons when focal nerve lesions necessitate surgical repair. Recent experience with a patient who had a complete suprascapular nerve lesion in the retroclavicular region (combined with axillary and musculocutaneous nerve lesions) is presented to illustrate that successful direct nerve repair is possible despite resection of a neuroma. Specifically, we found that neurolysis and mobilization of the suprascapular nerve and release of the superior transverse scapular ligament provided the necessary nerve length to achieve direct nerve repair after the neuroma was removed. A combined supraclavicular and infraclavicular approach to the suprascapular nerve provided excellent visualization, especially in the retroclavicular region. Postoperatively, the patient recovered complete shoulder abduction and external rotation with the direct repair, an outcome uncommonly achieved with interpositional grafting. Based on our operative experience, we set out to quantify the length that the suprascapular nerve could be mobilized with neurolysis. Mobilization of the nerve and release of the superior transverse scapular ligament generated an average of 1.6 cm and 0.7 cm of extra nerve length respectively, totaling 2.3 cm of additional usable nerve length overall. The ability to expose the suprascapular nerve in the retroclavicular/infraclavicular region and to mobilize the suprascapular nerve for possible direct repair has not been previously emphasized and is clinically important. This surgical approach and technique permits direct nerve repair after resection of a focal neuroma in the retroclavicular or infraclavicular region, thus avoiding interpositional grafting, and improving outcomes.

  18. Long term outcomes of tympanoplasty with sectioning of tensor tympani tendon%切除鼓膜张肌肌腱的鼓室成形术远期临床疗效分析

    Institute of Scientific and Technical Information of China (English)

    邓瑞; 方延青; 欧熊; 刘杨文易; 王冰; 程晓婷; 陈兵

    2016-01-01

    目的:探讨在开放式鼓室成形伴Ⅰ期听骨链重建术中切除鼓膜张肌肌腱的远期听力影响。方法回顾性分析2010年1月至2014年6月行开放式鼓室成形伴I期听骨链重建术病例,从中筛选具有完整长期随访资料者76例,根据术中是否切除鼓膜张肌肌腱将其分为剪肌腱组(36例)和保留肌腱组(40例),随访12至36个月,分别比较两组手术前后0.5、1、2、4 kHz纯音平均气导听阈(AC)、平均气骨导差(ABG)的变化及术后听力重建成功率的情况。结果剪肌腱组术后平均气导听阈和气骨导差为35.9±13.6dB和13.5±5.9dB,而保留肌腱组术后平均气导听阈和气骨导差分别为34.7±13.0dB和14.8±4.8dB,无明显差异(P值均>0.05)。两组听力重建的成功率分别为88.9%和90.0%。两组在听力改善、气骨导差闭合及听力重建成功率等方面差异均无统计学意义(P值均>0.05)。结论本研究未发现在开放式鼓室成形伴I期听骨链重建术中切除鼓膜张肌肌腱对术后听力恢复产生远期影响。%[Astract]Objectives To evaluate acoustic effect after canal wall-down tympanoplasty with section of the tensor tym-pani muscle(TTM) tendon in patients with chronic otitis media on long-term follow-up.Materials and Methods From Janu-ary 2010 to june 2014, 76 patients underwent canal wall-down tympanoplasty with ossicular chain reconstruction in a 1-stage surgery. For this study, the patients were assigned into two groups. In group 1(36 patients), the TTM tensor would be removed during the surgery while it would be retained in group 2(40 patients).Pre-and postoperative air and bone conduc-tion (AC, BC) thresholds at 0.5, 1, 2, and 4 kHz were reported and the air-bone gaps were measured.Results Mean postop-erative AC and air–bone gap was 35.9±13.6dB and 13.5±5.9dB in Group 1 . While Mean postoperative AC and air–bone gap was 34.7±13.0dB and 14.8±4.8dB in Group 2. Both were not

  19. Autotransplante de cordas tendíneas: nova técnica para o tratamento cirúrgico da insuficiência mitral por rotura de cordas tendíneas da cúspide anterior Allotransplantation of chordae tendineae: new technique for the surgical approach of mitral insufficiency

    Directory of Open Access Journals (Sweden)

    Francisco Gregori Jr

    1992-12-01

    Full Text Available Uma das causas mais freqüentes de prolapso valvar mitral, com conseqüente regurgitação, é a rotura de cordas tendíneas. Várias técnicas têm sido empregadas em tal situação. Entretanto, a substituição valvar mitral tem sido o procedimento mais utilizado. E apresentada uma nova técnica cirúrgica empregada em 4 pacientes com insuficiência valvar mitral severa devido a rotura de cordas tendíneas da cúspide anterior da valva mitral. Um autotransplante de cordas da valva tricúspide para a valva mitral é realizado. Em 2 casos, um retalho é retirado da cúspide anterior da valva tricúspide com cordas tendíneas e parte do músculo papilar correspondente. Nos outros 2 casos a cúspide posterior da valva tricúspide foi retirada, inteiramente, com cordas e músculo papilar. Na primeira variante técnica, a cúspide anterior da valva tricúspide foi reparada e, na segunda, através, da plicatura do anel, a valva tricúspide foi transformada em bicúspide. A peça retirada é transplantada para a valva mitral, sendo suturada a cúspide doadora com a cúspide anterior da valva mitral e o músculo papilar doador com o topo do músculo papilar posterior da valva mitral em 3 casos e com o músculo papilar anterior e 1 caso. Os 4 pacientes foram reestudados clínica e laboratorialmente aos 15, 11, 2 e 1 mês de pós-operatório, respectivamente, com execelente evolução. Apesar da limitada experiência, acreditamos ser esta nova técnica uma boa alternativa para o tratamento cirúrgico da insuficiência mitral por rotura de cordas tendíneas da cúspide anterior.One of the most frequent causes of mitral valve prolapse is rupture of the chordae tendineae. Several techniques have been used to correct severe mitral regurgitation. However, mitral valve replacement is the principal surgical approach to it. We describe a technique used in four patients with marked mitral regurgitation due to ruptured chordae tendineae of the anterior leaflet. We

  20. Poly(DL-lactide-epsilon-caprolactone) nerve guides perform better than autologous nerve grafts

    NARCIS (Netherlands)

    DenDunnen, WFA; VanderLei, B; Schakenraad, JM; Stokroos, [No Value; Blaauw, E; Pennings, AJ; Robinson, PH; Bartels, H.

    1996-01-01

    The aim of this study was to compare the speed and quality of nerve regeneration after reconstruction using a biodegradable nerve guide or an autologous nerve graft. We evaluated nerve regeneration using light microscopy, transmission electron microscopy and morphometric analysis. Nerve regeneration

  1. Imaging of the facial nerve

    Energy Technology Data Exchange (ETDEWEB)

    Veillon, F. [Service de Radiologie I, Hopital de Hautepierre, 67098 Strasbourg Cedex (France)], E-mail: Francis.Veillon@chru-strasbourg.fr; Ramos-Taboada, L.; Abu-Eid, M. [Service de Radiologie I, Hopital de Hautepierre, 67098 Strasbourg Cedex (France); Charpiot, A. [Service d' ORL, Hopital de Hautepierre, 67098 Strasbourg Cedex (France); Riehm, S. [Service de Radiologie I, Hopital de Hautepierre, 67098 Strasbourg Cedex (France)

    2010-05-15

    The facial nerve is responsible for the motor innervation of the face. It has a visceral motor function (lacrimal, submandibular, sublingual glands and secretion of the nose); it conveys a great part of the taste fibers, participates to the general sensory of the auricle (skin of the concha) and the wall of the external auditory meatus. The facial mimic, production of tears, nasal flow and salivation all depend on the facial nerve. In order to image the facial nerve it is mandatory to be knowledgeable about its normal anatomy including the course of its efferent and afferent fibers and about relevant technical considerations regarding CT and MR to be able to achieve high-resolution images of the nerve.

  2. GRP nerves in pig antrum

    DEFF Research Database (Denmark)

    Holst, J J; Poulsen, Steen Seier

    1987-01-01

    We extracted gastrin-releasing peptide (GRP) and its C-terminal decapeptide corresponding to 6.4 and 6.8 pmol/g from pig antrum mucosa. By immunohistochemistry GRP was localized to mucosal, submucosal, and myenteric nerve fibers. A few nerve cell bodies were also identified. Using isolated perfused...... pig antrum with intact vagal innervation, we found concomitant, atropine-resistant release of GRP and gastrin during electrical stimulation of the vagal nerves. Intra-arterial GRP at 10(-11)-10(-10) mol/l caused up to fivefold, dose-dependent increases in gastrin secretion; higher doses were less...... response to GRP and abolished the effect of vagal stimulation. The available evidence strongly suggests that GRP nerves are responsible for the stimulatory vagal effects on gastrin secretion in the pig....

  3. Large Extremity Peripheral Nerve Repair

    Science.gov (United States)

    2015-10-01

    human amnion membrane and periosteal autograft on tendon healing: experimental study in rabbits. J Hand Surg Eur Vol 2010;35:262e8. 674 N.G. Fairbairn...SE, Hunter DA. Functional evaluation of complete sciatic, peroneal, and posterior tibial nerve lesions in the rat. Plast Reconstr Surg. 1989;83:129...complete sciatic, peroneal, and posterior tibial nerve lesions in the rat. Plastic and reconstructive surgery. 1989 Jan;83(1):129-38. PubMed PMID: 2909054

  4. Substituição da valva mitral com tração dos músculos papilares em pacientes com miocardiopatia dilatada Mitral valve replacement with chordae tendineae preservation, traction and fixation in end-stage dilated cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Fabio Antonio Gaiotto

    2007-03-01

    Full Text Available OBJETIVO: Avaliar a geometria e a função do ventrículo esquerdo (VE após a troca mitral com tração e fixação dos papilares, em portadores de insuficiência cardíaca terminal com insuficiência mitral secundária. MÉTODO: Dos 20 pacientes avaliados, 70% eram homens, com idade média de 50,2 anos e 55% recebiam inotrópicos. A fração de ejeção (FEVE foi menor que 30% em todos; 85% estavam em classe funcional (CF IV. Dezoito receberam próteses de pericárdio bovino e dois, mecânicas. Os períodos considerados foram: 3, 6, 12 e 18 meses. As variáveis consideradas: volume sistólico do VE (VS, a FEVE, os diâmetros sistólico e diastólico finais (DSF e DDF e os volumes sistólico e diastólico finais (VSF e VDF. No estudo estatístico, empregou-se da análise de variância (AV e o teste de Friedmann (F. A sobrevida foi aferida pelo método de Kaplan-Meyer. RESULTADOS: Dois (10% faleceram no período imediato. A sobrevida no primeiro ano foi de 85%, no segundo, 44%, no terceiro, 44%, no quarto, 44% e no quinto, 44%. A comparação entre pré e 3 meses, empregando-se a AV, não revelou alteração significativa para o VS (p=0,086. Houve acréscimo da FEVE (p=0,008 e decréscimo do DDF (p=0,038; do DSF (p=0,008; do VDF (p=0,029 e do VSF (p=0,009. Os momentos pré, 3 e 6 meses, com o teste F, não revelaram alterações. Entre os momentos pré, 3 meses e final, empregando-se a AV, não houve significância. CONCLUSÃO: Há melhora da FEVE, dos VDF, VSF, DDF e DSF; até o terceiro mês. A partir de então, as variáveis permanecem estáveis.OBJECTIVE: This study aimed at evaluating results of mitral valve replacement using a new technique of complete chordae tendineae adjustment for left ventricular remodeling. METHODS: Twenty end-stage idiopathic dilated cardiomyopathy patients with severe functional mitral valve regurgitation underwent mitral valve replacement. Seventeen (85% were in functional class IV. Both anterior and posterior

  5. 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.

  6. Comparison of nerve graft integration after segmentar resection versus epineural burying in crushed rat sciatic nerves

    Directory of Open Access Journals (Sweden)

    Cunha Marco Túlio Rodrigues da

    1997-01-01

    Full Text Available The aim of the present paper is to compare and correlate the take of nerve segments in a severely crushed nerve. Forty adult Wistar rats had their right sciatic nerve by a "Péan-Murphy" forceps for 40 minutes. In Group 1 (n=20, a segmentar serection in the crushed sciatic nerve was made. A sural nerve segment from the opposite hindpaw was placed in the gap. In Group 2 (n=20, a lontudinal insision in the epineurium of the lesioned sciatic nerve was made. A sural nerve segment was buried underneath the epineurium. The crushed sciatic nerves undergone Wallerian degeneration and endoneurial fibrosis. Sciatic nerves from Group 2 had significant better histological aspects than those from Group 1. Sural nerve grafts presented better degrees of regeneration than crushed sciatic nerves. Sural nerve grafts from Group 2 (burying method integrated as well as those from Group 1 (segmentar resection.

  7. Clinical use of nerve conduits in peripheral-nerve repair : Review of the literature

    NARCIS (Netherlands)

    Meek, MF; Coert, JH

    2002-01-01

    The use of nerve conduits has evolved from a previous experimental idea to a clinical reality over the last ten years. An overview of the literature on the clinical use of nerve conduits in peripheral-nerve repair is presented.

  8. What Protects Certain Nerves from Stretch Injury?

    Science.gov (United States)

    Schraut, Nicholas B; Walton, Sharon; Bou Monsef, Jad; Shott, Susan; Serici, Anthony; Soulii, Lioubov; Amirouche, Farid; Gonzalez, Mark H; Kerns, James M

    2016-01-01

    The human tibial nerves is less prone to injury following joint arthroplasty compared with the peroneal nerves. Besides the anatomical distribution, other features may confer protection from stretch injury. We therefore examined the size, shape and connective tissue distribution for the two nerves. The tibial and peroneal nerves from each side of nine fresh human cadavers we reharvested mid-thigh. Proximal segments manually stretched 20%-25% were fixed in aldehyde, while the adjacent distal segments were fixed in their natural length. Paraffin sections stained by Masson's trichrome method for connective tissue were examined by light microscopy. Tibial nerves had 2X more fascicles compared with the peroneal, but the axonal content appeared similar. Analysis showed that neither nerve had a significant reduction in cross sectional area of the fascicles following stretch. However, fascicles from stretched tibial nerves become significantly more oval compared with those from unstretched controls and peroneal nerves. Tibial nerves had a greater proportion that was extrafascicular tissue (50-55%) compared with peroneal nerves (38%-42%). This epineurium was typically adipose tissue. Perineurial thickness in both nerves was directly related to fascicular size. Tibial nerves have several unique histological features associated with size, shape and tissue composition compared with the peroneal nerve. We suggest that more fascicles with their tightly bound perineurium and more robust epineurium afford protection against stretch injury. Mechanical studies should clarify how size and shape contribute to nerve protection and/or neurapraxia.

  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. 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.

  11. 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

  12. Imaging the ocular motor nerves

    Energy Technology Data Exchange (ETDEWEB)

    Ferreira, Teresa [Department of Radiology, Leiden University Medical Center (Netherlands)], E-mail: T.A.Ferreira@lumc.nl; Verbist, Berit [Department of Radiology, Leiden University Medical Center (Netherlands)], E-mail: B.M.Verbist@lumc.nl; Buchem, Mark van [Department of Radiology, Leiden University Medical Center (Netherlands)], E-mail: M.A.van_Buchem@lumc.nl; Osch, Thijs van [C.J. Gorter for High-Field MRI, Department of Radiology, Leiden University Medical Center (Netherlands)], E-mail: M.J.P.van_Osch@lumc.nl; Webb, Andrew [C.J. Gorter for High-Field MRI, Department of Radiology, Leiden University Medical Center (Netherlands)], E-mail: A.Webb@lumc.nl

    2010-05-15

    The ocular motor nerves (OMNs) comprise the oculomotor, trochlear and the abducens nerves. According to their course, they are divided into four or five anatomic segments: intra-axial, cisternal, cavernous and intra-orbital and, for the abducens nerve, an additional interdural segment. Magnetic resonance imaging is the imaging method of choice in the evaluation of the normal and pathologic ocular motor nerves. CT still plays a limited but important role in the evaluation of the intraosseous portions at the skull base and bony foramina. We describe for each segment of these cranial nerves, the normal anatomy, the most appropriate image sequences and planes, their imaging appearance and pathologic conditions. Magnetic resonance imaging with high magnetic fields is a developing and promising technique. We describe our initial experience with a Phillips 7.0 T MRI scanner in the evaluation of the brainstem segments of the OMNs. As imaging becomes more refined, an understanding of the detailed anatomy is increasingly necessary, as the demand on radiology to diagnose smaller lesions also increases.

  13. Imaging the ocular motor nerves.

    Science.gov (United States)

    Ferreira, Teresa; Verbist, Berit; van Buchem, Mark; van Osch, Thijs; Webb, Andrew

    2010-05-01

    The ocular motor nerves (OMNs) comprise the oculomotor, trochlear and the abducens nerves. According to their course, they are divided into four or five anatomic segments: intra-axial, cisternal, cavernous and intra-orbital and, for the abducens nerve, an additional interdural segment. Magnetic resonance imaging is the imaging method of choice in the evaluation of the normal and pathologic ocular motor nerves. CT still plays a limited but important role in the evaluation of the intraosseous portions at the skull base and bony foramina. We describe for each segment of these cranial nerves, the normal anatomy, the most appropriate image sequences and planes, their imaging appearance and pathologic conditions. Magnetic resonance imaging with high magnetic fields is a developing and promising technique. We describe our initial experience with a Phillips 7.0T MRI scanner in the evaluation of the brainstem segments of the OMNs. As imaging becomes more refined, an understanding of the detailed anatomy is increasingly necessary, as the demand on radiology to diagnose smaller lesions also increases.

  14. 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...... methods including nerve conduction studies and electromyography used in the study of patients suspected of having a neuropathy and the significance of the findings are discussed in detail and more novel and experimental methods are mentioned. Diagnostic considerations are based on a flow chart classifying...

  15. Mitral Valve Repair: The Chordae Tendineae

    Directory of Open Access Journals (Sweden)

    Carlos-A Mestres

    2015-10-01

    Full Text Available Repair of the mitral valve is the treatment of choice for mitral valve regurgitation when the anatomy is favorable. It is well known that mitral valve repair enjoys better clinical and functional results than any other type of valve substitute. This fact is beyond doubt regardless of the etiology of the valve lesion and is of particular importance in degenerative diseases.This review analyzes the most important advances in the knowledge of the anatomy, pathophysiology, and chordal function of the mitral valve as well as the different alternatives in the surgical repair and clinical results of the most prevalent diseases of the mitral valve. An attempt has been made to organize the acquired information available in a practical way.

  16. 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.

  17. Nerve injuries about the elbow.

    Science.gov (United States)

    Hariri, Sanaz; McAdams, Timothy R

    2010-10-01

    The ulnar, radial, median, medial antebrachial cutaneous, and lateral antebrachial cutaneous nerves are subject to traction and compression in athletes who place forceful, repetitive stresses across their elbow joint. Throwing athletes are at greatest risk, and cubital tunnel syndrome (involving the ulnar nerve) is clearly the most common neuropathy about the elbow. The anatomy and innervation pattern of the nerve involved determines the characteristic of the neuropathy syndrome. The most important parts of the work-up are the history and physical examination as electrodiagnostic testing and imaging are often not reliable. In general, active rest is the first line of treatment. Tailoring the surgery and rehabilitation protocol according to the functional requirements of that athlete's sport(s) can help optimize the operative outcomes for recalcitrant cases.

  18. 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.

  19. Neuronal differentiation of PC12 cells induced by sciatic nerve and optic nerve conditioned medium

    Institute of Scientific and Technical Information of China (English)

    DU Chan; YANG De-mei; ZHANG Pei-xun; DENG Lei; JIANG Bao-guo

    2010-01-01

    Background Previous work has shown that optic nerve and sciatic nerve conditional medium had neurotrophic activity on neurons. In order to find if the optic nerve conditioned media (CM) had a similar activity to make PC12 cells differentiate as sciatic nerve CM did, we explored the neurotrophic activity in optic nerve CM in the same in vitro system and compared the neurotrophin expression levels in optic and sciatic nerves under both conditions.Methods PC12 cells were used to examine the effects of neurotrophins secreted by the sciatic nerve and optic nerve. RT-PCR and real-time QPCR showed that the sciatic nerve and optic nerve produced a range of neurotrophins including nerve growth factor (NGF), brain derived neurotrophic factor (BDNF) and neurotrophin-3 (NT-3).Results The effects of sciatic nerve and optic nerve CM on neurite outgrowth were tested against a range of neurotrophins, and they had different neuritogenic activities. Only NGF and sciatic nerve CM had obvious neuritogenic activities, although the concentration of NGF in the sciatic nerve CM was very low.Conclusions Our experiment showed that sciatic nerve CM had a higher neurotrophic activity on PC12 cells than optic nerve CM. These results suggested that peripheral nervous system (PNS) and central nervous system (CNS) had different expression levels of neurotrophin, which may in part explain the lack of ability to regenerate the CNS.

  20. 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

  1. 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.

  2. 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

  3. Infraspinatus muscle atrophy from suprascapular nerve compression.

    Science.gov (United States)

    Cordova, Christopher B; Owens, Brett D

    2014-02-01

    Muscle weakness without pain may signal a nerve compression injury. Because these injuries should be identified and treated early to prevent permanent muscle weakness and atrophy, providers should consider suprascapular nerve compression in patients with shoulder muscle weakness.

  4. Optic nerve invasion of uveal melanoma

    DEFF Research Database (Denmark)

    Lindegaard, Jens; Isager, Peter; Prause, Jan Ulrik

    2007-01-01

    The aim of the study was to identify the histopathological characteristics associated with the invasion of the optic nerve of uveal melanoma and to evaluate the association between invasion of the optic nerve and survival. In order to achieve this, all uveal melanomas with optic nerve invasion...... in Denmark between 1942 and 2001 were reviewed (n=157). Histopathological characteristics and depth of optic nerve invasion were recorded. The material was compared with a control material from the same period consisting of 85 cases randomly drawn from all choroidal/ciliary body melanomas without optic nerve......; and 4) in one case a tumor spread along the inner limiting membrane to the optic nerve through the lamina cribrosa. Invasion of the optic nerve had no impact on all-cause mortality or melanoma-related mortality in multivariate analyses. The majority of melanomas invading the optic nerve are large...

  5. Vagus Nerve Stimulation for Treating Epilepsy

    Science.gov (United States)

    ... Evidence-based Guideline for PATIENTS and their FAMILIES VAGUS NERVE STIMULATION FOR TREATING EPILEPSY This information sheet is provided to help you understand how vagus nerve stimulation (VNS) may help treat epilepsy. The American ...

  6. Outcome of contralateral C7 nerve transferring to median nerve

    Institute of Scientific and Technical Information of China (English)

    GAO Kai-ming; LAO Jie; ZHAO Xin; GU Yu-dong

    2013-01-01

    Background Contralateral C7 (cC7) transfer had been widely used in many organizations in the world,but the outcomes were significantly different.So the purpose of the study was to evaluate the outcome of patients treated with cC7 transferring to median nerve and to determine the factors affecting the outcome of this procedure.Methods A retrospective review of 51 patients with total root avulsion brachial plexus injuries who underwent cC7 transfer was conducted.All of the surgeries were performed with two surgery stages and median nerve was the recipient nerve.The cC7 nerve was used in three different ways.The entire C7 root was used in 11 patients; the posterior division together with the lateral part of the anterior division was used in 15 patients; the anterior or the posterior division alone was used in 25 patients.The mean follow-up period was 6.9 years.Results The efficiency of the surgery in these 51 patients was 49.02% in motor and 62.75% in sensory function.The patients with entire C7 root transfer obtained significantly better recovery in both motor and sensory function than the patients with partial C7 transfer.The best function recovery could be induced if the interval between the two surgery stages was 4-8 months.Conclusions cC7 transfer is an effective procedure in repairing median nerve.But using the entire C7 root transfer can obtain better recovery; so we emphasize using the entire root as the donor.The optimal interval between two surgery stages is 4-8 months.

  7. Drug Delivery for Peripheral Nerve Regeneration

    Science.gov (United States)

    2015-11-01

    compared functional recovery between an autograft, PLGA nerve conduit, and PLGA nerve conduit that releases NGF in a rat sciatic nerve gap model...and scope of the research. Combat gear for the modern day warrior has greatly improved protection for the head and body, but limbs are still...and non-combat veterans peripheral nerve injuries affect 2-3% of trauma patients and vastly more subsequent to tumor extirpation or iatrogenic

  8. 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.

  9. Shoulder posture and median nerve sliding

    Directory of Open Access Journals (Sweden)

    Dilley Andrew

    2004-07-01

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

  10. 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.

  11. Diverse mechanisms for assembly of branchiomeric nerves

    OpenAIRE

    Cox, Jane A.; LaMora, Angela; Johnson, Stephen L.; Voigt, Mark M.

    2011-01-01

    The formation of branchiomeric nerves (cranial nerves V, VII, IX and X) from their sensory, motor and glial components is poorly understood. The current model for cranial nerve formation is based on the Vth nerve, in which sensory afferents are formed first and must enter the hindbrain in order for the motor efferents to exit. Using transgenic zebrafish lines to discriminate between motor neurons, sensory neurons and peripheral glia, we show that this model does not apply to the remaining thr...

  12. A Review of Facial Nerve Anatomy

    OpenAIRE

    2004-01-01

    An intimate knowledge of facial nerve anatomy is critical to avoid its inadvertent injury during rhytidectomy, parotidectomy, maxillofacial fracture reduction, and almost any surgery of the head and neck. Injury to the frontal and marginal mandibular branches of the facial nerve in particular can lead to obvious clinical deficits, and areas where these nerves are particularly susceptible to injury have been designated danger zones by previous authors. Assessment of facial nerve function is no...

  13. 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.

  14. An anatomical study of porcine peripheral nerve and its potential use in nerve tissue engineering

    Science.gov (United States)

    Zilic, Leyla; Garner, Philippa E; Yu, Tong; Roman, Sabiniano; Haycock, John W; Wilshaw, Stacy-Paul

    2015-01-01

    Current nerve tissue engineering applications are adopting xenogeneic nerve tissue as potential nerve grafts to help aid nerve regeneration. However, there is little literature that describes the exact location, anatomy and physiology of these nerves to highlight their potential as a donor graft. The aim of this study was to identify and characterise the structural and extracellular matrix (ECM) components of porcine peripheral nerves in the hind leg. Methods included the dissection of porcine nerves, localisation, characterisation and quantification of the ECM components and identification of nerve cells. Results showed a noticeable variance between porcine and rat nerve (a commonly studied species) in terms of fascicle number. The study also revealed that when porcine peripheral nerves branch, a decrease in fascicle number and size was evident. Porcine ECM and nerve fascicles were found to be predominately comprised of collagen together with glycosaminoglycans, laminin and fibronectin. Immunolabelling for nerve growth factor receptor p75 also revealed the localisation of Schwann cells around and inside the fascicles. In conclusion, it is shown that porcine peripheral nerves possess a microstructure similar to that found in rat, and is not dissimilar to human. This finding could extend to the suggestion that due to the similarities in anatomy to human nerve, porcine nerves may have utility as a nerve graft providing guidance and support to regenerating axons. PMID:26200940

  15. Simultaneous paresthesia of the lingual nerve and inferior alveolar nerve caused by a radicular cyst.

    Science.gov (United States)

    Hamada, Yoshiki; Yamada, Hiroyuki; Hamada, Akiko; Kondoh, Toshirou; Suzuki, Mami; Noguchi, Kazuhide; Ito, Ko; Seto, Kanichi

    2005-10-01

    The inferior alveolar nerve is sometimes affected by periapical pathoses and mandibular cysts. However, mandibular intraosseous lesions have not been reported to disturb the lingual nerve. A case of simultaneous paresthesia of the right lingual nerve and the right inferior alveolar nerve is presented. The possible mechanisms of this extremely uncommon condition are discussed.

  16. [Transformation of trigeminal nerve tumor into malignant peripheral nerve sheath tumor (MPNST)].

    Science.gov (United States)

    Nenashev, E A; Cherekaev, V A; Kadasheva, A B; Kozlov, A V; Rotin, D L; Stepanian, M A

    2012-01-01

    Malignant peripheral nerve sheath tumor (MPNST) is a rare entity with only 18 cases of trigeminal nerve MPNST described by now and only one report of malignant transformation of trigeminal nerve tumor into MPNST published up to date. One more case of malignant transformation of trigeminal nerve (1st division) tumor into MPNST is demonstrated.

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

    NARCIS (Netherlands)

    Meek, MF; Nicolai, JPA; Robinson, PH

    2006-01-01

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

  18. Routine exposure of recurrent laryngeal nerve in thyroid surgery can prevent nerve injury

    Institute of Scientific and Technical Information of China (English)

    Chenling Shen; Mingliang Xiang; Hao Wu; Yan Ma; Li Chen; Lan Cheng

    2013-01-01

    To determine the value of dissecting the recurrent laryngeal nerve during thyroid surgery with respect to preventing recurrent laryngeal nerve injury, we retrospectively analyzed clinical data from 5 344 patients undergoing thyroidectomy. Among these cases, 548 underwent dissection of the recurrent laryngeal nerve, while 4 796 did not. There were 12 cases of recurrent laryngeal nerve injury following recurrent laryngeal nerve dissection (injury rate of 2.2%) and 512 cases of recurrent laryngeal nerve injury in those not undergoing nerve dissection (injury rate of 10.7%). This difference remained statistically significant between the two groups in terms of type of thyroid disease, type of surgery, and number of surgeries. Among the 548 cases undergoing recurrent laryngeal nerve dissection, 128 developed anatomical variations of the recurrent laryngeal nerve (incidence rate of 23.4%), but no recurrent laryngeal nerve injury was found. In addition, the incidence of recurrent laryngeal nerve injury was significantly lower in patients with the inferior parathyroid gland and middle thyroid veins used as landmarks for locating the recurrent laryngeal nerve compared with those with the entry of the recurrent laryngeal nerve into the larynx as a landmark. These findings indicate that anatomical variations of the recurrent laryngeal nerve are common, and that dissecting the recurrent laryngeal nerve during thyroid surgery is an effective means of preventing nerve injury.

  19. An anatomical study of porcine peripheral nerve and its potential use in nerve tissue engineering.

    Science.gov (United States)

    Zilic, Leyla; Garner, Philippa E; Yu, Tong; Roman, Sabiniano; Haycock, John W; Wilshaw, Stacy-Paul

    2015-09-01

    Current nerve tissue engineering applications are adopting xenogeneic nerve tissue as potential nerve grafts to help aid nerve regeneration. However, there is little literature that describes the exact location, anatomy and physiology of these nerves to highlight their potential as a donor graft. The aim of this study was to identify and characterise the structural and extracellular matrix (ECM) components of porcine peripheral nerves in the hind leg. Methods included the dissection of porcine nerves, localisation, characterisation and quantification of the ECM components and identification of nerve cells. Results showed a noticeable variance between porcine and rat nerve (a commonly studied species) in terms of fascicle number. The study also revealed that when porcine peripheral nerves branch, a decrease in fascicle number and size was evident. Porcine ECM and nerve fascicles were found to be predominately comprised of collagen together with glycosaminoglycans, laminin and fibronectin. Immunolabelling for nerve growth factor receptor p75 also revealed the localisation of Schwann cells around and inside the fascicles. In conclusion, it is shown that porcine peripheral nerves possess a microstructure similar to that found in rat, and is not dissimilar to human. This finding could extend to the suggestion that due to the similarities in anatomy to human nerve, porcine nerves may have utility as a nerve graft providing guidance and support to regenerating axons.

  20. Large Extremity Peripheral Nerve Repair

    Science.gov (United States)

    2014-10-01

    Nerve wrap biomaterials Human amniotic membrane was obtained from elective caesarean section patients who had been screened serologically for human...80°C until the day of surgery. Human amnion (HAM) harvest and processing Amniotic membrane was obtained from elective caesarean section patients

  1. Large Extremity Peripheral Nerve Repair

    Science.gov (United States)

    2015-10-01

    factors and mis- guided axons into adjacent tissues further compromises outcome and likely contributes to neuroma formation. These effects are... effects on neurite outgrowth and can support axonal regeneration in the absence of SCs. Whilst this may be sufficient over short lengths of ANA... effective for nerve regeneration than autograft in clinical implementation using microsurgical attachment, we hypothesized that the photosealing benefit may

  2. Intraoral myxoid nerve sheath tumour

    NARCIS (Netherlands)

    Schortinghuis, J; Hille, JJ; Singh, S

    2001-01-01

    A case of an intraoral myxoid nerve sheath tumour of the dorsum of the tongue in a 73-year-old Caucasian male is reported. This case describes the oldest patient with this pathology to date. Immunoperoxidase staining for neuronspecific enolase (NSE) and epithelial membrane antigen (EMA) expression d

  3. Autologous nerve anastomosis versus human amniotic membrane anastomosis A rheological comparison following simulated sciatic nerve injury

    Institute of Scientific and Technical Information of China (English)

    Guangyao Liu; Qiao Zhang; Yan Jin; Zhongli Gao

    2011-01-01

    The sciatic nerve is biological viscoelastic solid, with stress relaxation and creep characteristics. In this study, a comparative analysis of the stress relaxation and creep characteristics of the sciatic nerve was conducted after simulating sciatic nerve injury and anastomosing with autologous nerve or human amniotic membrane. The results demonstrate that, at the 7 200-second time point, both stress reduction and strain increase in the human amniotic membrane anastomosis group were significantly greater than in the autologous nerve anastomosis group. Our findings indicate that human amniotic membrane anastomosis for sciatic nerve injury has excellent rheological characteristics and is conducive to regeneration of the injured nerve.

  4. Selective measurement of digital nerve conduction velocity.

    Science.gov (United States)

    Terai, Y; Senda, M; Hashizume, H; Nagashima, H; Inoue, H

    2001-01-01

    We developed a new method to measure the nerve conduction velocity of a single digital nerve. In 27 volunteers (27 hands), we separately stimulated each digital nerve on the radial and ulnar sides of the middle and ring fingers. A double-peaked potential was recorded above the median nerve at the wrist joint when either the radial-side nerve or the ulnar-side nerve of the middle finger was stimulated. The first peak of this potential had disappeared after the digital nerve was blocked under the stimulating electrodes, and the peak appeared again coinciding with the decrease of anesthesia. Shifting the stimulating electrodes on the digital nerve resulted in no significant difference in the peak conduction velocity. It is possible that each peak of the potential was attributable to conduction of an action potential along one of the two digital nerves. This new method allows the assessment of a single digital nerve, and may be clinically useful for assessing the rupture of a digital nerve and the sensory nerve action potentials in carpal tunnel syndrome.

  5. Bilateral high division of sciatic nerve

    Directory of Open Access Journals (Sweden)

    K. Shwetha

    2014-08-01

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

  6. Vagus nerve stimulation in clinical practice.

    Science.gov (United States)

    Farmer, Adam D; Albu-Soda, Ahmed; Aziz, Qasim

    2016-11-02

    The diverse array of end organ innervations of the vagus nerve, coupled with increased basic science evidence, has led to vagus nerve stimulation becoming a management option in a number of clinical disorders. This review discusses methods of electrically stimulating the vagus nerve and its current and potential clinical uses.

  7. The Road to Optimized Nerve Reconstruction

    NARCIS (Netherlands)

    C.A. Hundepool (Caroline)

    2016-01-01

    markdownabstractTraumatic injuries to the peripheral nerves cause considerable disability and economic burden. It is estimated that 5% of patients admitted to Level I trauma centers have peripheral nerve injury. The reconstruction of peripheral nerve defects remains a clinical challenge. The gold st

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

    Institute of Scientific and Technical Information of China (English)

    Yanru Zhang; Hui Zhang; Kaka Katiella; Wenhua Huang

    2014-01-01

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

  9. Pharmacology of airway afferent nerve activity

    Directory of Open Access Journals (Sweden)

    Carr Michael J

    2001-05-01

    Full Text Available Abstract Afferent nerves in the airways serve to regulate breathing pattern, cough, and airway autonomic neural tone. Pharmacologic agents that influence afferent nerve activity can be subclassified into compounds that modulate activity by indirect means (e.g. bronchial smooth muscle spasmogens and those that act directly on the nerves. Directly acting agents affect afferent nerve activity by interacting with various ion channels and receptors within the membrane of the afferent terminals. Whether by direct or indirect means, most compounds that enter the airspace will modify afferent nerve activity, and through this action alter airway physiology.

  10. Tractography of lumbar nerve roots: initial results

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-06-15

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

  11. Vagus nerve stimulation regulates hemostasis in swine.

    Science.gov (United States)

    Czura, Christopher J; Schultz, Arthur; Kaipel, Martin; Khadem, Anna; Huston, Jared M; Pavlov, Valentin A; Redl, Heinz; Tracey, Kevin J

    2010-06-01

    The central nervous system regulates peripheral immune responses via the vagus nerve, the primary neural component of the cholinergic anti-inflammatory pathway. Electrical stimulation of the vagus nerve suppresses proinflammatory cytokine release in response to endotoxin, I/R injury, and hypovolemic shock and protects against lethal hypotension. To determine the effect of vagus nerve stimulation on coagulation pathways, anesthetized pigs were subjected to partial ear resection before and after electrical vagus nerve stimulation. We observed that electrical vagus nerve stimulation significantly decreased bleeding time (pre-electrical vagus nerve stimulation = 1033 +/- 210 s versus post-electrical vagus nerve stimulation = 585 +/- 111 s; P vagus nerve stimulation = 48.4 +/- 6.8 mL versus post-electrical vagus nerve stimulation = 26.3 +/- 6.7 mL; P vagus nerve stimulation was independent of changes in heart rate or blood pressure and correlated with increased thrombin/antithrombin III complex generation in shed blood. These data indicate that electrical stimulation of the vagus nerve attenuates peripheral hemorrhage in a porcine model of soft tissue injury and that this protective effect is associated with increased coagulation factor activity.

  12. Amniotic membrane covering for facial nerve repair

    Institute of Scientific and Technical Information of China (English)

    Murat Karaman; Arzu Tuncel; Shahrouz Sheidaei; Mehmet Güney (S)enol; Murat Hakan Karabulut; Ildem Deveci; Nihan Karaman

    2013-01-01

    Amniotic membranes have been widely used in ophthalmology and skin injury repair because of their anti-inflammatory properties. In this study, we measured therapeutic efficacy and determined if amniotic membranes could be used for facial nerve repair. The facial nerves of eight rats were dissected and end-to-end anastomosis was performed. Amniotic membranes were covered on the anastomosis sites in four rats. Electromyography results showed that, at the end of the 3rd and 8th weeks after amniotic membrane covering, the latency values of the facial nerves covered by amniotic membranes were significantly shortened and the amplitude values were significantly increased. Compared with simple facial nerve anastomosis, after histopathological examination, facial nerve anastomosed with amniotic membrane showed better continuity, milder inflammatory reactions, and more satisfactory nerve conduction. These findings suggest that amniotic membrane covering has great potential in facial nerve repair.

  13. Parotid lymphangioma associated with facial nerve paralysis.

    Science.gov (United States)

    Imaizumi, Mitsuyoshi; Tani, Akiko; Ogawa, Hiroshi; Omori, Koichi

    2014-10-01

    Parotid lymphangioma is a relatively rare disease that is usually detected in infancy or early childhood, and which has typical features. Clinical reports of facial nerve paralysis caused by lymphangioma, however, are very rare. Usually, facial nerve paralysis in a child suggests malignancy. Here we report a very rare case of parotid lymphangioma associated with facial nerve paralysis. A 7-year-old boy was admitted to hospital with a rapidly enlarging mass in the left parotid region. Left peripheral-type facial nerve paralysis was also noted. Computed tomography and magnetic resonance imaging also revealed multiple cystic lesions. Open biopsy was undertaken in order to investigate the cause of the facial nerve paralysis. The histopathological findings of the excised tumor were consistent with lymphangioma. Prednisone (40 mg/day) was given in a tapering dose schedule. Facial nerve paralysis was completely cured 1 month after treatment. There has been no recurrent facial nerve paralysis for eight years.

  14. A review of facial nerve anatomy.

    Science.gov (United States)

    Myckatyn, Terence M; Mackinnon, Susan E

    2004-02-01

    An intimate knowledge of facial nerve anatomy is critical to avoid its inadvertent injury during rhytidectomy, parotidectomy, maxillofacial fracture reduction, and almost any surgery of the head and neck. Injury to the frontal and marginal mandibular branches of the facial nerve in particular can lead to obvious clinical deficits, and areas where these nerves are particularly susceptible to injury have been designated danger zones by previous authors. Assessment of facial nerve function is not limited to its extratemporal anatomy, however, as many clinical deficits originate within its intratemporal and intracranial components. Similarly, the facial nerve cannot be considered an exclusively motor nerve given its contributions to taste, auricular sensation, sympathetic input to the middle meningeal artery, and parasympathetic innervation to the lacrimal, submandibular, and sublingual glands. The constellation of deficits resulting from facial nerve injury is correlated with its complex anatomy to help establish the level of injury, predict recovery, and guide surgical management.

  15. An unusual cause of radial nerve palsy

    Directory of Open Access Journals (Sweden)

    Agrawal Hemendra Kumar

    2014-06-01

    Full Text Available Neurapraxia frequently occurs following traction injury to the nerve intraoperatively, leading to radial nerve palsy which usually recovers in 5-30 weeks. In our case, we had operated a distal one-third of humeral shaft fracture and fixed it with 4.5 mm limited contact dynamic compression plate. The distal neurovascular status of the limb was assessed postoperatively in the recovery room and was found to be intact and all the sensory-motor functions of the radial nerve were normal. On the second postoperative day, following the suction drain removal and dressing, patient developed immediate radial nerve palsy along with wrist drop. We reviewed theliterature and found no obvious cause for the nerve palsy and concluded that it was due to traction injury to the radial nerve while removing the suction drain in negative pressure. Key words: Radial nerve; Humeral fractures; Paralysis; Diaphyses

  16. Complement components of nerve regeneration conditioned lfuid inlfuence the microenvironment of nerve regeneration

    Institute of Scientific and Technical Information of China (English)

    Guang-shuai Li; Qing-feng Li; Ming-min Dong; Tao Zan; Shuang Ding; Lin-bo Liu

    2016-01-01

    Nerve regeneration conditioned lfuid is secreted by nerve stumps inside a nerve regeneration chamber. A better understanding of the pro-teinogram of nerve regeneration conditioned lfuid can provide evidence for studying the role of the microenvironment in peripheral nerve regeneration. In this study, we used cylindrical silicone tubes as the nerve regeneration chamber model for the repair of injured rat sciatic nerve. Isobaric tags for relative and absolute quantitation proteomics technology and western blot analysis conifrmed that there were more than 10 complement components (complement factor I, C1q-A, C1q-B, C2, C3, C4, C5, C7, C8β and complement factor D) in the nerve regeneration conditioned lfuid and each varied at different time points. These ifndings suggest that all these complement components have a functional role in nerve regeneration.

  17. Complement components of nerve regeneration conditioned fluid influence the microenvironment of nerve regeneration

    Directory of Open Access Journals (Sweden)

    Guang-shuai Li

    2016-01-01

    Full Text Available Nerve regeneration conditioned fluid is secreted by nerve stumps inside a nerve regeneration chamber. A better understanding of the proteinogram of nerve regeneration conditioned fluid can provide evidence for studying the role of the microenvironment in peripheral nerve regeneration. In this study, we used cylindrical silicone tubes as the nerve regeneration chamber model for the repair of injured rat sciatic nerve. Isobaric tags for relative and absolute quantitation proteomics technology and western blot analysis confirmed that there were more than 10 complement components (complement factor I, C1q-A, C1q-B, C2, C3, C4, C5, C7, C8ß and complement factor D in the nerve regeneration conditioned fluid and each varied at different time points. These findings suggest that all these complement components have a functional role in nerve regeneration.

  18. Delayed peripheral nerve repair: methods, including surgical ′cross-bridging′ to promote nerve regeneration

    Directory of Open Access Journals (Sweden)

    Tessa Gordon

    2015-01-01

    Full Text Available Despite the capacity of Schwann cells to support peripheral nerve regeneration, functional recovery after nerve injuries is frequently poor, especially for proximal injuries that require regenerating axons to grow over long distances to reinnervate distal targets. Nerve transfers, where small fascicles from an adjacent intact nerve are coapted to the nerve stump of a nearby denervated muscle, allow for functional return but at the expense of reduced numbers of innervating nerves. A 1-hour period of 20 Hz electrical nerve stimulation via electrodes proximal to an injury site accelerates axon outgrowth to hasten target reinnervation in rats and humans, even after delayed surgery. A novel strategy of enticing donor axons from an otherwise intact nerve to grow through small nerve grafts (cross-bridges into a denervated nerve stump, promotes improved axon regeneration after delayed nerve repair. The efficacy of this technique has been demonstrated in a rat model and is now in clinical use in patients undergoing cross-face nerve grafting for facial paralysis. In conclusion, brief electrical stimulation, combined with the surgical technique of promoting the regeneration of some donor axons to ′protect′ chronically denervated Schwann cells, improves nerve regeneration and, in turn, functional outcomes in the management of peripheral nerve injuries.

  19. The nerves around the shoulder

    Energy Technology Data Exchange (ETDEWEB)

    Blum, Alain, E-mail: alain.blum@gmail.com [Service d’Imagerie GUILLOZ, CHU Nancy, Nancy 54000 (France); Lecocq, Sophie; Louis, Matthias; Wassel, Johnny; Moisei, Andreea; Teixeira, Pedro [Service d’Imagerie GUILLOZ, CHU Nancy, Nancy 54000 (France)

    2013-01-15

    Neuropathies of the shoulder are considered to be entrapment syndromes. They are relatively common, accounting for about 2% of cases of sport-related shoulder pain. Many instances involve suprascapular neuropathy, but the clinical diagnosis is often delayed because of nonspecific symptoms. Classically, EMG is the gold standard investigation but MRI currently reveals muscular abnormality in 50% of cases. Muscle edema, the most characteristic symptom, is nonspecific. In general, the topography of edema, the presence of a lesion compressing the nerve and clinical history contribute to the diagnosis. Although atrophy and fatty degeneration may persist after the disappearance of edema, they are rarely symptomatic. The main differential diagnosis is Parsonage–Turner syndrome. Evidence of a cyst pressing on a nerve may prompt puncture-infiltration guided by ultrasonography or CT-scan.

  20. Large Extremity Peripheral Nerve Repair

    Science.gov (United States)

    2015-10-01

    MB, Roberts AB, Wakersfield LM, de Crombrugghe B. Some recent advances in the chemistry and biology of trans- forming growth factor-beta. J Cell Biol...with donor age ! þ þ Age and environmental acquired DNA damage ! þ þ Cryogenic storage of cells for future use following birth þ ! ! The clinical...Adobe Systems, Inc., San Jose, Calif.). Two blinded researchers manually measured nerve cross-sectional area from 40× images and counted axons from

  1. Neuralgias of the Trigeminal Nerve

    OpenAIRE

    Gordon, Allan S

    2000-01-01

    Practitioners are often presented with patients who complain bitterly of facial pain. The trigeminal nerve is involved in four conditions that are sometimes mixed up. The four conditions - trigeminal neuralgia, trigeminal neuropathic pain, postherpetic neuralgia and atypical facial pain - are discussed under the headings of clinical features, differential diagnosis, cause and treatment. This article should help practitioners to differentiate one from the other and to manage their care.

  2. Neuralgias of the Trigeminal Nerve

    Directory of Open Access Journals (Sweden)

    Allan S Gordon

    2000-01-01

    Full Text Available Practitioners are often presented with patients who complain bitterly of facial pain. The trigeminal nerve is involved in four conditions that are sometimes mixed up. The four conditions - trigeminal neuralgia, trigeminal neuropathic pain, postherpetic neuralgia and atypical facial pain - are discussed under the headings of clinical features, differential diagnosis, cause and treatment. This article should help practitioners to differentiate one from the other and to manage their care.

  3. The Dehiscent Facial Nerve Canal

    Directory of Open Access Journals (Sweden)

    Sertac Yetiser

    2012-01-01

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

  4. Ulnar nerve stimulation at the palm in diagnosing distal ulnar nerve entrapment.

    Science.gov (United States)

    Wee, A S

    2005-01-01

    Distal entrapment of the ulnar nerve at the wrist and hand (Guyon's syndrome) is a relatively uncommon condition. It may present with a confusing permutation of sensory and motor symptoms, depending on which branches of the ulnar nerve are involved Electrodiagnostic test procedures are often helpful in sorting out this quandary. Electrophysiologic studies that include electrical stimulation of the nerve at the palm, in addition to stimulation of the ulnar nerve at other locations, are useful in demonstrating the focal nerve conduction abnormality that is involved in the entrapment. Sensory and motor recordings from palmar stimulation of the ulnar nerve are not technically difficult procedures, and can be performed routinely.

  5. Trigeminal neuralgia and facial nerve paralysis

    Energy Technology Data Exchange (ETDEWEB)

    Borges, Alexandra [IPOFG, Department of Radiology, Lisbon (Portugal)

    2005-03-01

    The trigeminal nerve is the largest of the cranial nerves. It provides sensory input from the face and motor innervation to the muscles of mastication. The facial nerve is the cranial nerve with the longest extracranial course, and its main functions include motor innervation to the muscles of facial expression, sensory control of lacrimation and salivation, control of the stapedial reflex and to carry taste sensation from the anterior two-thirds of the tongue. In order to be able adequately to image and follow the course of these cranial nerves and their main branches, a detailed knowledge of neuroanatomy is required. As we are dealing with very small anatomic structures, high resolution dedicated imaging studies are required to pick up normal and pathologic nerves. Whereas CT is best suited to demonstrate bony neurovascular foramina and canals, MRI is preferred to directly visualize the nerve. It is also the single technique able to detect pathologic processes afflicting the nerve without causing considerable expansion such as is usually the case in certain inflammatory/infectious conditions, perineural spread of malignancies and in very small intrinsic tumours. Because a long course from the brainstem nuclei to the peripheral branches is seen, it is useful to subdivide the nerve in several segments and then tailor the imaging modality and the imaging study to that specific segment. This is particularly true in cases where topographic diagnosis can be used to locate a lesion in the course of these nerves. (orig.)

  6. Microsurgical anatomy of the ocular motor nerves.

    Science.gov (United States)

    Zhang, Yi; Liu, Hao; Liu, En-Zhong; Lin, You-Zhi; Zhao, Shi-Guang; Jing, Guo-Hua

    2010-08-01

    This study was designed to provide anatomic data to help surgeons avoid damage to the ocular motor nerves during intraorbital operations. The microsurgical anatomy of the ocular motor nerves was studied in 50 adult cadaveric heads (100 orbits). Dissections were performed with a microscope. The nerves were exposed and the neural and muscular relationships of each portion of the nerve were examined and measured. The superior division of the oculomotor nerve coursed between the optic nerve and the superior rectus muscle after it left the annular tendon, and its branches entered into the superior rectus muscle and levator muscle. A mean of five fibers (range 3-7) innervated the superior rectus muscle, and a mean of one fiber (range 1-2) followed a medial direction (84%) or went straight through the superior rectus muscle (16%). The inferior division of the oculomotor nerve branched into the medial rectus, inferior rectus and inferior oblique muscles. The trochlear nerve ended on the orbital side of the posterior one-third of the superior oblique muscle in 76 specimens. The abducens nerve ended on the posterior one-third of the lateral rectus muscle in 86 specimens. If the belly of the lateral rectus muscle was divided into three superior-inferior parts, the nerve commonly entered into the middle one-third in 74 specimens. Based on the observed data, microanatomical relationships of the orbital contents were revised.

  7. Tumors Presenting as Multiple Cranial Nerve Palsies

    Directory of Open Access Journals (Sweden)

    Kishore Kumar

    2017-04-01

    Full Text Available Cranial nerve palsy could be one of the presenting features of underlying benign or malignant tumors of the head and neck. The tumor can involve the cranial nerves by local compression, direct infiltration or by paraneoplastic process. Cranial nerve involvement depends on the anatomical course of the cranial nerve and the site of the tumor. Patients may present with single or multiple cranial nerve palsies. Multiple cranial nerve involvement could be sequential or discrete, unilateral or bilateral, painless or painful. The presentation could be acute, subacute or recurrent. Anatomic localization is the first step in the evaluation of these patients. The lesion could be in the brain stem, meninges, base of skull, extracranial or systemic disease itself. We present 3 cases of underlying neoplasms presenting as cranial nerve palsies: a case of glomus tumor presenting as cochlear, glossopharyngeal, vagus and hypoglossal nerve palsies, clivus tumor presenting as abducens nerve palsy, and diffuse large B-cell lymphoma presenting as oculomotor, trochlear, trigeminal and abducens nerve palsies due to paraneoplastic involvement. History and physical examination, imaging, autoantibodies and biopsy if feasible are useful for the diagnosis. Management outcomes depend on the treatment of the underlying tumor.

  8. 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.

  9. Diverse mechanisms for assembly of branchiomeric nerves.

    Science.gov (United States)

    Cox, Jane A; Lamora, Angela; Johnson, Stephen L; Voigt, Mark M

    2011-09-15

    The formation of branchiomeric nerves (cranial nerves V, VII, IX and X) from their sensory, motor and glial components is poorly understood. The current model for cranial nerve formation is based on the Vth nerve, in which sensory afferents are formed first and must enter the hindbrain in order for the motor efferents to exit. Using transgenic zebrafish lines to discriminate between motor neurons, sensory neurons and peripheral glia, we show that this model does not apply to the remaining three branchiomeric nerves. For these nerves, the motor efferents form prior to the sensory afferents, and their pathfinding show no dependence on sensory axons, as ablation of cranial sensory neurons by ngn1 knockdown had no effect. In contrast, the sensory limbs of the IXth and Xth nerves (but not the Vth or VIIth) were misrouted in gli1 mutants, which lack hindbrain bmn, suggesting that the motor efferents are crucial for appropriate sensory axon projection in some branchiomeric nerves. For all four nerves, peripheral glia were the intermediate component added and had a critical role in nerve integrity but not in axon guidance, as foxd3 null mutants lacking peripheral glia exhibited defasciculation of gVII, gIX, and gX axons. The bmn efferents were unaffected in these mutants. These data demonstrate that multiple mechanisms underlie formation of the four branchiomeric nerves. For the Vth, sensory axons initiate nerve formation, for the VIIth the sensory and motor limbs are independent, and for the IXth/Xth the motor axons initiate formation. In all cases the glia are patterned by the initiating set of axons and are needed to maintain axon fasciculation. These results reveal that coordinated interactions between the three neural cell types in branchiomeric nerves differ according to their axial position.

  10. Polymeric Nerve Conduits with Contact Guidance Cues Used in Nerve Repair

    Institute of Scientific and Technical Information of China (English)

    G DAI; X NIU; J YIN

    2016-01-01

    In the modern life, the nerve injury frequently happens due to mechanical, chemical or thermal accidents. In the trivial injuries, the peripheral nerves can regenerate on their own; however, in most of the cases the clinical treatments are required, where relatively large nerve injury gaps are formed. Currently, the nerve repair can be accomplished by direct suture when the injury gap is not too large;while the autologous nerve graft working as the gold standard of peripheral nerve injury treatment for nerve injuries with larger gaps. However, the direct suture is limited by heavy tension at the suture sites, and the autologous nerve graft also has the drawbacks of donor site morbidity and insufifcient donor tissue. Recently, artiifcial nerve conduits have been developed as an alternative for clinical nerve repair to overcome the limitations associated with the above treatments. In order to further improve the efifciency of nerve conduits, various guidance cues are incorporated, including physical cues, biochemical signals, as well as support cells. First, this paper reviewed the contact guidance cues applied in nerve conduits, such as lumen ifllers, multi-channels and micro-patterns on the inner surface. Then, the paper focused on the polymeric nerve conduits with micro inner grooves. The polymeric nerve conduits were fabricated using the phase inversion-based ifber spinning techniques. The smart spinneret with grooved die was designed in the spinning platform, while different spinning conditions, including flow rates, air-gap distances, and polymer concentrations, were adjusted to investigate the inlfuence of fabrication conditions on the geometry of nerve conduits. The inner groove size in the nerve conduits can be precisely controlled in our hollow ifber spinning process, which can work as the efifcient contact guidance cue for nerve regeneration.

  11. Use of nerve elongator to repair short-distance peripheral nerve defects: a prospective randomized study

    Directory of Open Access Journals (Sweden)

    Lu Bai

    2015-01-01

    Full Text Available Repair techniques for short-distance peripheral nerve defects, including adjacent joint flexion to reduce the distance between the nerve stump defects, "nerve splint" suturing, and nerve sleeve connection, have some disadvantages. Therefore, we designed a repair technique involving intraoperative tension-free application of a nerve elongator and obtained good outcomes in the repair of short-distance peripheral nerve defects in a previous animal study. The present study compared the clinical outcomes between the use of this nerve elongator and performance of the conventional method in the repair of short-distance transection injuries in human elbows. The 3-, 6-, and 12-month postoperative follow-up results demonstrated that early neurological function recovery was better in the nerve elongation group than in the conventional group, but no significant difference in long-term neurological function recovery was detected between the two groups. In the nerve elongation group, the nerves were sutured without tension, and the duration of postoperative immobilization of the elbow was decreased. Elbow function rehabilitation was significantly better in the nerve elongation group than in the control group. Moreover, there were no security risks. The results of this study confirm that the use of this nerve elongator for repair of short-distance peripheral nerve defects is safe and effective.

  12. Nanofibrous nerve conduits for repair of 30-mm-long sciatic nerve defects*

    Institute of Scientific and Technical Information of China (English)

    Esmaeil Biazar; Saeed Heidari Keshel; Majid Pouya; Hadi Rad; Melody Omrani Nava; Mohammad Azarbakhsh; Shirin Hooshmand

    2013-01-01

    It has been confirmed that nanofibrous poly(3-hydroxybutyrate-co-3-hydroxyvalerate) nerve conduit can promote peripheral nerve regeneration in rats. However, its efficiency in repair of over 30-mm-long sciatic nerve defects needs to be assessed. In this study, we used a nanofibrous poly(3-hydroxybutyrate-co-3-hydroxyvalerate) nerve conduit to bridge a 30-mm-long gap in the rat sciatic nerve. At 4 months after nerve conduit implantation, regenerated nerves were macroscopi-cal y observed and histological y assessed. In the nanofibrous graft, the rat sciatic nerve trunk had been reconstructed by restoration of nerve continuity and formation of myelinated nerve fiber. There were Schwann cel s and glial cel s in the regenerated nerves. Masson’s trichrome staining showed that there were no pathological changes in the size and structure of gastrocnemius muscle cel s on the operated side of rats. These findings suggest that nanofibrous poly(3-hydroxybutyrate-co-3-hydroxyvalerate) nerve conduit is suitable for repair of long-segment sciatic nerve defects.

  13. Nanofiber Nerve Guide for Peripheral Nerve Repair and Regeneration

    Science.gov (United States)

    2014-01-01

    months 24-33) 3d. Retrograde labeling and tissue harvesting (months 32-33) 3e. Nerve morphometry (months 33-35) 3f. Histopathological evaluations...divided into specific tasks related to various components of optimization schemes. In vitro fiber size dependent Schwann cell migration for...5/7/13 17 4 S(design medium 1200 0 Uniform 6/27/13 Tier(5 18 4 S(Design medium 1200 0 Shallow(Gradient(60L180 6/28/13 19 8 S(Design medium 1200 0

  14. Magnetic resonance imaging of optic nerve

    Directory of Open Access Journals (Sweden)

    Foram Gala

    2015-01-01

    Full Text Available Optic nerves are the second pair of cranial nerves and are unique as they represent an extension of the central nervous system. Apart from clinical and ophthalmoscopic evaluation, imaging, especially magnetic resonance imaging (MRI, plays an important role in the complete evaluation of optic nerve and the entire visual pathway. In this pictorial essay, the authors describe segmental anatomy of the optic nerve and review the imaging findings of various conditions affecting the optic nerves. MRI allows excellent depiction of the intricate anatomy of optic nerves due to its excellent soft tissue contrast without exposure to ionizing radiation, better delineation of the entire visual pathway, and accurate evaluation of associated intracranial pathologies.

  15. An unusual cause of radial nerve palsy

    Institute of Scientific and Technical Information of China (English)

    Hemendra Kumar Agrawal; Vipin Khatkar; Mohit Garg; Balvinder Singh; Ashish Jaiman; Vinod Kumar Sharma

    2014-01-01

    Neurapraxia frequently occurs following traction injury to the nerve intraoperatively,leading to radial nerve palsy which usually recovers in 5-30 weeks.In our case,we had operated a distal one-third of humeral shaft fracture and fixed it with 4.5 mm limited contact dynamic compression plate.The distal neurovascular status of the limb was assessed postoperatively in the recovery room and was found to be intact and all the sensory-motor functions of the radial nerve were normal.On the second postoperative day,following the suction drain removal and dressing,patient developed immediate radial nerve palsy along with wrist drop.We reviewed the literature and found no obvious cause for the nerve palsy and concluded that it was due to traction injury to the radial nerve while removing the suction drain in negative pressure.

  16. An audit of traumatic nerve injury.

    LENUS (Irish Health Repository)

    O'Connor, G

    2009-07-01

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

  17. Ephaptic coupling of myelinated nerve fibers

    DEFF Research Database (Denmark)

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

    2001-01-01

    Numerical predictions of a simple myelinated nerve fiber model are compared with theoretical results in the continuum and discrete limits, clarifying the nature of the conduction process on an isolated nerve axon. Since myelinated nerve fibers are often arranged in bundles, this model is used...... to study ephaptic (nonsynaptic) interactions between impulses on parallel fibers, which may play a functional role in neural processing. (C) 2001 Published by Elsevier Science B.V....

  18. VAGUS NERVE STIMULATION REGULATES HEMOSTASIS IN SWINE

    OpenAIRE

    Czura, Christopher J.; Schultz, Arthur; Kaipel, Martin; Khadem, Anna; Huston, Jared M.; Pavlov, Valentin A; Redl, Heinz; Tracey, Kevin J.

    2010-01-01

    The central nervous system regulates peripheral immune responses via the vagus nerve, the primary neural component of the cholinergic anti-inflammatory pathway. Electrical stimulation of the vagus nerve suppresses pro-inflammatory cytokine release in response to endotoxin, I/R injury, and hypovolemic shock and protects against lethal hypotension. To determine the effect of vagus nerve stimulation on coagulation pathways, anesthetized pigs were subjected to partial ear resection before and aft...

  19. Variant position of the medial plantar nerve

    OpenAIRE

    Astik RB; Dave UH; Gajendra KS

    2011-01-01

    Knowledge of variation of position of the medial plantar nerve is important for the forefoot surgeon for plantar reconstruction, local injection therapy and an excision of interdigital neuroma. During routine dissection of 50-year-old female cadaver, we found the medial plantar nerve and vessels variably located between plantar aponeurosis and the muscles of the first layer of the sole of the right foot. Due to this variant position, the medial plantar nerve and vessels lose their protection ...

  20. Optic Nerve Decompression for Orbitofrontal Fibrous Dysplasia

    OpenAIRE

    Abe, Takumi; Sato, Kaneshige; Otsuka, Takaharu; Kawamura, Noriyoshi; Shimazu, Motohiko; Izumiyama, Hitoshi; Matsumoto, Kiyoshi

    2002-01-01

    Orbitofrontal fibrous dysplasia often involves the bony orbit and the optic canal. Although fibrous dysplasia reportedly produces compression of the optic nerve leading to visual distrubances, optic nerve decompression in patients without clinical signs of optic neuropathy is still controversial. We describe two patients with orbitofrontal fibrous dysplasia without signs of visual disturbance and one patient with McCune-Albright syndrome and progressive visual impairment. Optic nerve decompre...

  1. Nerve Transfers to Restore Shoulder Function.

    Science.gov (United States)

    Leechavengvongs, Somsak; Malungpaishorpe, Kanchai; Uerpairojkit, Chairoj; Ng, Chye Yew; Witoonchart, Kiat

    2016-05-01

    The restoration of shoulder function after brachial plexus injury represents a significant challenge facing the peripheral nerve surgeons. This is owing to a combination of the complex biomechanics of the shoulder girdle, the multitude of muscles and nerves that could be potentially injured, and a limited number of donor options. In general, nerve transfer is favored over tendon transfer, because the biomechanics of the musculotendinous units are not altered. This article summarizes the surgical techniques and clinical results of nerve transfers for restoration of shoulder function.

  2. Chitosan Conduit for Peripheral Nerve Regeneration

    Institute of Scientific and Technical Information of China (English)

    1999-01-01

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

  3. Raman microspectroscopy for visualization of peripheral nerves

    Science.gov (United States)

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

    2013-02-01

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

  4. Vagus nerve stimulation inhibits cortical spreading depression.

    Science.gov (United States)

    Chen, Shih-Pin; Ay, Ilknur; de Morais, Andreia Lopes; Qin, Tao; Zheng, Yi; Sadeghian, Homa; Oka, Fumiaki; Simon, Bruce; Eikermann-Haerter, Katharina; Ayata, Cenk

    2016-04-01

    Vagus nerve stimulation has recently been reported to improve symptoms of migraine. Cortical spreading depression is the electrophysiological event underlying migraine aura and is a trigger for headache. We tested whether vagus nerve stimulation inhibits cortical spreading depression to explain its antimigraine effect. Unilateral vagus nerve stimulation was delivered either noninvasively through the skin or directly by electrodes placed around the nerve. Systemic physiology was monitored throughout the study. Both noninvasive transcutaneous and invasive direct vagus nerve stimulations significantly suppressed spreading depression susceptibility in the occipital cortex in rats. The electrical stimulation threshold to evoke a spreading depression was elevated by more than 2-fold, the frequency of spreading depressions during continuous topical 1 M KCl was reduced by ∼40%, and propagation speed of spreading depression was reduced by ∼15%. This effect developed within 30 minutes after vagus nerve stimulation and persisted for more than 3 hours. Noninvasive transcutaneous vagus nerve stimulation was as efficacious as direct invasive vagus nerve stimulation, and the efficacy did not differ between the ipsilateral and contralateral hemispheres. Our findings provide a potential mechanism by which vagus nerve stimulation may be efficacious in migraine and suggest that susceptibility to spreading depression is a suitable platform to optimize its efficacy.

  5. Nerve Biopsy In The Diagnosis Of Leporsy

    Directory of Open Access Journals (Sweden)

    Hazra B

    1997-01-01

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

  6. Research Status of Astragali Radix on Nerve Cells and Nerve System Diseases

    Institute of Scientific and Technical Information of China (English)

    LUAN Zeng-qiang; ZHAO Ping-li; CAO Wen-fu

    2012-01-01

    Astragali Radix has a wide application in the nerve system diseases because of its obvious nerve cell protection and recovery effects.Astragali Radix has good clinical effects both in acute and chronic cerebrovascular diseases and neurological degenerative diseases.This paper reviews the experimental and clinical research status of Astragali Radix on nerve system and nerve system diseases,which may promote its experimental research and clinical application.

  7. 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 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.

  8. Biodegradable p(DLLA-epsilon-CL) nerve guides versus autologous nerve grafts : Electromyographic and video analysis

    NARCIS (Netherlands)

    Meek, MF; Nicolai, JPA; Gramsbergen, A; van der Werf, J.F.A.

    2001-01-01

    The aim of this study was to evaluate the functional effects of bridging a gap in the sciatic nerve of the rat with either a biodegradable copolymer of (DL)-lactide and epsilon -caprolactone [p(DLLA-epsilon -CL)] nerve guide or an autologous nerve graft. Electromyograms (EMGs) of the gastrocnemius (

  9. A prospective clinical evaluation of biodegradable neurolac nerve guides for sensory nerve repair in the hand

    NARCIS (Netherlands)

    Bertleff, MJOE; Meek, MF; Nicolai, JPA

    2005-01-01

    Purpose: Our purpose was to study the recovery of sensory nerve function, after treatment of traumatic peripheral nerve lesions with a biodegradable poly(DL-lactide-ε-caprolactone) Neurolac nerve guide (Polyganics B.V., Groningen, the Netherlands) versus the current standard reconstruction technique

  10. A simple model of radial nerve injury in the rhesus monkey to evaluate peripheral nerve repair

    Institute of Scientific and Technical Information of China (English)

    Dong Wang; Qingtang Zhu; Xijun Huang; Guo Fu; Liqiang Gu; Xiaolin Liu; Honggang Wang; Jun Hu; Jianhua Yi; Xiaofeng Niu

    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 peripher-al 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, or acellular allografts seeded with autologous bone marrow stem cells. Five months after surgery, regenerated nerve tissue was assessed for function, electrophysiology, and histomorphometry. Postoperative functional recovery was evaluated by the wrist-extension test. Compared with the simple autografts, the acellular allografts and allografts seeded with bone marrow stem cells facilitated remarkable recovery of the wrist-extension functions in the rhesus monkeys. This functional improvement was coupled with radial nerve distal axon growth, a higher percentage of neuron survival, increased nerve fiber density and diameter, increased myelin sheath thickness, and increased nerve conduction velocities and peak amplitudes of compound motor action potentials. Furthermore, the quality of nerve regeneration in the bone marrow stem cells-laden allografts group was comparable to that achieved with autografts. The wrist-extension test is a simple behavioral method for objective quantification of peripheral nerve regeneration.

  11. Muscle potentials evoked by magnetic stimulation of the sciatic nerve in unilateral sciatic nerve dysfunction

    NARCIS (Netherlands)

    Van Soens, I.; Struys, M. M. R. F.; Van Ham, L. M. L.

    2010-01-01

    Magnetic stimulation of the sciatic nerve and subsequent recording of the muscle-evoked potential (MEP) was performed in eight dogs and three cats with unilateral sciatic nerve dysfunction. Localisation of the lesion in the sciatic nerve was based on the history, clinical neurological examination an

  12. LONG-TERM EVALUATION OF NERVE REGENERATION IN A BIODEGRADABLE NERVE GUIDE

    NARCIS (Netherlands)

    DENDUNNEN, WFA; VANDERLEI, B; SCHAKENRAAD, JM; BLAAUW, EH; STOKROOS, [No Value; PENNINGS, AJ; ROBINSON, PH

    1993-01-01

    Nerve regeneration using artificial biodegradable conduits is of increasing interest. The aim of this study is to evaluate the regeneration and maturation of a nerve after long-term implantation (2 years) of a biodegradable poly-L-lactide/poly-E-caprolactone (PLLA/PCL) copolymeric nerve guide in the

  13. Comparison of Nerve Excitability Testing, Nerve Conduction Velocity, and Behavioral Observations for Acrylamide Induced Peripheral Neuropathy

    Science.gov (United States)

    Nerve excitability (NE) testing is a sensitive method to test for peripheral neurotoxicity in humans,and may be more sensitive than compound nerve action potential (CNAP) or nerve conduction velocity (NCV).We used acrylamide to compare the NE and CNAP/NCV methods. Behavioral test...

  14. Immunobiology of Facial Nerve Repair and Regeneration

    Institute of Scientific and Technical Information of China (English)

    QUAN Shi-ming; GAO Zhi-qiang

    2006-01-01

    Immunobiological study is a key to revealing the important basis of facial nerve repair and regeneration for both research and development of clinic treatments. The microenvironmental changes around an injuried facial motoneuron, i.e., the aggregation and expression of various types of immune cells and molecules in a dynamic equilibrium, impenetrate from the start to the end of the repair of an injured facial nerve. The concept of "immune microenvironment for facial nerve repair and regeneration", mainly concerns with the dynamic exchange between expression and regulation networks and a variaty of immune cells and immune molecules in the process of facial nerve repair and regeneration for the maintenance of a immune microenvironment favorable for nerve repair.Investigation on microglial activation and recruitment, T cell behavior, cytokine networks, and immunological cellular and molecular signaling pathways in facial nerve repair and regeneration are the current hot spots in the research on immunobiology of facial nerve injury. The current paper provides a comprehensive review of the above mentioned issues. Research of these issues will eventually make immunological interventions practicable treatments for facial nerve injury in the clinic.

  15. Femoral nerve entrapment: a new insight.

    Science.gov (United States)

    Vázquez, M T; Murillo, J; Maranillo, E; Parkin, I G; Sanudo, J

    2007-03-01

    Compression of the femoral nerve in the iliac fossa has been reported as a consequence of several pathologies, but never as a result of muscular compression. Aberrant slips of iliacus, however, have occasionally been reported to cover or split the femoral nerve. This study aimed to assess such variations as potential factors in femoral nerve compression. A large and homogeneous sample of 121 embalmed cadavers (242 specimens) was studied. Statistical comparisons were made using the chi-squared test. Muscular slips from iliacus and psoas, piercing or covering the femoral nerve, were found in 19 specimens (7.9%). No significant differences by sex or side were found. The more frequent variation was piercing of the femoral nerve by a muscular slip (17 specimens, 7.0%). The nerve then entered the thigh as one or more branches. The less frequent variation found was a muscular slip or sheet covering the femoral nerve as it lay on iliacus (2 specimens, 0.8%). Each disposition may be a potential risk for nerve entrapment.

  16. Sensory nerve conduction studies in neuralgic amyotrophy.

    NARCIS (Netherlands)

    Alfen, N. van; Huisman, W.J.; Overeem, S.; Engelen, B.G.M. van; Zwarts, M.J.

    2009-01-01

    Neuralgic amyotrophy is a painful, episodic peripheral nerve disorder localized to the brachial plexus. Sensory symptoms occur in 80% of the patients. We assessed the frequency of abnormalities in sensory nerve conduction studies of the lateral and medial antebrachial cutaneous, radial sensory, medi

  17. Nerve Transfers to Restore Elbow Function.

    Science.gov (United States)

    Bulstra, Liselotte F; Shin, Alexander Y

    2016-05-01

    The purpose of this article is to provide an overview of the various nerve transfer options for restoration of elbow function. This article describes nerve transfer strategies for elbow flexion and extension including the indications, limitations, and expected outcomes based on current literature.

  18. 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.

  19. Etiological factors of traumatic peripheral nerve injuries

    Directory of Open Access Journals (Sweden)

    Eser Filiz

    2009-01-01

    Full Text Available Background: Traumatic injury of peripheral nerves is a worldwide problem and can result in significant disability. Management of peripheral nerve injuries (PNIs requires accurate localization and the assessment of severity of the lesion. Aim: The purpose of this study is to analyze the data of patients with PNIs referred for electromyography to a tertiary care hospital. Materials and Methods: This is a retrospective study of clinical and electromyographic data of patients with PNIs seen over a period of eight-years (1999-2007 in a tertiary hospital. The data collected included: Demographic data, cause, type of lesion, anatomical location of the lesion, and the mechanism of lesion. Results: During the study period 938 patients were seen with nerve injuries and the distribution of nerve injuries was: PNIs: 1,165; brachial plexus lesions: 76; and lumbar plexus lesions: 7. The mean age was 31.8 years (range 2-81 years and the male to female ratio was 2.4:1. The most frequent nerve injuries were ulnar nerve in the upper extremity and sciatic nerve in the lower extremity. The most common cause of nerve injury was motor vehicle accidents. Two-thirds of the PNIs were partial. Conclusion: This study can serve as a guide to determine the epidemiology and classification of traumatic peripheral and plexus injuries.

  20. Prognostic factors in sensory recovery after digital nerve repair

    OpenAIRE

    Bulut, Tugrul; Akgun, Ulas; Citlak, Atilla; Aslan, Cihan; Sener, Ufuk; Sener, Muhittin

    2017-01-01

    Objective: The prognostic factors that affect sensory nerve recovery after digital nerve repair are variable because of nonhomogeneous data, subjective tests, and different assessment/scoring methods. The aim of this study was to evaluate the success of sensory nerve recovery after digital nerve repair and to investigate the prognostic factors in sensorial healing.Methods: Ninety-six digital nerve repairs of 63 patients were retrospectively evaluated. All nerves were repaired with end-to-end ...

  1. Human Vagus Nerve Branching in the Cervical Region

    OpenAIRE

    Niels Hammer; Juliane Glätzner; Christine Feja; Christian Kühne; Jürgen Meixensberger; Uwe Planitzer; Stefan Schleifenbaum; Tillmann, Bernhard N.; Dirk Winkler

    2015-01-01

    Background: Vagus nerve stimulation is increasingly applied to treat epilepsy, psychiatric conditions and potentially chronic heart failure. After implanting vagus nerve electrodes to the cervical vagus nerve, side effects such as voice alterations and dyspnea or missing therapeutic effects are observed at different frequencies. Cervical vagus nerve branching might partly be responsible for these effects. However, vagus nerve branching has not yet been described in the context of vagus nerve...

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

    Directory of Open Access Journals (Sweden)

    Naumenko L.Yu.

    2010-01-01

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

  3. Anatomical feasibility of vagus nerve esophageal branch transfer to the phrenic nerve

    Institute of Scientific and Technical Information of China (English)

    Ce Wang; Jun Liu; Wen Yuan; Xuhui Zhou; Xinwei Wang; Peng Xu; Jian Chen; Guoxin Wu; Sheng Shi

    2012-01-01

    This study measured the vagus and phrenic nerves from 12 adult cadavers. We found that the width and thickness of the vagus and phrenic nerves were different in the chest. The distance from the point of the vagus nerve and phrenic nerve on the plane of the inferior border of portal pulmonary arteries (T point) was approximately 7 cm to the diaphragm and was approximately 10 cm to the clavicle level. The number of motor fibers in the vagus nerves was 1 716 ± 362, and the number of nerve fibers was 4 473 ± 653. The number of motor fibers in the phrenic nerves ranged from 3 078 ± 684 to 4 794 ± 638, and the number of nerve fibers ranged from 3 437 ± 642 to 5 071 ± 723. No significant difference was found in the total number of nerve fibers. The results suggest that width, thickness, and total number of nerve fibers are similar between the vagus and phrenic nerves, but the number of motor fibers is different between them.

  4. The surgery of peripheral nerves (including tumors)

    DEFF Research Database (Denmark)

    Fugleholm, Kåre

    2013-01-01

    Surgical pathology of the peripheral nervous system includes traumatic injury, entrapment syndromes, and tumors. The recent significant advances in the understanding of the pathophysiology and cellular biology of peripheral nerve degeneration and regeneration has yet to be translated into improved...... surgical techniques and better outcome after peripheral nerve injury. Decision making in peripheral nerve surgery continues to be a complex challenge, where the mechanism of injury, repeated clinical evaluation, neuroradiological and neurophysiological examination, and detailed knowledge of the peripheral...... nervous system response to injury are prerequisite to obtain the best possible outcome. Surgery continues to be the primary treatment modality for peripheral nerve tumors and advances in adjuvant oncological treatment has improved outcome after malignant peripheral nerve tumors. The present chapter...

  5. Ulnar nerve sonography in leprosy neuropathy.

    Science.gov (United States)

    Wang, Zhu; Liu, Da-Yue; Lei, Yang-Yang; Yang, Zheng; Wang, Wei

    2016-01-01

    A 23-year-old woman presented with a half-year history of right forearm sensory and motor dysfunction. Ultrasound imaging revealed definite thickening of the right ulnar nerve trunk and inner epineurium, along with heterogeneous hypoechogenicity and unclear nerve fiber bundle. Color Doppler exhibited a rich blood supply, which was clearly different from the normal ulnar nerve presentation with a scarce blood supply. The patient subsequently underwent needle aspiration of the right ulnar nerve, and histopathological examination confirmed that granulomatous nodules had formed with a large number of infiltrating lymphocytes and a plurality of epithelioid cells in the fibrous connective tissues, with visible atypical foam cells and proliferous vascularization, consistent with leprosy. Our report will familiarize readers with the characteristic sonographic features of the ulnar nerve in leprosy, particularly because of the decreasing incidence of leprosy in recent years.

  6. Histological assessment in peripheral nerve tissue engineering

    Institute of Scientific and Technical Information of China (English)

    Vctor Carriel; Ingrid Garzn; Miguel Alaminos; Maria Cornelissen

    2014-01-01

    The histological analysis of peripheral nerve regeneration is one of the most used methods to demonstrate the success of the regeneration through nerve conduits. Nowadays, it is possible to evaluate different parameters of nerve regeneration by using histological, histochemical, immunohistochemical and ultrastructural techniques. The histochemical methods are very sensible and are useful tools to evaluate the extracellular matrix remodeling and the myelin sheath, but they are poorly speciifc. In contrast, the immunohistochemical methods are highly speciifc and are frequently used for the identiifcation of the regenerated axons, Schwann cells and proteins associated to nerve regeneration or neural linage. The ultrastructural techniques offer the possibility to perform a high resolution morphological and quantitative analysis of the nerve regeneration. However, the use of a single histological method may not be enough to assess the degree of regeneration, and the combination of different histological techniques could be necessary.

  7. Symptoms of Nerve Dysfunction After Hip Arthroscopy

    DEFF Research Database (Denmark)

    Dippmann, Christian; Thorborg, Kristian; Kraemer, Otto

    2014-01-01

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

  8. Nerves Regulate Cardiomyocyte Proliferation and Heart Regeneration.

    Science.gov (United States)

    Mahmoud, Ahmed I; O'Meara, Caitlin C; Gemberling, Matthew; Zhao, Long; Bryant, Donald M; Zheng, Ruimao; Gannon, Joseph B; Cai, Lei; Choi, Wen-Yee; Egnaczyk, Gregory F; Burns, Caroline E; Burns, C Geoffrey; MacRae, Calum A; Poss, Kenneth D; Lee, Richard T

    2015-08-24

    Some organisms, such as adult zebrafish and newborn mice, have the capacity to regenerate heart tissue following injury. Unraveling the mechanisms of heart regeneration is fundamental to understanding why regeneration fails in adult humans. Numerous studies have revealed that nerves are crucial for organ regeneration, thus we aimed to determine whether nerves guide heart regeneration. Here, we show using transgenic zebrafish that inhibition of cardiac innervation leads to reduction of myocyte proliferation following injury. Specifically, pharmacological inhibition of cholinergic nerve function reduces cardiomyocyte proliferation in the injured hearts of both zebrafish and neonatal mice. Direct mechanical denervation impairs heart regeneration in neonatal mice, which was rescued by the administration of neuregulin 1 (NRG1) and nerve growth factor (NGF) recombinant proteins. Transcriptional analysis of mechanically denervated hearts revealed a blunted inflammatory and immune response following injury. These findings demonstrate that nerve function is required for both zebrafish and mouse heart regeneration.

  9. Microsurgical anatomy and clinical application of cochlear implant via facial recess approach%经面神经隐窝径路显微解剖及人工耳蜗植入术的临床应用

    Institute of Scientific and Technical Information of China (English)

    蔡志毅; 李志海; 陶宝鸿; 章华元; 储洪娟; 叶星星

    2011-01-01

    Objective To study the anatomy of facial recess and to perform cochlear implantation via facial recess approach.Methods Thirty (60 sides) temple bone specimens were dissected to observe the dimension, shape and variation of the facialrecess.Cochlear implants were performed in 10 patients with severe sensor neural hearing loss via facial recess approach.Results Distance between the second genu of facial nerve and tympanichordal eminentia was 5.29± 0.42mm.Distance between vertical segment of facialnerve and chorda tympaninerve at level of round windowwas 2.95± 0.23mm.Distance between vertical segment of facial nerve and chorda tympani nerve at level of oval window was 3.84± 0.25mm.Distance between pyramidal eminence and round window was 3.71 ± 0.15mm.Distance between pyramidal eminence and oval window was 1.23± 0.10mm.Distance between round window and vertical segment of facial nerve was 3.82± 0.31mm.Distance between round window and oval window was 1.91± 0.16mm.The cochlear implant electrodes were inserted successfully in 10 patients.The facialnerve function were normal in all cases postoperatively.Conclusion Important anatomical landmarks of facial recess approach include round window, oval window, pyramidal eminence, facial nerve, chorda tympani nerve and lateral semicircular canals, which are essential for insertion of cochlear implant electrodes.%目的 观察经面神经隐窝径路的局部显微解剖结构,并探讨其在人工耳蜗植入术中的临床应用.方法 对30例(60侧)国人尸体头颅进行面神经隐窝的显微解剖测量;经面神经隐窝入路,对10例重度感音神经性耳聋患者施行人工耳蜗植入术.结果 面神经锥段到鼓索隆起距离为(5.29±0.42)mm;在圆窗、卵圆窗平面,面神经乳突段到鼓索神经的距离分别为(2.95±0.23)mm和(3.84±0.25)mm;锥隆起到圆窗龛和卵圆窗的距离分别为(3.71±0.15)mm和(1.23±0.10)mm;圆窗龛到面神经乳突段距离为(3.82±0.31)mm;卵

  10. Peripheral nerve imaging: Not only cross-sectional area.

    Science.gov (United States)

    Tagliafico, Alberto Stefano

    2016-08-28

    Peripheral nerve imaging is recognized as a complement to clinical and neurophysiological assessment in the evaluation of peripheral nerves with the ability to impact patient management, even for small and difficult nerves. The European Society of Musculoskeletal Radiology, suggest to use ultrasound (US) for nerve evaluation due to the fact that, in sever anatomical area, magnetic resonance imaging is not able to give additional informations. US could be considered the first-choice approach for the assessment of peripheral nerves. The relative drawback of peripheral nerve US is the long learning curve and the deep anatomic competence to evaluate even small nerves. In the recent years, the role of US in peripheral nerve evaluation has been widened. In the past, nerve US was mainly used to assess nerve-cross sectional area, but now more advanced measurements and considerations are desirable and can boost the role of peripheral nerve US. Nerve echotexture evaluation was defined in 2010: The ratio between the hypoechoic and hyperechoic areas of peripheral nerves on US was called "nerve density". For evaluation of patients who have peripheral neuropathies, the role of peripheral nerve is US wider than simple cross-sectional area evaluation. Quantitative measurements describing the internal fascicular echotexture of peripheral nerves introduce the concept of considering US as a possible quantitative imaging biomarker technique. The potential of nerve US has started to be uncovered. It seems clear that only cross-sectional area measurement is no more sufficient for a comprehensive US evaluation of peripheral nerves.

  11. Cadaveric nerve allotransplantation in the treatment of persistent thoracic neuralgia.

    Science.gov (United States)

    Barbour, John R; Yee, Andrew; Moore, Amy M; Trulock, Elbert P; Buchowski, Jacob M; Mackinnon, Susan E

    2015-04-01

    When relief from neuralgia cannot be achieved with traditional methods, neurectomy may be considered to abate the stimulus, and primary opposition of the terminal nerve ending is recommended to prevent neuroma. Nerve repair with autograft is limited by autologous nerves available for large nerve defects. Cadaveric allografts provide an unlimited graft source without donor-site morbidities, but are rapidly rejected unless appropriate immunosuppression is achieved. An optimal treatment method for nerve allograft transplantation would minimize rejection while simultaneously permitting nerve regeneration. This report details a novel experience of nerve allograft transplantation using cadaveric nerve grafts to desensitize persistent postoperative thoracic neuralgia.

  12. Multifunctional Silk Nerve Guides for Axon Outgrowth

    Science.gov (United States)

    Tupaj, Marie C.

    Peripheral nerve regeneration is a critical issue as 2.8% of trauma patients present with this type of injury, estimating a total of 200,000 nerve repair procedures yearly in the United States. While the peripheral nervous system exhibits slow regeneration, at a rate of 0.5 mm -- 9 mm/day following trauma, this regenerative ability is only possible under certain conditions. Clinical repairs have changed slightly in the last 30 years and standard methods of treatment include suturing damaged nerve ends, allografting, and autografting, with the autograft the gold standard of these approaches. Unfortunately, the use of autografts requires a second surgery and there is a shortage of nerves available for grafting. Allografts are a second option however allografts have lower success rates and are accompanied by the need of immunosuppressant drugs. Recently there has been a focus on developing nerve guides as an "off the shelf" approach. Although some natural and synthetic guidance channels have been approved by the FDA, these nerve guides are unfunctionalized and repair only short gaps, less than 3 cm in length. The goal of this project was to identify strategies for functionalizing peripheral nerve conduits for the outgrowth of neuron axons in vitro . To accomplish this, two strategies (bioelectrical and biophysical) were indentified for increasing axon outgrowth and promoting axon guidance. Bioelectrical strategies exploited electrical stimulation for increasing neurite outgrowth. Biophysical strategies tested a range of surface topographies for axon guidance. Novel methods were developed for integrating electrical and biophysical strategies into silk films in 2D. Finally, a functionalized nerve conduit system was developed that integrated all strategies for the purpose of attaching, elongating, and guiding nervous tissue in vitro. Future directions of this work include silk conduit translation into a rat sciatic nerve model in vivo for the purpose of repairing long

  13. 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.

  14. Role of sensory factors in chewing and feeding behavior.

    Science.gov (United States)

    Kawamura, Y

    1975-01-01

    Since feeding behavior has a complex physiological background, in the physiology of feeding behavoir not only the mechanisms in the hypothalamus, but also input and output physiologic factors which stimulate and/or inhibit the central network for feeding and aversion behavior, must be considered. Normal feeding and aversion behavior are accomplished by a series of highly co-ordinated physiological functions involving various parts of the body, and humoral, hormonal, metabolic, and sensory and motor functions for feeding behavior must be well considered from a wider wiew point. For this purpose, morphological, biochemical, and neurophysiological extensive approaches to study the feeding behavior mechanisms are essentially important. In the present paper, neurophysiological network concerning feeding and aversion behavior was under discussion. Particularly, relations between input, central and output factors for these behaviors were considered. As an input factor, a role of the nerve impulses of the chorda tympani and lingual nerves was evaluated. As a central factor, involvement of the neurons in the cortical taste area was discussed, and response patterns of cortical taste neurons to negative and positive taste information was analyzed with regard to taste perception mechanisms. In addition, mechanisms in the posterior hypothalamus for the taste aversion behavior were explained through ablation and recording techniques in the rat; and the neuromuscular mechanisms of chewing, which complete the feeding behavior, were also discussed. Importance of such comprehensive systematic approach to proper understanding of feeding and aversion behaviors was emphasized.

  15. Integrative role of the histaminergic system in feeding and taste perception

    Directory of Open Access Journals (Sweden)

    Tomoko eIshizuka

    2012-05-01

    Full Text Available Feeding behavior is regulated by a complex interplay of many endogenous substances, such as peptides and neurotransmitters in the central nervous system. Histamine is a neurotransmitter which expresses an anorectic effect on food intake via histamine H1 receptors. The histaminergic system exists downstream of leptin, a satiety factor secreted from white adipose tissue. Because direct stimulation of the histaminergic system by histamine H3-inverse agonists or antagonists can normalize the obese phenotype in which animal models with exogenous leptin resistance, which resembles human obesity, the potential roles of histamine H3 receptors as a therapeutic target now draw attention. Histaminergic activity is enhanced during feeding, and an oral somatic sensation is thought to affect histaminergic activity while blood glucose levels do not. In addition, gustatory information can modulate histaminergic activity by two mechanisms: by physiological excitation of the chorda tympani nerve, one of the taste nerves, and by emotions elicited by taste perception, i.e. taste palatability. Particularly, aversive and hazardous taste stimuli tonically facilitate histaminergic activity, suggesting that the histaminergic system is involved in the response to harmful stimuli. Together with recent findings, it is postulated that the histaminergic system responds to both mechanical and chemical sensory input from the oral cavity during feeding and is exerted as a part of the danger response system.

  16. Integrative role of the histaminergic system in feeding and taste perception.

    Science.gov (United States)

    Ishizuka, Tomoko; Yamatodani, Atsushi

    2012-01-01

    Feeding behavior is regulated by a complex interplay of many endogenous substances, such as peptides and neurotransmitters in the central nervous system. Histamine is a neurotransmitter which expresses an anorectic effect on food intake via histamine H(1) receptors. The histaminergic system exists downstream of leptin, a satiety factor secreted from white adipose tissue. Because direct stimulation of the histaminergic system by histamine H(3)-inverse agonists or antagonists can normalize the obese phenotype in which animal models with exogenous leptin resistance, which resembles human obesity, the potential roles of histamine H(3) receptors as a therapeutic target now draw attention. Histaminergic activity is enhanced during feeding, and an oral somatic sensation is thought to affect histaminergic activity while blood glucose levels do not. In addition, gustatory information can modulate histaminergic activity by two mechanisms: by physiological excitation of the chorda tympani nerve, one of the taste nerves and by emotions elicited by taste perception, i.e., taste palatability. Particularly, aversive and hazardous taste stimuli tonically facilitate histaminergic activity, suggesting that the histaminergic system is involved in the response to harmful stimuli. Together with recent findings, it is postulated that the histaminergic system responds to both mechanical and chemical sensory input from the oral cavity during feeding and is exerted as a part of the danger response system.

  17. Primary optic nerve sheath meningioma

    Energy Technology Data Exchange (ETDEWEB)

    Jeremic, Branislav [International Atomic Energy Agency, Vienna (Austria); Pitz, Susanne (eds.) [University Eye Hospital, Mainz (Germany)

    2008-07-01

    Optic nerve sheath meningioma (ONSM) is a rare tumour. Cases are usually separated into primary ONSM, which arises either intraorbitally or, less commonly, intracanalicularly, and secondary ONSM, which arises intracranially and subsequently invades the optic canal and orbit. This is the first book to cover all important aspects of the diagnosis and treatment of primary ONSM. After a general introduction, individual chapters discuss the clinical presentation, clinical examination and diagnosis, imaging, and histology. Treatment options are then addressed in detail, with special emphasis on external beam radiation therapy, and in particular stereotactic fractionated radiation therapy. The latter has recently produced consistently good results and is now considered the emerging treatment of choice for the vast majority of patients with primary ONSM. This well-illustrated book will prove invaluable to all practitioners who encounter primary ONSM in their clinical work. (orig.)

  18. 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.

  19. Phrenic nerve transfer to the musculocutaneous nerve for the repair of brachial plexus injury:electrophysiological characteristics

    Institute of Scientific and Technical Information of China (English)

    Ying Liu; Xun-cheng Xu; Yi Zou; Su-rong Li; Bin Zhang; Yue Wang

    2015-01-01

    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 per-formed 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 conduc-tion 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 regener-ated potentials ifrst 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 ‘ex-cellent’ 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 func-tional recovery of a transplanted nerve can be dynamically observed after the surgery.

  20. 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.

  1. Outcome following nerve repair of high isolated clean sharp injuries of the ulnar nerve.

    Directory of Open Access Journals (Sweden)

    René Post

    Full Text Available OBJECTIVE: The detailed outcome of surgical repair of high isolated clean sharp (HICS ulnar nerve lesions has become relevant in view of the recent development of distal nerve transfer. Our goal was to determine the outcome of HICS ulnar nerve repair in order to create a basis for the optimal management of these lesions. METHODS: High ulnar nerve lesions are defined as localized in the area ranging from the proximal forearm to the axilla just distal to the branching of the medial cord of the brachial plexus. A meta-analysis of the literature concerning high ulnar nerve injuries was performed. Additionally, a retrospective study of the outcome of nerve repair of HICS ulnar nerve injuries at our institution was performed. The Rotterdam Intrinsic Hand Myometer and the Rosén-Lundborg protocol were used. RESULTS: The literature review identified 46 papers. Many articles presented outcomes of mixed lesion groups consisting of combined ulnar and median nerves, or the outcome of high and low level injuries was pooled. In addition, outcome was expressed using different scoring systems. 40 patients with HICS ulnar nerve lesions were found with sufficient data for further analysis. In our institution, 15 patients had nerve repair with a median interval between trauma and reconstruction of 17 days (range 0-516. The mean score of the motor and sensory domain of the Rosen's Scale instrument was 58% and 38% of the unaffected arm, respectively. Two-point discrimination never reached less then 12 mm. CONCLUSION: From the literature, it was not possible to draw a definitive conclusion on outcome of surgical repair of HICS ulnar nerve lesions. Detailed neurological function assessment of our own patients showed that some ulnar nerve function returned. Intrinsic muscle strength recovery was generally poor. Based on this study, one might cautiously argue that repair strategies of HICS ulnar nerve lesions need to be improved.

  2. Gene therapy in peripheral nerve reconstruction approaches.

    Science.gov (United States)

    Haastert, Kirsten; Grothe, Claudia

    2007-06-01

    Gene transfer to a transected peripheral nerve or avulsed nerve root is discussed to be helpful where neurosurgical peripheral nerve reconstruction alone will not result in full recovery of function. Axonal regeneration is supposed to be facilitated by this new therapeutic approach via delivery of specific regeneration promoting molecules as well as survival proteins for the injured sensory and motor neurons. Therefore gene therapy aims in long-term and site-specific delivery of those neurotrophic factors. This paper reviews methods and perspectives for gene therapy to promote functional recovery of severely injured and thereafter reconstructed peripheral nerves. Experimental in vivo and ex vivo gene therapy approaches are reported by different groups. In vivo gene therapy generally uses direct injection of cDNA vectors to injured peripheral nerves. Ex vivo gene therapy is based on the isolation of autologous cells followed by genetic modification of these cells in vitro and re-transplantation of the modified cells to the patient as part of tissue engineered nerve transplants. Vectors of different origin are published to be suitable for peripheral nerve gene therapy and this review discusses the different strategies with regard to their efficiency in gene transfer, their risks and their potential relevance for clinical application.

  3. Terminal Branch of Recurrent Human Laryngeal Nerve

    Directory of Open Access Journals (Sweden)

    Andréa Aparecida Ferreira Pascoal

    2014-01-01

    Full Text Available The importance of the recurrent laryngeal nerve in surgery on the anterior region of the neck has motivated many published papers on critical points of its pathway, relationship with the inferior thyroid artery, penetration in the larynx, division outside the larynx, and branches communicating with the internal branch of the superior laryngeal nerve. We analyze the terminal branches of the recurrent laryngeal nerve and their distribution through the laryngeal muscles. 44 laryngeal nerves had been dissected. Most frequently, the recurrent laryngeal nerve presents a division below or at the level of the lower margin of the cricoid cartilage (outside the larynx. One of these branches forms the communication with the internal branch of the superior laryngeal nerve, and the other penetrates the laryngeal space. Above the lower margin of the cricoid cartilage, the inferior laryngeal nerve issues a variable number of branches to muscles (3 to 7: to the posterior cricoarytenoid muscle; to the oblique and transversal arytenoid muscles; and to the lateral cricoarytenoid muscle and the thyroarytenoid muscle.

  4. The Ultrasonographic Findings of Bifid Median Nerve

    Energy Technology Data Exchange (ETDEWEB)

    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. Surgical management of third nerve palsy

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    Anupam Singh

    2016-01-01

    Full Text Available Third nerve paralysis has been known to be associated with a wide spectrum of presentation and other associated factors such as the presence of ptosis, pupillary involvement, amblyopia, aberrant regeneration, poor bell′s phenomenon, superior oblique (SO overaction, and lateral rectus (LR contracture. Correction of strabismus due to third nerve palsy can be complex as four out of the six extraocular muscles are involved and therefore should be approached differently. Third nerve palsy can be congenital or acquired. The common causes of isolated third nerve palsy in children are congenital (43%, trauma (20%, inflammation (13%, aneurysm (7%, and ophthalmoplegic migraine. Whereas, in adult population, common etiologies are vasculopathic disorders (diabetes mellitus, hypertension, aneurysm, and trauma. Treatment can be both nonsurgical and surgical. As nonsurgical modalities are not of much help, surgery remains the main-stay of treatment. Surgical strategies are different for complete and partial third nerve palsy. Surgery for complete third nerve palsy may involve supra-maximal recession - resection of the recti. This may be combined with SO transposition and augmented by surgery on the other eye. For partial third nerve, palsy surgery is determined according to nature and extent of involvement of extraocular muscles.

  6. Anatomical considerations to prevent facial nerve injury.

    Science.gov (United States)

    Roostaeian, Jason; Rohrich, Rod J; Stuzin, James M

    2015-05-01

    Injury to the facial nerve during a face lift is a relatively rare but serious complication. A large body of literature has been dedicated toward bettering the understanding of the anatomical course of the facial nerve and the relative danger zones. Most of these prior reports, however, have focused on identifying the location of facial nerve branches based on their trajectory mostly in two dimensions and rarely in three dimensions. Unfortunately, the exact location of the facial nerve relative to palpable or visible facial landmarks is quite variable. Although the precise location of facial nerve branches is variable, its relationship to soft-tissue planes is relatively constant. The focus of this report is to improve understanding of facial soft-tissue anatomy so that safe planes of dissection during surgical undermining may be identified for each branch of the facial nerve. Certain anatomical locations more prone to injury and high-risk patient parameters are further emphasized to help minimize the risk of facial nerve injury during rhytidectomy.

  7. Posterior Interosseous Nerve Syndrome from Thermal Injury

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    Vijay A. Singh

    2014-01-01

    Full Text Available Background. Due to anatomical proximity to bone, the radial nerve is the most frequently injured major nerve of the upper extremity, frequently secondary to fractures (Li et al. (2013. We describe an incidence when a branch of the radial nerve is injured as a result of a thermal injury. Observation. Radial nerve injury can occur anywhere along the anatomical course with varied etiologies, but commonly related to trauma. The most frequent site is in the proximal forearm involving the posterior interosseous branch. However, problems can occur at the junction of the middle and proximal thirds of the humerus and wrist radially. When the radial nerve is injured by a burn, a new rehabilitation dynamic arises. Not only does one agonize about the return of nerve function but also fret about the skin grafts that replaced the devitalized tissue housing that compartment. Discussion. Although posterior interosseous nerve syndrome has been described in the context of many different etiologies, it has not previously been discussed in relation to burn injuries. In this case, not only did the patient’s rehabilitation involve aggressive therapy for return of sensation and function of the arm, but also prevention of contracture normally seen in replacement of full thickness burns.

  8. Unilateral optic nerve aplasia associated with microphthalmos

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    Stanković-Babić Gordana

    2012-01-01

    Full Text Available Intraduction. Optic nerve aplasia is a rare developmental anomaly characterised by the congenital absence of the optic nerve, central retinal vessels and retinal ganglion cells that is seen most often in a unilaterally malformed eye. Case report. We reported a girl with a very rare anomaly of the eye, unilateral aplasia of the optic nerve and microphthalmia. We carried out a complete ophthalmological examination, A- and Bscan ultrasonography, magnetic resonance imaging (MRI of the orbit and brain, pediatrician, neurological examinations and karyotype determination. The examined child was a third child from the third regular pregnancy, born at term (39 GS, BM 3100 g. Family ocular history was negative. The right corneal diameter was 7.5 mm and left 10 mm. On dilated fundus examination, the right eye showed the absence of optic nerve and central retinal vessels. B-scan echography showed a small right globe (axial length 13.80 mm, normal size left globe (axial length 18.30 mm and the absence of optic nerve on the right eye. Physical and neurological findings and karyotype was normal. MRI of the orbits and brain marked asymmetry of globe size and unilateral absence of the optic nerve. The patient is under the control of a competent ophthalmologist and prosthetic. Conclusion. Further aesthetic and functional development of a young person is the primary goal in tracking this rare congenital optic nerve anomalies in the malformed eye.

  9. Study on Variant Anatomy of Sciatic Nerve

    Science.gov (United States)

    V, Sangeetha

    2014-01-01

    Introduction: Sciatic Nerve (SN) is the nerve of the posterior compartment of thigh formed in the pelvis from the ventral rami of the L4 to S3 spinal nerves. It leaves the pelvis via the greater sciatic foramen below piriformis and divides into Common Peroneal Nerve (CPN) and Tibial Nerve (TN) at the level of the upper angle of the popliteal fossa. Higher division of the sciatic nerve is the most common variation where the TN and CPN may leave the pelvis through different routes. Such variation may lead to compression of the nerve and lead to Non-discogenic sciatica. Materials and Methods: Fifty lower limbs were used for the study from Department of Anatomy, J.J.M.M.C Davangere, Karnataka, India. Observation and Results: In our study on 25 cadavers (50 lower limbs), we have observed 4 (8 %) lower limbs high division of sciatic nerve was noted. High division of sciatic nerve in the back of thigh was noted in one specimen (2%), while high division within the pelvis was noted in 3 specimens (6%), while in 46 (92%) it occurred outside the pelvis. Conclusion: Knowledge regarding such variation and differences in the course of SN is important for the surgeons to plan for various surgical interventions pertaining to the gluteal region. The variant anatomy of SN may cause piriformis syndrome and failure of SN block. Hence present study is undertaken to know the level of division, exit, course, relationship to piriformis and variations in the branching pattern of SN. PMID:25302181

  10. Nerve injury caused by mandibular block analgesia

    DEFF Research Database (Denmark)

    Hillerup, S; Jensen, Rigmor H

    2006-01-01

    Fifty-four injection injuries in 52 patients were caused by mandibular block analgesia affecting the lingual nerve (n=42) and/or the inferior alveolar nerve (n=12). All patients were examined with a standardized test of neurosensory functions. The perception of the following stimuli was assessed......: feather light touch, pinprick, sharp/dull discrimination, warm, cold, point location, brush stroke direction, 2-point discrimination and pain perception. Gustation was tested for recognition of sweet, salt, sour and bitter. Mandibular block analgesia causes lingual nerve injury more frequently than...

  11. Intratemporal Hemangiomas Involving the Facial Nerve

    Science.gov (United States)

    Bhatia, Sanjaya; Karmarkar, Sandeep; Calabrese, V.; Landolfi, Mauro; Taibah, Abdelkader; Russo, Alessandra; Mazzoni, Antonio; Sanna, Mario

    1995-01-01

    Intratemporal vascular tumors involving the facial nerve are rare benign lesions. Because of their variable clinical features, they are often misdiagnosed preoperatively. This study presents a series of 21 patients with such lesions managed from 1977 to 1994. Facial nerve dysfunction was the most common complaint, present in 60% of the cases, followed by hearing loss, present in 40% of cases. High-resolution computed tomography, magnetic resonance imaging with gadolinium, and a high index of clinical suspicion is required for preoperative diagnosis of these lesions. Early surgical resection of these tumors permits acceptable return of facial nerve function in many patients. ImagesFigure 1Figure 2Figure 3 PMID:17170963

  12. Variant position of the medial plantar nerve

    Directory of Open Access Journals (Sweden)

    Astik RB

    2011-01-01

    Full Text Available Knowledge of variation of position of the medial plantar nerve is important for the forefoot surgeon for plantar reconstruction, local injection therapy and an excision of interdigital neuroma. During routine dissection of 50-year-old female cadaver, we found the medial plantar nerve and vessels variably located between plantar aponeurosis and the muscles of the first layer of the sole of the right foot. Due to this variant position, the medial plantar nerve and vessels lose their protection from the muscles of the first layer of the sole of the foot and became vulnerable for compression.

  13. Expression changes of nerve cell adhesion molecules L1 and semaphorin 3A after peripheral nerve injury

    Directory of Open Access Journals (Sweden)

    Qian-ru He

    2016-01-01

    Full Text Available The expression of nerve cell adhesion molecule L1 in the neuronal growth cone of the central nervous system is strongly associated with the direction of growth of the axon, but its role in the regeneration of the peripheral nerve is still unknown. This study explored the problem in a femoral nerve section model in rats. L1 and semaphorin 3A mRNA and protein expressions were measured over the 4-week recovery period. Quantitative polymerase chain reaction showed that nerve cell adhesion molecule L1 expression was higher in the sensory nerves than in motor nerves at 2 weeks after injury, but vice versa for the expression of semaphorin 3A. Western blot assay results demonstrated that nerve cell adhesion molecule L1 expression was higher in motor nerves than in the sensory nerves at the proximal end after injury, but its expression was greater in the sensory nerves at 2 weeks. Semaphorin 3A expression was higher in the motor nerves than in the sensory nerves at 3 days and 1 week after injury. Nerve cell adhesion molecule L1 and semaphorin 3A expressions at the distal end were higher in the motor nerves than in the sensory nerves at 3 days, 1 and 2 weeks. Immunohistochemical staining results showed that nerve cell adhesion molecule L1 expression at the proximal end was greater in the sensory nerves than in the motor nerves; semaphorin 3A expression was higher in the motor nerves than in the sensory nerves at 2 weeks after injury. Taken together, these results indicated that nerve cell adhesion molecules L1 and semaphorin 3A exhibited different expression patterns at the proximal and distal ends of sensory and motor nerves, and play a coordinating role in neural chemotaxis regeneration.

  14. [Anatomical study of the cavernous nerve in relation to nerve sparing operation].

    Science.gov (United States)

    Hanawa, K

    1994-08-01

    Recently, nerve sparing radical prostatectomy has became widely considered as the primary goal for maintaining a high standard of quality of life (QOL). However, anatomical localization of the cavernous nerve has not yet been precisely clarified in terms of the terminal end in the corpus cavernous penis distal to the urogenital membrane. Here in attempt to demonstrate the precise localization of the cavernous nerve, in six adult male cadaver. The cavernous nerves ran between the prostatic capsule and the prostatic fascia, through the capsule of the seminal vesicle. The nerves penetrated the membranous urethra at 8 mm from the margin of the urethra at the position of 5 and 7 o'clock. Therefore, the following procedures are critical to achieve successful nerve sparing: 1) meticulous division of the seminal-vesicle, 2) precise separation of the neurovascular bundle between the prostatic capsule and fascia, and 3) the careful transaction of the membranous urethra.

  15. Sericin protects against diabetes-induced injuries in sciatic nerve and related nerve cells

    Institute of Scientific and Technical Information of China (English)

    Chengjun Song; Zhenjun Yang; Meirong Zhong; Zhihong Chen

    2013-01-01

    Sericin from discarded silkworm cocoons of silk reeling has been used in different fields, such as cosmetology, skin care, nutrition, and oncology. The present study established a rat model of type 2 diabetes by consecutive intraperitoneal injections of low-dose (25 mg/kg) streptozotocin. After intragastrical perfusion of sericin for 35 days, blood glucose levels significantly declined, and the expression of neurofilament protein in the sciatic nerve and nerve growth factor in L4–6 spinal ganglion and anterior horn cells significantly increased. However, the expression of neuropeptide Y in spinal ganglion and anterior horn cells significantly decreased in model rats. These findings indicate that sericin protected the sciatic nerve and related nerve cells against injury in a rat type 2 diabetic model by upregulating the expression of neurofilament protein in the sciatic nerve and nerve growth factor in spinal ganglion and anterior horn cells, and downregulating the expression of neuropeptide Y in spinal ganglion and anterior horn cells.

  16. Nerve transfers and neurotization in peripheral nerve injury, from surgery to rehabilitation.

    Science.gov (United States)

    Korus, Lisa; Ross, Douglas C; Doherty, Christopher D; Miller, Thomas A

    2016-02-01

    Peripheral nerve injury (PNI) and recent advances in nerve reconstruction (such as neurotization with nerve transfers) have improved outcomes for patients suffering peripheral nerve trauma. The purpose of this paper is to bridge the gap between the electromyographer/clinical neurophysiologist and the peripheral nerve surgeon. Whereas the preceding literature focuses on either the basic science behind nerve injury and reconstruction, or the surgical options and algorithms, this paper demonstrates how electromyography is not just a 'decision tool' when deciding whether to operate but is also essential to all phases of PNI management including surgery and rehabilitation. The recent advances in the reconstruction and rehabilitation of PNI is demonstrated using case examples to assist the electromyographer to understand modern surgical techniques and the unique demands they ask from electrodiagnostic testing.

  17. Transection of peripheral nerves, bridging strategies and effect evaluation

    NARCIS (Netherlands)

    IJkema-Paassen, J; Jansen, K; Gramsbergen, A; Meek, MF

    2004-01-01

    Disruption of peripheral nerves due to trauma is a frequently Occurring clinical problem. Gaps in the nerve are bridged by guiding the regenerating nerves along autologous grafts or artificial guides. This review gives an overview oil the different methods of nerve repair techniques. Conventional su

  18. A rare case of malignant peripheral nerve sheath tumour

    Directory of Open Access Journals (Sweden)

    Anita Harry, Nirankumar Samuel, Vigil TD

    2014-04-01

    Full Text Available Malignant Peripheral Nerve Sheath Tumours are tumours of ectomesenchymal origin often originating from major nerves or their nerve sheaths, they are commonly found in patients with neurofibromatosis-1 though sporadic cases have been reported. We report a rare sporadic case of MPNST in a 20 year old patient arising from the spinal accessory nerve.

  19. [Peripheral nerve injuries complicating extracranial vascular surgery (author's transl)].

    Science.gov (United States)

    Grobe, T; Raithel, D

    1978-10-01

    Peripheral nerve injuries may complicate extracranial vascular surgery. Pareses of the recurrent and hypoglossal nerves are clinically important. The nervus laryngeus superior, the ramus marginalis mandibulae of the facial nerve and the brachial plexus may be involved. Horner's syndrom indicating damage of sympathetic fibers may also appear. Lesions of the glossopharyngeal, vagus and phrenic nerves are rather seldom.

  20. Neuroprotective effects of ultrasound-guided nerve growth factor injections after sciatic nerve injury

    OpenAIRE

    Hong-fei Li; Yi-ru Wang; Hui-ping Huo; Yue-xiang Wang; Jie Tang

    2015-01-01

    Nerve growth factor (NGF) plays an important role in promoting neuroregeneration after peripheral nerve injury. However, its effects are limited by its short half-life; it is therefore important to identify an effective mode of administration. High-frequency ultrasound (HFU) is increasingly used in the clinic for high-resolution visualization of tissues, and has been proposed as a method for identifying and evaluating peripheral nerve damage after injury. In addition, HFU is widely used for g...

  1. Inflammatory trigeminal nerve and tract lesions associated with inferior alveolar nerve anaesthesia.

    Science.gov (United States)

    Blair, N F; Parratt, J D E; Garsia, R; Brazier, D H; Cremer, P D

    2013-11-01

    Inferior alveolar nerve blocks are commonly performed for dental anaesthesia. The procedure is generally safe with a low rate of complications. We report a patient with a reproducible, delayed-onset sensory deficit associated with contrast-enhancing lesions in the trigeminal nerve, pons and medulla following inferior alveolar nerve local anaesthesia. We propose that this previously undescribed condition is a form of Type IV hypersensitivity reaction.

  2. Median Nerve Repair with Autologous Sciatic Nerve Graft: A Case Report

    OpenAIRE

    Ragel, Brian T.; Park, Gregory C.; Sid Brevard

    2011-01-01

    Background. Peripheral nerve injury treatment options are limited to primary nerve repair, nerve grafting, and tendon transfers. In this case, a large suitable donor site was easily accessible and delayed grafting was indicative of poor prognosis. Case Description. A 25-year-old soldier presented to a military hospital in Afghanistan following a roadside bomb attack. The patient had a medial shrapnel wound in the bicipital groove with a cool pulseless hand and catastrophic lower extremity inj...

  3. A polylactic acid non-woven nerve conduit for facial nerve regeneration in rats.

    Science.gov (United States)

    Matsumine, Hajime; Sasaki, Ryo; Yamato, Masayuki; Okano, Teruo; Sakurai, Hiroyuki

    2014-06-01

    This study developed a biodegradable nerve conduit with PLA non-woven fabric and evaluated its nerve regeneration-promoting effect. The buccal branch of the facial nerve of 8 week-old Lewis rats was exposed, and a 7 mm nerve defect was created. A nerve conduit made of either PLA non-woven fabric (mean fibre diameter 460 nm), or silicone tube filled with type I collagen gel, or an autologous nerve, was implanted into the nerve defect, and their nerve regenerative abilities were evaluated 13 weeks after the surgery. The number of myelinated neural fibres in the middle portion of the regenerated nerve was the highest for PLA tubes (mean ± SD, 5051 ± 2335), followed by autologous nerves (4233 ± 590) and silicone tubes (1604 ± 148). Axon diameter was significantly greater in the PLA tube group (5.17 ± 1.69 µm) than in the silicone tube group (4.25 ± 1.60 µm) and no significant difference was found between the PLA tube and autograft (5.53 ± 1.93 µm) groups. Myelin thickness was greatest for the autograft group (0.65 ± 0.24 µm), followed by the PLA tube (0.54 ± 0.18 µm) and silicone tube (0.38 ± 0.12 µm) groups, showing significant differences among the three groups. The PLA non-woven fabric tube, composed of randomly-connected PLA fibres, is porous and has a number of advantages, such as sufficient strength to maintain luminal structure. The tube has demonstrated a comparable ability to induce peripheral nerve regeneration following autologous nerve transplantation.

  4. Comparison of safety and efficiency of microendoscopic discectomy with automatic nerve retractor and with nerve hook

    OpenAIRE

    Yin, He-Ping; Wang, Yu-Peng; Qiu, Zhi-Ye; Du, Zhi-Cai; Wu, Yi-Min; Li, Shu-Wen

    2016-01-01

    This study compares the safety and efficiency of two techniques in microendoscopic discectomy (MED) for lumbar disc herniation. The two techniques are MED with automatic nerve retractor and MED with nerve hook which had been widely used for many years. The former involves a newly developed MED device which contains three parts to protect nerve roots during operation. Four hundred and twenty-eight patients underwent MED treatments between October 2010 and September 2015 were recruited and rand...

  5. Catecholamine-containing nerve fibres in the human abdominal vagus.

    Science.gov (United States)

    Lundberg, J; Ahlman, H; Dahlström, A; Kewenter, J

    1976-03-01

    The vagal nerve of man has been investigated for the presence of adrenergic nerve fibres using the histochemical fluorescence method of Hillarp and Falck. Following 30-60 min of nerve ligation during surgical operations, the right anterior main trunk (subdiafragmatic level) from one patient, and the anterior nerve of Latarget of 5 patients were found to contain unmyelinated nerve fibres with accumulations of green fluorescent material representing a catecholamine. The observations indicate the presence of adrenergic nerve fibres running caudally in the human vagal nerve, in accordance with similar findings in other mammals, e.g. cats and dogs.

  6. Prevention and Management of Nerve Injuries in Thoracic Surgery.

    Science.gov (United States)

    Auchincloss, Hugh G; Donahue, Dean M

    2015-11-01

    Nerve injuries can cause substantial morbidity after thoracic surgical procedures. These injuries are preventable, provided that the surgeon has a thorough understanding of the anatomy and follows important surgical principles. When nerve injuries occur, it is important to recognize the options available in the immediate and postoperative settings, including expectant management, immediate nerve reconstruction, or auxiliary procedures. This article covers the basic anatomy and physiology of nerves and nerve injuries, an overview of techniques in nerve reconstruction, and a guide to the nerves most commonly involved in thoracic operative procedures.

  7. Low intensity laser treatment of nerve injuries

    Science.gov (United States)

    Liu, Xiao-Guang; Liu, Timon Cheng-Yi; Luo, Qing-Ming

    2007-05-01

    The neural regeneration and functional recovery after nerve injuries has long been an important field in neuroscience. Low intensity laser (LIL) irradiation is a novel and useful tool for the treatment of many injuries and disorders. The aim of this study was to assess the role of LIL irradiation in the treatment of peripheral and central nerve injuries. Some animal experiments and clinical investigations have shown beneficial effects of LIL irradiation on neural tissues, but its therapeutic value and efficacy are controversial. Reviewing the data of experimental and clinical studies by using the biological information model of photobiomodulation, we conclude that LIL irradiation in specific parameters can promote the regeneration of injured peripheral and central nerves and LIL therapy is a safe and valuable treatment for superficial peripheral nerve injuries and spinal cord injury. The biological effects of LIL treatment depend largely on laser wavelength, power and dose per site and effective irradiation doses are location-specific.

  8. Ulnar nerve paralysis after forearm bone fracture.

    Science.gov (United States)

    Schwartsmann, Carlos Roberto; Ruschel, Paulo Henrique; Huyer, Rodrigo Guimarães

    2016-01-01

    Paralysis or nerve injury associated with fractures of forearm bones fracture is rare and is more common in exposed fractures with large soft-tissue injuries. Ulnar nerve paralysis is a rare condition associated with closed fractures of the forearm. In most cases, the cause of paralysis is nerve contusion, which evolves with neuropraxia. However, nerve lacerations and entrapment at the fracture site always need to be borne in mind. This becomes more important when neuropraxia appears or worsens after reduction of a closed fracture of the forearm has been completed. The importance of diagnosing this injury and differentiating its features lies in the fact that, depending on the type of lesion, different types of management will be chosen.

  9. Zika Attacks Nerves, Muscles, Other Tissues

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_164010.html Zika Attacks Nerves, Muscles, Other Tissues Monkey study may ... 2017 (HealthDay News) -- Scientists have learned where the Zika virus attacks the body in monkeys. In their ...

  10. Neurologic complication after anterior sciatic nerve block.

    Science.gov (United States)

    Shah, Shruti; Hadzic, Admir; Vloka, Jerry D; Cafferty, Maureen S; Moucha, Calin S; Santos, Alan C

    2005-05-01

    The lack of reported complications related to lower extremity peripheral nerve blocks (PNBs) may be related to the relatively infrequent application of these techniques and to the fact that most such events go unpublished. Our current understanding of the factors that lead to neurologic complications after PNBs is limited. This is partly the result of our inability to conduct meaningful retrospective studies because of a lack of standard and objective monitoring and documentation procedures for PNBs. We report a case of permanent injury to the sciatic nerve after sciatic nerve block through the anterior approach and discuss mechanisms that may have led to the injury. Intraneural injection and nerve injury can occur in the absence of pain on injection and it may be heralded by high injection pressure (resistance).

  11. Nerve excitability in the rat forelimb

    DEFF Research Database (Denmark)

    Arnold, Ria; Moldovan, Mihai; Rosberg, Mette Romer;

    2017-01-01

    Background Nerve excitability testing by threshold-tracking is the only available method to study axonal ion channel function and membrane potential in the clinical setting. The measures are, however, indirect and the interpretation of neuropathic changes remains challenging. The same multiple...... measures of axonal excitability were adapted to further explore the pathophysiological changes in rodent disease models under pharmacologic and genetic manipulations. These studies are typically limited to the investigation of the “long nerves” such as the tail or the tibial nerves. New method We introduce...... a novel setup to explore the ulnar nerve excitability in rodents. We provide normative ulnar data in 11 adult female Long Evans rats under anaesthesia by comparison with tibial and caudal nerves. Additionally, these measures were repeated weekly on 3 occasions to determine the repeatability of these tests...

  12. Nerve abscess in primary neuritic leprosy.

    Science.gov (United States)

    Rai, Dheeraj; Malhotra, Hardeep Singh; Garg, Ravindra Kumar; Goel, Madhu Mati; Malhotra, Kiran Preet; Kumar, Vijay; Singh, Arun Kumar; Jain, Amita; Kohli, Neera; Singh, Shailesh Kumar

    2013-06-01

    Nerve abscess is an infrequently reported complication of leprosy. We describe a patient with a pure neuritic type of leprosy with multiple nerve abscesses, who presented with tingling and numbness in the medial aspect of his right forearm and hand. Subsequently he developed pain, redness and swelling over the medial side of his right elbow and the flexor aspect of his right wrist. High-resolution ultrasound showed diffuse thickening of the right ulnar nerve with hypoechoic texture housing a cystic lesion with internal debris suggesting an abscess, at the cubital tunnel. Histopathological examination of the pus and tissue obtained from the abscess revealed presence of granulomas with lepra bacilli. The patient responded to surgery and multidrug therapy. In conclusion, the nerve abscess as the first manifestation of leprosy is uncommon and a high index of suspicion is required to make a correct diagnosis.

  13. Intrasellar malignant peripheral nerve sheath tumor (MPNST).

    Science.gov (United States)

    Krayenbühl, N; Heppner, F; Yonekawa, Y; Bernays, R L

    2007-02-01

    Intracranial malignant peripheral nerve sheath tumors (MPNST) and intrasellar schwannomas are rare tumors. We describe a case of an intrasellar schwannoma with progression to a MPNST, a finding that, although very rare, extends the differential diagnosis of intrasellar lesions.

  14. Ulnar nerve paralysis after forearm bone fracture

    Directory of Open Access Journals (Sweden)

    Carlos Roberto Schwartsmann

    2016-08-01

    Full Text Available ABSTRACT Paralysis or nerve injury associated with fractures of forearm bones fracture is rare and is more common in exposed fractures with large soft-tissue injuries. Ulnar nerve paralysis is a rare condition associated with closed fractures of the forearm. In most cases, the cause of paralysis is nerve contusion, which evolves with neuropraxia. However, nerve lacerations and entrapment at the fracture site always need to be borne in mind. This becomes more important when neuropraxia appears or worsens after reduction of a closed fracture of the forearm has been completed. The importance of diagnosing this injury and differentiating its features lies in the fact that, depending on the type of lesion, different types of management will be chosen.

  15. Facial nerve palsy due to birth trauma

    Science.gov (United States)

    Seventh cranial nerve palsy due to birth trauma; Facial palsy - birth trauma; Facial palsy - neonate; Facial palsy - infant ... this condition. Some factors that can cause birth trauma (injury) include: Large baby size (may be seen ...

  16. Expression of nerve growth factor and its receptor in distracted tibial nerve after limb lengthening.

    Science.gov (United States)

    Shao, Heng; Shu, Hengsheng; Wang, Chunmei; Yuan, Wu; Li, Yunsheng

    2013-02-01

    Despite many experimental and clinical studies conducted on distraction osteogenesis (DO) in the past decade, changes in the surrounding tissues that occur after the procedure remains poorly understood. To study the biochemical changes of recovery in nerve tissues upon DO-induced nerve injury, we prepared a rabbit model of tibia lengthening to observe the expression pattern of nerve growth factor (NGF) and low-affinity NGF receptor (p75NGFR) in the distracted tibial nerve. The distracted tibial nerve was harvested at various time points during the consolidation period of new bone formation and immunohistochemical staining was performed to detect the expression of NGF and p75NGFR. The expression levels of NGF and p75NGFR were found to be different at various times after DO. The changes in expression of these two cellular factors show similar tendencies with significantly elevated expression in Schwann cells at 7 and 14 days after distraction, but low or undetectable levels of expression at 0, 28, and 56 days. These results suggest that NGF and p75NGFR may play important roles in the adaptive process of the distracted nerve. NGF and p75NGFR are autocrine growth factors present in the distracted nerve during the early consolidation period. NGF interacts with p75NGFR to promote damage repair and reconstruction of nerves. Together, this study furthers the understanding of the relative mechanisms of nerve repair, as well as provides a further basis for the clinical application of neurotrophins.

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

    Science.gov (United States)

    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

  18. Enhanced MRI in compressed lumbosacral nerve root; Alteration of vascular peameability in nerve root

    Energy Technology Data Exchange (ETDEWEB)

    Morita, Tomofumi; Yoshizawa, Hidezo; Nakai, Sadaaki; Kobayashi, Shigeru; Hachiya, Hiromichi; Nakagawa, Masato; Nishimoto, Satoshi (Fujita Health Univ., Toyoake, Aichi (Japan). School of Medicine)

    1993-04-01

    The study was undertaken to assess how enhanced MRI reflects pathophysiology of the nerve root. In fundamental study, the seventh left lumbar nerve root was compressed by a clip for one hour in 10 mongrel dogs. Thirty min after removal of mechanical compression, gadolinium and Evans blue albumin (EBA) were iv injected. Then, the dogs were killed 10 min later. A mass of lumbosacral nerve root was removed for MR imaging. In addition, nerve root slices were prepared to examine changes in vascular permeability of EBA under microscopy. The compression area of nerve root was seen as hyperintensity on enhanced MRI, corresponding to extravascular leakage of EBA that resulted from the damaged blood-nerve barrier, i.e., edema within the root on microscope. In a clinical setting, 27 patients with lumbar disc herniation underwent MRI for the observation of the nerve root. In 8 of these 27 patients, the nerve root was seen as hyperintensity. This suggests that approximately one third of such patients may have edema within the nerve root. (N.K.).

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

    Directory of Open Access Journals (Sweden)

    Mohammadi Rahim

    2013-12-01

    Full Text Available 【Abstract】Objective: To evaluate the local effect of vascular endothelial growth factor (VEGF on transected sciatic nerve regeneration. Methods: Sixty male white Wistar rats were divided into four experimental groups randomly (n=15. In transected group the left sciatic nerve was transected and the stump was fixed to adjacent muscle. In treatment group the defect was bridged using a silicone graft filled with 10 µL VEGF. In silicone group the graft was filled with phosphate-buffered saline. In sham-operated group the sciatic nerve was ex- posed and manipulated. Each group was subdivided into three subgroups with five animals in each and nerve fibers were studied 4, 8 and 12 weeks after operation. Results: Behavioral test, functional study of sciatic nerve, gastrocnemius muscle mass and morphometric indi- ces confirmed a faster recovery of regenerated axons in VEGF group than in silicone group (P<0.05. In immunohistochemi- cal assessment, reactions to S-100 in VEGF group were more positive than that in silicone group. Conclusion: Local administration of VEGF will im- prove functional recovery and morphometric indices of sci- atic nerve. Key words: Peripheral nerves; Nerve regeneration; Sciatic nerve; Vascular endothelial growth factor

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

    Institute of Scientific and Technical Information of China (English)

    Mingtang Gao; Dianming Jiang; Hong An

    2006-01-01

    BACKGROUND: Some experimental studies demonstrate that subcutaneous implant of allograft can significantly decrease lymphocyte infiltration and reduce immunological reaction. However, compared with autologous nerve grafting, what is the effect of nerve regeneration after repair?OBJECTIVE: To observe the local nervous status of the detected part of sciatic nerve repaired through subcutaneously implanting peripheral nerve allograft, and compare the effect with fresh autologous nerve grafting.DESIGN: Contrast observation.SETTING: Departments of Orthopaedics of Zhengzhou Fifth People's Hospital and First Hospital Affiliated to Chongqing Medical University.MATERIALS: Totally 30 healthy adult Wistar male rats, with body mass of (200±20)g, were enrolled. Optical microscope (Olympus biological microscope BHS, Japan), Electron microscope (H-600, Japan),CM-2000 biomedical image analysis system (CM-2000,Beihang) and myoelectricity scanner (KEYPOINT,Denmark) were used in this experiment.METHODS: This experiment was carried out in the Orthopaedic Laboratory of Chongqing Medical University between October 2000 and April 2002. ① Six rats were chosen as the donors for allogenic nerve grafting,and 15 mm sciatic nerve segment was chosen as graft. The other rats were randomly divided into two groups: allogenic nerve grafting group and autologous nerve grafting group, with 12 rats in each group. In the allogenic nerve grafting group, a skin incision was made on the posterior side of right thigh, and subcutaneous blunt dissection was performed prorsally a little, then allograft was implanted. Two weeks later, sciatic nerve was exposed at the posterior side of left thigh and cut respectively at 5 mm and another 10 mm away from pelvis. The donor nerve (with connective tissue veil) implanted subcutaneously on the right thigh was taken out. Sectioned connective tissue at the proximal end was trimmed and that at the distal end as done but reserved 10 mm in length, and inosculated

  1. Extratemporal Malignant Nerve Sheath Tumor of Facial Nerve with Coexistent Intratemporal Neurofibroma Mimicking Malignant Intratemporal Extension

    Directory of Open Access Journals (Sweden)

    Mitsuhiko Nakahira

    2015-01-01

    Full Text Available We present an extremely unusual case of an extratemporal facial nerve malignant peripheral nerve sheath tumor (MPNST arising from preexistent intratemporal neurofibroma, illustrating a difficulty in discriminating between perineural spread of the MPNST and the preexistent intratemporal neurofibroma on preoperative radiographic images. The most interesting point was that preoperative CT scan and MR images led to misinterpretation that MPNST extended proximally along the facial nerve canal. It is important to recognize that the intratemporal perineural spread of neurofibromas and MPNST share common imaging characteristics. This is the first report (to our knowledge of these 2 lesions coexisting in the facial nerve, leading to misinterpretation on preoperative images.

  2. Mechanical tension promotes skin nerve regeneration by upregulating nerve growth factor expression

    Institute of Scientific and Technical Information of China (English)

    Hu Xiao; Dechang Wang; Ran Huo; Yibing Wang; Yongqiang Feng; Qiang Li

    2013-01-01

    This study aimed to explore the role of mechanical tension in hypertrophic scars and the change in nerve density using hematoxylin-eosin staining and S100 immunohistochemistry, and to observe the expression of nerve growth factor by western blot analysis. The results demonstrated that mechanical tension contributed to the formation of a hyperplastic scar in the back skin of rats, in conjunction with increases in both nerve density and nerve growth factor expression in the scar tissue. These experimental findings indicate that the cutaneous nervous system plays a role in hypertrophic scar formation caused by mechanical tension.

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

    Directory of Open Access Journals (Sweden)

    Gholam Hossein Farjah

    2013-08-01

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

  4. Ulnar nerve entrapment by anconeus epitrochlearis ligament.

    LENUS (Irish Health Repository)

    Tiong, William H C

    2012-01-01

    Ulnar nerve entrapment at the elbow is the second most common upper limb entrapment neuropathy other than carpal tunnel syndrome. There have been many causes identified ranging from chronic aging joint changes to inflammatory conditions or systemic disorders. Among them, uncommon anatomical variants accounts for a small number of cases. Here, we report our experience in managing ulnar nerve entrapment caused by a rare vestigial structure, anconeus epitrochlearis ligament, and provide a brief review of the literature of its management.

  5. Optic Nerve Avulsion after Blunt Trauma

    Directory of Open Access Journals (Sweden)

    Hacı Halil Karabulut

    2014-05-01

    Full Text Available Optic nerve avulsion is an uncommon presentation of ocular trauma with a poor prognosis. It can be seen as complete or partial form due to the form of trauma. We assessed the complete optic nerve avulsion in a 16-year-old female patient complaining of loss of vision in her left eye after a traffic accident. (Turk J Ophthalmol 2014; 44: 249-51

  6. US imaging of the musculocutaneous nerve

    Energy Technology Data Exchange (ETDEWEB)

    Tagliafico, Alberto Stefano [National Institute for Cancer Research, Department of Radiology, Genoa (Italy); Michaud, Johan [University of Montreal, Department of Physiatry, Montreal, Quebec (Canada); Marchetti, Alessandra; Garello, Isabella; Martinoli, Carlo [Universita di Genova, Radiology Department, Genova (Italy); Padua, Luca [Universita Cattolica del Sacro Cuore-Rome, Institute of Neurology, Rome (Italy); Fondazione Don Carlo Gnocchi, Rome (Italy)

    2011-05-15

    To describe the potential value of high-resolution sonography for evaluation of the musculocutaneous nerve (MCN). The normal anatomy of the MCN was evaluated on three cadaveric limbs and correlated with the US images obtained in 15 healthy subjects. Seven consecutive patients with MCN neuropathy were then evaluated with sonography using 17.5 and 12.5-MHz broadband linear array transducers. All patients had abnormal nerve conduction studies and underwent correlative MR imaging on a 1.5-T system. One-to-one comparison between cadaveric specimens and sonographic images showed that the MCN can be reliably identified from the axilla through the elbow, including the lateral antebrachial cutaneous (LAbC) nerve. In the patients group with MCN neuropathy, sonography allowed detection of a wide spectrum of abnormalities. In 5/7 cases, a spindle neuroma was depicted in continuity with the nerve. In one case, US identified focal swelling of the nerve and in another case US was negative. The neuroma was hyperintense on T2-weighted sequences in 75% of cases. In one patient, the nerve showed Gd-enhancement on fat-suppressed T1-weighted sequences. The nerve was never detected on unenhanced T1-scans. Owing to its small-size and out-of-plane course, the MCN may be more reliably depicted with sonography rather than with MR imaging. US is promising for evaluating traumatic injuries of the MCN. By providing unique information on the entire course of the nerve, US can be used as a valuable complement of clinical and electrophysiologic findings. (orig.)

  7. Stabilized subcutaneous transposition of the ulnar nerve

    OpenAIRE

    2003-01-01

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

  8. Peripheral nerve extract effects on mesenchymal cells.

    OpenAIRE

    Dietz, F. R.; Mukhopadhyay, B.; Becker, G.; Daniels, K.; Solursh, M

    1996-01-01

    Several common congenital limb disorders are characterized by normal tissue differentiation but abnormal somatic growth. These include: idiopathic clubfoot, idiopathic leg length discrepancy, hemi-atrophy and hemi-hypertrophy. Both clinical and research studies have suggested that peripheral nerves may be important in regulating somatic growth of limb tissues. To investigate the hypothesis that peripheral nerves convey trophic substances to mesenchymal tissues that are involved in the regulat...

  9. Organophosphate Nerve Agent Detection with Europium Complexes

    OpenAIRE

    Schwierking, Jake R.; Laird W. Menzel; E. Roland Menzel

    2004-01-01

    We explore the detection of paraoxon, a model compound for nonvolatile organophosphate nerve agents such as VX. The detection utilizes europium complexes with 1,10 phenanthroline and thenoyltrifluoroacetone as sensitizing ligands. Both europium luminescence quenching and luminescence enhancement modalities are involved in the detection, which is simple, rapid, and sensitive. It is adaptable as well to the more volatile fluorophosphate nerve agents. It involves nothing more than visual lumines...

  10. Nerves Regulate Cardiomyocyte Proliferation and Heart Regeneration

    OpenAIRE

    Mahmoud, Ahmed I.; O’Meara, Caitlin C.; Gemberling, Matthew; Zhao, Long; Bryant, Donald M.; Zheng, Ruimao; Gannon, Joseph B.; Cai, Lei; Choi, Wen-Yee; Egnaczyk, Gregory F.; Burns, Caroline E.; Burns, C. Geoffrey; MacRae, Calum A.; Poss, Kenneth D.; Lee, Richard T.

    2015-01-01

    Some organisms, such as adult zebrafish and newborn mice, have the capacity to regenerate heart tissue following injury. Unraveling the mechanisms of heart regeneration is fundamental to understanding why regeneration fails in adult humans. Numerous studies have revealed that nerves are crucial for organ regeneration, thus we aimed to determine whether nerves guide heart regeneration. Here, we show using transgenic zebrafish that inhibition of cardiac innervation leads to reduction of myocyte...

  11. Evaluation of functional nerve recovery after reconstruction with a new biodegradable poly (DL-lactide-epsilon-caprolactone) nerve guide

    NARCIS (Netherlands)

    Meek, MF; denDunnen, WFA; Robinson, PH; Pennings, AJ; Schakenraad, JM

    1997-01-01

    The aim of this study was to evaluate functional nerve recovery following reconstruction of a 1 cm gap in the sciatic nerve of a rat, using a new biodegradable p (DLLA-epsilon-CL) nerve guide. To evaluate both motor and sensory nerve recovery, walking track analysis and electrostimulation tests were

  12. [Spinal accessory nerve and lymphatic neck dissection].

    Science.gov (United States)

    Pinsolle, V; Michelet, V; Majoufre, C; Caix, P; Siberchicot, F; Pinsolle, J

    1997-09-01

    Radical neck dissection was the golden standard of treatment for cervical nodes in head and neck tumors. From the seventies, the preservation of the spinal accessory nerve has become increasingly popular in order to improve the functional result of the neck dissections. The aim of this study was to assess the degree of functional disability associated with each type of neck dissection and the value of anatomical references for dissection of the spinal accessory nerve. One hundred twenty seven patients were evaluated 1 month and 1 year after radical, functional or supraomohyoid neck dissection with a questionnaire and a physical examination. Anatomical measurements of the spinal accessory nerve were performed in 20 patients. We found considerable or severe shoulder dysfunction in 7%, 34% and 51% respectively of patients in whom supraomohyoid, functional and radical neck dissections were performed. Furthermore 49% of patients having undergone a radical neck dissection had little or no symptoms. Sacrifice of the spinal accessory nerve in radical neck dissection may lead to shoulder dysfunction. A functional disability may also be associated, although in a less extent, with any neck dissection in which the spinal accessory nerve is dissected and placed in traction. There is a large variation in the degree of functional disability and pain in patients with similar neck dissections. The course of the spinal accessory nerve in the neck makes it particularly vulnerable to injury during the dissection near the sternocleidomastoid muscle and in the posterior cervical triangle.

  13. Extracellular matrix components in peripheral nerve regeneration.

    Science.gov (United States)

    Gonzalez-Perez, Francisco; Udina, Esther; Navarro, Xavier

    2013-01-01

    Injured axons of the peripheral nerve are able to regenerate and, eventually, reinnervate target organs. However, functional recovery is usually poor after severe nerve injuries. The switch of Schwann cells to a proliferative state, secretion of trophic factors, and the presence of extracellular matrix (ECM) molecules (such as collagen, laminin, or fibronectin) in the distal stump are key elements to create a permissive environment for axons to grow. In this review, we focus attention on the ECM components and their tropic role in axonal regeneration. These components can also be used as molecular cues to guide the axons through artificial nerve guides in attempts to better mimic the natural environment found in a degenerating nerve. Most used scaffolds tested are based on natural molecules that form the ECM, but use of synthetic polymers and functionalization of hydrogels are bringing new options. Progress in tissue engineering will eventually lead to the design of composite artificial nerve grafts that may replace the use of autologous nerve grafts to sustain regeneration over long gaps.

  14. The Angle at Which the Facial Nerve Leaves the Mastoid

    OpenAIRE

    Holt, James J.

    1991-01-01

    Some skull base procedures require extensive dissection of the facial nerve. This can be difficult at the mastoid tip, where the nerve is approximated to soft tissues. The nerve was dissected in this area in 15 cadaver specimens. The mean angle at which the facial nerve leaves the mastoid tip in 117°. This information should aid the skull base surgeon in the identification of the facial nerve at the mastoid tip.

  15. Degeneration and regeneration of motor and sensory nerves: a stereological study of crush lesions in rat facial and mental nerves

    DEFF Research Database (Denmark)

    Barghash, Ziad; Larsen, Jytte Overgaard; Al-Bishri, Awad

    2013-01-01

    The aim of this study was to evaluate the degeneration and regeneration of a sensory nerve and a motor nerve at the histological level after a crush injury. Twenty-five female Wistar rats had their mental nerve and the buccal branch of their facial nerve compressed unilaterally against a glass rod...... in the degenerative pattern; however, at day 19 the buccal branch had regenerated to the normal number of axons, whereas the mental nerve had only regained 50% of the normal number of axons. We conclude that the regenerative process is faster and/or more complete in the facial nerve (motor function) than...... for 30 s. Specimens of the compressed nerves and the corresponding control nerves were dissected at 3, 7, and 19 days after surgery. Nerve cross-sections were stained with osmium tetroxide and toluidine blue and analysed using two-dimensional stereology. We found differences between the two nerves both...

  16. Axillary nerve conduction changes in hemiplegia

    Directory of Open Access Journals (Sweden)

    Ring Haim

    2008-12-01

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

  17. Therapeutic results in sixth nerve palsy

    Directory of Open Access Journals (Sweden)

    Pruna Violeta-Ioana

    2015-03-01

    Full Text Available Authors aim to assess through a retrospective study the efficiency of different therapeutic methods used in VIth nerve palsy. 60 patients with VIth nerve palsy, admitted and treated in Oftapro Clinic, were divided into two groups: a group with partial dysfunction (paresis of sixth nerve and a group with the complete abolition of neuromuscular function (VIth nerve palsy. Initial examination included assessment of neuromuscular function, binocular vision and existence of medial rectus muscle contracture (ipsi- and contralateral and contralateral lateral rectus inhibitory palsy. Neuromuscular dysfunction was graded from - 8 (paralysis to 0 (normal abduction. Therapeutic modalities ranged from conservative treatment (occlusion, prism correction, botulinum toxin chemodenervation and surgical treatment: medial rectus recession + lateral rectus resection, in cases of paresis, and transposition procedures (Hummelscheim and full tendon transfer in cases of sixth nerve palsy. Functional therapeutic success was defined as absence of diplopia in primary position, with or without prism correction, and surgical success was considered obtaining orthoptic alignment in primary position or a small residual deviation (under 10 PD. 51 patients had unilateral dysfunction, and 9 patients had bilateral VI-th nerve dysfunction. 8 patients had associated fourth or seventh cranial nerves palsy. The most common etiology was traumatic, followed by tumor and vascular causes. There were 18 cases of spontaneous remission, partial or complete (4-8 months after the onset, and 6 cases enhanced by botulinum toxin chemodenervation. 17 paretic eyes underwent surgery, showing a very good outcome, with restoration of binocular single vision. The procedure of choice was recession of medial rectus muscle, combined with resection of lateral rectus muscle. All patients with sixth nerve palsy underwent surgery, except one old female patient, who refused surgery. Hummelscheim procedure was

  18. 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

  19. Human vagus nerve branching in the cervical region.

    Directory of Open Access Journals (Sweden)

    Niels Hammer

    Full Text Available Vagus nerve stimulation is increasingly applied to treat epilepsy, psychiatric conditions and potentially chronic heart failure. After implanting vagus nerve electrodes to the cervical vagus nerve, side effects such as voice alterations and dyspnea or missing therapeutic effects are observed at different frequencies. Cervical vagus nerve branching might partly be responsible for these effects. However, vagus nerve branching has not yet been described in the context of vagus nerve stimulation.Branching of the cervical vagus nerve was investigated macroscopically in 35 body donors (66 cervical sides in the carotid sheath. After X-ray imaging for determining the vertebral levels of cervical vagus nerve branching, samples were removed to confirm histologically the nerve and to calculate cervical vagus nerve diameters and cross-sections.Cervical vagus nerve branching was observed in 29% of all cases (26% unilaterally, 3% bilaterally and proven histologically in all cases. Right-sided branching (22% was more common than left-sided branching (12% and occurred on the level of the fourth and fifth vertebra on the left and on the level of the second to fifth vertebra on the right side. Vagus nerves without branching were significantly larger than vagus nerves with branches, concerning their diameters (4.79 mm vs. 3.78 mm and cross-sections (7.24 mm2 vs. 5.28 mm2.Cervical vagus nerve branching is considerably more frequent than described previously. The side-dependent differences of vagus nerve branching may be linked to the asymmetric effects of the vagus nerve. Cervical vagus nerve branching should be taken into account when identifying main trunk of the vagus nerve for implanting electrodes to minimize potential side effects or lacking therapeutic benefits of vagus nerve stimulation.

  20. Nerve plane-sparing radical hysterectomy: a simplified technique of nerve-sparing radical hysterectomy for invasive cervical cancer

    Institute of Scientific and Technical Information of China (English)

    LI Bin; LI Wei; SUN Yang-chun; ZHANG Rong; ZHANG Gong-yi; YU Gao-zhi; WU Ling-ying

    2011-01-01

    Background In order to simplify the complicated procedure of nerve-sparing radical hysterectomy, a novel technique characterized by integral preservation of the autonomic nerve plane has been employed for invasive cervical cancer. The objective of this study was to introduce the nerve plane-sparing radical hysterectomy technique and compare its efficacy and safety with that of nerve-sparing radical hysterectomy.Methods From September 2006 to August 2010, 73 consecutive patients with International Federation of Gynecology and Obstetrics stage IB to IIA cervical cancer underwent radical hysterectomy with two different nerve-sparing approaches. Nerve-sparing radical hysterectomy was performed for the first 16 patients (nerve-sparing radical hysterectomy group). The detailed autonomic nerve structures were identified and separated by meticulous dissection during this procedure. After January 2008, the nerve plane-sparing radical hysterectomy procedure was developed and performed for the next 57 patients (nerve plane-sparing radical hysterectomy group). During this modified procedure, the nerve plane (meso-ureter and its extension) containing most of the autonomic nerve structures was integrally preserved. The patients' clinicopathologic characteristics, surgical parameters, and outcomes of postoperative bladder function were compared between the two groups.Conclusion Nerve plane-sparing radical hysterectomy Is a reproducible and simplified modification of nerve-sparing radical hysterectomy, and may be preferable to nerve-sparing radical hysterectomy for treatment of early-stage invasive cervical cancer.

  1. GLP-1 signals via ERK in peripheral nerve and prevents nerve dysfunction in diabetic mice

    DEFF Research Database (Denmark)

    Jolivalt, CG; Fineman, M; Deacon, Carolyn F.

    2011-01-01

    not affected by streptozotocin-induced diabetes. GLP-1R agonists did not signal via ERK1/2 in sciatic nerve of normal rats. However, GLP-1R agonists significantly increased pERK1/2 levels in sciatic nerves from diabetic rats, indicating that GLP-1Rs are functional in this tissue. Exenatide treatment did...

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

    Directory of Open Access Journals (Sweden)

    Lu Bai

    2015-01-01

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

  3. A biosynthetic nerve guide conduit based on silk/SWNT/fibronectin nanocomposite for peripheral nerve regeneration.

    Science.gov (United States)

    Mottaghitalab, Fatemeh; Farokhi, Mehdi; Zaminy, Arash; Kokabi, Mehrdad; Soleimani, Masoud; Mirahmadi, Fereshteh; Shokrgozar, Mohammad Ali; Sadeghizadeh, Majid

    2013-01-01

    As a contribution to the functionality of nerve guide conduits (NGCs) in nerve tissue engineering, here we report a conduit processing technique through introduction and evaluation of topographical, physical and chemical cues. Porous structure of NGCs based on freeze-dried silk/single walled carbon nanotubes (SF/SWNTs) has shown a uniform chemical and physical structure with suitable electrical conductivity. Moreover, fibronectin (FN) containing nanofibers within the structure of SF/SWNT conduits produced through electrospinning process have shown aligned fashion with appropriate porosity and diameter. Moreover, fibronectin remained its bioactivity and influenced the adhesion and growth of U373 cell lines. The conduits were then implanted to 10 mm left sciatic nerve defects in rats. The histological assessment has shown that nerve regeneration has taken places in proximal region of implanted nerve after 5 weeks following surgery. Furthermore, nerve conduction velocities (NCV) and more myelinated axons were observed in SF/SWNT and SF/SWNT/FN groups after 5 weeks post implantation, indicating a functional recovery for the injured nerves. With immunohistochemistry, the higher S-100 expression of Schwann cells in SF/SWNT/FN conduits in comparison to other groups was confirmed. In conclusion, an oriented conduit of biocompatible SF/SWNT/FN has been fabricated with acceptable structure that is particularly applicable in nerve grafts.

  4. A biosynthetic nerve guide conduit based on silk/SWNT/fibronectin nanocomposite for peripheral nerve regeneration.

    Directory of Open Access Journals (Sweden)

    Fatemeh Mottaghitalab

    Full Text Available As a contribution to the functionality of nerve guide conduits (NGCs in nerve tissue engineering, here we report a conduit processing technique through introduction and evaluation of topographical, physical and chemical cues. Porous structure of NGCs based on freeze-dried silk/single walled carbon nanotubes (SF/SWNTs has shown a uniform chemical and physical structure with suitable electrical conductivity. Moreover, fibronectin (FN containing nanofibers within the structure of SF/SWNT conduits produced through electrospinning process have shown aligned fashion with appropriate porosity and diameter. Moreover, fibronectin remained its bioactivity and influenced the adhesion and growth of U373 cell lines. The conduits were then implanted to 10 mm left sciatic nerve defects in rats. The histological assessment has shown that nerve regeneration has taken places in proximal region of implanted nerve after 5 weeks following surgery. Furthermore, nerve conduction velocities (NCV and more myelinated axons were observed in SF/SWNT and SF/SWNT/FN groups after 5 weeks post implantation, indicating a functional recovery for the injured nerves. With immunohistochemistry, the higher S-100 expression of Schwann cells in SF/SWNT/FN conduits in comparison to other groups was confirmed. In conclusion, an oriented conduit of biocompatible SF/SWNT/FN has been fabricated with acceptable structure that is particularly applicable in nerve grafts.

  5. Differential gene expression profiling and biological process analysis in proximal nerve segments after sciatic nerve transection.

    Science.gov (United States)

    Li, Shiying; Liu, Qianqian; Wang, Yongjun; Gu, Yun; Liu, Dong; Wang, Chunming; Ding, Guohui; Chen, Jianping; Liu, Jie; Gu, Xiaosong

    2013-01-01

    After traumatic injury, peripheral nerves can spontaneously regenerate through highly sophisticated and dynamic processes that are regulated by multiple cellular elements and molecular factors. Despite evidence of morphological changes and of expression changes of a few regulatory genes, global knowledge of gene expression changes and related biological processes during peripheral nerve injury and regeneration is still lacking. Here we aimed to profile global mRNA expression changes in proximal nerve segments of adult rats after sciatic nerve transection. According to DNA microarray analysis, the huge number of genes was differentially expressed at different time points (0.5 h-14 d) post nerve transection, exhibiting multiple distinct temporal expression patterns. The expression changes of several genes were further validated by quantitative real-time RT-PCR analysis. The gene ontology enrichment analysis was performed to decipher the biological processes involving the differentially expressed genes. Collectively, our results highlighted the dynamic change of the important biological processes and the time-dependent expression of key regulatory genes after peripheral nerve injury. Interestingly, we, for the first time, reported the presence of olfactory receptors in sciatic nerves. Hopefully, this study may provide a useful platform for deeply studying peripheral nerve injury and regeneration from a molecular-level perspective.

  6. Sciatic nerve block performed with nerve stimulation technique in an amputee a case study

    DEFF Research Database (Denmark)

    Heiring, C.; Kristensen, Billy

    2008-01-01

    We present a case of a sciatic nerve block performed with the nerve stimulation technique. This technique is normally not used in amputees because detection of a motor response to an electrical stimulation is impossible. In our patient the stimulation provoked a phantom sensation of movement...

  7. Effect of Surface Pore Structure of Nerve Guide Conduit on Peripheral Nerve Regeneration

    Science.gov (United States)

    Oh, Se Heang; Kim, Jin Rae; Kwon, Gu Birm; Namgung, Uk; Song, Kyu Sang

    2013-01-01

    Polycaprolactone (PCL)/Pluronic F127 nerve guide conduits (NGCs) with different surface pore structures (nano-porous inner surface vs. micro-porous inner surface) but similar physical and chemical properties were fabricated by rolling the opposite side of asymmetrically porous PCL/F127 membranes. The effect of the pore structure on peripheral nerve regeneration through the NGCs was investigated using a sciatic nerve defect model of rats. The nerve fibers and tissues were shown to have regenerated along the longitudinal direction through the NGC with a nano-porous inner surface (Nanopore NGC), while they grew toward the porous wall of the NGC with a micro-porous inner surface (Micropore NGC) and, thus, their growth was restricted when compared with the Nanopore NGC, as investigated by immunohistochemical evaluations (by fluorescence microscopy with anti-neurofilament staining and Hoechst staining for growth pattern of nerve fibers), histological evaluations (by light microscopy with Meyer's modified trichrome staining and Toluidine blue staining and transmission electron microscopy for the regeneration of axon and myelin sheath), and FluoroGold retrograde tracing (for reconnection between proximal and distal stumps). The effect of nerve growth factor (NGF) immobilized on the pore surfaces of the NGCs on nerve regeneration was not so significant when compared with NGCs not containing immobilized NGF. The NGC system with different surface pore structures but the same chemical/physical properties seems to be a good tool that is used for elucidating the surface pore effect of NGCs on nerve regeneration. PMID:22871377

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

    Institute of Scientific and Technical Information of China (English)

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

    2015-01-01

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

  9. Effect of surface pore structure of nerve guide conduit on peripheral nerve regeneration.

    Science.gov (United States)

    Oh, Se Heang; Kim, Jin Rae; Kwon, Gu Birm; Namgung, Uk; Song, Kyu Sang; Lee, Jin Ho

    2013-03-01

    Polycaprolactone (PCL)/Pluronic F127 nerve guide conduits (NGCs) with different surface pore structures (nano-porous inner surface vs. micro-porous inner surface) but similar physical and chemical properties were fabricated by rolling the opposite side of asymmetrically porous PCL/F127 membranes. The effect of the pore structure on peripheral nerve regeneration through the NGCs was investigated using a sciatic nerve defect model of rats. The nerve fibers and tissues were shown to have regenerated along the longitudinal direction through the NGC with a nano-porous inner surface (Nanopore NGC), while they grew toward the porous wall of the NGC with a micro-porous inner surface (Micropore NGC) and, thus, their growth was restricted when compared with the Nanopore NGC, as investigated by immunohistochemical evaluations (by fluorescence microscopy with anti-neurofilament staining and Hoechst staining for growth pattern of nerve fibers), histological evaluations (by light microscopy with Meyer's modified trichrome staining and Toluidine blue staining and transmission electron microscopy for the regeneration of axon and myelin sheath), and FluoroGold retrograde tracing (for reconnection between proximal and distal stumps). The effect of nerve growth factor (NGF) immobilized on the pore surfaces of the NGCs on nerve regeneration was not so significant when compared with NGCs not containing immobilized NGF. The NGC system with different surface pore structures but the same chemical/physical properties seems to be a good tool that is used for elucidating the surface pore effect of NGCs on nerve regeneration.

  10. Electromechanical properties of biomembranes and nerves

    Science.gov (United States)

    Heimburg, T.; Blicher, A.; Mosgaard, L. D.; Zecchi, K.

    2014-12-01

    Lipid membranes are insulators and capacitors, which can be charged by an external electric field. This phenomenon plays an important role in the field of electrophysiology, for instance when describing nerve pulse conduction. Membranes are also made of polar molecules meaning that they contain molecules with permanent electrical dipole moments. Therefore, the properties of membranes are subject to changes in trans-membrane voltage. Vice versa, mechanical forces on membranes lead to changes in the membrane potential. Associated effects are flexoelectricity, piezoelectricity, and electrostriction. Lipid membranes can melt from an ordered to a disordered state. Due to the change of membrane dimensions associated with lipid membrane melting, electrical properties are linked to the melting transition. Melting of the membrane can induce changes in trans-membrane potential, and application of voltage can lead to a shift of the melting transition. Further, close to transitions membranes are very susceptible to piezoelectric phenomena. We discuss these phenomena in relation with the occurrence of lipid ion channels. Close to melting transitions, lipid membranes display step-wise ion conduction events, which are indistinguishable from protein ion channels. These channels display a voltage-dependent open probability. One finds asymmetric current-voltage relations of the pure membrane very similar to those found for various protein channels. This asymmetry falsely has been considered a criterion to distinguish lipid channels from protein channels. However, we show that the asymmetry can arise from the electromechanical properties of the lipid membrane itself. Finally, we discuss electromechanical behavior in connection with the electromechanical theory of nerve pulse transduction. It has been found experimentally that nerve pulses are related to changes in nerve thickness. Thus, during the nerve pulse a solitary mechanical pulse travels along the nerve. Due to

  11. Swimming Exercise in the Acute or Late Phase after Sciatic Nerve Crush Accelerates Nerve Regeneration

    Directory of Open Access Journals (Sweden)

    Rosana Macher Teodori

    2011-01-01

    Full Text Available There is no consensus about the best time to start exercise after peripheral nerve injury. We evaluated the morphological and functional characteristics of the sciatic nerves of rats that began to swim immediately after crush nerve injury (CS1, those that began to swim 14 days after injury (CS14, injured rats not submitted to swimming (C, and uninjured rats submitted to swimming (S. After 30 days the number of axons in CS1 and CS14 was lower than in C (P0.05. Swimming exercise applied during the acute or late phase of nerve injury accelerated nerve regeneration and synaptic elimination after axonotmesis, suggesting that exercise may be initiated immediately after injury.

  12. Comparative neuro tissue engineering using different nerve guide implants.

    Science.gov (United States)

    Sinis, N; Schaller, H E; Schulte-Eversum, C; Lanaras, T; Schlosshauer, B; Doser, M; Dietz, K; Rösner, H; Müller, H W; Haerle, M

    2007-01-01

    At the moment autologous nerve grafting remains the only reasonable technique for reconstruction of peripheral nerve defects. Unfortunately, this technique has a lot of complications and disadvantages. These problems are related to the autologous nerve that is harvested for this procedure. Donor site morbidity with loss of sensitivity, painful neuroma formation and of course the restricted availability of autologous nerves stimulates the idea for alternative techniques on that field. In this paper we describe our experience with different graft materials for reconstruction of a 2 cm nerve gap in a median nerve model in rats. After implantation of various materials (biological/synthetic) the main experiments were conducted with a synthetic, biodegradable nerve conduit seeded with autologous Schwann cells. With this material we were able to reconstruct successfully a 2 cm gap in the rat median nerve. Regeneration with this material was found to be equally to an autologous nerve graft.

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

    Directory of Open Access Journals (Sweden)

    Wei-ling Cui

    2016-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    Wei-ling Cui; Long-hai Qiu; Jia-yan Lian; Jia-chun Li; Jun Hu; Xiao-lin Liu

    2016-01-01

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

  15. How electrodiagnosis predicts clinical outcome of focal peripheral nerve lesions.

    Science.gov (United States)

    Robinson, Lawrence R

    2015-09-01

    This article reviews the electrodiagnostic (EDX) prognostic factors for focal traumatic and nontraumatic peripheral nerve injuries. Referring physicians and patients often benefit from general and nerve-specific prognostic information from the EDX consultant. Knowing the probable outcome from a nerve injury allows the referring physician to choose the best treatment options for his/her patients. Nerve injuries are variable in their mechanism, location, and pathophysiology. The general effects of the injuries on nerve and muscle are well known, but more research is needed for nerve-specific information. Several factors currently known to influence prognosis include: nature of the nerve trauma, amount of axon loss, recruitment in muscles supplied by the nerve, the extent of demyelination, and the distance to reinnervate functional muscles. This article reviews these general concepts and also nerve-specific EDX measures that predict outcome after focal neuropathies.

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

    Directory of Open Access Journals (Sweden)

    Wei Li

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

  17. 3 dimensional volume MR imaging of intratemporal facial nerve

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Jeong Jin; Kang, Heoung Keun; Kim, Hyun Ju; Kim, Jae Kyu; Jung, Hyun Ung; Moon, Woong Jae [Chonnam University Medical School, Kwangju (Korea, Republic of)

    1994-10-15

    To evaluate the usefulness of 3 dimensional volume MR imaging technique for demonstrating the facial nerves and to describe MR findings in facial palsy patients and evaluate the significance of facial nerve enhancement. We reviewed the MR images of facial nerves obtained with 3 dimensional volume imaging technique before and after intravenous administration of Gadopentetate dimeglumine in 13 cases who had facial paralysis and 33 cases who had no facial palsy. And we analyzed the detectability of ananatomical segments of intratemporal facial nerves and facial nerve enhancement. When the 3 dimensional volume MR images of 46 nerves were analyzed subjectively, the nerve courses of 43(93%) of 46 nerves were effectively demonstrated on 3 dimensional volume MR images. Internal acoustic canal portions and geniculate ganglion of facial nerve were well visualized on axial images and tympanic and mastoid segments were well depicted on oblique sagittal images. 10 of 13 patients(77%) were visibly enhanced along at least one segment of the facial nerve with swelling or thickening, and nerves of 8 of normal 33 cases(24%) were enhanced without thickening or swelling. MR findings of facial nerve parelysis is asymmetrical thickening of facial nerve with contrast enhancement. The 3 dimensional volume MR imaging technique should be a useful study for the evaluation of intratemporal facial nerve disease.

  18. SCIATIC NERVE AND ITS VARIATIONS: AN ANATOMICAL STUDY

    Directory of Open Access Journals (Sweden)

    Anbumani T.L

    2015-06-01

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

  19. Purinergic nerves and purinoceptors: early perspectives.

    Science.gov (United States)

    Satchell, D

    2000-07-01

    I have had the pleasure and privilege of being involved in one facet of Geoffrey Burnstock's early career. I have reviewed this work together with more recent developments in the area. In 1968, the presence of non-adrenergic, non-cholinergic inhibitory nerves had been established but the identity of their neurotransmitter was unknown. Stimulation of these nerves in recycled perfused toad and guinea-pig stomachs caused release of adenosine and inosine. When ATP was added to recycled perfusates, it was broken down to adenosine and inosine. These findings together with information that AMP was released from stimulated, isolated turkey Auerbach's plexus which was known to contain the nerves, suggested that ATP could be the neurotransmitter. This was supported by observations that ATP elicited responses similar to that of nerve stimulation in a variety of tissues. Developments from the early purinergic nerve hypothesis are considered including independence of extracellular actions of ATP from its intracellular actions, identification and cloning of purinoceptors and cotransmission of ATP with other substances.

  20. Endocrine tumors associated with the vagus nerve.

    Science.gov (United States)

    Varoquaux, Arthur; Kebebew, Electron; Sebag, Fréderic; Wolf, Katherine; Henry, Jean-François; Pacak, Karel; Taïeb, David

    2016-09-01

    The vagus nerve (cranial nerve X) is the main nerve of the parasympathetic division of the autonomic nervous system. Vagal paragangliomas (VPGLs) are a prime example of an endocrine tumor associated with the vagus nerve. This rare, neural crest tumor constitutes the second most common site of hereditary head and neck paragangliomas (HNPGLs), most often in relation to mutations in the succinate dehydrogenase complex subunit D (SDHD) gene. The treatment paradigm for VPGL has progressively shifted from surgery to abstention or therapeutic radiation with curative-like outcomes. Parathyroid tissue and parathyroid adenoma can also be found in close association with the vagus nerve in intra or paravagal situations. Vagal parathyroid adenoma can be identified with preoperative imaging or suspected intraoperatively by experienced surgeons. Vagal parathyroid adenomas located in the neck or superior mediastinum can be removed via initial cervicotomy, while those located in the aortopulmonary window require a thoracic approach. This review particularly emphasizes the embryology, molecular genetics, and modern imaging of these tumors.

  1. Mandibular nerve entrapment in the infratemporal fossa.

    Science.gov (United States)

    Piagkou, Maria N; Demesticha, T; Piagkos, G; Androutsos, G; Skandalakis, P

    2011-05-01

    The posterior trunk of the mandibular nerve (V(3)) comprises of three main branches. Various anatomic structures may entrap and potentially compress the mandibular nerve branches. A usual position of mandibular nerve (MN) compression is the infratemporal fossa (ITF) which is one of the most difficult regions of the skull base to access surgically. The anatomical positions of compression are: the incomplete or complete ossified pterygospinous (LPs) or pterygoalar (LPa) ligament, the large lamina of the lateral plate of the pterygoid process and the medial fibres of the lower belly of the lateral pterygoid (LPt). A contraction of the LPt, due to the connection between nerve and anatomic structures (soft and hard tissues), might lead to MN compression. Any variations of the course of the MN branches can be of practical significance to surgeons and neurologists who are dealing with this region, because of possibly significant complications. The entrapment of the MN motor branches can lead to paresis or weakness in the innervated muscle. Compression of the sensory branches can provoke neuralgia or paraesthesia. Lingual nerve (LN) compression causes numbness, hypoesthesia or even anaesthesia of the mucous of the tongue, anaesthesia and loss of taste in the anterior two-thirds of the tongue, anaesthesia of the lingual gums, as well as pain related to speech articulation disorders. Dentists should be very suspicious of possible signs of neurovascular compression in the region of the ITF.

  2. Optic nerve decompression for orbitofrontal fibrous dysplasia.

    Science.gov (United States)

    Abe, Takumi; Sato, Kaneshige; Otsuka, Takaharu; Kawamura, Noriyoshi; Shimazu, Motohiko; Izumiyama, Hitoshi; Matsumoto, Kiyoshi

    2002-08-01

    Orbitofrontal fibrous dysplasia often involves the bony orbit and the optic canal. Although fibrous dysplasia reportedly produces compression of the optic nerve leading to visual distrubances, optic nerve decompression in patients without clinical signs of optic neuropathy is still controversial. We describe two patients with orbitofrontal fibrous dysplasia without signs of visual disturbance and one patient with McCune-Albright syndrome and progressive visual impairment. Optic nerve decompression was performed prophylactically for two patients and therapeutically for one patient through the transcranial extradural route. Dystopias and craniofacial deformities induced by fibrous dysplasia also were corrected. The micropressure suction-irrigation system was especially effective for decreasing heat transfer and thereby preventing thermal injury of the optic nerve. The orbitofrontal area was reconstructed from cranial bone, iliac bone, and ribs. Postoperative follow-up revealed no disturbances in visual function and no evidence of cerebrospinal fluid leakage. These findings suggest that optic nerve decompression may be effective in preventing visual disturbances with minimal risk of other neurological sequelae. Subsequent orbital reconstruction yielded satisfactory cosmetic results.

  3. 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.

  4. Using an end-to-side interposed sural nerve graft for facial nerve reinforcement after vestibular schwannoma resection. Technical note.

    Science.gov (United States)

    Samii, Madjid; Koerbel, Andrei; Safavi-Abbasi, Sam; Di Rocco, Federico; Samii, Amir; Gharabaghi, Alireza

    2006-12-01

    Increasing rates of facial and cochlear nerve preservation after vestibular schwannoma surgery have been achieved in the last 30 years. However, the management of a partially or completely damaged facial nerve remains an important issue. In such a case, several immediate or delayed repair techniques have been used. On the basis of recent studies of successful end-to-side neurorrhaphy, the authors applied this technique in a patient with an anatomically preserved but partially injured facial nerve during vestibular schwannoma surgery. The authors interposed a sural nerve graft to reinforce the facial nerve whose partial anatomical continuity had been preserved. On follow-up examinations 18 months after surgery, satisfactory cosmetic results for facial nerve function were observed. The end-to-side interposed nerve graft appears to be a reasonable alternative in cases of partial facial nerve injury, and might be a future therapeutic option for other cranial nerve injuries.

  5. Platelet-rich plasma-induced bone marrow mesenchymal stem cells versus autologous nerve grafting for sciatic nerve repair

    Institute of Scientific and Technical Information of China (English)

    Changsuo Xia; Yajuan Li; Wen Cao; Zhaohua Yu

    2010-01-01

    Autologous nerve grafting is the gold standard of peripheral nerve repair.We previously showed that autologous platelet-rich plasma(PRP)contains high concentrations of growth factors and can induce in vitro cultured bone marrow mesenchymal stem cells(BMSCs)to differentiate into Schwann cells.Here we used PRP-induced BMSCs combined with chemically extracted acellular nerves to repair sciatic nerve defects and compared the effect with autologous nerve grafting.The BMSCs and chemically extracted acellular nerve promoted target muscle wet weight restoration,motor nerve conduction velocity,and axonal and myelin sheath regeneration,with similar effectiveness to autologous nerve grafting.This finding suggests that PRP induced BMSCs can be used to repair peripheral nerve defects.

  6. On the use of upper extremity proximal nerve action potentials in the localization of focal nerve lesions producing axonotmesis.

    Science.gov (United States)

    White, J C

    1997-09-01

    Ulnar, median, and radial proximal nerve action potentials (PNAPs) were recorded from the axilla and supraclavicularly, with stimulation of the nerves at the elbow or the radial groove, in 30 control subjects for each nerve. In addition to routine nerve conduction studies, wrist to elbow median nerve action potentials were recorded proximal to the lesion in 76 patients with carpal tunnel syndrome of varying degrees of severity to determine the effect that the distal lesion might have on more proximal nerve conduction. Utilizing this information, PNAPs, standard nerve conduction studies, and needle electrode examinations were carried out in patients with focal elbow area nerve or brachial plexus lesions producing axonotmesis. PNAPs confirmed the site of the lesions producing axonotmesis when localization was possible with standard nerve conduction and/or needle electrode studies and were the sole means by which localization of the lesions producing only sensory axonotmesis was accomplished.

  7. Lipomatosis of the sciatic nerve: typical and atypical MRI features

    Energy Technology Data Exchange (ETDEWEB)

    Wong, Bernadette Zhi Ying [Mayo Clinic School of Medicine, Rochester, MN (United States); University College London, Royal Free and University College Medical School, London (United Kingdom); Amrami, Kimberly K.; Wenger, Doris E. [Mayo Clinic, Department of Radiology, Rochester, MN (United States); Dyck, P. James B. [Mayo Clinic, Department of Neurology, Rochester, MN (United States); Scheithauer, Bernd W. [Mayo Clinic, Department of Pathology, Rochester, MN (United States); Spinner, Robert J. [Mayo Clinic, Department of Neurologic Surgery, Rochester, MN (United States); Mayo Clinic, Department of Orthopedics, Rochester, MN (United States)

    2006-03-15

    Lipomatosis of nerve, also known as fibrolipomatous hamartoma, is a rare condition of nerve, usually affecting the median nerve. The MRI appearance is characteristic. We describe two cases of lipomatosis of nerve involving the sciatic nerve, an extremely unusual location for this lesion, in patients with sciatic neuropathy. These cases share the typical features previously described in the literature for other nerves, but also contain atypical features not previously highlighted, relating to the variability in distribution and extent of the fatty deposition. Recognition of the MRI appearance of this entity is important in order to avoid unnecessary attempts at surgical resection of this lesion. (orig.)

  8. Nerve repair and cable grafting for facial paralysis.

    Science.gov (United States)

    Humphrey, Clinton D; Kriet, J David

    2008-05-01

    Facial nerve injury and facial paralysis are devastating for patients. Although imperfect, primary repair is currently the best option to restore facial nerve function. Cable, or interposition, nerve grafting is an acceptable alternative when primary repair is not possible. Several donor nerves are at the surgeon's disposal. Great auricular, sural, or medial and lateral antebrachial cutaneous nerves are all easily obtained. Both primary repair and interposition grafting typically result in better facial function than do other dynamic and static rehabilitation strategies. Proficient anastomotic technique and, when necessary, selection of an appropriate interposition graft will optimize patient outcomes. Promising research is under way that will enhance future nerve repair and grafting efforts.

  9. Surgical complications following cochlear implantation in adults based on a proposed reporting consensus

    DEFF Research Database (Denmark)

    Jeppesen, Jonas; Faber, Christian Emil

    2013-01-01

    Abstract Conclusion: The rate of severe complications was low and cochlear implantation is a relatively safe procedure. Standardization is crucial when reporting on cochlear implant complications to ensure comparability between studies. A consensus on the reporting of complications proposed by a ...... occurred following one implantation (0.3%). Transient chorda tympani syndrome (30.8%), vertigo/dizziness (29.5%) and tinnitus (4.9%) were the most frequent minor complications....

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

    Science.gov (United States)

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

    2013-02-01

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

  11. Lateralization Technique and Inferior Alveolar Nerve Transposition

    Directory of Open Access Journals (Sweden)

    Angélica Castro Pimentel

    2016-01-01

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

  12. Lateralization Technique and Inferior Alveolar Nerve Transposition

    Science.gov (United States)

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

    2016-01-01

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

  13. Clavicle fractures - incidence of supraclavicular nerve injury

    Directory of Open Access Journals (Sweden)

    Pedro Jose Labronici

    2013-08-01

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

  14. Theobromine inhibits sensory nerve activation and cough.

    Science.gov (United States)

    Usmani, Omar S; Belvisi, Maria G; Patel, Hema J; Crispino, Natascia; Birrell, Mark A; Korbonits, Márta; Korbonits, Dezso; Barnes, Peter J

    2005-02-01

    Cough is a common and protective reflex, but persistent coughing is debilitating and impairs quality of life. Antitussive treatment using opioids is limited by unacceptable side effects, and there is a great need for more effective remedies. The present study demonstrates that theobromine, a methylxanthine derivative present in cocoa, effectively inhibits citric acid-induced cough in guinea-pigs in vivo. Furthermore, in a randomized, double-blind, placebo-controlled study in man, theobromine suppresses capsaicin-induced cough with no adverse effects. We also demonstrate that theobromine directly inhibits capsaicin-induced sensory nerve depolarization of guinea-pig and human vagus nerve suggestive of an inhibitory effect on afferent nerve activation. These data indicate the actions of theobromine appear to be peripherally mediated. We conclude theobromine is a novel and promising treatment, which may form the basis for a new class of antitussive drugs.

  15. Selective activation of the human tibial and common peroneal nerves with a flat interface nerve electrode

    Science.gov (United States)

    Schiefer, M. A.; Freeberg, M.; Pinault, G. J. C.; Anderson, J.; Hoyen, H.; Tyler, D. J.; Triolo, R. J.

    2013-10-01

    Objective. Electrical stimulation has been shown effective in restoring basic lower extremity motor function in individuals with paralysis. We tested the hypothesis that a flat interface nerve electrode (FINE) placed around the human tibial or common peroneal nerve above the knee can selectively activate each of the most important muscles these nerves innervate for use in a neuroprosthesis to control ankle motion. Approach. During intraoperative trials involving three subjects, an eight-contact FINE was placed around the tibial and/or common peroneal nerve, proximal to the popliteal fossa. The FINE's ability to selectively recruit muscles innervated by these nerves was assessed. Data were used to estimate the potential to restore active plantarflexion or dorsiflexion while balancing inversion and eversion using a biomechanical simulation. Main results. With minimal spillover to non-targets, at least three of the four targets in the tibial nerve, including two of the three muscles constituting the triceps surae, were independently and selectively recruited in all subjects. As acceptable levels of spillover increased, recruitment of the target muscles increased. Selective activation of muscles innervated by the peroneal nerve was more challenging. Significance. Estimated joint moments suggest that plantarflexion sufficient for propulsion during stance phase of gait and dorsiflexion sufficient to prevent foot drop during swing can be achieved, accompanied by a small but tolerable inversion or eversion moment.

  16. Ganglioneuromas involving the hypoglossal nerve and the vagus nerve in a child: Surgical difficulties.

    Science.gov (United States)

    Bakshi, Jaimanti; Mohammed, Abdul Wadood; Lele, Saudamini; Nada, Ritambra

    2016-02-01

    Ganglioneuromas are benign tumors that arise from the Schwann cells of the autonomic nervous system. They are usually seen in the posterior mediastinum and the paraspinal retroperitoneum in relation to the sympathetic chain. In the head and neck, they are usually related to the cervical sympathetic ganglia or to the ganglion nodosum of the vagus nerve or the hypoglossal nerve. We describe what we believe is the first reported case of multiple ganglioneuromas of the parapharyngeal space in which two separate cranial nerves were involved. The patient was a 10-year-old girl who presented with a 2-year history of a painless and slowly progressive swelling on the left side of her neck and a 1-year history hoarseness. She had no history of relevant trauma or surgery. Intraoperatively, we found two tumors in the left parapharyngeal space-one that had arisen from the hypoglossal nerve and the other from the vagus nerve. Both ganglioneuromas were surgically removed, but the affected nerves had to be sacrificed. Postoperatively, the patient exhibited hypoglossal nerve and vocal fold palsy, but she was asymptomatic. In addition to the case description, we discuss the difficulties we faced during surgical excision.

  17. Trends in the design of nerve guidance channels in peripheral nerve tissue engineering.

    Science.gov (United States)

    Chiono, Valeria; Tonda-Turo, Chiara

    2015-08-01

    The current trend of peripheral nerve tissue engineering is the design of advanced nerve guidance channels (NGCs) acting as physical guidance for regeneration of nerves across lesions. NGCs should present multifunctional properties aiming to direct the sprouting of axons from the proximal nerve end, to concentrate growth factors secreted by the injured nerve ends, and to reduce the ingrowth of scar tissue into the injury site. A critical aspect in the design of NGCs is conferring them the ability to provide topographic, chemotactic and haptotactic cues that lead to functional nerve regeneration thus increasing the axon growth rate and avoiding or minimizing end-organ (e.g. muscle) atrophy. The present work reviews the recent state of the art in NGCs engineering and defines the external guide and internal fillers structural and compositional requirements that should be satisfied to improve nerve regeneration, especially in the case of large gaps (>2 cm). Techniques for NGCs fabrication were described highlighting the innovative approaches direct to enhance the regeneration of axon stumps compared to current clinical treatments. Furthermore, the possibility to apply stem cells as internal cues to the NGCs was discussed focusing on scaffold properties necessary to ensure cell survival. Finally, the optimized features for NGCs design were summarized showing as multifunctional cues are needed to produce NGCs having improved results in clinics.

  18. A novel internal fixator device for peripheral nerve regeneration.

    Science.gov (United States)

    Chuang, Ting-Hsien; Wilson, Robin E; Love, James M; Fisher, John P; Shah, Sameer B

    2013-06-01

    Recovery from peripheral nerve damage, especially for a transected nerve, is rarely complete, resulting in impaired motor function, sensory loss, and chronic pain with inappropriate autonomic responses that seriously impair quality of life. In consequence, strategies for enhancing peripheral nerve repair are of high clinical importance. Tension is a key determinant of neuronal growth and function. In vitro and in vivo experiments have shown that moderate levels of imposed tension (strain) can encourage axonal outgrowth; however, few strategies of peripheral nerve repair emphasize the mechanical environment of the injured nerve. Toward the development of more effective nerve regeneration strategies, we demonstrate the design, fabrication, and implementation of a novel, modular nerve-lengthening device, which allows the imposition of moderate tensile loads in parallel with existing scaffold-based tissue engineering strategies for nerve repair. This concept would enable nerve regeneration in two superposed regimes of nerve extension--traditional extension through axonal outgrowth into a scaffold and extension in intact regions of the proximal nerve, such as that occurring during growth or limb-lengthening. Self-sizing silicone nerve cuffs were fabricated to grip nerve stumps without slippage, and nerves were deformed by actuating a telescoping internal fixator. Poly(lactic co-glycolic) acid (PLGA) constructs mounted on the telescoping rods were apposed to the nerve stumps to guide axonal outgrowth. Neuronal cells were exposed to PLGA using direct contact and extract methods, and they exhibited no signs of cytotoxic effects in terms of cell morphology and viability. We confirmed the feasibility of implanting and actuating our device within a sciatic nerve gap and observed axonal outgrowth following device implantation. The successful fabrication and implementation of our device provides a novel method for examining mechanical influences on nerve regeneration.

  19. Taste responsiveness to sweeteners is resistant to elevations in plasma leptin.

    Science.gov (United States)

    Glendinning, John I; Elson, Amanda E T; Kalik, Salina; Sosa, Yvett; Patterson, Christa M; Myers, Martin G; Munger, Steven D

    2015-05-01

    There is uncertainty about the relationship between plasma leptin and sweet taste in mice. Whereas 2 studies have reported that elevations in plasma leptin diminish responsiveness to sweeteners, another found that they enhanced responsiveness to sucrose. We evaluated the impact of plasma leptin on sweet taste in C57BL/6J (B6) and leptin-deficient ob/ob mice. Although mice expressed the long-form leptin receptor (LepRb) selectively in Type 2 taste cells, leptin failed to activate a critical leptin-signaling protein, STAT3, in taste cells. Similarly, we did not observe any impact of intraperitoneal (i.p.) leptin treatment on chorda tympani nerve responses to sweeteners in B6 or ob/ob mice. Finally, there was no effect of leptin treatment on initial licking responses to several sucrose concentrations in B6 mice. We confirmed that basal plasma leptin levels did not exceed 10ng/mL, regardless of time of day, physiological state, or body weight, suggesting that taste cell LepRb were not desensitized to leptin in our studies. Furthermore, i.p. leptin injections produced plasma leptin levels that exceeded those previously reported to exert taste effects. We conclude that any effect of plasma leptin on taste responsiveness to sweeteners is subtle and manifests itself only under specific experimental conditions.

  20. FGF21 Mediates Endocrine Control of Simple Sugar Intake and Sweet Taste Preference by the Liver.

    Science.gov (United States)

    von Holstein-Rathlou, Stephanie; BonDurant, Lucas D; Peltekian, Lila; Naber, Meghan C; Yin, Terry C; Claflin, Kristin E; Urizar, Adriana Ibarra; Madsen, Andreas N; Ratner, Cecilia; Holst, Birgitte; Karstoft, Kristian; Vandenbeuch, Aurelie; Anderson, Catherine B; Cassell, Martin D; Thompson, Anthony P; Solomon, Thomas P; Rahmouni, Kamal; Kinnamon, Sue C; Pieper, Andrew A; Gillum, Matthew P; Potthoff, Matthew J

    2016-02-09

    The liver is an important integrator of nutrient metabolism, yet no liver-derived factors regulating nutrient preference or carbohydrate appetite have been identified. Here we show that the liver regulates carbohydrate intake through production of the hepatokine fibroblast growth factor 21 (FGF21), which markedly suppresses consumption of simple sugars, but not complex carbohydrates, proteins, or lipids. Genetic loss of FGF21 in mice increases sucrose consumption, whereas acute administration or overexpression of FGF21 suppresses the intake of both sugar and non-caloric sweeteners. FGF21 does not affect chorda tympani nerve responses to sweet tastants, instead reducing sweet-seeking behavior and meal size via neurons in the hypothalamus. This liver-to-brain hormonal axis likely represents a negative feedback loop as hepatic FGF21 production is elevated by sucrose ingestion. We conclude that the liver functions to regulate macronutrient-specific intake by producing an endocrine satiety signal that acts centrally to suppress the intake of "sweets."

  1. A crossmodal role for audition in taste perception.

    Science.gov (United States)

    Yan, Kimberly S; Dando, Robin

    2015-06-01

    Our sense of taste can be influenced by our other senses, with several groups having explored the effects of olfactory, visual, or tactile stimulation on what we perceive as taste. Research into multisensory, or crossmodal perception has rarely linked our sense of taste with that of audition. In our study, 48 participants in a crossover experiment sampled multiple concentrations of solutions of 5 prototypic tastants, during conditions with or without broad spectrum auditory stimulation, simulating that of airline cabin noise. Airline cabins are an unusual environment, in which food is consumed routinely under extreme noise conditions, often over 85 dB, and in which the perceived quality of food is often criticized. Participants rated the intensity of solutions representing varying concentrations of the 5 basic tastes on the general Labeled Magnitude Scale. No difference in intensity ratings was evident between the control and sound condition for salty, sour, or bitter tastes. Likewise, panelists did not perform differently during sound conditions when rating tactile, visual, or auditory stimulation, or in reaction time tests. Interestingly, sweet taste intensity was rated progressively lower, whereas the perception of umami taste was augmented during the experimental sound condition, to a progressively greater degree with increasing concentration. We postulate that this effect arises from mechanostimulation of the chorda tympani nerve, which transits directly across the tympanic membrane of the middle ear.

  2. Familial dysautonomia (Riley-Day syndrome). Temporal bone findings and otolaryngological manifestations.

    Science.gov (United States)

    Tokita, N; Sekhar, H K; Sachs, M; Daly, J F

    1978-01-01

    Familial dysautonomia, or Riley-Day syndrome, is inherited in an autosomal recessive fashion and occurs almost exclusively in Jewish families. This disorder is characterized by a smooth tongue devoid of fungiform papillae and of taste buds, and is clinically associated with poor taste discrimination. An unsteady gait and dizziness on change in position are also common presenting symptoms. This study reports the histopathological findings of eight temporal bones from four patients with documented familial dysautonomia. For the control series, 13 normal temporal bones were also studied. The most striking finding in the dysautonomic patients was an extreme paucity of geniculate ganglion cells (P less than 0.001). A statistically significant reduction in the number of neurons was also found both in the superior and in the inferior divisions of the vestibular nerve (P less than 0.001). The paucity of the geniculate ganglion cells correlates well with the impairment of the taste in dysautonomic individuals, since the afferent fibers leaving taste buds of the anterior two-thirds of the tongue run via the chorda tympani and have their cell bodies in the geniculate ganglion. Furthermore, the reduction in the number of Scarpa's ganglion cells observed in the dysautonomic patients studied here could account for a poor response to caloric test, positional vertigo and an unsteady gait in this condition.

  3. Characteristics of sodium currents in rat geniculate ganglion neurons.

    Science.gov (United States)

    Nakamura, Shiro; Bradley, Robert M

    2011-12-01

    Geniculate ganglion (GG) cell bodies of chorda tympani (CT), greater superficial petrosal (GSP), and posterior auricular (PA) nerves transmit orofacial sensory information to the rostral nucleus of the solitary tract. We have used whole cell recording to investigate the characteristics of the Na(+) channels in isolated Fluorogold-labeled GG neurons that innervate different peripheral receptive fields. GG neurons expressed two classes of Na(+) channels, TTX sensitive (TTX-S) and TTX resistant (TTX-R). The majority of GG neurons expressed TTX-R currents of different amplitudes. TTX-R currents were relatively small in 60% of the neurons but were large in 12% of the sampled population. In a further 28% of the neurons, TTX completely abolished all Na(+) currents. Application of TTX completely inhibited action potential generation in all CT and PA neurons but had little effect on the generation of action potentials in 40% of GSP neurons. Most CT, GSP, and PA neurons stained positively with IB(4), and 27% of the GSP neurons were capsaicin sensitive. The majority of IB(4)-positive GSP neurons with large TTX-R Na(+) currents responded to capsaicin, whereas IB(4)-positive GSP neurons with small TTX-R Na(+) currents were capsaicin insensitive. These data demonstrate the heterogeneity of GG neurons and indicate the existence of a subset of GSP neurons sensitive to capsaicin, usually associated with nociceptors. Since there are no reports of nociceptors in the GSP receptive field, the role of these capsaicin-sensitive neurons is not clear.

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

    Directory of Open Access Journals (Sweden)

    Bhandari P

    2009-01-01

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

  5. Peripheral facial nerve palsy after therapeutic endoscopy.

    Science.gov (United States)

    Kim, Eun Jeong; Lee, Jun; Lee, Ji Woon; Lee, Jun Hyung; Park, Chol Jin; Kim, Young Dae; Lee, Hyun Jin

    2015-03-01

    Peripheral facial nerve palsy (FNP) is a mononeuropathy that affects the peripheral part of the facial nerve. Primary causes of peripheral FNP remain largely unknown, but detectable causes include systemic infections (viral and others), trauma, ischemia, tumor, and extrinsic compression. Peripheral FNP in relation to extrinsic compression has rarely been described in case reports. Here, we report a case of a 71-year-old man who was diagnosed with peripheral FNP following endoscopic submucosal dissection. This case is the first report of the development of peripheral FNP in a patient undergoing therapeutic endoscopy. We emphasize the fact that physicians should be attentive to the development of peripheral FNP following therapeutic endoscopy.

  6. Palm to Finger Ulnar Sensory Nerve Conduction

    OpenAIRE

    2015-01-01

    Ulnar neuropathy at the wrist (UNW) is rare, and always challenging to localize. To increase the sensitivity and specificity of the diagnosis of UNW many authors advocate the stimulation of the ulnar nerve (UN) in the segment of the wrist and palm. The focus of this paper is to present a modified and simplified technique of sensory nerve conduction (SNC) of the UN in the wrist and palm segments and demonstrate the validity of this technique in the study of five cases of type III UNW. The SNC ...

  7. Sciatic nerve: beyond the sacral foramen

    Science.gov (United States)

    Sanal, Hatice Tuba

    2016-01-01

    Sciatica may result from pathologies affecting the nerve both in its intraspinal and extraspinal course. In daily routine, the vast majority of cases are caused by herniation of the lumbar discs compressing the neural roots. Extraspinal causes of sciatic pain are usually underestimated and the imaging study may be completed after reporting the lumbar MRIs. However, early diagnosis of the exact etiology of sciatica is paramount for both relieving the symptoms and preventing any additional neurologic injury. In this pictorial assay, some relatively rare causes of sciatic neuralgia along the route of the sciatic nerve after leaving the sacral foramen will be displayed. PMID:27670092

  8. An Implantable CMOS Amplifier for Nerve Signals

    DEFF Research Database (Denmark)

    Nielsen, Jannik Hammel; Lehmann, Torsten

    2003-01-01

    In this paper, a low noise high gain CMOS amplifier for minute nerve signals is presented. The amplifier is constructed in a fully differential topology to maximize noise rejection. By using a mixture of weak- and strong inversion transistors, optimal noise suppression in the amplifier is achieved....... A continuous-time current-steering offset-compensation technique is utilized in order to minimize the noise contribution and to minimize dynamic impact on the amplifier input nodes. The method for signal recovery from noisy nerve signals is presented. A prototype amplifier is realized in a standard digital 0...

  9. Organophosphate Nerve Agent Detection with Europium Complexes

    Directory of Open Access Journals (Sweden)

    Jake R. Schwierking

    2004-01-01

    Full Text Available We explore the detection of paraoxon, a model compound for nonvolatile organophosphate nerve agents such as VX. The detection utilizes europium complexes with 1,10 phenanthroline and thenoyltrifluoroacetone as sensitizing ligands. Both europium luminescence quenching and luminescence enhancement modalities are involved in the detection, which is simple, rapid, and sensitive. It is adaptable as well to the more volatile fluorophosphate nerve agents. It involves nothing more than visual luminescence observation under sample illumination by an ordinary hand-held ultraviolet lamp.

  10. Pudendal nerve block for vaginal birth.

    Science.gov (United States)

    Anderson, Deborah

    2014-01-01

    Pudendal nerve block is a safe and effective pain relief method for vaginal birth. Providing analgesia to the vulva and anus, it is used for operative vaginal birth and subsequent repair, late second stage pain relief with spontaneous vaginal birth, repair of complex lacerations, or repair of lacerations in women who are unable to achieve adequate or satisfactory pain relief during perineal repair with local anesthesia. Key to its efficacy is the knowledge of pudendal nerve anatomy, the optimal point of infiltration of local anesthetic, and an understanding of the amount of time necessary to effect adequate analgesia.

  11. Tissue-Engineered Nanofibrous Nerve Grafts for Enhancing the Rate of Nerve Regeneration

    Science.gov (United States)

    2015-10-01

    Matrices Derived from Schiff Base Derivative for Tissue Engineering Applications . Jaiswal D., James, R., Shelke N.B., Harmon M.D., Brown J. L., Hussain F...BMSCs seeded on nerve grafts. Based on our current progress with the in vivo animal studies, we have observed that the autograft group yielded better...coaptation of the proximal and distal stump when the nerve gap is ɜmm and when the nerve gap is >4mm, application of an autograft, in which a patient’s own

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

    Institute of Scientific and Technical Information of China (English)

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

    2008-01-01

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

  13. Clinical implications of the surgical anatomy of the sural nerve.

    Science.gov (United States)

    Coert, J H; Dellon, A L

    1994-11-01

    The exact anatomy of the sural nerve remains important for many clinical situations. To better understand this anatomy, 25 embalmed and 10 fresh cadaver pairs were studied. The origin of the common sural nerve in relation to the fibular head and its medial and lateral sural components were investigated. The lateral sural nerve was absent in 4 percent of the embalmed cadavers. The lateral and medial sural nerves united in the popliteal fossa in 12 percent and in the lower third of the leg in 84 percent of the cadavers. A site was identified where the lateral sural and lateral cutaneous nerve of the calf pierced the deep fascia. This site was centered about the fibular head and may be viewed as a potential site of nerve compression. There is application of these findings to nerve grafting, neuroma prevention and treatment, and sural nerve biopsy.

  14. Motonuclear changes after cranial nerve injury and regeneration.

    Science.gov (United States)

    Fernandez, E; Pallini, R; Lauretti, L; La Marca, F; Scogna, A; Rossi, G F

    1997-09-01

    Little is known about the mechanisms at play in nerve regeneration after nerve injury. Personal studies are reported regarding motonuclear changes after regeneration of injured cranial nerves, in particular of the facial and oculomotor nerves, as well as the influence that the natural molecule acetyl-L-carnitine (ALC) has on post-axotomy cranial nerve motoneuron degeneration after facial and vagus nerve lesions. Adult and newborn animal models were used. Massive motoneuron response after nerve section and reconstruction was observed in the motonuclei of all nerves studied. ALC showed to have significant neuroprotective effects on the degeneration of axotomized motoneurons. Complex quantitative, morphological and somatotopic nuclear changes occurred that sustain new hypotheses regarding the capacities of motoneurons to regenerate and the possibilities of new neuron proliferation. The particularities of such observations are described and discussed.

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

    Directory of Open Access Journals (Sweden)

    Shyam Sundar Krishnan

    2015-01-01

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

  16. Intraneural fibroma of the median nerve at the wrist.

    Science.gov (United States)

    Burrows, Anthony M; Folpe, Andrew L; Wenger, Doris E; Spinner, Robert J

    2014-06-01

    Distal median neuropathy from carpal tunnel syndrome is the most well known lesion affecting the median nerve. Mass lesions may affect the nerve at the wrist. We present to our knowledge the first histologically confirmed case of an intraneural fibroma.

  17. Role of the vegus nerve in epilepsy (image)

    Science.gov (United States)

    The vagus nerves branch off the brain on either side of the head and travel down the neck, along the ... the body, and affect swallowing and speech. The vagus nerves also connect to parts of the brain involved ...

  18. Zika Connection to Rare Nerve Disorder Bolstered by Study

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_161325.html Zika Connection to Rare Nerve Disorder Bolstered by Study ... has developed the strongest evidence to date that Zika virus can cause a rare nerve disorder called ...

  19. Neurosyphilis Involving Cranial Nerves in Brain Stem: 2 Case Reports

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Ji Hye [Dept. of Radiology, Kyung Hee University College of Medicine, Seoul (Korea, Republic of); Choi, Woo Suk; Kim, Eui Jong [Dept. of Radiology, Kyung Hee University Hospital, Seoul (Korea, Republic of); Yoon, Sung Sang; Heo, Sung Hyuk [Dept. of Neurology, Kyung Hee University Hospital, Seoul (Korea, Republic of)

    2012-01-15

    Neurosyphilis uncommonly presents with cranial neuropathies in acute syphilitic meningitis and meningovascular neurosyphilis. We now report two cases in which the meningeal form of neurosyphilis involved cranial nerves in the brain stem: the oculomotor and trigeminal nerve.

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

    CERN Document Server

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

    2003-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Jiang Xinquan

    2011-07-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2012-01-01

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

  3. Degeneration and regeneration of motor and sensory nerves: a stereological study of crush lesions in rat facial and mental nerves.

    Science.gov (United States)

    Barghash, Z; Larsen, J O; Al-Bishri, A; Kahnberg, K-E

    2013-12-01

    The aim of this study was to evaluate the degeneration and regeneration of a sensory nerve and a motor nerve at the histological level after a crush injury. Twenty-five female Wistar rats had their mental nerve and the buccal branch of their facial nerve compressed unilaterally against a glass rod for 30s. Specimens of the compressed nerves and the corresponding control nerves were dissected at 3, 7, and 19 days after surgery. Nerve cross-sections were stained with osmium tetroxide and toluidine blue and analysed using two-dimensional stereology. We found differences between the two nerves both in the normal anatomy and in the regenerative pattern. The mental nerve had a larger cross-sectional area including all tissue components. The mental nerve had a larger volume fraction of myelinated axons and a correspondingly smaller volume fraction of endoneurium. No differences were observed in the degenerative pattern; however, at day 19 the buccal branch had regenerated to the normal number of axons, whereas the mental nerve had only regained 50% of the normal number of axons. We conclude that the regenerative process is faster and/or more complete in the facial nerve (motor function) than it is in the mental nerve (somatosensory function).

  4. Use of nerve elongator to repair short-distance peripheral nerve defects:a prospective randomized study

    Institute of Scientific and Technical Information of China (English)

    Lu Bai; Min-tao Tian; Hong Chen; Dian-ying Zhang; Zhong-guo Fu; Pei-xun Zhang; Bao-guo Jiang; Tian-bing Wang; Xin Wang; Wei-wen Zhang; Ji-hai Xu; Xiao-ming Cai; Dan-ya Zhou; Li-bing Cai; Jia-dong Pan

    2015-01-01

    Repair techniques for short-distance peripheral nerve defects, including adjacent joint lfexion to reduce the distance between the nerve stump defects, “nerve splint” suturing, and nerve sle eve connection, have some disadvantages. Therefore, we designed a repair technique involving intraoperative tension-free application of a nerve elongator and obtained good outcomes in the repair of short-distance peripheral nerve defects in a previous animal study. The present study compared the clinical outcomes between the use of this nerve elongator and performance of the conventional method in the repair of short-distance transection injuries in human elbows. The 3-, 6-, and 12-month postoperative follow-up results demonstrated that early neurological function recovery was better in the nerve elongation group than in the conventional group, but no signif-icant difference in long-term neurological function recovery was detected between the two gro ups. In the nerve elongation group, the nerves were sutured without tension, and the duration of postoperative immobilization of the elbow was decreased. Elbow function rehabilitation was signiifcantly better in the nerve elongation group than in the control group. Moreover, there were no security risks. The results of this study conifrm that the use of this nerve elongator for repair of short-distance peripheral nerve defects is safe and effective.

  5. High-resolution CT of lesions of the optic nerve

    Energy Technology Data Exchange (ETDEWEB)

    Peyster, R.G.; Hoover, E.D.; Hershey, B.L.; Haskin, M.E.

    1983-05-01

    The optic nerves are well demonstrated by high-resolution computed tomography. Involvement of the optic nerve by optic gliomas and optic nerve sheath meningiomas is well known. However, nonneoplastic processes such as increased intracranial pressure, optic neuritis, Grave ophthalmopathy, and orbital pseudotumor may also alter the appearance of the optic nerve/sheath on computed tomography. Certain clinical and computed tomographic features permit distinction of these nonneoplastic tumefactions from tumors.

  6. Piriformis syndrome surgery causing severe sciatic nerve injury.

    Science.gov (United States)

    Justice, Phillip E; Katirji, Bashar; Preston, David C; Grossman, Gerald E

    2012-09-01

    Piriformis syndrome is a controversial entrapment neuropathy in which the sciatic nerve is thought to be compressed by the piriformis muscle. Two patients developed severe left sciatic neuropathy after piriformis muscle release. One had a total sciatic nerve lesion, whereas the second had a predominantly high common peroneal nerve lesion. Follow-up studies showed reinnervation of the hamstrings only. We conclude that piriformis muscle surgery may be hazardous and result in devastating sciatic nerve injury.

  7. Biomechanical properties of peripheral nerve after acellular treatment

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

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

  8. VLSI circuits for bidirectional interface to peripheral and visceral nerves.

    Science.gov (United States)

    Greenwald, Elliot; Wang, Qihong; Thakor, Nitish V

    2015-08-01

    This paper presents an architecture for sensing nerve signals and delivering functional electrical stimulation to peripheral and visceral nerves. The design is based on the very large scale integration (VLSI) technology and amenable to interface to microelectrodes and building a fully implantable system. The proposed stimulator was tested on the vagus nerve and is under further evaluation and testing of various visceral nerves and their functional effects on the innervated organs.

  9. Peripheral nerve involvement in spinocerebellar ataxias

    NARCIS (Netherlands)

    van de Warrenburg, Bart P C; Notermans, Nicolette C; Schelhaas, Helenius J; van Alfen, Nens; Sinke, Richard J; Knoers, Nine V A M; Zwarts, Machiel J; Kremer, Berry P H

    2004-01-01

    BACKGROUND: In autosomal dominant cerebellar ataxias (ADCAs), it is unclear whether the associated peripheral nerve involvement is always a typical length-dependent axonopathy rather than primary neuronopathy due to neuronal degeneration in the spinal anterior horns and/or dorsal root ganglia. OBJEC

  10. Iatrogenic injury to the inferior alveolar nerve

    DEFF Research Database (Denmark)

    Hillerup, Søren

    2008-01-01

    The purpose of this prospective, non-randomised, descriptive study is to characterise the neurosensory deficit and associated neurogenic discomfort in 52 patients with iatrogenic injury to the inferior alveolar nerve (IAN). All patients were examined and followed up according to a protocol assess...

  11. Anatomy of the retinal nerve fiber layer.

    Science.gov (United States)

    Radius, R L; de Bruin, J

    1981-11-01

    Anatomy of the retinal nerve fiber layer in rabbit eyes is studied by light microscopy, transmission electron microscopy, and scanning electron microscopy. It is demonstrated that retinal striations noted ophthalmoscopically in these eyes represent individual fiber bundles, Axon bundles are compartmentalized within tissue tunnels comprised of elongated processes of glial cell origin.

  12. The Imaging of Large Nerve Perineural Spread.

    Science.gov (United States)

    Gandhi, Mitesh; Sommerville, Jennifer

    2016-04-01

    We present a review of the imaging findings of large nerve perineural spread within the skull base. The MRI techniques and reasons for performing different sequences are discussed. A series of imaging examples illustrates the appearance of perineural tumor spread with an emphasis on the zonal staging system.

  13. Sympathetic vasoconstrictor nerve function in alcoholic neuropathy

    DEFF Research Database (Denmark)

    Jensen, K; Andersen, K; Smith, T;

    1984-01-01

    The peripheral sympathetic vasomotor nerve function was investigated in 18 male chronic alcoholics admitted for intellectual impairment or polyneuropathy. By means of the local 133Xenon washout technique, the sympathetic veno-arteriolar axon-reflex was studied. This normally is responsible for a ...

  14. Cyclosarin-An Organophosphate Nerve Agent

    Directory of Open Access Journals (Sweden)

    G. Krejcova

    2005-04-01

    Full Text Available Organophosphorus compounds ascribed to as nerve agents (sarin, soman, tabun, cyclosarin are highly toxic, and are considered to be the most dangerous chemical compounds. All apparently share a common mechanism of cholinesterase inhibition and can cause similar sv.m .ot oms. The standard therapy, in the case of organophosphorus poisoning, has the prophylactic use of reversibly acting AChE inhibitors and antidotal administration of AChE reactivators-oximes. Unfortunately, none of these oximes can be regarded as a broad spectrum antidote, ie, effective against all nerve agents. While the presently available oximes (pralidoxime, ohidoxime are not considered to be sufficiently effective against nerve agents, especially in the case of soman poisoning, the H oximes (HI-6, HLo7 appear to,be very promising antidotes against nerve agents because these are able to protect the experimental animals from toxic effects and improve survival of animals poisoned with supralethal doses. A lot of research has been pursued on the treatment of sarin, soman, and tabun, but cyclosarin was not considered for such a study for a long time. Recently, attention of researchers has also turned to cyclosarin because of its potential use as a chemical warfare agent. Cyclosarin is highly toxic organophosphorus compound which is resistant to conventional oxime therapy. This paper reviews the latest positionof cyclosarin in standpoint of medical treatment by various reactivators considering the ability of various oximes, HI-6, HS-6, BI-6, and KO33 of their reactivation potency.

  15. Heart rate control via vagus nerve stimulation

    NARCIS (Netherlands)

    Buschman, Hendrik P.; Storm, Corstiaan J.; Duncker, Dirk J.; Verdouw, Pieter D.; Aa, van der Hans E.; Kemp, van der Peter

    2006-01-01

    Objectives: There is ample and well-established evidence that direct electrical stimulation of the vagus nerve can change heart rate in animals and humans. Since tachyarrhythmias cannot always be controlled through medication, we sought, in this pilot study, to elucidate whether a clinical implantab

  16. Drug Delivery for Peripheral Nerve Regeneration

    Science.gov (United States)

    2014-09-01

    and connect the two tubes; (b) A scanning electron microscope image of the transverse cross-sectional view of the PLGA nerve conduit. The filter is...reprints of manuscripts and abstracts, a curriculum vitae, patent applications, study questionnaires, and surveys, etc. Bioresorbable Multi-Drug

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

    Science.gov (United States)

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

    2016-06-01

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

  18. 21 CFR 868.2775 - Electrical peripheral nerve stimulator.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Electrical peripheral nerve stimulator. 868.2775... (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Monitoring Devices § 868.2775 Electrical peripheral nerve stimulator. (a) Identification. An electrical peripheral nerve stimulator (neuromuscular blockade monitor)...

  19. Unmyelinated nerve fiber degeneration in chronic inflammatory demyelinating polyneuropathy

    NARCIS (Netherlands)

    Bosboom, WMJ; Van den Berg, LH; Dieks, HJG; Plante, E; Veldman, H; Franssen, H; Wokke, JHJ

    2000-01-01

    To determine whether unmyelinated nerve fibers escape degeneration as one might expect in an immune response exclusively directed at myelin, we performed a morphometric examination of unmyelinated axons and myelinated nerve fibers in sural nerve biopsy specimens of 14 patients with a chronic inflamm

  20. Periodic solutions and refractory periods in the soliton theory for nerves and the locust femoral nerve

    CERN Document Server

    Vargas, Edgar Villagran; Hustert, Reinhold; Gumrich, Peter; Jackson, Andrew D; Heimburg, Thomas

    2010-01-01

    Close to melting transitions it is possible to propagate solitary electromechanical pulses which reflect many of the experimental features of the nerve pulse including mechanical dislocations and reversible heat production. Here we show that one also obtains the possibility of periodic pulse generation when the boundary condition for the nerve is the conservation of the overall length of the nerve. This condition generates an undershoot beneath the baseline (`hyperpolarization') and a `refractory period', i.e., a minimum distance between pulses. In this paper, we outline the theory for periodic solutions to the wave equation and compare these results to action potentials from the femoral nerve of the locust (locusta migratoria). In particular, we describe the frequently occurring minimum-distance doublet pulses seen in these neurons and compare them to the periodic pulse solutions.

  1. Does nerve identification during open inguinal herniorrhaphy reduce the risk of nerve damage and persistent pain?

    DEFF Research Database (Denmark)

    Bischoff, J M; Aasvang, E K; Kehlet, H

    2012-01-01

    PURPOSE: Nerve identification during open inguinal hernia herniorrhaphy has been suggested as one of the factors that may reduce the risk of development of persistent postherniorrhaphy pain. In this prospective study, we evaluated whether intraoperative inguinal nerve identification influenced...... the risk of development of persistent postherniorrhaphy pain, sensory dysfunction in the groin and functional ability score after open hernia repair. METHODS: A total of 244 men with a primary inguinal hernia underwent open Lichtenstein repair in a high-volume hernia surgery centre, where information.......0 %) had substantial pain-related functional impairment at 6 months follow-up. There was no difference in risk of development of substantial pain-related functional impairment in patients with identification compared with non-identification of the iliohypogastric nerve (P = 1.0), the ilioinguinal nerve (P...

  2. Altered prosaposin expression in the rat facial nerve nucleus following facial nerve transection and repair

    Institute of Scientific and Technical Information of China (English)

    Dong Wang; Wenlong Luo; Cuiying Zhou; Jingjing Li

    2009-01-01

    BACKGROUND: Studies have demonstrated that damaged facial nerves synthesize prosaposin to promote repair of facial neurons.OBJECTIVE: To observe time-course changes of prosaposin expression in the facial nerve nucleus of Sprague Dawley rats following facial nerve transection and repair.DESIGN, TIME AND SETTING: A randomized control neuropathological animal experiment was performed in Chongqing Medical University between March 2007 and September 2008.MATERIALS: A total of 48 adult, male, Sprague Dawley rats were selected and randomly divided into transection and transection + end-to-end anastomosis groups (n =24). Rabbit anti-rat prosaposin antibody, instant SABC immunohistochemical kit, and antibody dilution solution were purchased from Wuhan Uscn Science Co., Ltd., China.METHODS: In the transection group, the nerve trunk of the distal retroauricular branch of the left facial nerves was ligated in Sprague Dawley rats, and a 5-mm nerve trunk at the distal end of the ligation site was removed. In the transection + end-to-end anastomosis group, epineurial anastomosis was performed immediately following transection of the left facial nerves. The right facial nerves in the two groups sewed as the normal control group.MAIN OUTCOME MEASURES: The number of prosaposin-positive neurons, as well as intensity of immunostaining in facial nerve nucleus, following transection and end-to-end anastomosis were determined by immunohistochemistry at 1,3, 7, 14, 21, and 35 days after injury.RESULTS: Transection group: transection of facial nerves resulted in increased number of prosaposin-positive neurons and immunoreactivity intensity in the facial nucleus on day 1. These values significantly increased by day 3. Expression was greater than in the control side. The peak of the reduction was reached at 7 days post-surgery. Transection + end-to-end anastomosis group: the number of prosaposin-positive neurons and immunoreactivity intensity was reduced in the facial nerve nucleus following

  3. Morphology of nerve fiber regeneration along a biodegradable poly (DLLA-epsilon-CL) nerve guide filled with fresh skeletal muscle.

    Science.gov (United States)

    Varejão, Artur S P; Cabrita, António M; Meek, Marcel F; Fornaro, Michele; Geuna, Stefano; Giacobini-Robecchi, Maria G

    2003-01-01

    Previous morphological and morphometrical studies showed that fresh-skeletal-muscle-enriched vein segments are good conduits for leading peripheral nerve regeneration. In the present study, we investigated the morphological features of peripheral nerve fibers regenerated along a 10-mm-long biodegradable poly (DLLA-epsilon-CL) nerve guide enriched with fresh skeletal muscle, comparing them to nerve fiber regeneration along 10-mm-long phosphate-buffered saline (PBS)-enriched poly (DLLA-epsilon-CL) tubes. Repaired nerves were analyzed at weeks 6 and 24 postoperatively. Structural and ultrastructural observation showed that good nerve fiber regeneration occurred in both PBS-enriched and fresh-skeletal-muscle-enriched nerve guides, and histomorphometrical analysis of regenerated myelinated fibers revealed no statistically significant differences between the two experimental groups at week 24 after surgery. The employment of fresh-muscle-enriched conduits for the repair of nerve defects is critically discussed in the light of these results.

  4. Optic Nerve Sheath Mechanics in VIIP Syndrome

    Science.gov (United States)

    Raykin, Julia; Forte, Taylor E.; Wang, Roy; Feola, Andrew; Samuels, Brian; Myers, Jerry; Nelson, Emily; Gleason, Rudy; Ethier, C. Ross

    2016-01-01

    Visual Impairment Intracranial Pressure (VIIP) syndrome is a major concern in current space medicine research. While the exact pathology of VIIP is not yet known, it is hypothesized that the microgravity-induced cephalad fluid shift increases intracranial pressure (ICP) and drives remodeling of the optic nerve sheath. To investigate this possibility, we are culturing optic nerve sheath dura mater samples under different pressures and investigating changes in tissue composition. To interpret results from this work, it is essential to first understand the biomechanical response of the optic nerve sheath dura mater to loading. Here, we investigated the effects of mechanical loading on the porcine optic nerve sheath.Porcine optic nerves (number: 6) were obtained immediately after death from a local abattoir. The optic nerve sheath (dura mater) was isolated from the optic nerve proper, leaving a hollow cylinder of connective tissue that was used for biomechanical characterization. We developed a custom mechanical testing system that allowed for unconfined lengthening, twisting, and circumferential distension of the dura mater during inflation and under fixed axial loading. To determine the effects of variations in ICP, the sample was inflated (0-60 millimeters Hg) and circumferential distension was simultaneously recorded. These tests were performed under variable axial loads (0.6 grams - 5.6 grams at increments of 1 gram) by attaching different weights to one end of the dura mater. Results and Conclusions: The samples demonstrated nonlinear behavior, similar to other soft connective tissue (Figure 1). Large increases in diameter were observed at lower transmural pressures (approximately 0 to 5 millimeters Hg), whereas only small diameter changes were observed at higher pressures. Particularly interesting was the existence of a cross-over point at a pressure of approximately 11 millimeters Hg. At this pressure, the same diameter is obtained for all axial loads applied

  5. Restudy of malformations of the internal auditory meatus, cochlear nerve canal and cochlear nerve

    OpenAIRE

    Li, Youjin; YANG, Jun; Liu, Jinfen; Wu, Hao

    2014-01-01

    The present study aims to restudy the correlation between the internal auditory meatus (IAM), the cochlear nerve canal (CNC), the cochlear nerve (CN) and inner ear malformations. In this retrospective study design, the abnormal diameter of the IAM, CNC and CN in patients with any kind of inner ear malformations was evaluated using multi-slice spiral computed tomography (MSCT) (37 patients) and magnetic resonance imaging (MRI) (18 patients). Of 37 MSCT-diagnosed patients, 2 had IAM atresia, 11...

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

    Directory of Open Access Journals (Sweden)

    Hao Li

    2015-01-01

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

  7. Ginsenoside Rg1 promotes peripheral nerve regeneration in rat model of nerve crush injury.

    Science.gov (United States)

    Ma, Junxiong; Li, Wenxian; Tian, Ruifeng; Lei, Wei

    2010-07-05

    Searching for effective drugs which are capable of promoting nerve regeneration after nerve injuries has gained extensive attention. Ginsenoside Rg1 (GRg1) is one of the bioactive compounds extracted from ginseng. GRg1 has been shown to be neuroprotective in many in vitro studies, which raises the possibility of using GRg1 as a neuroprotective agent after nerve injuries. However, such a possibility has never been tested in in vivo studies. The present study was designed to investigate the efficacy of GRg1 in promoting nerve regeneration after nerve crush injury in rats. All rats were randomly divided into four groups (n=8 in each group) after crush injury and were intraperitoneally administrated daily for 4 weeks with 1mg/kg, or 5mg/kg GRg1 (low or high dose GRg1 groups), or 100mug/kg mecobalamin or normal saline, respectively. The axonal regeneration was investigated by retrograde labeling and morphometric analysis. The motor functional recovery was evaluated by electrophysiological studies, behavioral tests and histological appearance of the target muscles. Our data showed that high dose GRg1 achieved better axonal regeneration and functional recovery than those achieved by low dose GRg1 and mecobalamin. The final outcome of low dose GRg1 and mecobalamin was similar in both morphological and functional items, which was significantly better than that in saline group. These findings show that GRg1 is capable of promoting nerve regeneration after nerve injuries, suggesting the possibility of developing GRg1 a neuroprotective drug for peripheral nerve repair applications.

  8. Enhancing Peripheral Nerve Regeneration with a Novel Drug Delivering Nerve Conduit

    Science.gov (United States)

    2014-10-01

    Products 21 7. Participants & Other Collaborating Organizations 22 8. Special Reporting Requirements 23 9. Appendices 24 3... Corning Inc) were also added to the nerve conduit. Figure 2 illustrates the nerve conduit in which the drug (NGF) stored in the orifice between...7525 DLG 7E, Evonik). The PLGA was dissolved in acetone and ethanol and conduits were then formed and emulsified in water. 15µm diffusion holes

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

    Directory of Open Access Journals (Sweden)

    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.

  10. Aberrant course of a communicating branch of the ulnar nerve to the median nerve contributing to hypothenar Hammer syndrome.

    Science.gov (United States)

    Richards, Winston T; Bullocks, Jamal M; Norris, Morgan E

    2007-06-01

    This presentation represents a unique anatomic predisposition to the development of hypothenar hammer syndrome (HHS). In this case, a communicating branch of the ulnar nerve to the median common digital nerve of the ring finger was identified crossing volar to the superficial palmar arch. This relationship caused thrombosis of the superficial palmar arch proximal to this crossing nerve branch. The aberrant course of this nerve created a structural anomaly contributing to HHS, which ultimately mandated surgical intervention.

  11. Corneal nerve microstructure in Parkinson's disease.

    Science.gov (United States)

    Misra, Stuti L; Kersten, Hannah M; Roxburgh, Richard H; Danesh-Meyer, Helen V; McGhee, Charles N J

    2017-03-03

    Ocular surface changes and blink abnormalities are well-established in Parkinson's disease. Blink rate may be influenced by corneal sub-basal nerve density, however, this relationship has not yet been investigated in Parkinson's disease. This case-control study examined the ocular surface in patients with moderately severe Parkinson's disease, including confocal microscopy of the cornea. Fifteen patients with moderately severe Parkinson's disease (modified Hoehn and Yahr grade 3 or 4) and fifteen control participants were recruited. Ophthalmic assessment included slit-lamp examination, blink rate assessment, central corneal aesthesiometry and in vivo corneal confocal microscopy. The effect of disease laterality was also investigated. Of the 15 patients with Parkinson's disease, ten were male and the mean age was 65.5±8.6years. The corneal sub-basal nerve plexus density was markedly reduced in patients with Parkinson's disease (7.56±2.4mm/mm(2)) compared with controls (15.91±2.6mm/mm(2)) (pParkinson's disease (0.79±1.2mBAR) and the control group (0.26±0.35mBAR), p=0.12. Sub-basal nerve density was not significantly different between the eye ipsilateral to the side of the body with most-severe motor symptoms, and the contralateral eye. There was a significant positive correlation between ACE-R scores and sub-basal corneal nerve density (R(2)=0.66, p=0.02). This is the first study to report a significant reduction in corneal sub-basal nerve density in Parkinson's disease and demonstrate an association with cognitive dysfunction. These results provide further evidence to support the involvement of the peripheral nervous system in Parkinson's disease, previously thought to be a central nervous system disorder.

  12. Peripheral nerve extract effects on mesenchymal cells.

    Science.gov (United States)

    Dietz, F R; Mukhopadhyay, B; Becker, G; Daniels, K; Solursh, M

    1996-01-01

    Several common congenital limb disorders are characterized by normal tissue differentiation but abnormal somatic growth. These include: idiopathic clubfoot, idiopathic leg length discrepancy, hemi-atrophy and hemi-hypertrophy. Both clinical and research studies have suggested that peripheral nerves may be important in regulating somatic growth of limb tissues. To investigate the hypothesis that peripheral nerves convey trophic substances to mesenchymal tissues that are involved in the regulation of growth, we developed an in vitro assay to assess the effect of fractions of peripheral nerve on myoblast and chondroblast growth and differentiation in a mammalian (rat) system. Whole rat sciatic nerve extract was fractionated by ammonium sulfate precipitation and by affinity chromatography. Concavalin A chromatography resolved whole nerve extract into a glycoprotein and a non-glycoprotein fraction. Serial ammonium sulfate precipitation yielded three pellet fractions designated as 35%, 70%, and 100% pellets; corresponding to ammonium sulfate concentrations of 0 to 35%, 35 to 70%, and 70 to 100% saturation, respectively. Dialyzed solutions of these pellets as well as the fractions from Concavalin A chromatography were assayed for biological activity in micromass cultures of rat limb bud mesenchyme, which allowed assessment of both myoblast and chondroblast stimulation. Stimulation of protein synthesis and myoblast proliferation (as measured by MF20 staining) occurred with both 70% and 100% ammonium sulfate fractions. Stimulation of chondroblasts (as measured by the number of alcian blue staining nodules) occurred with the 35% and 100% fractions. The glycoprotein fraction from the affinity chromatography stimulated protein synthesis and myoblast proliferation and inhibited chondroblast development. Stimulation of chondroblasts was seen with the non-glycoprotein fraction. No effect on protein synthesis, myoblast proliferation or chondroblast proliferation was found in

  13. Neuroprotective effects of ultrasound-guided nerve growth factor injections after sciatic nerve injury

    Directory of Open Access Journals (Sweden)

    Hong-fei Li

    2015-01-01

    Full Text Available Nerve growth factor (NGF plays an important role in promoting neuroregeneration after peripheral nerve injury. However, its effects are limited by its short half-life; it is therefore important to identify an effective mode of administration. High-frequency ultrasound (HFU is increasingly used in the clinic for high-resolution visualization of tissues, and has been proposed as a method for identifying and evaluating peripheral nerve damage after injury. In addition, HFU is widely used for guiding needle placement when administering drugs to a specific site. We hypothesized that HFU guiding would optimize the neuroprotective effects of NGF on sciatic nerve injury in the rabbit. We performed behavioral, ultrasound, electrophysiological, histological, and immunohistochemical evaluation of HFU-guided NGF injections administered immediately after injury, or 14 days later, and compared this mode of administration with intramuscular NGF injections. Across all assessments, HFU-guided NGF injections gave consistently better outcomes than intramuscular NGF injections administered immediately or 14 days after injury, with immediate treatment also yielding better structural and functional results than when the treatment was delayed by 14 days. Our findings indicate that NGF should be administered as early as possible after peripheral nerve injury, and highlight the striking neuroprotective effects of HFU-guided NGF injections on peripheral nerve injury compared with intramuscular administration.

  14. Neuroprotective effects of ultrasound-guided nerve growth factor injections after sciatic nerve injury.

    Science.gov (United States)

    Li, Hong-Fei; Wang, Yi-Ru; Huo, Hui-Ping; Wang, Yue-Xiang; Tang, Jie

    2015-11-01

    Nerve growth factor (NGF) plays an important role in promoting neuroregeneration after peripheral nerve injury. However, its effects are limited by its short half-life; it is therefore important to identify an effective mode of administration. High-frequency ultrasound (HFU) is increasingly used in the clinic for high-resolution visualization of tissues, and has been proposed as a method for identifying and evaluating peripheral nerve damage after injury. In addition, HFU is widely used for guiding needle placement when administering drugs to a specific site. We hypothesized that HFU guiding would optimize the neuroprotective effects of NGF on sciatic nerve injury in the rabbit. We performed behavioral, ultrasound, electrophysiological, histological, and immunohistochemical evaluation of HFU-guided NGF injections administered immediately after injury, or 14 days later, and compared this mode of administration with intramuscular NGF injections. Across all assessments, HFU-guided NGF injections gave consistently better outcomes than intramuscular NGF injections administered immediately or 14 days after injury, with immediate treatment also yielding better structural and functional results than when the treatment was delayed by 14 days. Our findings indicate that NGF should be administered as early as possible after peripheral nerve injury, and highlight the striking neuroprotective effects of HFU-guided NGF injections on peripheral nerve injury compared with intramuscular administration.

  15. Effect of Frankincense Extract on Nerve Recovery in the Rat Sciatic Nerve Damage Model

    Directory of Open Access Journals (Sweden)

    Xiaowen Jiang

    2016-01-01

    Full Text Available This study investigated the effect of frankincense extract on peripheral nerve regeneration in a crush injury rat model. Forty-eight Sprague-Dawley rats were randomly divided into four groups: control and frankincense extract low-, medium-, and high-dose groups. At days 7, 14, 21, and 28 following the surgery, nerve regeneration and functional recovery were evaluated using the sciatic functional index (SFI, expression of GAP-43, and the proliferation of Schwann cells (SCs in vivo and in vitro. At day 7, the SFI in the frankincense extract high-dose group was significantly improved compared with the control group. After day 14, SFI was significantly improved in the medium- and high-dose groups. There was no significant difference in GAP-43 expression among the groups at day 7. However, after day 14, expression of GAP-43 in the high-dose group was higher than that in the control group. Histological evaluation showed that the injured nerve of frankincense extract high-dose group recovered better than the other groups 28 days after surgery. Further, S100 immunohistochemical staining, MTT colorimetry, and flow cytometry assays all showed that frankincense extract could promote the proliferation of SCs. In conclusion, frankincense extract is able to promote sciatic nerve regeneration and improve the function of a crushed sciatic nerve. This study provides a new direction for the repair of peripheral nerve injury.

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

    Science.gov (United States)

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

    2014-04-01

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

  17. Simultaneous Quantification of Unmyelinated Nerve Fibers in Sural Nerve and in Skin.

    Science.gov (United States)

    Duchesne, Mathilde; Magy, Laurent; Richard, Laurence; Ingrand, Pierre; Neau, Jean-Philippe; Mathis, Stéphane; Vallat, Jean-Michel

    2016-01-01

    Peripheral polyneuropathies are common and their diagnosis may be challenging. We compared the results from sural-nerve and skin biopsies in 33 patients with a polyneuropathy and neuropathic pain examined in our hospital over a 6-year period. The biopsies were all from the same lower limb of each patient. Intraepidermal nerve fiber (IENF) densities in the skin were determined by fluorescence microscopy; unmyelinated fiber densities in sural-nerve biopsies (UFNB) were determined by electron microscopy. There was no correlation with age or gender in either biopsy type; there was a weak trend to correlation between UFNB density and IENF density, possibly because of the small sample size. The sensitivity of detection of quantitative abnormalities of unmyelinated fibers was better in the skin than in the nerves. Proximal and distal IENF densities were strongly correlated; and counts of UFNB were highly reproducible. Thus, quantification of unmyelinated fibers in sural-nerve and skin biopsies seem to be complementary. Sural-nerve biopsy may be required to confirm a specific diagnosis, to identify lesion mechanisms, and to devise therapeutic strategies, whereas skin biopsy seems to be more efficient in the follow-up of length-dependent polyneuropathies and in the diagnosis of neuropathic pain.

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

    Institute of Scientific and Technical Information of China (English)

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

    2006-01-01

    BACKGROUND: Animal experiments and clinical studies about tissue engineering method applied to repair nerve injury mainly focus on seeking ideal artificial nerve grafts, nerve conduit and seed cells. Autologous nerve, allogeneic nerve and xenogeneic nerve are used to bridge nerve defects, it is one of the methods to promote the repair of nerve injury by culturing and growing Schwann cells, which can secrete various neurotrophic factor activities, in the grafts.OBJECTIVE: To observe the effect of acellular nerve grafts co-cultured with Schwann cells in repairing defects of sciatic nerve.DESIGN: An observational comparative study.SETTING: Tissue Engineering Laboratory of China Medical University.MATERIALS: The experiment was carried out in the Tissue Engineering Laboratory of China Medical University between April 2004 and April 2005. Forty neonatal Sprague-Dawley rats of 5-8 days (either males or females) and 24 male Wistar rats of 180-220 g were provided by the experimental animal center of China Medical University.METHODS: ① Culture of Schwann cells: The bilateral sciatic nerves and branchial plexus were isolated from the 40 neonatal SD rats. The sciatic nerves were enzymatically digested with collagenase and dispase, isolatd, purified and cultured with the method of speed-difference adhersion, and identified with the SABC immunohistochemical method. ② Model establishment: In vitro Schwann cells were microinjected into 10-mm long acellular nerve grafts repairing a surgically created gap in the rat sciatic nerve.According to the different grafted methods, the animals were randomly divided into three groups: autografts (n=8), acellular nerve grafts (n=8), or acellular nerve grafts with Schwann cells (n=8). ③ The regenerated nerve fiber number and average diameter of myeline sheath after culture were statistically anlayzed.MAIN OUTCOME MEASURES: ① The regenerated nerve ultrastructure, total number and density of myelinated nerve fibers, and the thickness of

  19. A case of mental nerve paresthesia due to dynamic compression of alveolar inferior nerve along an elongated styloid process

    NARCIS (Netherlands)

    Gooris, P.J.J.; Zijlmans, J.C.M.; Bergsma, J.E.; Mensink, G.

    2014-01-01

    Spontaneous paresthesia of the mental nerve is considered an ominous clinical sign. Mental nerve paresthesia has also been referred to as numb chin syndrome. Several potentially different factors have been investigated for their role in interfering with the inferior alveolar nerve (IAN) and causing

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

    Institute of Scientific and Technical Information of China (English)

    Jiren Zhang; Yubo Wang; Jincheng Zhang

    2012-01-01

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

  1. Recent Strategies in Tissue Engineering for Guided Peripheral Nerve Regeneration.

    Science.gov (United States)

    Belanger, Kayla; Dinis, Tony M; Taourirt, Sami; Vidal, Guillaume; Kaplan, David L; Egles, Christopher

    2016-04-01

    The repair of large crushed or sectioned segments of peripheral nerves remains a challenge in regenerative medicine due to the complexity of the biological environment and the lack of proper biomaterials and architecture to foster reconstruction. Traditionally such reconstruction is only achieved by using fresh human tissue as a surrogate for the absence of the nerve. However, recent focus in the field has been on new polymer structures and specific biofunctionalization to achieve the goal of peripheral nerve regeneration by developing artificial nerve prostheses. This review presents various tested approaches as well their effectiveness for nerve regrowth and functional recovery.

  2. Handcrafted multilayer PDMS microchannel scaffolds for peripheral nerve regeneration.

    Science.gov (United States)

    Hossain, Ridwan; Kim, Bongkyun; Pankratz, Rachel; Ajam, Ali; Park, Sungreol; Biswal, Sibani L; Choi, Yoonsu

    2015-12-01

    Injuries that result in the loss of limb functionality may be caused by the severing of the peripheral nerves within the affected limb. Several bioengineered peripheral nerve scaffolds have been developed in order to provide the physical support and topographical guidance necessary for the naturally disorganized axon outgrowth to reattach to distal nerve stumps as an alternative to other procedures, like nerve grafting. PDMS has been chosen for the base material of the scaffolds due to its biocompatibility, flexibility, transparency, and well-developed fabrication techniques. The process of observing the axon outgrowth across the nerve gaps with PDMS scaffolds has been challenging due to the limited number and fineness of longitudinal sections that can be extracted from harvested nerve tissue samples after implantation. To address this, multilayer microchannel scaffolds were developed with the object of providing more refined longitudinal observation of axon outgrowth by longitudinally 'sectioning' the device during fabrication, removing the need for much of the sample preparation process. This device was then implanted into the sciatic nerves of Lewis rats, and then harvested after two and four weeks to analyze the difference in nerve regeneration between two different time periods. The present layer by layer structure, which is separable after nerve regeneration and is treated as an individual layer during the histology process, provides the details of biological events during axonal regeneration. Confocal microscopic imaging showed the details of peripheral nerve regeneration including nerve branches and growth cones observable from within the microchannels of the multilayer PDMS microchannel scaffolds.

  3. [Inter-examiner reliability of nerve conduction measurements].

    Science.gov (United States)

    Hasegawa, O; Mimura, E; Kirigaya, N; Wada, N; Tsumura, M; Iino, M; Matsumoto, S

    1999-12-01

    A total of 122 patients were performed motor and sensory nerve conduction studies of the upper limb by two examiners (1. doctor, 2. medical technician) to know the inter-examiner reliability of nerve conduction measurements. Subjects contained normal individuals and various types of neuropathy patients. Motor nerve conduction studies were carried out in the median nerve, and antidromic sensory nerve conduction studies were performed in the median and ulnar nerves. F-wave latency of the median nerve and sensory conduction velocity between finger and wrist of the median and ulnar nerves presented the equal mean value between two examiners. A relatively good correlation between two examiners was pointed out in the distal motor latency and F-wave latency. Inappropriate measurements were caused by the differences in the site of placement of stimulating or recording electrodes and effects of submaximum stimuli or stimulus spread to other nerves. In sensory nerve conduction studies, especially in the ulnar nerve, careful attention should be paid to avoid the influence of motor artifact in giving supramaximum stimuli. Amplitude measurements showed larger inter-examiner difference than latency or velocity measurements. We reported the present condition of measurement reliability. We should do our best to minimize the error.

  4. Biodegradable magnesium wire promotes regeneration of compressed sciatic nerves.

    Science.gov (United States)

    Li, Bo-Han; Yang, Ke; Wang, Xiao

    2016-12-01

    Magnesium (Mg) wire has been shown to be biodegradable and have anti-inflammatory properties. It can induce Schwann cells to secrete nerve growth factor and promote the regeneration of nerve axons after central nervous system injury. We hypothesized that biodegradable Mg wire may enhance compressed peripheral nerve regeneration. A rat acute sciatic nerve compression model was made, and AZ31 Mg wire (3 mm diameter; 8 mm length) bridged at both ends of the nerve. Our results demonstrate that sciatic functional index, nerve growth factor, p75 neurotrophin receptor, and tyrosine receptor kinase A mRNA expression are increased by Mg wire in Mg model. The numbers of cross section nerve fibers and regenerating axons were also increased. Sciatic nerve function was improved and the myelinated axon number was increased in injured sciatic nerve following Mg treatment. Immunofluorescence histopathology showed that there were increased vigorous axonal regeneration and myelin sheath coverage in injured sciatic nerve after Mg treatment. Our findings confirm that biodegradable Mg wire can promote the regeneration of acute compressed sciatic nerves.

  5. 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.

  6. US and MR imaging of peripheral nerves in leprosy

    Energy Technology Data Exchange (ETDEWEB)

    Martinoli, C. [Department of Radiology ' ' R' ' , DICMI, University of Genoa, Genoa (Italy); Cattedra di Radiologia ' ' R' ' , Universita di Genova, Largo Rosanna Benzi, 8, I-16132 Genoa (Italy); Derchi, L.E.; Gandolfo, N. [Department of Radiology ' ' R' ' , DICMI, University of Genoa, Genoa (Italy); Bertolotto, M. [Department of Radiology, University of Trieste, Strada di Fiume, I-34149 Trieste (Italy); Bianchi, S. [Division de Radiodiagnostic. Hopital Cantonal Huniversitaire, Rue Micheli du Crest, Geneva (Switzerland); Fiallo, P.; Nunzi, E. [Department of Tropical Medicine, University of Genoa, Largo Rosanna Benzi 8, I-16132 Genoa (Italy)

    2000-03-30

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

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

    Directory of Open Access Journals (Sweden)

    Rejeena P Raj, Kunjumon PC, More Anju B

    2014-04-01

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

  8. MRI of peripheral nerve lesions of the lower limbs

    Energy Technology Data Exchange (ETDEWEB)

    Lacour-Petit, M.C.; Ducreux, D. [Dept. of Neuroradiology, Hopital Bicetre, Kremlin-Bicetre (France); Lozeron, P. [Dept. of Neurology, Hopital Bicetre, Kremlin-Bicetre (France)

    2003-03-01

    Our aim is to illustrate the contribution of MRI to diagnosis of lesions of the lower-limb nerve trunks. We report six patients who had clinical and electrophysiological examination for a peroneal or tibial nerve palsy. MRI of the knee showed in three cases a nonenhancing cystic lesion of the peroneal nerve suggesting an intraneural ganglion cyst, confirmed by histological study in one case. One patient with known neurofibromatosis had an enhancing nodular lesion of the peroneal nerve compatible with a neurofibroma. Two patients had diffuse hypertrophy with high signal on T2-weighted images, without contrast enhancement of the sciatic nerve or its branches. These lesions were compatible with localised hypertrophic neuropathy. In one case, biopsy of the superficial branch of the peroneal nerve showed insignificant axonal degeneration. MRI can provide information about the size and site of the abnormal segment of a nerve before treatment and can be used to distinguish different patterns of focal lesion. (orig.)

  9. Bilateral high radial nerve compressions: a case report.

    Science.gov (United States)

    Chuangsuwanich, A; Muangsombut, S; Sangruchi, T

    2000-06-01

    A 40-year-old woman with bilateral high radial nerve compressions by non-traumatic cause was reported. It occurred first at the right radial nerve which was explored after a period of investigation and conservative treatment. Two constricted sites 2.0 cm apart of the right radial nerve crossed by branches of the radial collateral artery beneath the lateral head of the triceps were found. The constricted sites including tissue in between was resected and replaced with a sural nerve graft. One year later the patient had the same episode on the left side. The operative finding was the same as the previous one. Sural nerve graft was performed after neurolysis had failed. The patient's normal radial nerve function returned in one year. This is the first reported case in the literature of bilateral high radial nerve compressions by branches of the radial collateral artery.

  10. A Romanian therapeutic approach to peripheral nerve injury.

    Science.gov (United States)

    Zegrea, I; Chivu, Laura Ioana; Albu, Mădălina Georgiana; Zamfirescu, D; Chivu, R D; Ion, Daniela Adriana; Lascăr, I

    2012-01-01

    The study of nerve regeneration and functional recovery of the injured peripheral nerves represents a worldwide subject of clinical and scientific research. Our team aimed to obtain the first guide for nerve regeneration, bioartificial and biodegradable, using exclusively Romanian resources and having the advantages of price and quality, over the imported nerve conduits already used in clinical practice. First steps of this project consisted in obtaining the prototype of nerve guide conduit and its' testing in vitro and in vivo. Tests of physicochemical characterization, FTIR (Fourier Transform Infrared) spectrometry, thermal analysis (differential calorimetry, thermo-gravimetry), electron microscopy, water absorption and enzymatic degradation of the obtained prototype were followed by in vivo testing. The first results, obtained on a group of Brown Norway rats who suffered experimental lesions of 1 cm at the level of left sciatic nerve, which have then been repaired using the Romanian conduit prototype, are favorable in terms of biocompatibility, biodegradable capacity and support of nerve regeneration.

  11. A case of mental nerve paresthesia due to dynamic compression of alveolar inferior nerve along an elongated styloid process.

    Science.gov (United States)

    Gooris, Peter J J; Zijlmans, Jan C M; Bergsma, J Eelco; Mensink, Gertjan

    2014-07-01

    Spontaneous paresthesia of the mental nerve is considered an ominous clinical sign. Mental nerve paresthesia has also been referred to as numb chin syndrome. Several potentially different factors have been investigated for their role in interfering with the inferior alveolar nerve (IAN) and causing mental nerve neuropathy. In the present case, the patient had an elongated calcified styloid process that we hypothesized had caused IAN irritation during mandibular movement. This eventually resulted in progressive loss of sensation in the mental nerve region. To our knowledge, this dynamic irritation, with complete recovery after resection of the styloid process, has not been previously reported.

  12. Does the addition of a nerve wrap to a motor nerve repair affect motor outcomes?

    Science.gov (United States)

    Lee, Joo-Yup; Parisi, Thomas J; Friedrich, Patricia F; Bishop, Allen T; Shin, Alexander Y

    2014-10-01

    The purpose of this study was to evaluate the effect of wrapping bioabsorbable nerve conduit around primary suture repair on motor nerve regeneration in a rat model. Forty rats were randomly divided into two experimental groups according to the type of repair of the rat sciatic nerve: group I had primary suture repair; group II had primary suture repair and bioabsorbable collagen nerve conduit (NeuraGen® 1.5 mm, Integra LifeSciences Corp., Plainsboro, NJ) wrapped around the repair. At 12 weeks, no significant differences in the percentage of recovery between the two groups were observed with respect to compound muscle action potentials, isometric muscle force, and muscle weight (P = 0.816, P = 0.698, P = 0.861, respectively). Histomorphometric analysis as compared to the non-operative sites was also not significantly different between the two groups in terms of number of myelinated axons, myelinated fiber area, and nerve fiber density (P = 0.368, P = 0.968, P = 0.071, respectively). Perineural scar tissue formation was greater in primary suture repair group (0.36 ± 0.15) than in primary repair plus conduit wrapping group (0.17 ± 0.08). This difference was statistically significant (P decrease perineural scar tissue formation. Although the scar-decreasing effect of bioabsorbable nerve wrap does not translate into better motor nerve recovery in this study, it might have an effect on the functional outcome in humans where scar formation is much more evident than in rats.

  13. Comparison of safety and efficiency of microendoscopic discectomy with automatic nerve retractor and with nerve hook

    Science.gov (United States)

    Yin, He-Ping; Wang, Yu-Peng; Qiu, Zhi-Ye; Du, Zhi-Cai; Wu, Yi-Min; Li, Shu-Wen

    2016-01-01

    This study compares the safety and efficiency of two techniques in microendoscopic discectomy (MED) for lumbar disc herniation. The two techniques are MED with automatic nerve retractor and MED with nerve hook which had been widely used for many years. The former involves a newly developed MED device which contains three parts to protect nerve roots during operation. Four hundred and twenty-eight patients underwent MED treatments between October 2010 and September 2015 were recruited and randomized to either intraoperative utilization of automatic nerve retractor (n = 315, group A) or application of nerve hook during surgery (n = 113, group B). Operation time and intraoperative bleeding volume were evaluated. Simultaneously, Visual Analogue Scales (VAS) and muscle strength grading were performed preoperatively, and 1, 2, 3 days, 1, 2 weeks, 3 and 6 months postoperatively. No dramatic difference of pain intensity was observed between the two groups before surgery and 6 months after surgery (P > 0.05). The operation time was shorter in group A (30.30 ± 1.89 min) than that in group B (59.41 ± 3.25 min). Group A (67.83 ± 13.14 ml) experienced a significant decrease in the amount of blood loss volume when compared with group B (100.04 ± 15.10 ml). There were remarkable differences of VAS score and muscle strength grading after postoperative 1, 2, 3 days, 1, 2 weeks and 3 months between both groups (P ≤ 0.05). MED with automatic nerve retractor effectively shortened operation time, decreased the amount of bleeding, down-regulated the incidence of nerve traction injury. PMID:27699062

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-12-15

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

  15. Structure-activity relationship of nerve-highlighting fluorophores.

    Directory of Open Access Journals (Sweden)

    Summer L Gibbs

    Full Text Available Nerve damage is a major morbidity associated with numerous surgical interventions. Yet, nerve visualization continues to challenge even the most experienced surgeons. A nerve-specific fluorescent contrast agent, especially one with near-infrared (NIR absorption and emission, would be of immediate benefit to patients and surgeons. Currently, there are only three classes of small molecule organic fluorophores that penetrate the blood nerve barrier and bind to nerve tissue when administered systemically. Of these three classes, the distyrylbenzenes (DSBs are particularly attractive for further study. Although not presently in the NIR range, DSB fluorophores highlight all nerve tissue in mice, rats, and pigs after intravenous administration. The purpose of the current study was to define the pharmacophore responsible for nerve-specific uptake and retention, which would enable future molecules to be optimized for NIR optical properties. Structural analogs of the DSB class of small molecules were synthesized using combinatorial solid phase synthesis and commercially available building blocks, which yielded more than 200 unique DSB fluorophores. The nerve-specific properties of all DSB analogs were quantified using an ex vivo nerve-specific fluorescence assay on pig and human sciatic nerve. Results were used to perform quantitative structure-activity relationship (QSAR modeling and to define the nerve-specific pharmacophore. All DSB analogs with positive ex vivo fluorescence were tested for in vivo nerve specificity in mice to assess the effect of biodistribution and clearance on nerve fluorescence signal. Two new DSB fluorophores with the highest nerve to muscle ratio were tested in pigs to confirm scalability.

  16. Comparison of rabbit facial nerve regeneration in nerve growth factor-containing silicone tubes to that in autologous neural grafts.

    Science.gov (United States)

    Spector, J G; Lee, P; Derby, A; Roufa, D G

    1995-11-01

    Previous reports suggest that nerve growth factor (NGF) enhanced nerve regeneration in rabbit facial nerves. We compared rabbit facial nerve regeneration in 10-mm silicone tubes prefilled with NGF or cytochrome C (Cyt C), bridging an 8-mm nerve gap, to regeneration of 8-mm autologous nerve grafts. Three weeks following implantation, NGF-treated regenerates exhibited a more mature fascicular organization and more extensive neovascularization than Cyt C-treated controls. Morphometric analysis at the middle of the tube of 3- and 5-week regenerates revealed no significant difference in the mean number of myelinated or unmyelinated axons between NGF- and Cyt C-treated implants. However, when the numbers of myelinated fibers in 5-week regenerates were compared to those in their respective preoperative controls, NGF-treated regenerates had recovered a significantly greater percentage of myelinated axons than Cyt C-treated implants (46% versus 18%, respectively). The number of regenerating myelinated axons in the autologous nerve grafts at 5 weeks was significantly greater than the number of myelinated axons in the silicone tubes. However, in the nerve grafts the majority of the axons were found in the extrafascicular connective tissue (66%). The majority of these myelinated fibers did not find their way into the distal nerve stump. Thus, although the number of regenerating myelinated axons within the nerve grafts is greater than that of axons within silicone tube implants, functional recovery of autologous nerve graft repairs may not be superior to that of intubational repairs.

  17. Impaired Prosaposin Secretion During Nerve Regeneration in Diabetic Rats and Protection of Nerve Regeneration by a Prosaposin-Derived Peptide

    Science.gov (United States)

    Jolivalt, Corinne G.; Vu, Yvonne; Mizisin, Leah M.; Mizisin, Andrew P.; Calcutt, Nigel A.

    2009-01-01

    Prosaposin is both a precursor of sphingolipid activator proteins and a secreted neurotrophic and myelinotrophic factor. Because peripheral nerve regeneration is impaired in diabetes mellitus, we measured prosaposin protein levels from control and streptozotocin-diabetic rats by collecting endoneurial fluid secreted into a bridging tube connecting the ends of transected sciatic nerve. Prosaposin protein levels were significantly reduced in endoneurial fluid from diabetic rats and increased in the proximal nerve stump compared to controls. To investigate whether a prosaposin-derived peptide could improve nerve regeneration, rats were treated with prosaptide TX14(A) following sciatic nerve crush. In control rats, TX14(A) was without effect in the uninjured nerve but shortened toe spread recovery time after nerve crush. In diabetic rats, efficacy of prosaptide TX14(A) was confirmed by correction of thermal hypoalgesia, formalin-evoked hyperalgesia and conduction slowing in the uninjured nerve. The peptide also prevented diabetes-induced abnormalities in nerve regeneration distance and mean axonal diameter of regenerated axons, whereas delayed recovery of toe spread was not improved. Muscle denervation atrophy was attenuated by TX14(A) in both control and diabetic rats. These results suggest that reduced prosaposin secretion after nerve injury may contribute to impaired regeneration rates in diabetic rats and that prosaptide TX14(A) can improve aspects of nerve regeneration. PMID:18596543

  18. Impaired prosaposin secretion during nerve regeneration in diabetic rats and protection of nerve regeneration by a prosaposin-derived peptide.

    Science.gov (United States)

    Jolivalt, Corinne G; Vu, Yvonne; Mizisin, Leah M; Mizisin, Andrew P; Calcutt, Nigel A

    2008-07-01

    Prosaposin is both a precursor of sphingolipid activator proteins and a secreted neurotrophic and myelinotrophic factor. Because peripheral nerve regeneration is impaired in diabetes mellitus, we measured prosaposin protein levels from control and streptozotocin-diabetic rats by collecting endoneurial fluid secreted into a bridging tube connecting the ends of transected sciatic nerve. Prosaposin protein levels were significantly reduced in endoneurial fluid from diabetic rats and increased in the proximal nerve stump compared to controls. To investigate whether a prosaposin-derived peptide could improve nerve regeneration, rats were treated with prosaptide TX14(A) after sciatic nerve crush. In control rats, TX14(A) was without effect in the uninjured nerve but shortened toe spread recovery time after nerve crush. In diabetic rats, efficacy of prosaptide TX14(A) was confirmed by correction of thermal hypoalgesia, formalin-evoked hyperalgesia, and conduction slowing in the uninjured nerve. The peptide also prevented diabetes-induced abnormalities in nerve regeneration distance and mean axonal diameter of regenerated axons, whereas delayed recovery of toe spread was not improved. Muscle denervation atrophy was attenuated by TX14(A) in both control and diabetic rats. These results suggest that reduced prosaposin secretion after nerve injury may contribute to impaired regeneration rates in diabetic rats, and that prosaptide TX14(A) can improve aspects of nerve regeneration.

  19. Musculocutaneous nerve substituting for the distal part of radial nerve: A case report and its embryological basis

    Directory of Open Access Journals (Sweden)

    A S Yogesh

    2011-01-01

    Full Text Available In the present case, we have reported a unilateral variation of the radial and musculocutaneous nerves on the left side in a 64-year-old male cadaver. The radial nerve supplied all the heads of the triceps brachii muscle and gave cutaneous branches such as lower lateral cutaneous nerve of the arm and posterior cutaneous nerve of forearm. The radial nerve ended without continuing further. The musculocutaneous nerve supplied the brachioradialis, extensor carpi radialis longus and extensor carpi radialis brevis muscles. The musculocutaneous nerve divided terminally into two branches, superficial and deep. The deep branch of musculocutaneous nerve corresponded to usual deep branch of the radial nerve while the superficial branch of musculocutaneous nerve corresponded to usual superficial branch of the radial nerve. The dissection was continued to expose the entire brachial plexus from its origin and it was found to be normal. The structures on the right upper limb were found to be normal. Surgeons should keep such variations in mind while performing the surgeries of the upper limb.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-09-15

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

  1. Optic Nerve Hemangioblastoma: A Case Report

    Directory of Open Access Journals (Sweden)

    Holly Zywicke

    2012-01-01

    Full Text Available Hemangioblastomas are World Health Organization (WHO grade I tumors of uncertain histologic origin. These central nervous system tumors are most often found in the posterior fossa, brainstem, and spinal cord. There are fewer than 20 reported cases of optic nerve hemangioblastomas in the literature. We present a patient with visual decline found to have a mass arising from within the posterior orbital canal that grossly involved the optic nerve sheath. Neuropathologic evaluation showed hemangioblastoma. Although not a common tumor in this location, consideration of hemangioblastoma in the differential diagnosis is important as they can have a more aggressive course than other tumors of this region and have a detrimental effect on visual prognosis.

  2. Acupuncture Treatment for Optic Nerve Contusion

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    @@ Optic nerve contusion is a commonly-seen eye injury, which is mostly caused by traffic accident, collision, and falling. Early diagnosis and timely emergency treatment can make such patients restore vision to a certain extent. Otherwise, there may appear optic atrophy or loss of vision. At present, in the treatment of this disease, cortical hormone, dehydrating agent, vasodilator, vitamin, energy mixture and neurotrophic agent, or surgical operation can all give certain therapeutic effect. In the recent 5 years, the Department of Ophthalmology of the Hospital Affiliated to Hubei College of Traditional Chinese Medicine has adopted acupuncture for treatment of optic nerve contusion, and obtained quite good therapeutic results. Some typical cases are reported in the following.

  3. An Implantable CMOS Amplifier for Nerve Signals

    DEFF Research Database (Denmark)

    Nielsen, Jannik Hammel; Lehmann, Torsten

    2001-01-01

    In this paper, a low noise high gain CMOS amplifier for minute nerve signals is presented. By using a mixture of weak- and strong inversion transistors, optimal noise suppression in the amplifier is achieved. A continuous-time offset-compensation technique is utilized in order to minimize impact...... on the amplifier input nodes. The method for signal recovery from noisy nerve signals is presented. A prototype amplifier is realized in a standard digital 0.5 μm CMOS single poly, n-well process. The prototype amplifier features a gain of 80 dB over a 3.6 kHz bandwidth, a CMRR of more than 87 dB and a PSRR...

  4. Facial Nerve Paralysis due to a Pleomorphic Adenoma with the Imaging Characteristics of a Facial Nerve Schwannoma.

    Science.gov (United States)

    Nader, Marc-Elie; Bell, Diana; Sturgis, Erich M; Ginsberg, Lawrence E; Gidley, Paul W

    2014-08-01

    Background Facial nerve paralysis in a patient with a salivary gland mass usually denotes malignancy. However, facial paralysis can also be caused by benign salivary gland tumors. Methods We present a case of facial nerve paralysis due to a benign salivary gland tumor that had the imaging characteristics of an intraparotid facial nerve schwannoma. Results The patient presented to our clinic 4 years after the onset of facial nerve paralysis initially diagnosed as Bell palsy. Computed tomography demonstrated filling and erosion of the stylomastoid foramen with a mass on the facial nerve. Postoperative histopathology showed the presence of a pleomorphic adenoma. Facial paralysis was thought to be caused by extrinsic nerve compression. Conclusions This case illustrates the difficulty of accurate preoperative diagnosis of a parotid gland mass and reinforces the concept that facial nerve paralysis in the context of salivary gland tumors may not always indicate malignancy.

  5. Late changes in human sural nerves in Minamata disease and in nerves of rats with experimental organic mercury poisoning.

    Science.gov (United States)

    Miyakawa, T; Murayama, E; Sumiyoshi, S; Deshimaru, M; Fujimoto, T

    1976-06-15

    The sural nerves of 2 human cases with Minamata disease and poisoned rats were examined histopathologically. Both showed similar findings: the myelinated nerve fibres were decreased in number, but small myelinated nerve fibres were increased: The latter were irregular in shape and their Schwann cells showed regressive changes, with high electron density of the cytoplasms and many glycogen granules. Onion bulb formation was not found. According to fibre diameter histograms, the ratio of small myelinated nerve fibres of 2-5 mum showed a high percentage. A large number of the small myelinated nerve fibres were presumed to be regenerated nerve fibres. These findings are different from other peripheral neuropathies and may be characteristics of the late changes of the sural nerve induced by organic mercury compound.

  6. Repairing peripheral nerve defects with tissue engineered artificial nerves in rats

    Institute of Scientific and Technical Information of China (English)

    WEI Ai-lin; LIU Shi-qing; TAO Hai-ying; PENG Hao

    2008-01-01

    Objective: To observe the effect of tissue engineered nerves in repairing peripheral nerve defects ( about 1. 5 cm in length) in rats to provide data for clinical application.Methods: Glycerinated sciatic nerves (2 cm in length) from 10 Sprague Dawley ( SD) rats ( aged 4 months) were used to prepare homologous dermal acellular matrix. Other 10 neonate SD rats (aged 5-7 days) were killed by neck dislocation. After removing the epineurium, the separated sciatic nerve tracts were cut into small pieces, then digested by 2.5 g/L trypsin and 625 U/ml collagenase and cultured in Dulbecco's modified Eagle's medium (DMEM) for 3 weeks. After proliferation, the Schwann cells ( SCs) were identified and prepared for use. And other 40 female adult SD rats (weighing 200 g and aged 3 months) with sciatic nerve defects of 1.5 cm in length were randomly divided into four groups: the defects of 10 rats bridged with proliferated SCs and homologous dermal acellular matrix (the tissue engineered nerve group, Group A), 10 rats with no SCs but homologous dermal acellular matrix with internal scaffolds ( Group B ), 10 with autologous nerves ( Group C) , and the other 10 with nothing (the blank control group, Group D). The general status of the rats was observed, the wet weight of triceps muscle of calf was monitored, and the histological observation of the regenerated nerves were made at 12 weeks after operation.Results: The wounds of all 40 rats healed after operation and no death was found. No foot ulceration was found in Groups A, B and C, but 7 rats suffered from foot ulceration in Group D. The triceps muscles of calf were depauperated in the experimental sides in all the groups compared with the uninjured sides,which was much more obvious in Group D. The wet weight of triceps muscle of calf and nerve electrophysiologic monitoring showed no statistical difference between Group A and Group C,but statistical difference was found between Groups A and B and Groups B and D. And significant

  7. Transverse Magnetic Waves in Myelinated Nerves

    Science.gov (United States)

    2007-11-02

    IN MYELINATED NERVES M. Mª Villapecellín-Cid1, L. Mª Roa2, and J. Reina-Tosina1 1Área de Teoría de la Señal y Comunicaciones , E.S. de Ingeniería...y Comunicaciones , E.S. de Ingeniería, University of Seville, Seville, Spain Performing Organization Report Number Sponsoring/Monitoring Agency Name(s

  8. IMMUNOGLOBULIN DEPOSITIONS IN PERIPHERAL NERVES IN POLYMYOSITIS

    Institute of Scientific and Technical Information of China (English)

    李越星; 陈清棠; 吴丽娟; 贾钟; 张秋荣; 左越焕

    1995-01-01

    An immunocytochemical study was performed in 6 peripheral nerve specimens from 6 cases of polymyositis.The results revealed that depositions of IgG,IgM,IgA and C3 were found in the epineurium,perineurium and the walls of capillaries.These findings demonstrated that depositions of immonoglobulins and the complement-mediated immunoreaction may play an important role in pathogenesis of polymyositis with peripheral nerfve involvements.

  9. NEONATAL NERVE PALSIES: A CONTEMPORARY OBSTETRIC PERSPECTIVE

    Directory of Open Access Journals (Sweden)

    Daren J. Roberts

    2014-05-01

    Full Text Available Background:Birth trauma and its often incorrect inference of iatrogenic causation has led to unfortunate implications for the affected child, the parents, the obstetrician and the midwife due to unwarranted medico-legal attention in our current litigious society.A more discerning evaluation of neonatal nerve palsies following labour and delivery has led to a better understanding of their aetiology with potentially more appropriate outcomes for all parties involved.

  10. Facial nerve involvement in pseudotumor cerebri.

    Directory of Open Access Journals (Sweden)

    Bakshi S

    1992-07-01

    Full Text Available A woman with history of bifrontal headache, vomiting and loss of vision was diagnosed as a case of pseudotumor cerebri based on clinical and MRI findings. Bilateral abducens and facial nerve palsies were detected. Pseudotumor cerebri in this patient was not associated with any other illness or related to drug therapy. Treatment was given to lower the raised intracranial pressure to which the patient responded.

  11. Sciatic nerve: beyond the sacral foramen

    OpenAIRE

    Sanal, Hatice Tuba

    2016-01-01

    Sciatica may result from pathologies affecting the nerve both in its intraspinal and extraspinal course. In daily routine, the vast majority of cases are caused by herniation of the lumbar discs compressing the neural roots. Extraspinal causes of sciatic pain are usually underestimated and the imaging study may be completed after reporting the lumbar MRIs. However, early diagnosis of the exact etiology of sciatica is paramount for both relieving the symptoms and preventing any additional neur...

  12. The optic nerve head in glaucoma

    Directory of Open Access Journals (Sweden)

    Rupert RA Bourne

    2006-09-01

    Full Text Available ll types of glaucoma involve glaucomatous optic neuropathy. The key to detection and management of glaucoma is understanding how to examine the optic nerve head (ONH. This pictorial glossary addresses the following issues: how to examine the ONH; normal characteristics of the ONH; characteristics of a glaucomatous ONH; how to tell if the glaucomatous optic neuropathy is getting worse;‘pitfalls and pearls’.

  13. Combined KHFAC + DC nerve block without onset or reduced nerve conductivity after block

    Science.gov (United States)

    Franke, Manfred; Vrabec, Tina; Wainright, Jesse; Bhadra, Niloy; Bhadra, Narendra; Kilgore, Kevin

    2014-10-01

    Objective. Kilohertz frequency alternating current (KHFAC) waveforms have been shown to provide peripheral nerve conductivity block in many acute and chronic animal models. KHFAC nerve block could be used to address multiple disorders caused by neural over-activity, including blocking pain and spasticity. However, one drawback of KHFAC block is a transient activation of nerve fibers during the initiation of the nerve block, called the onset response. The objective of this study is to evaluate the feasibility of using charge balanced direct current (CBDC) waveforms to temporarily block motor nerve conductivity distally to the KHFAC electrodes to mitigate the block onset-response. Approach. A total of eight animals were used in this study. A set of four animals were used to assess feasibility and reproducibility of a combined KHFAC + CBDC block. A following randomized study, conducted on a second set of four animals, compared the onset response resulting from KHFAC alone and combined KHFAC + CBDC waveforms. To quantify the onset, peak forces and the force-time integral were measured during KHFAC block initiation. Nerve conductivity was monitored throughout the study by comparing muscle twitch forces evoked by supra-maximal stimulation proximal and distal to the block electrodes. Each animal of the randomized study received at least 300 s (range: 318-1563 s) of cumulative dc to investigate the impact of combined KHFAC + CBDC on nerve viability. Main results. The peak onset force was reduced significantly from 20.73 N (range: 18.6-26.5 N) with KHFAC alone to 0.45 N (range: 0.2-0.7 N) with the combined CBDC and KHFAC block waveform (p < 0.001). The area under the force curve was reduced from 6.8 Ns (range: 3.5-21.9 Ns) to 0.54 Ns (range: 0.18-0.86 Ns) (p < 0.01). No change in nerve conductivity was observed after application of the combined KHFAC + CBDC block relative to KHFAC waveforms. Significance. The distal application of CBDC can significantly reduce or even

  14. 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.

  15. Laminin-modified and aligned PHBV/PEO nanofibrous nerve conduits promote peripheral nerve regeneration.

    Science.gov (United States)

    Zhang, Xiao-Feng; Liu, Hai-Xia; Ortiz, Lazarus Santiago; Xiao, Zhong-Dang; Huang, Ning-Ping

    2016-11-12

    Poly (3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV) has received much attention for its biodegradability and biocompatibility, characteristics which are required in tissue engineering. In this study, polyethylene oxide (PEO)-incorporated PHBV nanofibers with random or aligned orientation were obtained by electrospinning. For further use in vivo, the nanofiber films were made into nerve conduits after treated with NH3 plasma, which could improve the hydrophilicity of inner surfaces of nerve conduits and then facilitate laminin adsorption via electrostatic interaction for promoting cell adhesion and proliferation. Morphology of the surfaces of modified PHBV/PEO nanofibrous scaffolds were examined by scanning electron microscopy. Schwann cell viability assay was conducted and the results confirmed that the functionalized nanofibers were favorable for cell growth. Morphology of Schwann cells cultured on scaffolds showed that aligned nanofibrous scaffolds provided topographical guidance for cell orientation and elongation. Furthermore, 3D PHBV/PEO nerve conduits made from aligned and random-oriented nanofibers were implanted into 12-mm transected sciatic nerve rat model and subsequent analysis were conducted at 1 and 2 months post-surgery. The above functionalized PHBV/PEO scaffolds provide a novel and promising platform for peripheral nerve regeneration.

  16. Nerve Growth Factor Decreases in Sympathetic and Sensory Nerves of Rats with Chronic Heart Failure

    Science.gov (United States)

    Lu, Jian

    2014-01-01

    Nerve growth factor (NGF) plays a critical role in the maintenance and survival of both sympathetic and sensory nerves. Also, NGF can regulate receptor expression and neuronal activity in the sympathetic and sensory neurons. Abnormalities in NGF regulation are observed in patients and animals with heart failure (HF). Nevertheless, the effects of chronic HF on the levels of NGF within the sympathetic and sensory nerves are not known. Thus, the ELISA method was used to assess the levels of NGF in the stellate ganglion (SG) and dorsal root ganglion (DRG) neurons of control rats and rats with chronic HF induced by myocardial infarction. Our data show for the first time that the levels of NGF were significantly decreased (P < 0.05) in the SG and DRG neurons 6–20 weeks after ligation of the coronary artery. In addition, a close relation was observed between the NGF levels and the left ventricular function. In conclusion, chronic HF impairs the expression of NGF in the sympathetic and sensory nerves. Given that sensory afferent nerves are engaged in the sympathetic nervous responses to somatic stimulation (i.e. muscle activity during exercise) via a reflex mechanism, our data indicate that NGF is likely responsible for the development of muscle reflex-mediated abnormal sympathetic responsiveness observed in chronic HF. PMID:24913185

  17. Anterior cutaneous nerve entrapment syndrome: management challenges

    Directory of Open Access Journals (Sweden)

    Chrona E

    2017-01-01

    Full Text Available Eleni Chrona,1,2 Georgia Kostopanagiotou,1 Dimitrios Damigos,3 Chrysanthi Batistaki1 1Second Department of Anesthesiology, School of Medicine, National and Kapodistrian University of Athens, “Attikon” Hospital, Athens, 2Department of Anesthesiology, General Hospital of “Ag. Panteleimon,” Piraeus, 3Department of Medical Psychology, Medical School of Ioannina, University of Ioannina, Ioannina, Greece Abstract: Anterior cutaneous nerve entrapment syndrome (ACNES is a commonly underdiagnosed and undertreated chronic state of pain. This syndrome is characterized by the entrapment of the cutaneous branches of the lower thoracoabdominal intercostal nerves at the lateral border of the rectus abdominis muscle, which causes severe, often refractory, chronic pain. This narrative review aims to identify the possible therapeutic strategies for the management of the syndrome. Seventeen studies about ACNES therapy were reviewed; of them, 15 were case–control studies, case series, or case reports, and two were randomized controlled trials. The presently available management strategies for ACNES include trigger point injections (diagnostic and therapeutic, ultrasound-guided blocks, chemical neurolysis, and surgical ­neurectomy, in combination with systemic medication, as well as some emerging techniques, such as radiofrequency ablation and neuromodulation. An increased awareness of the syndrome and the use of specific diagnostic criteria for its recognition are required to facilitate an early and successful management. This review compiles the proposed ­management strategies for ACNES. Keywords: anterior cutaneous nerve entrapment syndrome, intercostal, neuralgia, management

  18. Management of peripheral facial nerve palsy.

    Science.gov (United States)

    Finsterer, Josef

    2008-07-01

    Peripheral facial nerve palsy (FNP) may (secondary FNP) or may not have a detectable cause (Bell's palsy). Three quarters of peripheral FNP are primary and one quarter secondary. The most prevalent causes of secondary FNP are systemic viral infections, trauma, surgery, diabetes, local infections, tumor, immunological disorders, or drugs. The diagnosis of FNP relies upon the presence of typical symptoms and signs, blood chemical investigations, cerebro-spinal-fluid-investigations, X-ray of the scull and mastoid, cerebral MRI, or nerve conduction studies. Bell's palsy may be diagnosed after exclusion of all secondary causes, but causes of secondary FNP and Bell's palsy may coexist. Treatment of secondary FNP is based on the therapy of the underlying disorder. Treatment of Bell's palsy is controversial due to the lack of large, randomized, controlled, prospective studies. There are indications that steroids or antiviral agents are beneficial but also studies, which show no beneficial effect. Additional measures include eye protection, physiotherapy, acupuncture, botulinum toxin, or possibly surgery. Prognosis of Bell's palsy is fair with complete recovery in about 80% of the cases, 15% experience some kind of permanent nerve damage and 5% remain with severe sequelae.

  19. Crossing axons in the third nerve nucleus.

    Science.gov (United States)

    Bienfang, D C

    1975-12-01

    The research presented in this paper studied the pathway taken by the crossed fibers of the third nerve nucleus in an animal whose nucleus has been well mapped and found to correlate well with higher mammals and man. Autoradiography using tritiated amino acid labeled the cell bodies an axons of the left side of the oculomotor nucleus of the cat. Axons so labeled could be seen emerging from the ventral portion of the left nucleus through the median longitudinal fasciculus (mlf) to join the left oculomotor nerve. Labeled axons were also seen to emerge from the medial border of the caudal left nucleus, cross the midline, and pass through the right nucleus and the right mlf to join the right oculomotor nerve. These latter axons must be the crossed axons of the superior rectus and levator palpebrae subnuclei. Since the path of these crossed axons is through the caudal portion of the nucleus of the opposite side, the destruction of one lateral half of the oculomotor nucleus would result in a bilateral palsy of the crossed subnuclei. Bilateral palsy of the superior rectus and bilateral assymetrical palsy of the levator palpebrae muscles would result.

  20. Traumatic globe luxation with optic nerve transection.

    Science.gov (United States)

    Bajaj, Mandeep S.; Kedar, Sachin; Sethi, Anita; Gupta, Vishal

    2000-09-01

    Luxation of the globe is a rare event that results from severe trauma to the orbit, often causing orbital rim and wall fractures. Though associated globe rupture often necessitates enucleation, repositioning of the globe can be attempted in these cases if the globe is intact. We report a case of globe luxation and optic nerve transection with its surgical management. A 17-year-old male presented with anterior luxation of the right globe and optic nerve transection following blunt trauma to the orbit. Computerized tomography revealed an anteriorly subluxated globe with complete transection of the optic nerve and multiple fractures of the orbital walls. The orbit was explored and the globe repositioned in the orbit with reattachment of the muscles. Postoperatively, the globe was in normal position with moderate motility and excellent overall cosmesis. Though the visual prognosis in these cases is usually extremely poor and depends on the extent and duration of injury, preservation of the globe not only helps the patient recover psychologically from the trauma but also allows better cosmesis.

  1. Recurrent laryngeal nerve pathology in spasmodic dysphonia.

    Science.gov (United States)

    Bocchino, J V; Tucker, H M

    1978-08-01

    Since it was first described in 1871, spasmodic (spastic) dysphonia has been considered a disease of psychogenic origin. Unsupported theories of possible organic etiology have appeared sporadically in the literature. In 1976 sectioning of the recurrent laryngeal nerve for patients with this disease was reported with resultant improvement in voice production. This was attempted because the spasmodic dysphonic has, in effect, already compensated vocal cords bilaterally. It was reasoned, therefore, that if one of these was paralyzed the patient would immediately be converted to a state approximating that of well-compensated unilateral vocal cord paralysis which situation, as is well known, usually carries with it a fairly good voice. A controlled study to evaluate the efficacy of this surgical approach has been undertaken at the Cleveland Clinic during the past year. In an attempt to elucidate the possible organic etiology of spasmodic dysphonia, a section of nerve was removed in every case and examined by both light and electron microscopy. Special stains for myelin were also used on the light microscopy specimens. Demyelinization has been found in most of the cases examined by electron microscopy. Possible correlation between this disease entity and other cranial nerve syndromes of unknown etiology is noted. Such conditions as trigeminal neuralgia, glossopharyngeal neuralgia, belpharospasm, hemifacial spasm, and even possibly Bell's palsy may exhibit a similar etiology.

  2. PUNICA GRANATUM ATTENUATES SCIATIC NERVE LIGATION INDUCED-NEUROPATHIC PAIN

    Directory of Open Access Journals (Sweden)

    Ramica Sharma et al.

    2012-02-01

    Full Text Available The study has been designed to investigate the effect of aqueous extract of rind of Punica granatum in sciatic nerve ligation induced-neuropathic pain in rats. Surgical procedure was performed with sciatic nerve ligation to develop neuropathic pain in rats. The development of neuropathic pain was assessed by employing behaviour parameters such as hyperalgesia and allodynia. Further, the functionality of sciatic nerve was assessed using the histopathological study of myelinated and unmyelinated fibers in sciatic nerve. Moreover, the oxidative stress was assessed by estimating serum thiobarbituric acid reactive substances (TBARS, catalase, glutathione and tissue TBARS and Superoxide dismutase (SOD. Rats exposed to sciatic nerve ligation produced marked increase in oxidative stress, which was assessed in terms of TBARS and SOD along with decrease in the level of catalase and glutathione. Moreover, it develops neuropathic pain by impairing the normal functions of myelinated and unmyelinated fibers in sciatic nerve. Treatment with aqueous extract of Punica granatum extract (100mg/kg, p.o markedly prevented sciatic nerve ligation-induced neuropathy and oxidative stress by increasing the pain threshold, by improving the functionality of sciatic nerve, by decreasing serum and tissue TBARS and tissue SOD, by increasing levels of serum glutathione and catalase. It may be concluded that Punica granatum extract reduced the oxidative stress via inhibiting p38MAPK and alleviates neuropathic symptoms and consequently improved the functionality of sciatic nerve and prevents sciatic nerve ligation–induced neuropathic pain.

  3. Interleukin 6 in intact and injured mouse peripheral nerves.

    Science.gov (United States)

    Reichert, F; Levitzky, R; Rotshenker, S

    1996-03-01

    The multifunctional cytokine interleukin 6 (IL-6) has direct growth, survival and differentiation effects on peripheral and central neurons. Furthermore, it can modulate the production by non-neuronal cells of other cytokines and growth factors, and thereby affect nerve cells indirectly. We have studied IL-6 expression and production in intact and injured peripheral nerves of C57/BL/6NHSD mice, which display the normal rapid progression of Wallerian degeneration. The IL-6 mRNA was detected in nerves degenerating in vitro or in vivo, but not in intact nerves. In vitro- and in vivo-degenerating nerve segments and neuroma nerve segments synthesized and secreted IL-6. The onset of IL-6 production was rapid and prolonged. It was detected as early as 2 h after injury and persisted for the entire period of 21 days tested after the injury. Of the non-neuronal cells that reside in intact and injured nerves, macrophages and fibroblasts were the major contributors to IL-6 production. We also studied IL-6 production in intact and injured nerves of mutant C57BL/6-WLD/OLA/NHSD mice, which display very slow progression of Wallerian degeneration. Injured nerves of C57BL/6-WLD/OLA/NHSD mice produced significantly lower amounts of IL-6 than did rapidly degenerating nerves of C57/BL/6NHSD mice.

  4. Surgical anatomy of the retroperitoneal spaces, Part IV: retroperitoneal nerves.

    Science.gov (United States)

    Mirilas, Petros; Skandalakis, John E

    2010-03-01

    We present surgicoanatomical topographic relations of nerves and plexuses in the retroperitoneal space: 1) six named parietal nerves, branches of the lumbar plexus: iliohypogastric, ilioinguinal, genitofemoral, lateral femoral cutaneous, obturator, femoral. 2) The sacral plexus is formed by the lumbosacral trunk, ventral rami of S1-S3, and part of S4; the remainder of S4 joining the coccygeal plexus. From this plexus originate the superior gluteal nerve, which passes backward through the greater sciatic foramen above the piriformis muscle; the inferior gluteal nerve also courses through the greater sciatic foramen, but below the piriformis; 3) sympathetic trunks: right and left lumbar sympathetic trunks, which comprise four interconnected ganglia, and the pelvic chains; 4) greater, lesser, and least thoracic splanchnic nerves (sympathetic), which pass the diaphragm and join celiac ganglia; 5) four lumbar splanchnic nerves (sympathetic), which arise from lumbar sympathetic ganglia; 6) pelvic splanchnic nerves (nervi erigentes), providing parasympathetic innervation to the descending colon and pelvic splanchna; and 7) autonomic (prevertebral) plexuses, formed by the vagus nerves, splanchnic nerves, and ganglia (celiac, superior mesenteric, aorticorenal). They include sympathetic, parasympathetic, and sensory (mainly pain) fibers. The autonomic plexuses comprise named parts: aortic, superior mesenteric, inferior mesenteric, superior hypogastric, and inferior hypogastric (hypogastric nerves).

  5. Bilateral abducens nerve and right facial nerve palsy occuring after head trauma

    Directory of Open Access Journals (Sweden)

    ismail Boyraz

    2016-06-01

    Full Text Available Lesions of the nervus abducens, the 6th cranial nerve tend to be rare, usually occur suddenly following head injuries. A 43-year-old male patient presented with a history of fall from a height due to an occupational accident on the date of 11.01.2014. Cranial tomography demonstrated bilateral epidural hematoma. The epidural hematoma was drained during the operation. After the surgery, eye examination showed no vision loss, except limited bilateral lateral gaze. When the patient was unable to walk due to diplopia, he was advised to close one eye. On the right side, there were findings suggesting central facial paralysis. There may be multiple cranial nerve damage following head injury. Therefore, all cranial nerves should be thoroughly examined. [J Contemp Med 2016; 6(2.000: 110-113

  6. Sciatica due to malignant nerve sheath tumour of sciatic nerve in the thigh.

    Directory of Open Access Journals (Sweden)

    Sharma R

    2001-04-01

    Full Text Available Malignant peripheral nerve sheath tumour (MPNST is a rare malignant neoplasm arising from the supportive non-neural component of the peripheral nerves. An unusual case of pain and weakness of the foot and calf muscles due to a giant MPNST of the sciatic nerve in the posterior compartment of the thigh is presented. The patient was already investigated as a case of sciatica due to a lumbar disc disease with a negative magnetic resonance imaging and then unsuccessfully operated elsewhere twice, with a misdiagnosis of tarsal tunnel syndrome. Neurosurgical referral prompted a diagnostic magnetic resonance study of the thigh, revealing the lesion, which was completely excised microsurgically with total relief in the pain and partial improvement in the weakness and sensations in the sole of the foot.

  7. Updates on the diagnosis and treatment of intracranial nerve malignant peripheral nerve sheath tumors

    Directory of Open Access Journals (Sweden)

    L'Heureux-Lebeau B

    2013-04-01

    Full Text Available Bénédicte L'Heureux-Lebeau,1 Issam Saliba2 1University of Montreal, 2Department of Otolaryngology Head and Neck Surgery, Montreal University Hospital Center (CHUM, University of Montreal, Montreal, Quebec, Canada Background: Malignant peripheral nerve sheath tumors (MPNSTs are rare entities and MPNSTs of intracranial nerves are even more sporadic. MPNSTs present diagnosis and treatment challenges since there are no defined diagnosis criteria and no established therapeutic strategies. Methods: We reviewed literature for MPNST-related articles. We found 45 relevant studies in which 60 cases were described. Results: We identified 60 cases of intracranial nerve MPNSTs. The age ranged from 3 to 75 years old. Male to female ratio was 1.5:1. The most involved cranial nerves (CNs were CN VIII (60%, CN V (27%, and CN VII (10%. Most of the MPNSTs reported (47% arose sporadically, 40% arose from a schwannoma, 8% arose from a neurofibroma, and 6% arose from an unspecified nerve tumor. Twenty patients had a history of radiation exposure, four patients had neurofibromatosis type 1 (NF1, four patients had neurofibromatosis type 2 (NF2, and NF2 was suspected in two other patients. Twenty-two patients were treated with radiotherapy and presented a higher survival rate. Seventy-two percent of patients died of their disease while 28% of patients survived. One-year survival rate was 33%. Forty-five percent of tumors recurred and 19% of patients had metastases. Conclusion: MPNSTs involving CNs are very rare. Diagnosis is made in regards to the histological and pathological findings. Imaging may help orient the diagnosis. A preexisting knowledge of the clinical situation is more likely to lead to a correct diagnosis. The mainstay of treatment is radical surgical resection with adjuvant radiotherapy. Since these tumors are associated with a poor prognosis, a close follow-up is mandatory. Keywords: malignant peripheral nerve sheath tumor, MPNST, neurofibroma

  8. Morphology of Donor and Recipient Nerves Utilised in Nerve Transfers to Restore Upper Limb Function in Cervical Spinal Cord Injury

    Directory of Open Access Journals (Sweden)

    Aurora Messina

    2016-09-01

    Full Text Available Loss of hand function after cervical spinal cord injury (SCI impacts heavily on independence. Multiple nerve transfer surgery has been applied successfully after cervical SCI to restore critical arm and hand functions, and the outcome depends on nerve integrity. Nerve integrity is assessed indirectly using muscle strength testing and intramuscular electromyography, but these measures cannot show the manifestation that SCI has on the peripheral nerves. We directly assessed the morphology of nerves biopsied at the time of surgery, from three patients within 18 months post injury. Our objective was to document their morphologic features. Donor nerves included teres minor, posterior axillary, brachialis, extensor carpi radialis brevis and supinator. Recipient nerves included triceps, posterior interosseus (PIN and anterior interosseus nerves (AIN. They were fixed in glutaraldehyde, processed and embedded in Araldite Epon for light microscopy. Eighty percent of nerves showed abnormalities. Most common were myelin thickening and folding, demyelination, inflammation and a reduction of large myelinated axon density. Others were a thickened perineurium, oedematous endoneurium and Renaut bodies. Significantly, very thinly myelinated axons and groups of unmyelinated axons were observed indicating regenerative efforts. Abnormalities exist in both donor and recipient nerves and they differ in appearance and aetiology. The abnormalities observed may be preventable or reversible.

  9. Raman spectroscopy of non-penetrating peripheral nerve damage in swine: a tool for spectral pathology of nerves

    Science.gov (United States)

    Cilwa, Katherine E.; Slaughter, Tiffani; Elster, Eric A.; Forsberg, Jonathan A.; Crane, Nicole J.

    2015-03-01

    Over 30% of combat injuries involve peripheral nerve injury compared to only 3% in civilian trauma. In fact, nerve dysfunction is the second leading cause of long-term disability in injured service members and is present in 37% of upper limb injuries with disability. Identification and assessment of non-penetrating nerve injury in trauma patients could improve outcome and aid in therapeutic monitoring. We report the use of Raman spectroscopy as a noninvasive, non-destructive method for detection of nerve degeneration in intact nerves due to non-penetrating trauma. Nerve trauma was induced via compression and ischemia/reperfusion injury using a combat relevant swine tourniquet model (>3 hours ischemia). Control animals did not undergo compression/ischemia. Seven days post-operatively, sciatic and femoral nerves were harvested and fixed in formalin. Raman spectra of intact, peripheral nerves were collected using a fiber-optic probe with 3 mm diameter spot size and 785 nm excitation. Data was preprocessed, including fluorescence background subtraction, and Raman spectroscopic metrics were determined using custom peak fitting MATLAB scripts. The abilities of bivariate and multivariate analysis methods to predict tissue state based on Raman spectroscopic metrics are compared. Injured nerves exhibited changes in Raman metrics indicative of 45% decreased myelin content and structural damage (pdetect nerve degeneration associated with non-penetrating injury, relevant to neurapraxic and axonotmetic injuries; future experiments will further explore the clinical utility of Raman spectroscopy to recognize neural injury.

  10. Application of MSCT multimodal 3D reconstruction in the assessment of temporal bone structures and cochlear ;implantation%MSCT 多模态三维重建观测颞骨结构及对人工耳蜗手术的指导意义

    Institute of Scientific and Technical Information of China (English)

    王一红; 李瑞玉; 陈彩龙; 王晓燕; 林美福; 周硕

    2015-01-01

    Objective To investigate the application and value of MSCT multimodal three-dimensional (3D)recon-struction in cochlear implantation.Methods ① The membranous structures with 3D imaging of cochlea,vestibular, semicircular canal and temporal bone transparent imaging were constructed with a double threshold reconstruction tech-nique,where the anatomical relationship between ossicles,inner ear and temporal bone were displayed.② The facial nerve reconstruction displayed the path of the facial nerve.The ultrastructure showed the facial nerve,facial nerve re-cess,posterior wall of the external auditory canal and the structure of chorda tympani nerve and neighboring structures.③ The distance between promontory plane vertical segment of the facial nerve and chorda tympani nerve was measured. Results Of the 83 patients recruited in this study,11 had inner ear malformation.Of them,2 had Mondini malforma-tion,2 had semicircular canal malformation,2 had common cavity malformation,1 had internal auditory canal stenosis, and 4 had enlarged vestibular aqueduct.The distance between normal structure of cape plane vertical segment of the fa-cial nerve and chorda tympani nerve was 0.27 ±0.057 cm at the left-side and 0.28 ±0.068 cm at the right-side.An in-tact structure of the implanted electrodes was clearly showed in 5 patients in the post-operative examination.Conclusion The 3D multimodal reconstruction technique is useful in providing ultrastructure imaging of the middle and inner ear, which is important for surgeons in pre-and post-operative evaluations of the success and potential risk factors for per-forming cochlear implantation.%目的:探讨采用 MSCT 影像三维多模态重建技术在人工耳蜗植入术术前评估、术后复查中的应用价值。方法①应用双阈值重建技术显示耳蜗、前庭、半规管的膜性立体结构及听小骨,颞骨透明成像,逐一融合显示听小骨、内耳与颞骨的关系;②面神经曲面重建显示

  11. Traumatic facial nerve palsy: CT patterns of facial nerve canal fracture and correlation with clinical severity

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Jae Cheol; Kim, Sang Joon; Park, Hyun Min; Lee, Young Suk; Lee, Jee Young [College of Medicine, Dankook Univ., Chonan (Korea, Republic of)

    2002-07-01

    To analyse the patterns of facial nerve canal injury seen at temporal bone computed tomography (CT) in patients with traumatic facial nerve palsy and to correlate these with clinical manifestations and outcome. Thirty cases of temporal bone CT in 29 patients with traumatic facial nerve palsy were analyzed with regard to the patterns of facial nerve canal involvement. The patterns were correlated with clinical grade, the electroneurographic (ENoG) findings, and clinical outcome. For clinical grading, the House-Brackmann scale was used, as follows:grade I-IV, partial palsy group; grade V-VI, complete palsy group. The electroneuronographic findings were categorized as mild to moderate (below 90%) or severe (90% and over) degeneration. In 25 cases, the bony wall of the facial nerve canals was involved directly (direct finding): discontinuity of the bony wall was onted in 22 cases, bony spicules in ten, and bony wall displacement in five. Indirect findings were canal widening in nine cases and adjacent bone fracture in two. In one case, there were no direct or indirect findings. All cases in which there was complete palsy (n=8) showed one or more direct findings including spicules in six, while in the incomplete palsy group (n=22), 17 cases showed direct findings. In the severe degeneration group (n=13), on ENog, 12 cases demonstrated direct findings, including spicules in nine cases. In 24 patients, symptoms of facial palsy showed improvement at follow up evaluation. Four of the five patients in whom symptoms did not improve had spicules. Among ten patients with spicules, five underwent surgery and symptoms improved in four of these; among the five patients not operated on , symptoms did not improve in three. In most patients with facial palsy after temporal bone injury, temporal bone CT revealed direct or indirect facial nerve canal involvement, and in complete palsy or severe degeneration groups, there were direct findings in most cases. We believe that meticulous

  12. Study of nerve fibers nature reinforcing duodenal contractions by electrical stimulation of sympathetic nerve

    Directory of Open Access Journals (Sweden)

    Sveshnikov D.S.

    2011-09-01

    Full Text Available The subject of the article is to investigate the mechanism of increased reactions by electrical stimulation of the sympathetic nerve. Materials and methods: Experiments on dogs have shown that stimulant reactions during blockade of a-adrenergic by phentolamine and (3-adrenergic receptors with propranolol were completely eliminated by lizer-gol —the blocker of 5-HT12-receptors. Results: Infusion of lizergol did not influence on duodenal motor activity and the function of the vagus nerve. Conclusion: Effector neuron is found out to be serotonergic and its action is provided by 5-HT1 2 receptors

  13. The role of exosomes in peripheral nerve regeneration

    Directory of Open Access Journals (Sweden)

    Rosanna C Ching

    2015-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

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

  15. MRI of optic nerve lesion in multiple sclerosis

    Energy Technology Data Exchange (ETDEWEB)

    Fujii, Koichi; Uehara, Masako; Ashikaga, Ryuuichirou; Inoue, Masaaki; Yamamoto, Takashi; Hamada, Tatsumi; Ishida, Osamu; Nakao, Yuzou; Miyakoshi, Keizou (Kinki Univ., Osakasayama, Osaka (Japan). School of Medicine)

    1992-12-01

    We evaluated the ability of MRI using short TI inversion recovery (STIR) to detect optic nerve lesions in multiple sclerosis (MS). Eleven patients with MS were studied with MRI at 0.5 T. STIR images revealed high signal lesions in all of 14 nerves in 11 patients with previous and recurrent attack of optic neuritis. In addition, two of seven asymptomatic nerves also showed high intensity on STIR images. The high signal lesions on STIR images seemed to reflect demyelination in the nerves with some attacks and to show occult lesions in the nerves without any attack. STIR method was concluded to be a potentially useful procedure in detection of optic nerve lesions in MS. (author).

  16. The blood-nerve barrier: structure and functional significance.

    Science.gov (United States)

    Weerasuriya, Ananda; Mizisin, Andrew P

    2011-01-01

    The blood-nerve barrier (BNB) defines the physiological space within which the axons, Schwann cells, and other associated cells of a peripheral nerve function. The BNB consists of the endoneurial microvessels within the nerve fascicle and the investing perineurium. The restricted permeability of these two barriers protects the endoneurial microenvironment from drastic concentration changes in the vascular and other extracellular spaces. It is postulated that endoneurial homeostatic mechanisms regulate the milieu intérieur of peripheral axons and associated Schwann cells. These mechanisms are discussed in relation to nerve development, Wallerian degeneration and nerve regeneration, and lead neuropathy. Finally, the putative factors responsible for the cellular and molecular control of BNB permeability are discussed. Given the dynamic nature of the regulation of the permeability of the perineurium and endoneurial capillaries, it is suggested that the term blood-nerve interface (BNI) better reflects the functional significance of these structures in the maintenance of homeostasis within the endoneurial microenvironment.

  17. A case of amblyopia with contralateral optic nerve hypoplasia.

    Science.gov (United States)

    Frantz, Kelly A; Pang, Yi

    2013-09-01

    We describe an unusual case of unilateral optic nerve hypoplasia (ONH) in a patient with contralateral anisometropic/strabismic amblyopia. A seven-year-old boy presented with visual acuities of 6/12 R and 6/18 L and eccentric fixation in the left eye. Cycloplegic retinoscopy was R +1.50/-0.50 × 180 and L +5.25 DS. Funduscopy revealed optic nerve hypoplasia of the right eye. The patient fixated with his better-seeing right eye, despite the optic nerve hypoplasia. His reduced vision may be attributed to optic nerve hypoplasia in the right eye and amblyopia in the left. Although optic nerve hypoplasia can occur with ipsilateral amblyopia, we believe this is the first reported case of unilateral optic nerve hypoplasia in the fellow eye of an amblyopic patient.

  18. Anatomy of the optic nerve head and glaucomatous optic neuropathy.

    Science.gov (United States)

    Radius, R L

    1987-01-01

    The mechanism of axon damage in eyes with glaucomatous optic neuropathy remains undefined. Interestingly, it has been observed that, although the entire nerve cross-section may be involved by the nerve damage, in many instances, the superior and inferior axon bundles are preferentially affected by the pressure insult. Thus, recent studies by many investigators have stressed a re-examination of the optic nerve head anatomy, including the nerve head microcirculation, the glial and connective tissue elements within the nerve head, and the morphology of the axons themselves. Any correlation between regional differences in this anatomy and the preferential involvement by specific axon bundles within the nerve head by the pressure insult may suggest some further insight into the mechanisms underlying the pressure-induced axon loss in glaucomatous eyes.

  19. Inferior alveolar nerve injuries associated with mandibular fractures.

    Science.gov (United States)

    Bede, Salwan Yousif Hanna; Ismael, Waleed Khaleel; Al-Assaf, Dhuha A; Omer, Saad Salem

    2012-11-01

    The study evaluates the incidence of inferior alveolar nerve injuries in mandibular fractures, the duration of their recovery, and the factors associated with them. Fifty-two patients with mandibular fractures involving the ramus, angle, and body regions were included in this study; the inferior alveolar nerve was examined for neurological deficit posttraumatically using sharp/blunt differentiation method, and during the follow-up period the progression of neural recovery was assessed. The incidence of neural injury of the inferior alveolar nerve was 42.3%, comminuted and displaced linear fractures were associated with higher incidence of inferior alveolar nerve injury and prolonged recovery time, and recovery of inferior alveolar nerve function occurred in 91%.Fractures of the mandible involving the ramus, angle, and body regions, and comminuted and displaced linear fractures are factors that increase the incidence of inferior alveolar nerve injuries. Missile injuries can be considered as another risk factor.

  20. The role of exosomes in peripheral nerve regeneration

    Institute of Scientific and Technical Information of China (English)

    Rosanna C Ching; Paul J Kingham

    2015-01-01

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

  1. Bacterial melanin promotes recovery after sciatic nerve injury in rats

    Institute of Scientific and Technical Information of China (English)

    Olga V Gevorkyan; Irina B Meliksetyan; Tigran R Petrosyan; Anichka S Hovsepyan

    2015-01-01

    Bacterial melanin, obtained from the mutant strain ofBacillus Thuringiensis, has been shown to promote recovery after central nervous system injury. It is hypothesized, in this study, that bacterial melanin can promote structural and functional recovery after peripheral nerve injury. Rats subjected to sciatic nerve transection were intramuscularly administered bacterial melanin. The sciatic nerve transected rats that did not receive intramuscular administration of bacterial melanin served as controls. Behavior tests showed that compared to control rats, the time taken for instrumental conditioned relfex recovery was signiifcantly shorter and the ability to keep the balance on the rotating bar was signiifcantly better in bacterial melanin-treated rats. Histomor-phological tests showed that bacterial melanin promoted axon regeneration after sciatic nerve injury. These ifndings suggest that bacterial melanin exhibits neuroprotective effects on injured sciatic nerve, contributes to limb motor function recovery, and therefore can be used for rehabil-itation treatment of peripheral nerve injury.

  2. Transtympanic Facial Nerve Paralysis: A Review of the Literature.

    Science.gov (United States)

    Schaefer, Nathan; O'Donohue, Peter; French, Heath; Griffin, Aaron; Elliott, Devlin; Gochee, Peter

    2015-05-01

    Facial nerve paralysis because of penetrating trauma through the external auditory canal is extremely rare, with a paucity of published literature. The objective of this study is to review the literature on transtympanic facial nerve paralysis and increase physician awareness of this uncommon injury through discussion of its clinical presentation, management and prognosis. We also aim to improve patient outcomes in those that have sustained this type of injury by suggesting an optimal management plan. In this case report, we present the case of a 46-year-old white woman who sustained a unilateral facial nerve paresis because of a garfish penetrating her tympanic membrane and causing direct damage to the tympanic portion of her facial nerve. On follow-up after 12 months, her facial nerve function has largely returned to normal. Transtympanic facial nerve paralysis is a rare injury but can have a favorable prognosis if managed effectively.

  3. Nerves and Anesthesia: A physics perspective on medicine

    CERN Document Server

    Heimburg, Thomas

    2014-01-01

    We present a recent theory for nerve pulse propagation and anesthesia and argue that both nerve activity and the action of anesthetics can be understood on the basis of simple physical laws. It was found experimentally that biological membranes melt from a solid state to a liquid state just below physiological temperature. Such melting processes have a profound influence on the physical properties of cell membranes. They make it possible for mechanical pulses (solitons) to travel along nerve axons. In these pulses, a region of solid phase travels in the liquid nerve membrane. These pulses display many properties associated with the action potential in nerves. Both general and local anesthetics lower melting temperatures of membranes. Thus, they make it more difficult to excite the nerve membrane. Since hydrostatic pressure increases melting temperatures, it counteracts anesthesia. This theory has the virtue of providing a simple explanation of the famous Meyer-Overton correlation, which states that the effect...

  4. Chondroitinase ABC improves recovery of long sciatic nerve defects

    Institute of Scientific and Technical Information of China (English)

    Hailong Yu; Liangbi Xiang; Wenjing Xu; Bin Zhao; Yu Wang; Jiang Peng; Shibi Lu

    2012-01-01

    Sciatic nerves from allogeneic Sprague-Dawley rats were pretreated with chondroitinase ABC and were used to bridge damaged sciatic nerves in Wistar rats. Chondroitin sulfate proteoglycans were removed from the chemically extracted acellular nerves. At 3 months after grafting, the footplate pinch test result was positive in the Wistar rats. Autotomy scores decreased, and increased muscular contraction tension appeared when triceps surae muscles were stimulated. In addition, the recovery rate of wet triceps surae muscle weight increased, and the distal segment of the chondroitinase ABC-treated graft exhibited Schwann cells next to the nerve fibers. These results suggested that chondroitinase ABC pretreatment enhanced repair of long nerve defects via acellular nerve grafting.

  5. Optic Nerve Lymphoma. Report of Two Cases and Review of the Literature

    Science.gov (United States)

    Kim, Jennifer L.; Mendoza, Pia; Rashid, Alia; Hayek, Brent; Grossniklaus, Hans E.

    2014-01-01

    Lymphoma may involve the optic nerve as isolated optic nerve lymphoma or in association with CNS or systemic lymphoma. We present two biopsy-proven non-Hodgkin lymphomas of the optic nerve and compare our findings with previously reported cases. We discuss the mechanism of metastasis, classification of optic nerve involvement, clinical features, radiologic findings, optic nerve biopsy indications and techniques, histologic features, and treatments. We propose a classification system of optic nerve lymphoma: isolated optic nerve involvement, optic nerve involvement with CNS disease, optic nerve involvement with systemic disease, and optic nerve involvement with primary intraocular lymphoma. Although it is an uncommon cause of infiltrative optic neuropathy, optic nerve metastasis should be considered in patients with a history of lymphoma. The recommended approach to a patient with presumed optic nerve lymphoma includes neuroimaging, and cerebrospinal fluid evaluation as part of the initial work-up, then judicious use of optic nerve biopsy, depending on the clinical situation. PMID:25595061

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

    OpenAIRE

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

    2013-01-01

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

  7. Multicenter Clinical Trial of Keratin Biomaterials for Peripheral Nerve Regeneration

    Science.gov (United States)

    2013-10-01

    purity (size exclusion chromatography for molecular weight, amino acids analysis, ELISA for protein identification, and gel rheology ) and 2) a cell...distribution study. Labeled keratin gel will be placed inside nerve conduits. The ends of the conduits will be closed, and the conduits will be implanted in...Marra KG. Keratin gel filler for peripheral nerve repair in a rodent sciatic nerve injury model. Plast Reconstr Surg 2012;129:67-78. Pace LA

  8. Identification of proteins in fluid collected from nerve regeneration chambers

    Directory of Open Access Journals (Sweden)

    Ye Yilin

    2014-01-01

    Full Text Available We examined whether there are novel neurotrophic factors (NTFs in nerve regeneration conditioned fluid (NRCF. Nerve regeneration chamber models were established in the sciatic nerves of 25 New Zealand rabbits, and NRCF was extracted from the chambers l week postoperatively. Proteins in NRCF were separated by native polyacrylamide gel electrophoresis (PAGE, and Western blot and ELISA were used to identify the proteins. A novel NTF was identified in a protein fraction corresponding to 220 kDa.

  9. Facial nerve stimulation after cochlear implantation: our experience

    OpenAIRE

    BERRETTINI, S.; De Vito, A.; Bruschini, L.; PASSETTI, S.; Forli, F.

    2011-01-01

    SUMMARY Post-implantation facial nerve stimulation is one of the best known and most frequent complications of the cochlear implant procedure. Some conditions, such as otosclerosis and cochlear malformations, as well as high stimulation levels that may be necessary in patients with long auditory deprivation, expose patients to a higher risk of developing post-implant facial nerve stimulation. Facial nerve stimulation can frequently be resolved with minimal changes in speech processor fitting ...

  10. Benign recurrent abducens (6th) nerve palsy in two children.

    Science.gov (United States)

    Knapp, Christopher M; Gottlob, Irene

    2004-03-01

    Benign recurrent abducens (6th) nerve palsy is rare. We found 23 cases in children reported in the literature; however, many of these cases followed immunization or were associated with viral illness. Here we report two cases of recurrent abducens nerve palsy with no obvious etiology. The diagnosis should be considered in any child who experiences abducens nerve palsy in the absence of any underlying pathology or precipitating factors.

  11. 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.

  12. Vagus nerve stimulation for epilepsy: A review of central mechanisms

    OpenAIRE

    Krahl, Scott E.; Clark, Kevin B.

    2012-01-01

    In a previous paper, the anatomy and physiology of the vagus nerve was discussed in an attempt to explain which vagus nerve fibers and branches are affected by clinically relevant electrical stimulation. This companion paper presents some of vagus nerve stimulation's putative central nervous system mechanisms of action by summarizing known anatomical projections of vagal afferents and their effects on brain biogenic amine pathways and seizure expression.

  13. An unusual radiological presentation of optic nerve sheath meningiom

    Directory of Open Access Journals (Sweden)

    Chameen Samarawickrama

    2016-04-01

    Full Text Available Our report describes an unusual radiological presentation of optic nerve sheath meningioma. The classic radiological appearance of optic nerve thickening with enhancement and calcification within the tumor was not seen; instead, an elongating gadolinium enhancing band-like area adjacent to the superomedial aspect of the left optic nerve sheath was identified. The diagnosis was confirmed on histopathology. Our report adds to the spectrum of presentations of this relatively common clinical entity.

  14. Neuroprotective effects of vagus nerve stimulation on traumatic brain injury

    OpenAIRE

    Zhou, Long; Lin, Jinhuang; Lin, Junming; Kui, Guoju; Zhang, Jianhua; Yu, Yigang

    2014-01-01

    Previous studies have shown that vagus nerve stimulation can improve the prognosis of traumatic brain injury. The aim of this study was to elucidate the mechanism of the neuroprotective effects of vagus nerve stimulation in rabbits with brain explosive injury. Rabbits with brain explosive injury received continuous stimulation (10 V, 5 Hz, 5 ms, 20 minutes) of the right cervical vagus nerve. Tumor necrosis factor-α, interleukin-1β and interleukin-10 concentrations were detected in serum and b...

  15. Phrenic nerve conduction time in Guillain-Barré syndrome.

    OpenAIRE

    Gourie-Devi, M; Ganapathy, G R

    1985-01-01

    Phrenic nerve conduction was studied in 28 patients with Guillain-Barré syndrome. Conduction time was prolonged in 18 (64.3%) patients and serial studies showed progressive improvement with restoration of normal values in the majority by 12 weeks. The conduction abnormalities had a positive correlation with the extent of the disease, morbidity and mortality. Phrenic nerve conduction time was found to be a more sensitive parameter than vital capacity or median nerve motor conduction velocity i...

  16. In vivo integration of poly(ε-caprolactone)/gelatin nanofibrous nerve guide seeded with teeth derived stem cells for peripheral nerve regeneration.

    Science.gov (United States)

    Beigi, Mohammad-Hossein; Ghasemi-Mobarakeh, Laleh; Prabhakaran, Molamma P; Karbalaie, Khadijeh; Azadeh, Hamid; Ramakrishna, Seeram; Baharvand, Hossein; Nasr-Esfahani, Mohammad-Hossein

    2014-12-01

    Artificial nanofiber nerve guides have gained huge interest in bridging nerve gaps and associated peripheral nerve regeneration due to its high surface area, flexibility and porous structure. In this study, electrospun poly (ε-caprolactone)/gelatin (PCL/Gel) nanofibrous mats were fabricated, rolled around a copper wire and fixed by medical grade adhesive to obtain a tubular shaped bio-graft, to bridge 10 mm sciatic nerve gap in in vivo rat models. Stem cells from human exfoliated deciduous tooth (SHED) were transplanted to the site of nerve injury through the nanofibrous nerve guides. In vivo experiments were performed in animal models after creating a sciatic nerve gap, such that the nerve gap was grafted using (i) nanofiber nerve guide (ii) nanofiber nerve guide seeded with SHED (iii) suturing, while an untreated nerve gap remained as the negative control. In vitro cell culture study was carried out for primary investigation of SHED-nanofiber interaction and its viability within the nerve guides after 2 and 16 weeks of implantation time. Walking track analysis, plantar test, electrophysiology and immunohistochemistry were performed to evaluate functional recovery during nerve regeneration. Vascularization was also investigated by hematoxilin/eosine (H&E) staining. Overall results showed that the SHED seeded on nanofibrous nerve guide could survive and promote axonal regeneration in rat sciatic nerves, whereby the biocompatible PCL/Gel nerve guide with cells can support axonal regeneration and could be a promising tissue engineered graft for peripheral nerve regeneration.

  17. Spatial clustering analysis in neuroanatomy: Applications of different approaches to motor nerve fiber distribution

    NARCIS (Netherlands)

    Prodanov, Dimiter; Nagelkerke, Nico; Marani, Enrico; Crunelli, V.

    2007-01-01

    Spatial organization of the nerve fibers in the peripheral nerves may be important for the studies of axonal regeneration, the degenerative nerve diseases and the construction of interfaces with peripheral nerves, such as nerve prostheses. Functional topography of motor axons related to the gastrocn

  18. Inferior alveolar nerve injury with laryngeal mask airway: a case report.

    LENUS (Irish Health Repository)

    Hanumanthaiah, Deepak

    2011-01-01

    The incidence of damage to the individual cranial nerves and their branches associated with laryngeal mask airway use is low; there have been case reports of damage to the lingual nerve, hypoglossal nerve and recurrent laryngeal nerve. To the best of our knowledge we present the first reported case of inferior alveolar nerve injury associated with laryngeal mask airway use.

  19. Tacrolimus reduces scar formation and promotes sciatic nerve regeneration

    Institute of Scientific and Technical Information of China (English)

    Jun Que; Quan Cao; Tao Sui; Shihao Du; Ailiang Zhang; Dechao Kong; Xiaojian Cao

    2012-01-01

    A sciatic nerve transection and repair model was established in Sprague-Dawley rats by transecting the tendon of obturator internus muscle in the greater sciatic foramen and suturing with nylon sutures. The models were treated with tacrolimus gavage (4 mg/kg per day) for 0, 2, 4 and 6 weeks. Specimens were harvested at 6 weeks of intragastric administration. Masson staining revealed that the collagen fiber content and scar area in the nerve anastomosis of the sciatic nerve injury rats were significantly reduced after tacrolimus administration. Hematoxylin-eosin staining showed that tacrolimus significantly increased myelinated nerve fiber density, average axon diameter and myelin sheath thickness. Intragastric administration of tacrolimus also led to a significant increase in the recovery rate of gastrocnemius muscle wet weight and the sciatic functional index after sciatic nerve injury. The above indices were most significantly improved at 6 weeks after of tacrolimus gavage. The myelinated nerve fiber density in the nerve anastomosis and the sciatic nerve functions had a significant negative correlation with the scar area, as detected by Spearman’s rank correlation analysis. These findings indicate that tacrolimus can promote peripheral nerve regeneration and accelerate the recovery of neurological function through the reduction of scar formation.

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

    LENUS (Irish Health Repository)

    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.

  1. An unusual cause of trochlear nerve palsy and brainstem compression

    Directory of Open Access Journals (Sweden)

    Jasmit Singh

    2016-01-01

    Full Text Available Schwannoma originates from the Schwann cells at the Obersteiner-Redlich zone, which marks the junction of central and peripheral myelin of the cranial nerves. Most frequently affected are the vestibular, trigeminal, and facial nerves followed by the lower cranial nerves. Trochlear schwannoma in the absence of neurofibromatosis is a rare entity. The purpose of this report is to serve as a reminder to consider trochlear nerve schwannoma in the list of differential diagnosis of such tumors as the outcome is far better than the intraaxial tumor in that location.

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

    Institute of Scientific and Technical Information of China (English)

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

    2002-01-01

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

  3. Twelfth cranial nerve involvement in Guillian Barre syndrome

    Directory of Open Access Journals (Sweden)

    Subrat Kumar Nanda

    2013-01-01

    Full Text Available Guillian Barre Syndrome (GBS is associated with cranial nerve involvement. Commonest cranial nerves involved were the facial and bulbar (IXth and Xth. Involvement of twelfth cranial nerve is rare in GBS. We present a case of GBS in a thirteen years old boy who developed severe tongue weakness and wasting at two weeks after the onset of GBS. The wasting and weakness of tongue improved at three months of follow up. Brief review of the literature about XIIth cranial nerve involvement in GBS is discussed.

  4. Ulnar nerve entrapment at wrist associated with carpal tunnel syndrome.

    Science.gov (United States)

    Gozke, E; Dortcan, N; Kocer, A; Cetinkaya, M; Akyuz, G; Us, O

    2003-11-01

    In this study, ulnar nerve entrapments at the wrist were investigated using nerve conduction studies in cases with established diagnosis of carpal tunnel syndrome (CTS). Cases with cervical radiculopathy and polyneuropathy as well as patients with ulnar nerve entrapment at elbow were excluded from the study. Fifty-three cases (46 females, seven males) whose ages ranged between 20 and 72 years (mean: 49.31 +/- 13.78) were evaluated. Among 53 cases, 12 (22.6%) bilateral and 41 (77.3%) unilateral CTS were detected. Totally 65 wrists evaluated and prolongation of median nerve wrist-3rd digit distal sensory latencies (DSL; N: 59; 90.7%) and wrist-abductor pollicis brevis distal motor latencies (N: 48; 73.8%) were seen. In six wrists, diagnoses were established with the detection of an increase in the differences between wrist-4th digit DSL of median and ulnar nerve. This test was used if other test results were in normal limits. Prolongation of ulnar nerve wrist-5th digit DSL were found in 12 wrists (18.4%) in cases with CTS. Among these 12 wrists mild (N: 2), moderate (N: 7) and severe (N: 3) CTS were detected. Ulnar nerve motor conduction studies provided normal results. In conclusion, we are in the opinion that for the detection of associated ulnar nerve wrist entrapments, ulnar nerve conduction studies paying special attention to DSL convey importance in established cases with CTS.

  5. Peripheral nerve regeneration with conduits:use of vein tubes

    Institute of Scientific and Technical Information of China (English)

    Rodrigo Guerra Sabongi; Marcela Fernandes; Joo Baptista Gomes dos Santos

    2015-01-01

    Treatment of peripheral nerve injuries remains a challenge to modern medicine due to the com-plexity of the neurobiological nerve regenerating process. There is a greater challenge when the transected nerve ends are not amenable to primary end-to-end tensionless neurorraphy. When facing a segmental nerve defect, great effort has been made to develop an alternative to the au-tologous nerve graft in order to circumvent morbidity at donor site, such as neuroma formation, scarring and permanent loss of function. Tubolization techniques have been developed to bridge nerve gaps and have been extensively studied in numerous experimental and clinical trials. The use of a conduit intends to act as a vehicle for moderation and modulation of the cellular and molecular ambience for nerve regeneration. Among several conduits, vein tubes were validated for clinical application with improving outcomes over the years. This article aims to address the investigation and treatment of segmental nerve injury and draw the current panorama on the use of vein tubes as an autogenous nerve conduit.

  6. Sciatic nerve repair using adhesive bonding and a modiifed conduit

    Institute of Scientific and Technical Information of China (English)

    Xiangdang Liang; Hongfei Cai; Yongyu Hao; Geng Sun; Yaoyao Song; Wen Chen

    2014-01-01

    When repairing nerves with adhesives, most researchers place glue directly on the nerve stumps, but this method does not ifx the nerve ends well and allows glue to easily invade the nerve ends. In this study, we established a rat model of completely transected sciatic nerve injury and re-paired it using a modiifed 1 cm-length conduit with inner diameter of 1.5 mm. Each end of the cylindrical conduit contains a short linear channel, while the enclosed central tube protects the nerve ends well. Nerves were repaired with 2-octyl-cyanoacrylate and suture, which complement the function of the modiifed conduit. The results demonstrated that for the same conduit, the av-erage operation time using the adhesive method was much shorter than with the suture method. No signiifcant differences were found between the two groups in sciatic function index, motor evoked potential latency, motor evoked potential amplitude, muscular recovery rate, number of medullated nerve fibers, axon diameter, or medullary sheath thickness. Thus, the adhesive method for repairing nerves using a modiifed conduit is feasible and effective, and reduces the operation time while providing an equivalent repair effect.

  7. Imaging of muscular denervation secondary to motor cranial nerve dysfunction

    Energy Technology Data Exchange (ETDEWEB)

    Connor, S.E.J. [Neuroradiology Department, Kings College Hospital, Denmark Hill, London SE5 9RS (United Kingdom)]. E-mail: sejconnor@tiscali.co.uk; Chaudhary, N. [Neuroradiology Department, Kings College Hospital, Denmark Hill, London SE5 9RS (United Kingdom); Fareedi, S. [Neuroradiology Department, Kings College Hospital, Denmark Hill, London SE5 9RS (United Kingdom); Woo, E.K. [Neuroradiology Department, Kings College Hospital, Denmark Hill, London SE5 9RS (United Kingdom)

    2006-08-15

    The effects of motor cranial nerve dysfunction on the computed tomography (CT) and magnetic resonance imaging (MRI) appearances of head and neck muscles are reviewed. Patterns of denervation changes are described and illustrated for V, VII, X, XI and XII cranial nerves. Recognition of the range of imaging manifestations, including the temporal changes in muscular appearances and associated muscular grafting or compensatory hypertrophy, will avoid misinterpretation as local disease. It will also prompt the radiologist to search for underlying cranial nerve pathology, which may be clinically occult. The relevant cranial nerve motor division anatomy will be described to enable a focussed search for such a structural abnormality.

  8. Peripheral nerve regeneration with conduits: use of vein tubes

    Directory of Open Access Journals (Sweden)

    Rodrigo Guerra Sabongi

    2015-01-01

    Full Text Available Treatment of peripheral nerve injuries remains a challenge to modern medicine due to the complexity of the neurobiological nerve regenerating process. There is a greater challenge when the transected nerve ends are not amenable to primary end-to-end tensionless neurorraphy. When facing a segmental nerve defect, great effort has been made to develop an alternative to the autologous nerve graft in order to circumvent morbidity at donor site, such as neuroma formation, scarring and permanent loss of function. Tubolization techniques have been developed to bridge nerve gaps and have been extensively studied in numerous experimental and clinical trials. The use of a conduit intends to act as a vehicle for moderation and modulation of the cellular and molecular ambience for nerve regeneration. Among several conduits, vein tubes were validated for clinical application with improving outcomes over the years. This article aims to address the investigation and treatment of segmental nerve injury and draw the current panorama on the use of vein tubes as an autogenous nerve conduit.

  9. Congenital optic nerve anomalies and hereditary optic neuropathies.

    Science.gov (United States)

    Heidary, Gena

    2014-12-01

    Congenital and hereditary optic nerve anomalies represent a significant cause of visual dysfunction. While some optic nerve abnormalities affect the visual system alone, others may be associated with neurologic and systemic findings. Correct identification of the optic nerve disease therefore is crucial both for developing a treatment plan with respect to visual rehabilitation, but also for initiating the appropriate multidisciplinary evaluation. The purpose of this review is to highlight common examples of congenital and inherited optic nerve abnormalities in an effort to familiarize the clinician with salient clinical features of these diseases and to review important systemic testing when relevant.

  10. Hemangioblastoma of the optic nerve--case report.

    Science.gov (United States)

    Higashida, Tetsuhiro; Sakata, Katsumi; Kanno, Hiroshi; Kawasaki, Takashi; Tanabe, Yutaka; Yamamoto, Isao

    2007-05-01

    A 64-year-old man presented with a rare sporadic hemangioblastoma arising in the left optic nerve manifesting as left visual disturbance gradually progressive over 5 years. Magnetic resonance imaging revealed a well-enhanced mass in the left optic nerve. Partial resection of the tumor was performed via the frontoorbital approach. The histological diagnosis was optic nerve hemangioblastoma. Hemangioblastoma must be considered in the differential diagnosis of optic nerve tumors even in the absence of other lesions associated with von Hippel-Lindau disease.

  11. A Bionic Neural Link for peripheral nerve repair.

    Science.gov (United States)

    Xu, Yong Ping; Yen, Shih-Cheng; Ng, Kian Ann; Liu, Xu; Tan, Ter Chyan

    2012-01-01

    Peripheral nerve injuries with large gaps and long nerve regrowth paths are difficult to repair using existing surgical techniques, due to nerve degeneration and muscle atrophy. This paper proposes a Bionic Neural Link (BNL) as an alternative way for peripheral nerve repair. The concept of the BNL is described, along with the hypothetical benefits. A prototype monolithic single channel BNL has been developed, which consists of 16 neural recording channels and one stimulation channel, and is implemented in a 0.35-µm CMOS technology. The BNL has been tested in in-vivo animal experiments. Full function of the BNL chip has been demonstrated.

  12. Mandibular branch of the facial nerve in wistar rats: new experimental model to assess facial nerve regeneration.

    Science.gov (United States)

    Bento, Ricardo Ferreira; Salomone, Raquel; Nascimento, Silvia Bona do; Ferreira, Ricardo Jose Rodriguez; Silva, Ciro Ferreira da; Costa, Heloisa Juliana Zabeu Rossi

    2014-07-01

    Introduction The ideal animal model for nerve regeneration studies is the object of controversy, because all models described by the literature have advantages and disadvantages. Objective To describe the histologic and functional patterns of the mandibular branch of the facial nerve of Wistar rats to create a new experimental model of facial nerve regeneration. Methods Forty-two male rats were submitted to a nerve conduction test of the mandibular branch to obtain the compound muscle action potential. Twelve of these rats had the mandibular branch surgically removed and submitted to histologic analysis (number, partial density, and axonal diameter) of the proximal and distal segments. Results There was no statistically significant difference in the functional and histologic variables studied. Conclusion These new histologic and functional standards of the mandibular branch of the facial nerve of rats establish an objective, easy, and greatly reproducible model for future facial nerve regeneration studies.

  13. Use of nerve conduits for peripheral nerve injury repair A Web of Science-based literature analysis

    Institute of Scientific and Technical Information of China (English)

    Jinniang Nan; Xuguang Hu; Hongxiu Li; Xiaonong Zhang; Renjing Piao

    2012-01-01

    OBJECTIVE: To identify global research trends in the use of nerve conduits for peripheral nerve injury repair.SELECTION CRITERIA: Inclusion criteria: peer-reviewed published articles on nerve conduits for peripheral nerve injury repair, indexed in the Web of Science; original research articles, reviews, meeting abstracts, proceedings papers, book chapters, editorial material, and news items. Exclusion criteria: articles requiring manual searching or telephone access; documents not published in the public domain; and several corrected papers.MAIN OUTCOME MEASURES: (a) Annual publication output; (b) publication type; (c) publication by research field; (d) publication by journal; (e) publication by funding agency; (f) publication by author; (g) publication by country and institution; (h) publications by institution in China; (i) most-cited papers.CONCLUSION: Nerve conduits have been studied extensively for peripheral nerve regeneration; however, many problems remain in this field, which are difficult for researchers to reach a consensus.

  14. Nerve growth factor improves ligament healing.

    Science.gov (United States)

    Mammoto, Takeo; Seerattan, Ruth A; Paulson, Kent D; Leonard, Catherine A; Bray, Robert C; Salo, Paul T

    2008-07-01

    Previous work has shown that innervation participates in normal ligament healing. The present study was performed to determine if exogenous nerve growth factor (NGF) would improve the healing of injured ligament by promoting reinnervation, blood flow, and angiogenesis. Two groups of 30 Sprague-Dawley rats underwent unilateral medial collateral ligament transection (MCL). One group was given 10 microg NGF and the other was given PBS via osmotic pump over 7 days after injury. After 7, 14, and 42 days, in vivo blood flow was measured using laser speckle perfusion imaging (LSPI). Morphologic assessments of nerve density, vascularity, and angiogenesis inhibitor production were done in three animals at each time point by immunohistochemical staining for the pan-neuronal marker PGP9.5, the endothelial marker vWF, and the angiogenesis inhibitor thrombospondin-2 (TSP-2). Ligament scar material and structural mechanical properties were assessed in seven rats at each time point. Increased nerve density was promoted by NGF at both 14 and 42 days. Exposure to NGF also led to increased ligament vascularity, as measured by histologic assessment of vWF immunohistochemistry, although LSPI-measured blood flow was not significantly different from controls. NGF treatment also led to decreased expression of TSP-2 at 14 days. Mechanical testing revealed that exposure to NGF increased failure load by 40%, ultimate tensile strength by 55%, and stiffness by 30% at 42 days. There were no detectable differences between groups in creep properties. The results suggest that local application of NGF can improve ligament healing by promoting both reinnervation and angiogenesis, and results in scars with enhanced mechanical properties.

  15. NERVE: New Enhanced Reverse Vaccinology Environment

    Directory of Open Access Journals (Sweden)

    Filippini Francesco

    2006-07-01

    Full Text Available Abstract Background Since a milestone work on Neisseria meningitidis B, Reverse Vaccinology has strongly enhanced the identification of vaccine candidates by replacing several experimental tasks using in silico prediction steps. These steps have allowed scientists to face the selection of antigens from the predicted proteome of pathogens, for which cell culture is difficult or impossible, saving time and money. However, this good example of bioinformatics-driven immunology can be further developed by improving in silico steps and implementing biologist-friendly tools. Results We introduce NERVE (New Enhanced Reverse Vaccinology Environment, an user-friendly software environment for the in silico identification of the best vaccine candidates from whole proteomes of bacterial pathogens. The software integrates multiple robust and well-known algorithms for protein analysis and comparison. Vaccine candidates are ranked and presented in a html table showing relevant information and links to corresponding primary data. Information concerning all proteins of the analyzed proteome is not deleted along selection steps but rather flows into an SQL database for further mining and analyses. Conclusion After learning from recent years' works in this field and analysing a large dataset, NERVE has been implemented and tuned as the first available tool able to rank a restricted pool (~8–9% of the whole proteome of vaccine candidates and to show high recall (~75–80% of known protective antigens. These vaccine candidates are required to be "safe" (taking into account autoimmunity risk and "easy" for further experimental, high-throughput screening (avoiding possibly not soluble antigens. NERVE is expected to help save time and money in vaccine design and is available as an additional file with this manuscript; updated versions will be available at http://www.bio.unipd.it/molbinfo.

  16. Nova técnica de transferência de cordas para sustentação das cúspides da valva mitral, após abertura completa de suas comissuras New technique for transference of chordae tendinae following mitral commissurotomy

    Directory of Open Access Journals (Sweden)

    José Alberto Caliani

    1988-08-01

    Full Text Available Desde 1983, 40 pacientes consecutivos, portadores de estenose mitral com alterações subvalvares, tais como: fusão e encurtamento das cordas, associadas a sinéquia dos músculos papilares, foram submetidos a comissurotomia mitral a "céu aberto". Com o intuito de ganhar área efetiva maior de abertura da valva mitral (sem restrições, as comissuras foram abertas, amplamente, às vezes não respeitando as cordas que sustentam as cúspides. A insuficiência mitral provocada, em 4 casos, como conseqüência, foi corrigida mediante a transferência de 2 a 6 cordas, ao nível da borda livre da cúspide anterior, ou posterior, da valva, na região das comissuras. A presença de uma regurgitação central por falha na coaptação das cúspides valvares, foi tratada, em 12 casos, com o implante de anel profético de Carpentier. As anomalias do aparelho subvalvar foram abordadas pelas técnicas convencionais: desbridamento, ressecção e abertura dos músculos papilares. Dos 38 sobreviventes, 32 não apresentam sopro de regurgitação mitral e os 6 restantes, apenas sopro sistólico de +/+ +. A avaliação pós-operatória, mediante ecocardiografia bidemensional, demonstrou abertura valvar satisfatória e ausência de estenose residual. Os pacientes que apresentam sopro sistólico mitral residual foram estudados com Doppler, concluindo que se trata de regurgitação bem localizada e sem repercussão hemodinâmica. Esta nova técnica operatória pode ser "extensível" ao tratamento do prolapso da valva mitral.Since 1983, 40 consecutive patients with mitral stenosis and significant disease of the subvalvular apparatus underwent open heart mitral commissurotomy. The aim of the study was to evaluate the effects of an unrestricted dilatation of the two commissures followed by repair of the subsequent mitral regurgitation. The mitral regurgitation created by this procedure in 24 cases was corrected by transferring 2 to 6 chordae tendinae to the free border

  17. Optical coherence tomography of the prostate nerves

    Science.gov (United States)

    Chitchian, Shahab

    Preservation of the cavernous nerves during prostate cancer surgery is critical in preserving a man's ability to have spontaneous erections following surgery. These microscopic nerves course along the surface of the prostate within a few millimeters of the prostate capsule, and they vary in size and location from one patient to another, making preservation of the nerves difficult during dissection and removal of a cancerous prostate gland. These observations may explain in part the wide variability in reported sexual potency rates (9--86%) following prostate cancer surgery. Any technology capable of providing improved identification, imaging, and visualization of the cavernous nerves during prostate cancer surgery would be of great assistance in improving sexual function after surgery, and result in direct patient benefit. Optical coherence tomography (OCT) is a noninvasive optical imaging technique capable of performing high-resolution cross-sectional in vivo and in situ imaging of microstructures in biological tissues. OCT imaging of the cavernous nerves in the rat and human prostate has recently been demonstrated. However, improvements in the OCT system and the quality of the images for identification of the cavernous nerves is necessary before clinical use. The following chapters describe complementary approaches to improving identification and imaging of the cavernous nerves during OCT of the prostate gland. After the introduction to OCT imaging of the prostate gland, the optimal wavelength for deep imaging of the prostate is studied in Chapter 2. An oblique-incidence single point measurement technique using a normal-detector scanning system was implemented to determine the absorption and reduced scattering coefficients, mua and m's , of fresh canine prostate tissue, ex vivo, from the diffuse reflectance profile of near-IR light as a function of source-detector distance. The effective attenuation coefficient, mueff, and the Optical Penetration Depth (OPD) were

  18. [Primitive neuroectodermal tumor of the vagus nerve].

    Science.gov (United States)

    Pegbessou, E; Diom, E S; Ndiaye, M; Dieng, P A; Nao, E E M; Thiam, A; Diouf, M S; Boube, D; Ndiaye, C; Kossinda, F; Tall, A; Diallo, B K; Ndiaye, I C; Diouf, R; Diop, E M

    2013-12-01

    Primitive neuroectodermal tumors are a rare type of malignant neuroectodermal tumor that is very aggressive. Cervicofacial location is rare, even exceptional. We report a case of a 4-month-old male infant, referred from the pediatric clinic for severe supralaryngeal dyspnea, a firm mass under the left mandibular angle, mobile and extended to the parotid area, painful, with a curve of the left side wall of the oropharynx. Cervical computed tomodensitometry showed a well-limited mass in the carotid area, enhanced by the contrast product. A vascularized mass, which had developed at the expense of the vagus nerve, was removed surgically. Histology found a primitive neuroectodermal tumor.

  19. Alkylation of Chitosan as Nerve Conduit Biomaterial

    Institute of Scientific and Technical Information of China (English)

    邓劲光; 公衍道; 程明愚; 赵南明; 张秀芳

    2002-01-01

    Chitosan under physiological conditions is a degradable and biocompatible biomaterial with a wide variety of useful physicochemical properties. However, as a nerve conduit biomaterial, its solubility was very low, so chitosan was modified chemically to enhance its solubility. The free amino groups of long molecular chains in chitosan are responsible for its solubility, and the solubility could be adjusted by controlling the free amidogen capacity with N-alkylation. The results show that the solubility of N-alkylation chitosan is increased to 10%, which is an increase of 500%.

  20. Ulnar nerve palsy due to axillary crutch.

    Directory of Open Access Journals (Sweden)

    Veerendrakumar M

    2001-01-01

    Full Text Available A young lady with residual polio, using axillary crutch since early childhood, presented with tingling, numbness and weakness in ulnar nerve distribution of five months duration. Ulnar motor conduction study revealed proximal conduction block near the axilla, at the point of pressure by the crutch while walking. Distal ulnar sensory conduction studies were normal but proximal ulnar sensory conduction studies showed absence of Erb′s point potential. These findings suggested the presence of conduction block in sensory fibers as well. Proper use and change of axillary crutch resulted in clinical recovery and resolution of motor and sensory conduction block.

  1. 20.7 Peripheral nerve disease

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    930394 A1—10 year follow—up study of 82cases of methamidophos induced delayedpolyneuropathy.Z1HENG Rongyuan (郑荣远),etal.Neurol Dept,Wenzhou Med Coll.325000.Chin J Industr Hyg & Occupat Dis 1992;10(6):344—347.A1—10 year follow—up study of 82 cases ofmethamidophos induced delayed polyneuropathywas reported.82 cases were classified into threetypes:motor (36.6%),sensory—motor (61%)and Guillain-Barre syndrome (2.4%).As awhole,the sensory disturbances disappearedwithin 2—3 months;the autonomic nerve func-tional disorder vanished within 3—6 months;

  2. Decompression of inferior alveolar nerve: case report.

    Science.gov (United States)

    Marques, Tiago Miguel Santos; Gomes, Joana Marques

    2011-01-01

    Paresthesia as a result of mechanical trauma is one of the most frequent sensory disturbances of the inferior alveolar nerve. This case report describes surgical treatment for paresthesia caused by a compressive phenomenon within the mandibular canal. The cause of the compression, a broken instrument left in the patient's mouth during previous endodontic therapy, was identified during routine radiography and computed tomography. Once the foreign object was removed by surgery, the paresthesia resolved quickly. This case highlights the potential for an iatrogenic mechanical cause of paresthesia.

  3. Genetic instability in nerve sheath cell tumors

    DEFF Research Database (Denmark)

    Rogatto, Silvia Regina; Casartelli, Cacilda; Rainho, Claudia Aparecida

    1995-01-01

    After in vitro culture, we analyzed cytogenetically four acoustic nerve neurinomas, one intraspinal neurinoma and one neurofibroma obtainedfrom unrelated patients. Monosomy of chromosomes 22 and 16 was an abnormality common to all cases, followed in frequency by loss of chromosomes 18 (three cases......) and chromosomes 8, 17 and 19 (two cases). Trisomy of chromosome 20 was also detected in two cases. Structural rearrangements were detected at low frequencies, with del(10)(p12) being present in two cases. In addition, we observed cell subpopulations showing a certain degree of genetic instability, reflected...

  4. Electrical stimulation of nerve cells using conductive nanofibrous scaffolds for nerve tissue engineering.

    Science.gov (United States)

    Ghasemi-Mobarakeh, Laleh; Prabhakaran, Molamma P; Morshed, Mohammad; Nasr-Esfahani, Mohammad Hossein; Ramakrishna, Seeram

    2009-11-01

    Fabrication of scaffolds with suitable chemical, mechanical, and electrical properties is critical for the success of nerve tissue engineering. Electrical stimulation was directly applied to electrospun conductive nanofibrous scaffolds to enhance the nerve regeneration process. In the present study, electrospun conductive nanofibers were prepared by mixing 10 and 15 wt% doped polyaniline (PANI) with poly (epsilon-caprolactone)/gelatin (PG) (70:30) solution (PANI/PG) by electrospinning. The fiber diameter, pore size, hydrophilicity, tensile properties, conductivity, Fourier transform infrared (FTIR), and X-ray photoelectron spectroscopy spectra of nanofibers were determined, and the in vitro biodegradability of the different nanofibrous scaffolds was also evaluated. Nanofibrous scaffolds containing 15% PANI was found to exhibit the most balanced properties to meet all the required specifications for electrical stimulation for its enhanced conductivity and is used for in vitro culture and electrical stimulation of nerve stem cells. 3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium (MTS) assay and scanning electron microscopy results showed that conductive nanofibrous scaffolds are suitable substrates for the attachment and proliferation of nerve stem cells. Electrical stimulation through conductive nanofibrous PANI/PG scaffolds showed enhanced cell proliferation and neurite outgrowth compared to the PANI/PG scaffolds that were not subjected to electrical stimulation.

  5. Lentiviral-mediated transfer of CDNF promotes nerve regeneration and functional recovery after sciatic nerve injury in adult rats

    Energy Technology Data Exchange (ETDEWEB)

    Cheng, Lei; Liu, Yi; Zhao, Hua; Zhang, Wen; Guo, Ying-Jun; Nie, Lin, E-mail: chengleiyx@126.com

    2013-10-18

    Highlights: •CDNF was successfully transfected by a lentiviral vector into the distal sciatic nerve. •CDNF improved S-100, NF200 expression and nerve regeneration after sciatic injury. •CDNF improved the remyelination and thickness of the regenerated sciatic nerve. •CDNF improved gastrocnemius muscle weight and sciatic functional recovery. -- Abstract: Peripheral nerve injury is often followed by incomplete and unsatisfactory functional recovery and may be associated with sensory and motor impairment of the affected limb. Therefore, a novel method is needed to improve the speed of recovery and the final functional outcome after peripheral nerve injuries. This report investigates the effect of lentiviral-mediated transfer of conserved dopamine neurotrophic factor (CDNF) on regeneration of the rat peripheral nerve in a transection model in vivo. We observed notable overexpression of CDNF protein in the distal sciatic nerve after recombinant CDNF lentiviral vector application. We evaluated sciatic nerve regeneration after surgery using light and electron microscopy and the functional recovery using the sciatic functional index and target muscle weight. HE staining revealed better ordered structured in the CDNF-treated group at 8 weeks post-surgery. Quantitative analysis of immunohistochemistry of NF200 and S-100 in the CDNF group revealed significant improvement of axonal and Schwann cell regeneration compared with the control groups at 4 weeks and 8 weeks after injury. The thickness of the myelination around the axons in the CDNF group was significantly higher than in the control groups at 8 weeks post-surgery. The CDNF group displayed higher muscle weights and significantly increased sciatic nerve index values. Our findings suggest that CDNF gene therapy could provide durable and stable CDNF protein concentration and has the potential to enhance peripheral nerve regeneration, morphological and functional recovery following nerve injury, which suggests a

  6. The Role of Nerve Growth Factor in Ginsenoside Rg1-Induced Regeneration of Injured Rat Sciatic Nerve.

    Science.gov (United States)

    Huo, Dong-Sheng; Zhang, Ming; Cai, Zhi-Ping; Dong, Chao-Xuan; Wang, He; Yang, Zhan-Jun

    2015-01-01

    Sciatic nerve injury is commonly seen in clinical practice predominantly associated with trauma or sports injuries. Recent studies indicated that ginsenoside Rg1 (Gs Rg1), extracted from Chinese herbs, was found to promote regeneration of injured rat sciatic nerve and that nerve growth factor (NGF) may be involved in this process. The aim of this study was to examine the role that NGF may play in ginsenoside Rg1-induced regeneration of rat sciatic nerve following injury. Animals following surgical right sciatic nerve injury were subsequently administered intraperitoneally either saline (sham control) or different doses of 2, 4, 8, or 12 mg/kg daily GsRg1 for 2 to 8 wk. In addition, 100 μg/kg mecobalamin, a drug utilized to treat nerve injuries, was employed as a positive control. After 2, 4, or 8 wk, sciatic functional index (SFI) and mean nerve conduction velocity (MNCV), markers of sciatic nerve function, were assessed to determine whether recovery of injured sciatic nerve occurred. In addition, immunohistochemistry and Western blot methods were used to examine NGF protein expression changes. Results showed that all doses of GsRg1 significantly increased SFI and MNCV in injured sciatic-nerve-damaged rats in a manner similar to that noted with mecobalamin. It is of interest that the intermediate 4- and 8-mg/kg doses were more effective in restoring nerve functions. Immunohistochemistry and Western blot results also demonstrated a similar pattern with enhanced NGF protein expression at all doses, but greater effects were noted at 4 and 8 mg/kg GsRg1. Data suggest that GsRg1 promotes recovery of injured sciatic nerve functions within a specific dose range and that NGF may be involved in this physiological process.

  7. Effect of nerve growth factor on changes of myelin basic protein and functional repair of peripheral nerve following sciatic nerve injury in rats

    Institute of Scientific and Technical Information of China (English)

    邵阳; 马海涵; 伍亚民; 陈恒胜; 曾琳; 李民; 龙在云; 李应玉; 杨恒文

    2002-01-01

    To investigate the therapeutic effect of nerve growth factor ( NGF ) on changes of myelin basic protein (MBP) and functional repair of sensory and motor nerve following sciatic nerve injury. Methods: The sciatic nerves of rats were injured by sectioning with shaver, and divided into 3 groups: NGF group ( Group A ), group of normal saline solution ( Group B), untreated group (Group C). The time point of observation was at the 4th week after operation. Sensory evoked potential (SEP) and motor evoked potential (MEP) were detected by Model WD-4000 nerve potential working diagnosis system. Immunohistochemical analysis was used for identification of MBP. Results: The latency of SEP in the Group A at the 4th week after operation was shorter than that in the Group B ( P < 0.05). The MEP was elicited in 76 % of the Group A and was higher than that in the Group B. Results of immunohistochemistry showed that there were less MBP-positive cells in the Group A than in the Group B in one and four weeks respectively. Conclusions: NGF can improve the conductive function of injured peripheral nerve and facilitate regeneration of nerve.

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

    Institute of Scientific and Technical Information of China (English)

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

    2012-01-01

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

  9. Adenoid cystic carcinoma of the parotid gland: Anastamosis of the facial nerve with the great auricular nerve after radical parotidectomy

    Directory of Open Access Journals (Sweden)

    Bahadir Osman

    2008-01-01

    Full Text Available Adenoid cystic carcinoma of the parotid gland is a rare and slowly growing, but highly malignant tumor. Surgical resection of a malignant parotid tumor should include resection of the facial nerve when the nerve is involved in the tumor. Facial nerve reconstruction is required after nerve resection. A 14 year-old female presented with complaints of painless enlargement of the right parotid gland and facial asymmetry. Physical examination revealed a firm mass in the region of the parotid gland as well as right facial paralysis. Biopsy obtained from the mass showed an adenoid cystic carcinoma of the parotid gland. A radical parotidectomy with a modified radical neck dissection was carried out. Grafting material for the facial reconstruction was harvested from the great auricular nerve. The proximal main trunk and each distal branch of the facial nerve were coapted with the greater auricular nerve. The patient received radiotherapy after surgery and was seen to achieve grade IV facial function one year after surgery. Thus, the great auricular nerve is appropriate grafting material for coaptation of each distal branch of the facial nerve.

  10. Expression changes of nerve cell adhesion molecules L1 and semaphorin 3A after peripheral nerve injury

    OpenAIRE

    Qian-ru He; Meng Cong; Qing-zhong Chen; Ya-feng Sheng; Jian Li; Qi Zhang; Fei Ding; Yan-pei Gong

    2016-01-01

    The expression of nerve cell adhesion molecule L1 in the neuronal growth cone of the central nervous system is strongly associated with the direction of growth of the axon, but its role in the regeneration of the peripheral nerve is still unknown. This study explored the problem in a femoral nerve section model in rats. L1 and semaphorin 3A mRNA and protein expressions were measured over the 4-week recovery period. Quantitative polymerase chain reaction showed that nerve cell adhesion molecul...

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

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    Pei-xun Zhang

    2015-01-01

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

  12. Nerve autografts and tissue-engineered materials for the repair of peripheral nerve injuries: a 5-year bibliometric analysis

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    Yuan Gao

    2015-01-01

    Full Text Available With advances in biomedical methods, tissue-engineered materials have developed rapidly as an alternative to nerve autografts for the repair of peripheral nerve injuries. However, the materials selected for use in the repair of peripheral nerve injuries, in particular multiple injuries and large-gap defects, must be chosen carefully. Various methods and materials for protecting the healthy tissue and repairing peripheral nerve injuries have been described, and each method or material has advantages and disadvantages. Recently, a large amount of research has been focused on tissue-engineered materials for the repair of peripheral nerve injuries. Using the keywords "pe-ripheral nerve injury", "autotransplant", "nerve graft", and "biomaterial", we retrieved publications using tissue-engineered materials for the repair of peripheral nerve injuries appearing in the Web of Science from 2010 to 2014. The country with the most total publications was the USA. The institutions that were the most productive in this field include Hannover Medical School (Germany, Washington University (USA, and Nantong University (China. The total number of publications using tissue-engineered materials for the repair of peripheral nerve injuries grad-ually increased over time, as did the number of Chinese publications, suggesting that China has made many scientific contributions to this field of research.

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

    Institute of Scientific and Technical Information of China (English)

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

    2015-01-01

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

  14. Chitosan-cross-linked nanofibrous PHBV nerve guide for rat sciatic nerve regeneration across a defect bridge.

    Science.gov (United States)

    Biazar, Esmaeil; Keshel, Saeed Heidari

    2013-01-01

    The aim of this study was to produce a chitosan-cross-linked nanofibrous biodegradable poly (3-hydroxybutyrate-co-3-hydroxyvalerate) nerve conduit. The artificial nerve scaffold designed by electrospinning method and cross-linked with chitosan by chemical method. Afterwards, the scaffolds were evaluated by microscopic, physical, and mechanical analyses and cell culture assays with Schwann cells. The conduits were implanted into a 10 mm gap in the sciatic nerves of the rats. Four months after surgery, the regenerated nerves were evaluated by macroscopic assessments and histology. This polymeric conduit had sufficiently good mechanical properties to serve as a nerve guide. Cellular experiments showed a better cell adhesion, growth, and proliferation inside the cross-linked nanofibrous scaffolds compared with un-cross-linked ones, also Schwann cells well attached on chitosan-cross-linked nanofibrous surface. The in vivo results demonstrated that in the nanofibrous graft, the sciatic nerve trunk had been reconstructed with restoration of nerve continuity and formatted nerve fibers with myelination. This neural conduit appears to have the right organization for testing in vivo nerve tissue engineering studies.

  15. Hemiplegic peripheral neuropathy accompanied with multiple cranial nerve palsy

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    Hirohisa Okuma

    2012-03-01

    Full Text Available A 32-year-old man experienced double vision around January, 2010, followed by weakness of his left upper and lower extremities. Articulation disorders and loss of hearing in his left ear developed, and he was admitted to our hospital on February 14, 2010. Physical examination was normal, and neurological examination showed clear consciousness with no impairment of cognitive function, but with articulation disorders. Olfactory sensation was reduced. Left ptosis and left gaze palsy, complete left facial palsy, perceptive deafness of the left ear, and muscle weakness of the left trapezius muscle were observed. Paresis in the left upper and lower extremities was graded 4/5 through manual muscle testing. Sensory system evaluation revealed complete left-side palsy, including the face. Deep tendon reflexes were slightly diminished equally on both sides; no pathologic reflex was seen. No abnormality of the brain parenchyma, cerebral nerves or cervicothoracolumbar region was found on brain magnetic resonance imaging. On electroencephalogram, alpha waves in the main frequency band of 8 to 9 Hz were recorded, indicating normal findings. Brain single photon emission computed tomography (SPECT scan showed reduced blood flow in the right inner frontal lobe and both occipital lobes. Nerve biopsy (left sural nerve showed reduction of nerve density by 30%, with demyelination. The patient also showed manifestations of multiple cranial nerve disorder, i.e., of the trigeminal nerve, glossopharyngeal nerve, vagus nerve, and hypoglossal nerve. Whole-body examination was negative. Finally, based on ischemic brain SPECT images, spinal fluid findings and nerve biopsy results, peripheral neuropathy accompanied with multiple cranial nerve palsy was diagnosed.

  16. Optical coherence tomography of the rat cavernous nerves

    Science.gov (United States)

    Fried, Nathaniel M.; Rais-Bahrami, Soroush; Lagoda, Gwen A.; Chuang, Ying; Burnett, Arthur L.; Su, Li-Ming

    2007-02-01

    Improvements in identification, imaging, and visualization of the cavernous nerves during radical prostatectomy, which are responsible for erectile function, may improve nerve preservation and postoperative potency. Optical coherence tomography (OCT) is capable of real-time, high-resolution, cross-sectional, in vivo tissue imaging. The rat prostate serves as an excellent model for studying the use of OCT for imaging the cavernous nerves, as the rat cavernous nerve is a large, visible, and distinct bundle allowing for easy identification with OCT in addition to histologic confirmation. Imaging was performed with the Niris OCT system and a handheld 8 Fr probe, capable of acquiring real-time images with 11-μm axial and 25-μm lateral resolution in tissue. Open surgical exposure of the prostate was performed on a total of 6 male rats, and OCT images of the prostate, cavernous nerve, pelvic plexus ganglion, seminal vesicle, blood vessels, and periprostatic fat were acquired. Cavernous nerve electrical stimulation with simultaneous intracorporeal pressure measurements was performed to confirm proper identification of the cavernous nerves. The prostate and cavernous nerves were also processed for histologic analysis and further confirmation. Cross-sectional and longitudinal OCT images of the cavernous nerves were acquired and compared with histologic sections. The cavernous nerve and ganglion could be differentiated from the surrounding prostate gland, seminal vesicle, blood vessels, bladder, and fatty tissue. We report preliminary results of OCT images of the rat cavernous nerves with histologic correlation and erectile stimulation measurements, thus providing interpretation of prostate structures as they appear in OCT images.

  17. Towards a thermodynamic theory of nerve pulse propagation.

    Science.gov (United States)

    Andersen, Søren S L; Jackson, Andrew D; Heimburg, Thomas

    2009-06-01

    Nerve membranes consist of an approximately equal mixture of lipids and proteins. The propagation of nerve pulses is usually described with the ionic hypothesis, also known as the Hodgkin-Huxley model. This model assumes that proteins alone enable nerves to conduct signals due to the ability of various ion channel proteins to transport selectively sodium and potassium ions. While the ionic hypothesis describes electrical aspects of the action potential, it does not provide a theoretical framework for understanding other experimentally observed phenomena associated with nerve pulse propagation. This fact has led to a revised view of the action potential based on the laws of thermodynamics and the assumption that membrane lipids play a fundamental role in the propagation of nerve pulses. In general terms, we describe how pulses propagating in nerve membranes resemble propagating sound waves. We explain how the language of thermodynamics enables us to account for a number of phenomena not addressed by the ionic hypothesis. These include a thermodynamic explanation of the effect of anesthetics, the induction of action potentials by local nerve cooling, the physical expansion of nerves during pulse propagation, reversible heat production and the absence of net heat release during the action potential. We describe how these measurable features of a propagating nerve pulse, as well as the observed voltage change that accompanies an action potential, represent different aspects of a single phenomenon that can be predicted and explained by thermodynamics. We suggest that the proteins and lipids of the nerve membrane naturally constitute a single ensemble with thermodynamic properties appropriate for the description of a broad range of phenomena associated with a propagating nerve pulse.

  18. Polymer scaffolds with preferential parallel grooves enhance nerve regeneration.

    Science.gov (United States)

    Mobasseri, Atefeh; Faroni, Alessandro; Minogue, Ben M; Downes, Sandra; Terenghi, Giorgio; Reid, Adam J

    2015-03-01

    We have modified the surface topography of poly ɛ-caprolactone (PCL) and polylactic acid (PLA) blended films to improve cell proliferation and to guide the regeneration of peripheral nerves. Films with differing shaped grooves were made using patterned silicon templates, sloped walls (SL), V-shaped (V), and square-shaped (SQ), and compared with nongrooved surfaces with micropits. The solvent cast films were tested in vitro using adult adipose-derived stem cells differentiated to Schwann cell-like cells. Cell attachment, proliferation, and cell orientation were all improved on the grooved surfaces, with SL grooves giving the best results. We present in vivo data on Sprague-Dawley rat sciatic nerve injury with a 10-mm gap, evaluating nerve regeneration at 3 weeks across a polymer nerve conduit modified with intraluminal grooves (SL, V, and SQ) and differing wall thicknesses (70, 100, 120, and 210 μm). The SL-grooved nerve conduit showed a significant improvement over the other topographical-shaped grooves, while increasing the conduit wall thickness saw no positive effect on the biological response of the regenerating nerve. Furthermore, the preferred SL-grooved conduit (C) with 70 μm wall thickness was compared with the current clinical gold standard of autologous nerve graft (Ag) in the rat 10-mm sciatic nerve gap model. At 3 weeks postsurgery, all nerve gaps across both groups were bridged with regenerated nerve fibers. At 16 weeks, features of regenerated axons were comparable between the autograft (Ag) and conduit (C) groups. End organ assessments of muscle weight, electromyography, and skin reinnervation were also similar between the groups. The comparable experimental outcome between conduit and autograft, suggests that the PCL/PLA conduit with inner lumen microstructured grooves could be used as a potential alternative treatment for peripheral nerve repair.

  19. Nerve growth factor interactions with mast cells.

    Science.gov (United States)

    Kritas, S K; Caraffa, A; Antinolfi, P; Saggini, A; Pantalone, A; Rosati, M; Tei, M; Speziali, A; Saggini, R; Pandolfi, F; Cerulli, G; Conti, P

    2014-01-01

    Neuropeptides are involved in neurogenic inflammation where there is vasodilation and plasma protein extravasion in response to this stimulus. Nerve growth factor (NGF), identified by Rita Levi Montalcini, is a neurotrophin family compound which is important for survival of nociceptive neurons during their development. Therefore, NGF is an important neuropeptide which mediates the development and functions of the central and peripheral nervous system. It also exerts its proinflammatory action, not only on mast cells but also in B and T cells, neutrophils and eosinophils. Human mast cells can be activated by neuropeptides to release potent mediators of inflammation, and they are found throughout the body, especially near blood vessels, epithelial tissue and nerves. Mast cells generate and release NGF after degranulation and they are involved in iperalgesia, neuroimmune interactions and tissue inflammation. NGF is also a potent degranulation factor for mast cells in vitro and in vivo, promoting differentiation and maturation of these cells and their precursor, acting as a co-factor with interleukin-3. In conclusion, these studies are focused on cross-talk between neuropeptide NGF and inflammatory mast cells.

  20. Automatic morphometry of nerve histological sections.

    Science.gov (United States)

    Romero, E; Cuisenaire, O; Denef, J F; Delbeke, J; Macq, B; Veraart, C

    2000-04-15

    A method for the automatic segmentation, recognition and measurement of neuronal myelinated fibers in nerve histological sections is presented. In this method, the fiber parameters i.e. perimeter, area, position of the fiber and myelin sheath thickness are automatically computed. Obliquity of the sections may be taken into account. First, the image is thresholded to provide a coarse classification between myelin and non-myelin pixels. Next, the resulting binary image is further simplified using connected morphological operators. By applying semantic rules to the zonal graph axon candidates are identified. Those are either isolated or still connected. Then, separation of connected fibers is performed by evaluating myelin sheath thickness around each candidate area with an Euclidean distance transformation. Finally, properties of each detected fiber are computed and false positives are removed. The accuracy of the method is assessed by evaluating missed detection, false positive ratio and comparing the results to the manual procedure with sampling. In the evaluated nerve surface, a 0.9% of false positives was found, along with 6.36% of missed detections. The resulting histograms show strong correlation with those obtained by manual measure. The noise introduced by this method is significantly lower than the intrinsic sampling variability. This automatic method constitutes an original tool for morphometrical analysis.