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Sample records for continuous sciatic nerve

  1. Liposomal Bupivacaine Versus Continuous Popliteal Sciatic Nerve Block in Total Ankle Arthroplasty.

    Science.gov (United States)

    Mulligan, Ryan P; Morash, Joel G; DeOrio, James K; Parekh, Selene G

    2017-11-01

    Liposomal bupivacaine (LB) is widely used in joint arthroplasty, but there is little reported on the use of LB in foot and ankle surgery. Continuous popliteal sciatic nerve block (CPSNB) is more commonly used for major foot and ankle reconstructions. The purpose of this study was to compare use of intraoperative LB injection to CPSNB as a regional anesthetic for total ankle arthroplasty (TAA), with attention to postoperative pain scores, narcotic use, and complications. Retrospective review of TAA patients of 2 fellowship-trained orthopedic foot and ankle surgeons was performed. Patients received either preoperative single-shot popliteal sciatic nerve block with 0.2% ropivacaine followed by intraoperative injection of LB or preoperative CPSNB alone. Outcomes examined were visual analog scale (VAS) pain score at 8 hours, 24 hours, 1 week, and 3 weeks following surgery; need for opioid pain medication refill; physician office notification for pain issues or other adverse events; and complications within the first 90 days following surgery. Standard statistical analysis was performed, and P < .05 was considered significant. Seventy-five patients were identified who underwent TAA and met inclusion criteria. Forty-one received LB, and 34 received CPSNB. No statistical difference was seen between groups with regard to complications, emergency department visits, readmissions, reoperations, VAS pain score at any time point, physician office contacts, and narcotic refills. Sixteen of 41 (39%) LB patients had narcotic refills, versus 12 of 34 (35%) CPSNB patients ( P = .81). Two of 41 (5%) LB patients had a complication postoperatively, versus 4 of 34 (12%) CPSNB patients. There were no complications specific to the anesthetic used in either group. This is the first study evaluating the use of LB for total ankle arthroplasty. Liposomal bupivacaine was safe and effective as an option for regional anesthetic and postoperative pain control, with comparable results to CPSNB

  2. MR neurography of sciatic nerve injection injury.

    Science.gov (United States)

    Pham, Mirko; Wessig, Carsten; Brinkhoff, Jörg; Reiners, Karlheinz; Stoll, Guido; Bendszus, Martin

    2011-06-01

    We report on magnetic resonance neurography (MRN) as a supplementary diagnostic tool in sciatic nerve injection injury. The object of the study was to test if T2-weighted (w) contrast within the sciatic nerve serves as an objective criterion for sciatic injection injury. Three patients presented with acute sensory and/or motor complaints in the distribution of the sciatic nerve after dorsogluteal injection and underwent MRN covering gluteal, thigh and knee levels. Native and contrast-enhanced T1-w images were employed to identify the tibial and peroneal division of the sciatic nerve while T2-w images with fat suppression allowed visualization of the site and extent of the nerve lesion. MRN in the two patients with clinically severe sensory and motor impairment correctly depicted sciatic injury: continuity of the T2-w lesion within the nerve at the lesion site and distal to it corresponded well to severe injury confirmed by NCS/EMG as axonotmetic or neurotmetic. Topography of the T2-w lesion on cross-section corresponded to predominant peroneal involvement; moreover, associated denervation patterns of distal target muscles were revealed. One of these patients completely recovered with concomitant complete regression of MRN abnormalities on follow-up. The third patient experienced transient sensory and mild motor impairment with complete recovery after 2 weeks. In this patient, T2-w signal within the nerve and distal target muscles remained normal indicating only mild, non-axonal nerve affliction. Our case series shows that MRN can be very useful in precisely determining the site of sciatic injection injury and may provide diagnostic criteria for the assessment of lesion severity and recovery.

  3. 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.

    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

  4. Blood Bupivacaine Concentrations After a Combined Single-Shot Sciatic Block and a Continuous Femoral Nerve Block in Pediatric Patients: A Prospective Observational Study.

    Science.gov (United States)

    Suresh, Santhanam; De Oliveira, Gildasio S

    2017-05-01

    We evaluated blood bupivacaine concentrations in children having a single-shot sciatic and continuous femoral blocks after anterior cruciate ligament repair. Dried blood spot samples were analyzed for bupivacaine levels at 0, 5, 15, 30, 60, and 120 minutes and 4, 24, and 48 hours. The highest 99% upper confidence interval limit was 135 ng/mL at the 4-hour evaluation point. The 99% upper confidence interval was below potentially toxic levels (1500 ng/mL) across all sampling times. The risk of local anesthetic toxicity in pediatric patients receiving single-shot sciatic and continuous femoral nerve blocks is very low.

  5. A new, lateral, continuous, combined, femoral–sciatic nerve approach via a single skin puncture for postoperative analgesia in intramedullary tibial nail insertion

    Directory of Open Access Journals (Sweden)

    Imbelloni LE

    2013-02-01

    Full Text Available Luiz Eduardo Imbelloni,1,2 Carlos Rava,1,3 Marildo A Gouveia21Faculdade de Medicina Nova Esperança, 2Institute for Regional Anesthesia, 3Complexo Hospitalar de Mangabeira Governador Tarcisio Burity, João Pessoa, BrazilBackground: The prevalence of anterior knee pain following intramedullary tibial nail insertion is high. Continuous peripheral nerve blockade is an alternative method of pain control to opiods. This case illustrates the use of femoral nerve and sciatic nerve peripheral catheters with an elastomeric infusion pump for major intramedullary nailing surgery.Case report: A 36-year-old male with fractures to the left leg bones presented for placement of an intramedullary nail under spinal anesthesia. At the end of the procedure, access to the lateral femoral and sciatic continuous nerve block was achieved by using a stimulator connected to a 110 mm 18G Tuohy needle. Postoperative analgesia was provided with a 40-hour infusion of 0.1% bupivacaine (400 mL at a rate of 10 mL hour-1 with an elastomeric pump. Anesthetic dispersion and contrast were investigated. The analog scale remained with scores below 3 during the 40 hours after surgery, and boluses were not necessary.Conclusion: The use of a femoral and sciatic nerve peripheral catheter offered an alternative to conventional pain control. Continuous femoral–sciatic peripheral blockade via a skin puncture with an infusion of 0.1% bupivacaine with elastomeric pumps is a safe and effective procedure in adults.Keywords: local anesthetic, bupivacaine, continuous peripheral nerve block, orthopedic surgery, tibia, elastomeric pump

  6. Sciatic Nerve Injury Associated with Acetabular Fractures

    OpenAIRE

    Issack, Paul S.; Helfet, David L.

    2008-01-01

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

  7. A rare cause of chronic sciatic pain: Schwannoma of the sciatic nerve.

    Science.gov (United States)

    Rhanim, Abdelkarim; El Zanati, Rachid; Mahfoud, Mustapha; Berrada, Mohammed Saleh; El Yaacoubi, Moradh

    2013-06-01

    Schwannomas are common, benign tumors of the shelth of peripheral nerves. Sciatic schwannomas are rare. Their symptomatology usually mimics sciatic pain due to a herniated disc, which can delay the diagnosis. If there is no lumbar pain and lumbar MRI is normal, the sciatic nerve must be clinically and radiologically examined all along its course. We report a case of sciatic nerve schwannoma presenting with chronic sciatica which was diagnosed and monitored radiologically for several years before successful surgical resection.

  8. The anatomy of the perineal branch of the sciatic nerve.

    Science.gov (United States)

    Gibbs, Christopher M; Ginsburg, Alexander D; Wilson, Thomas J; Lachman, Nirusha; Hevesi, Mario; Spinner, Robert J; Krych, Aaron J

    2018-04-01

    A "perineal" branch of the sciatic nerve has been visualized during surgery, but there is currently no description of this nerve branch in the literature. Our study investigates the presence and frequency of occurrence of perineal innervation by the sciatic nerve and characterizes its anatomy in the posterior thigh. Fifteen cadavers were obtained for dissection. Descriptive results were recorded and analyzed statistically. Twenty-one sciatic nerves were adequately anatomically preserved. Six sciatic nerves contained a perineal branch. Five sciatic nerves had a branch contributing to the perineal branch of the posterior femoral cutaneous (PFC) nerve. In specimens with adequate anatomical preservation, the perineal branch of the sciatic nerve passed posterior to the ischial tuberosity in three specimens and posterior to the conjoint tendon of the long head of biceps femoris and semitendinosus muscles (conjoint tendon) in one. In specimens in which the perineal branch of the PFC nerve received a contribution from the sciatic nerve, the branch passed posterior to the sacrotuberous ligament in one case and posterior to the conjoint tendon in three. Unilateral nerve anatomy was found to be a poor predictor of contralateral anatomy (Cohen's kappa = 0.06). Our study demonstrates for the first time the presence and frequency of occurrence of the perineal branch of the sciatic nerve and a sciatic contribution to the perineal branch of the PFC nerve. Clinicians should be cognizant of this nerve and its varying anatomy so their practice is better informed. Clin. Anat. 31:357-363, 2018. © 2018 Wiley Periodicals, Inc. © 2018 Wiley Periodicals, Inc.

  9. Bilateral high division of the sciatic nerve: incidence and clinical ...

    African Journals Online (AJOL)

    Results: One out of the twenty-six had the sciatic nerve dividing into its two main branches in the pelvis and the common peroneal passing over the piriformis muscle as it enters the posterior thigh. Conclusion: High division of the sciatic nerve is seen in 3.8% of Nigerians and could predispose to injury during intragluteal ...

  10. Bilateral sciatic nerve injury is a possible iatrogenic complication of ...

    African Journals Online (AJOL)

    Injection-induced sciatic nerve palsy is a major iatrogenic problem which results in disability among children under 6-years-old in the developing countries. It manifests as paresis in the muscles supplied by sciatic nerve distribution associated with a burning pain in the affected extremity. Its sequela is a deformity that limits ...

  11. Successful treatment of Raynaud's syndrome in a lupus patient with continuous bilateral popliteal sciatic nerve blocks: a case report

    Directory of Open Access Journals (Sweden)

    Dao T

    2016-06-01

    Full Text Available Thuan Dao,1 David Amaro-Driedger,2 Jaideep Mehta,1 1Department of Anesthesiology, 2McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA Abstract: Raynaud’s syndrome has been treated medically and invasively, sometimes with regional anesthesia leading up to sympathectomy. We demonstrate that regional anesthesia was in this case a useful technique that can allow some patients to find temporary but significant relief from symptoms of Raynaud's syndrome exacerbation. We present a 43-year-old woman with Raynaud’s syndrome secondary to lupus who was treated with bilateral popliteal nerve block catheters for ischemic pain and necrosis of her feet; this led to almost immediate resolution of her pain and return of color and function of her feet. While medical management should continue to be a front-line treatment for Raynaud’s syndrome, regional anesthesia can be useful in providing rapid dissipation of symptoms and may thus serve as a viable option for short-term management of this syndrome. Keywords: Peripheral nerve block, lupus, ischemic pain, regional anesthesia

  12. Successful treatment of Raynaud's syndrome in a lupus patient with continuous bilateral popliteal sciatic nerve blocks: a case report.

    Science.gov (United States)

    Dao, Thuan; Amaro-Driedger, David; Mehta, Jaideep

    2016-01-01

    Raynaud's syndrome has been treated medically and invasively, sometimes with regional anesthesia leading up to sympathectomy. We demonstrate that regional anesthesia was in this case a useful technique that can allow some patients to find temporary but significant relief from symptoms of Raynaud's syndrome exacerbation. We present a 43-year-old woman with Raynaud's syndrome secondary to lupus who was treated with bilateral popliteal nerve block catheters for ischemic pain and necrosis of her feet; this led to almost immediate resolution of her pain and return of color and function of her feet. While medical management should continue to be a front-line treatment for Raynaud's syndrome, regional anesthesia can be useful in providing rapid dissipation of symptoms and may thus serve as a viable option for short-term management of this syndrome.

  13. Sciatic nerve injury caused by a stretching exercise in a trained dancer.

    Science.gov (United States)

    Shim, Ho Yong; Lim, Oh Kyung; Bae, Keun Hwan; Park, Seok Min; Lee, Ju Kang; Park, Ki Deok

    2013-12-01

    Sciatic nerve injury after stretching exercise is uncommon. We report a case of an 18-year-old female trained dancer who developed sciatic neuropathy primarily involving the tibial division after routine stretching exercise. The patient presented with dysesthesia and weakness of the right foot during dorsiflexion and plantarflexion. The mechanism of sciatic nerve injury could be thought as hyperstretching alone, not caused by both hyperstretching and compression. Electrodiagnostic tests and magnetic resonance imaging revealed evidence of the right sciatic neuropathy from the gluteal fold to the distal tibial area, and partial tear of the left hamstring origin and fluid collection between the left hamstring and ischium without left sciatic nerve injury. Recovery of motor weakness was obtained by continuous rehabilitation therapy and some evidence of axonal regeneration was obtained by follow-up electrodiagnostic testing performed at 3, 5, and 12 months after injury.

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

    OpenAIRE

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

    2015-01-01

    Bacterial melanin, obtained from the mutant strain of Bacillus 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...

  15. A RARE BIFURCATION PATTERN OF THE SCIATIC NERVE

    African Journals Online (AJOL)

    Emran

    2017-08-17

    Aug 17, 2017 ... In the course of dissection, an anomaly was noticed in the right lower limb. Two nerves, as opposed to a single sciatic nerve, were observed along the entire length of the posterior thigh (Figure 1). The nerves were followed proximally into the gluteal region, where the common fibular nerve was seen to be ...

  16. Correlative CT and anatomic study of the sciatic nerve

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    Pech, P.; Haughton, V.

    1985-05-01

    Sciatica can be caused by numerous processes affecting the sciatic nerve or its components within the pelvis including tumors, infectious diseases, aneurysms, fractures, and endometriosis. The CT diagnosis of these causes of sciatica has not been emphasized. This study identified the course and appearance of the normal sciatic nerve in the pelvis by correlating CT and anatomic slices in cadavers. For purposes of discussion, the sciatic nerve complex is conveniently divided into three parts: presacral, muscular, and ischial. Each part is illustrated here by two cryosections with corresponding CT images.

  17. Anatomical basis for sciatic nerve block at the knee level.

    Science.gov (United States)

    Barbosa, Fabiano Timbó; Barbosa, Tatiana Rosa Bezerra Wanderley; da Cunha, Rafael Martins; Rodrigues, Amanda Karine Barros; Ramos, Fernando Wagner da Silva; de Sousa-Rodrigues, Célio Fernando

    2015-01-01

    Recently, administration of sciatic nerve block has been revised due to the potential benefit for postoperative analgesia and patient satisfaction after the advent of ultrasound. The aim of this study was to describe the anatomical relations of the sciatic nerve in the popliteal fossa to determine the optimal distance the needle must be positioned in order to realize the sciatic nerve block anterior to its bifurcation into the tibial and common fibular nerve. The study was conducted by dissection of human cadavers' popliteal fossa, fixed in 10% formalin, from the Laboratory of Human Anatomy and Morphology Departments of the Universidade Federal de Alagoas and Universidade de Ciências da Saúde de Alagoas. Access to the sciatic nerve was obtained. 44 popliteal fossa were analyzed. The bifurcation of the sciatic nerve in relation to the apex of the fossa was observed. There was bifurcation in: 67.96% below the apex, 15.90% above the apex, 11.36% near the apex, and 4.78% in the gluteal region. The sciatic nerve bifurcation to its branches occurs at various levels, and the chance to succeed when the needle is placed between 5 and 7 cm above the popliteal is 95.22%. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  18. [Anatomical basis for sciatic nerve block at the knee level].

    Science.gov (United States)

    Barbosa, Fabiano Timbó; Barbosa, Tatiana Rosa Bezerra Wanderley; Cunha, Rafael Martins da; Rodrigues, Amanda Karine Barros; Ramos, Fernando Wagner da Silva; Sousa-Rodrigues, Célio Fernando de

    2015-01-01

    Recently, administration of sciatic nerve block has been revised due to the potential benefit for postoperative analgesia and patient satisfaction after the advent of ultrasound. The aim of this study was to describe the anatomical relations of the sciatic nerve in the popliteal fossa to determine the optimal distance the needle must be positioned in order to realize the sciatic nerve block anterior to its bifurcation into the tibial and common fibular nerve. The study was conducted by dissection of human cadavers' popliteal fossa, fixed in 10% formalin, from the Laboratory of Human Anatomy and Morphology Departments of the Universidade Federal de Alagoas and Universidade de Ciências da Saúde de Alagoas. Access to the sciatic nerve was obtained. 44 popliteal fossa were analyzed. The bifurcation of the sciatic nerve in relation to the apex of the fossa was observed. There was bifurcation in: 67.96% below the apex, 15.90% above the apex, 11.36% near the apex, and 4.78% in the gluteal region. The sciatic nerve bifurcation to its branches occurs at various levels, and the chance to succeed when the needle is placed between 5 and 7 cm above the popliteal is 95.22%. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  19. Multivesicular liposomal bupivacaine at the sciatic nerve

    Science.gov (United States)

    McAlvin, J. Brian; Padera, Robert F.; Shankarappa, Sahadev A.; Reznor, Gally; Kwon, Albert H.; Chiang, Homer; Yang, Jason; Kohane, Daniel S.

    2014-01-01

    Clinical translation of sustained release formulations for local anesthetics has been limited by adverse tissue reaction. Exparel™ (DepoFoam bupivacaine) is a new liposomal local anesthetic formulation whose biocompatibility near nerve tissue is not well characterized. Exparel™ injection caused sciatic nerve blockade in rats lasting 240 minutes compared to 120 minutes for 0.5% (w/v) bupivacaine HCl and 210 minutes for 1.31% (w/v) bupivacaine HCl (same bupivacaine content as Exparel™). On histologic sections four days after injection, median inflammation scores in the Exparel™ group (2.5 of 4) were slightly higher than in groups treated with bupivacaine solutions (score 2). Myotoxicity scores in the Exparel™ group (2.5 of 6) were similar to in the 0.5% (w/v) bupivacaine HCl group (3), but significantly less than in the 1.31% (w/v) bupivacaine HCl group (5). After two weeks, inflammation from Exparel™ (score 2 of 6) was greater than from 0.5% (w/v) bupivacaine HCl (1) and similar to that from 1.31% (w/v) bupivacaine HCl (1). Myotoxicity in all three groups was not statistically significantly different. No neurotoxicity was detected in any group. Tissue reaction to Exparel™ was similar to that of 0.5% (w/v) bupivacaine HCl. Surveillance for local tissue injury will be important during future clinical evaluation. PMID:24612918

  20. A rare bifurcation pattern of the sciatic nerve | Huq | Anatomy Journal ...

    African Journals Online (AJOL)

    Variations in branching patterns of the sciatic nerve are thought to be clinically significant because of the nerve's extensive distribution area. Here we report a rare and unusual branching pattern of the sciatic nerve which was observed in a male cadaver. Sciatic nerve underwent a high division inside the pelvic cavity, and ...

  1. Sciatic nerve tumor and tumor-like lesions - uncommon pathologies

    Energy Technology Data Exchange (ETDEWEB)

    Wadhwa, Vibhor; Thakkar, Rashmi S.; Carrino, John A.; Chhabra, Avneesh [Johns Hopkins University School of Medicine, Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States); Maragakis, Nicholas; Hoeke, Ahmet; Sumner, Charlotte J.; Lloyd, Thomas E. [Johns Hopkins University School of Medicine, Department of Neurology, Baltimore, MD (United States); Belzberg, Allan J. [Johns Hopkins University School of Medicine, Department of Neurosurgery, Baltimore, MD (United States)

    2012-07-15

    Sciatic nerve mass-like enlargement caused by peripheral nerve sheath tumors or neurocutaneous syndromes such as neurofibromatosis or schwannomatosis has been widely reported. Other causes of enlargement, such as from perineuroma, fibromatosis, neurolymphoma, amyloidosis, endometriosis, intraneural ganglion cyst, Charcot-Marie-Tooth disease, and chronic inflammatory demyelinating polyneuropathy are relatively rare. High-resolution magnetic resonance imaging (MRI) is an excellent non-invasive tool for the evaluation of such lesions. In this article, the authors discuss normal anatomy of the sciatic nerve and MRI findings of the above-mentioned lesions. (orig.)

  2. Sciatic nerve tumor and tumor-like lesions - uncommon pathologies

    International Nuclear Information System (INIS)

    Wadhwa, Vibhor; Thakkar, Rashmi S.; Carrino, John A.; Chhabra, Avneesh; Maragakis, Nicholas; Hoeke, Ahmet; Sumner, Charlotte J.; Lloyd, Thomas E.; Belzberg, Allan J.

    2012-01-01

    Sciatic nerve mass-like enlargement caused by peripheral nerve sheath tumors or neurocutaneous syndromes such as neurofibromatosis or schwannomatosis has been widely reported. Other causes of enlargement, such as from perineuroma, fibromatosis, neurolymphoma, amyloidosis, endometriosis, intraneural ganglion cyst, Charcot-Marie-Tooth disease, and chronic inflammatory demyelinating polyneuropathy are relatively rare. High-resolution magnetic resonance imaging (MRI) is an excellent non-invasive tool for the evaluation of such lesions. In this article, the authors discuss normal anatomy of the sciatic nerve and MRI findings of the above-mentioned lesions. (orig.)

  3. Injection inside the paraneural sheath of the sciatic nerve

    DEFF Research Database (Denmark)

    Andersen, Henning Lykke; Andersen, Sofie L; Tranum-Jensen, Jørgen

    2012-01-01

    There exists little anatomic knowledge regarding the structure and sonographic features of the sheath enveloping the sciatic nerve in the popliteal fossa. We investigated the spread of an injection inside the sheath to (1) determine whether the sheath is a structure distinct from the nerve or par...

  4. The Histological Effects of Ozone Therapy on Sciatic Nerve Crush Injury in Rats.

    Science.gov (United States)

    Somay, Hakan; Emon, Selin Tural; Uslu, Serap; Orakdogen, Metin; Meric, Zeynep Cingu; Ince, Umit; Hakan, Tayfun

    2017-09-01

    Peripheral nerve injury is a common, important problem that lacks a definitive, effective treatment. It can cause neurologic deficits ranging from paresthesia to paralysis. This study evaluated the effect of ozone therapy on sciatic nerve crush injury in rats. Twenty-four male rats were divided into control sham surgery, sciatic nerve injury, and sciatic nerve injury with ozone groups (each n = 8). The sciatic nerve injury was inflicted via De Koning's crush-force method. The sciatic nerve injury group received medical air and the sciatic nerve injury ozone group received 0.7 mg/kg ozone. Sciatic nerve samples were obtained 4 weeks after injury. Vascular congestion, vacuolization, edema formation, S100 expression, and the thicknesses of the perineurium and endoneurium and diameter of the injured sciatic nerves were evaluated. The diameter of the sciatic nerve and thicknesses of the perineurium and epineurium were significantly greater in the sciatic nerve injury group (P ozone group (P ozone group (P Ozone therapy improved sciatic nerve injury recovery without causing an increase in fibrotic tissue. Ozone reduced fibrosis, vascular congestion, vacuolization, and edema in rodents. Ozone treatment might be used to assist in sciatic nerve injury. Copyright © 2017 Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Xing-long Cheng

    2015-01-01

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

  6. External iliac artery thrombus masquerading as sciatic nerve palsy in anterior column fracture of the acetabulum

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    Narender Kumar Magu

    2015-01-01

    Full Text Available We report a case of ischemic neuropathy of the sciatic nerve in a patient with an anterior column fracture of the acetabulum operated by ilioinguinal approach. It resulted from occlusion of the blood supply to the sciatic nerve. There were no signs of a vascular insult until ischemic changes ensued on the 6 th postoperative day on the lateral part of great toe. The patient underwent crossover femoro-femoral bypass grafting and there was a complete reversal of the ischemic changes at 6 months. The sciatic nerve palsy continued to recover until the end of 1 year; by which time the only deficit was a Grade 4 power in the extensor hallucis longus (EHL and the extensor digitorum longus (EDL. There was no further recovery at 2 years followup.

  7. Solitary schwannoma of sciatic nerve. Diagnosis by CT

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    Sato, M.; Handa, J. (Shiga Univ. of Medical Science, Ohtsu, Shiga (Japan)); Koyama, T.

    1982-05-01

    A solitary schwannoma of the peripheral nerve may arise sporadically in patients who have no evidence of a genetic predetermination of von Recklinghausen's disease. In the leg, schwannomas usually appear on the flexor aspect, especially near the elbow, wrist and knee, and the feet are usually spared. A solitary schwannoma of the sciatic nerve is very rare as a case of a sciatic pain, and the CT diagnosis of such a lesion has not been previously reported. In the present case, the deeply situated, small lesion was clearly delineated with high resolution CT.

  8. Balance and coordination training after sciatic nerve injury.

    Science.gov (United States)

    Bonetti, Leandro Viçosa; Korb, Arthiese; Da Silva, Sandro Antunes; Ilha, Jocemar; Marcuzzo, Simone; Achaval, Matilde; Faccioni-Heuser, Maria Cristina

    2011-07-01

    Numerous therapeutic interventions have been tested to enhance functional recovery after peripheral nerve injuries. After sciatic nerve crush in rats we tested balance and coordination and motor control training in sensorimotor tests and analyzed nerve and muscle histology. The balance and coordination training group and the sham group had better results than the sedentary and motor control groups in sensorimotor tests. The sham and balance and coordination groups had a significantly larger muscle area than the other groups, and the balance and coordination group showed significantly better values than the sedentary and motor control groups for average myelin sheath thickness and g-ratio of the distal portion of the nerve. The findings indicate that balance and coordination training improves sciatic nerve regeneration, suggesting that it is possible to revert and/or prevent soleus muscle atrophy and improve performance on sensorimotor tests. Copyright © 2011 Wiley Periodicals, Inc.

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

    OpenAIRE

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

    2013-01-01

    It is well known that peripheral nerve injury should be treated immediately in the clinic, but in some instances, repair can be delayed. This study investigated the effects of immediate versus delayed (3 days after injury) neurorrhaphy on repair of transected sciatic nerve in New Zealand rabbits using stereological, histomorphological and biomechanical methods. At 8 weeks after immediate and delayed neurorrhaphy, axon number and area in the sciatic nerve, myelin sheath and epineurium thicknes...

  10. The functional results of acute nerve grafting in traumatic sciatic nerve injuries.

    Science.gov (United States)

    Vayvada, Haluk; Demirdöver, Cenk; Menderes, Adnan; Yılmaz, Mustafa; Karaca, Can

    2013-03-01

    The sciatic and peroneal nerves are the most frequently injured in lower extremities, followed by tibial and femoral nerves. The aim of this study is to evaluate the functional results of acute nerve grafting in traumatic sciatic nerve injuries. A total of 9 patients with sciatic nerve defect were treated with primary nerve grafting. The mean age was 31.7 years. The etiologic factors were gunshot wounds, traffic accident, and penetrating trauma. All of the patients had sciatic nerve defects ranging from 3.4 to 13.6 cm. The follow-up period ranged between 25 and 84 months. The tibial nerve motor function was "good" or "very good" (M3-M4) in 5 patients (55.6%). The plantar flexion was not sufficient for the rest of the patients. The peroneal nerve motor function was also "good" and "very good" in 3 patients (33.3%). The functional results of the acute nerve grafting of the sciatic nerve within the first week after the injury are poorer than reported in the related literature. This protocol should only be applied to select patients who have adequate soft tissue coverage and healthy nerve endings.

  11. Toe out angle : a functional index for the evaluation of sciatic nerve recovery in the rat model

    NARCIS (Netherlands)

    Varejao, ASP; Cabrita, AM; Geuna, S; Melo-Pinto, P; Filipe, VM; Gramsbergen, A; Meek, MF

    2003-01-01

    In experimental peripheral nerve studies, the rat sciatic nerve model is widely used to examine functional outcome following nerve injury and repair. A variety of evaluation methods exist in the literature, but an adequate selection continues to be a critical point for the researcher. Rats with

  12. Sciatic nerve palsy associated with intramuscular quinine injections ...

    African Journals Online (AJOL)

    Sct?ior ikfeclical O[ficcr. Department of Orthopaeclics, Mulago Hospital, Makerere University, Kampala, Uganda. Key Words: Sciatic nerve palsy, intramuscular injections, children, quinine dil~ydrochloride. The purpose of this paper is to show that, in children, gluteal injection of quinine dihydrochloride (QDH) may result in ...

  13. Sciatic nerve palsy associated with intramuscular quinine injections ...

    African Journals Online (AJOL)

    The purpose of this paper is to show that, in children, gluteal injection of quinine dihydrochloride (QDH) may result in damage to the sciatic nerve. Forty-six children were seen with foot drop following intramuscular injections in the same limb. They were analyzed for the type of injection, injection site, route of injection, the ...

  14. Levels of Bifurcation of the Sciatic Nerve among Ugandans at ...

    African Journals Online (AJOL)

    Eighty adult cadavers were dissected in the gluteal region and posterior thigh to establish the level of bifurcation of the sciatic nerve above the transverse popliteal crease, and the distance from the crease was measured in cm using a caliper calibrated in millimeters. Results: Eighty left lower limbs of 56 male and 24 female ...

  15. Acetabular paralabral cyst causing compression of the sciatic nerve

    Directory of Open Access Journals (Sweden)

    Caoimhe Byrne, MB BCh BAO

    2017-12-01

    Full Text Available Acetabular paralabral cysts are common. They vary in their clinical presentation and may be asymptomatic or cause pain and restriction at the hip joint. In rare instances they may cause symptoms by compressing local neurovascular structures. We report a case of symptomatic compression of the sciatic nerve by a posteriorly displaced acetabular paralabral cyst.

  16. Effects of ozone on sciatic nerve in rat.

    Science.gov (United States)

    Lin, Q; Chen, H; Lu, C; Wang, B; Zhang, Y; He, X; Yu, B

    2011-09-01

    This study evaluated the influence of ozone on rat sciatic nerve structure and function. Thirty Wistar rats were randomly divided into six groups (n = 5). In groups I to IV, 1ml of ozone (O(3)) 10 μg/ml, 30 μg/ml, 50 μg/ml, 8 0 μg/ml was injected at the junction of gluteus maximus margin and lateral edge of the long head of biceps femoris respectively, in group V, 1 ml of pure O(2) was injected at the same point, and group V had puncture without any injection. Ozone was manufactured by an ozone generator (Ozone Line Co, Italy). The rats were investigated by both gross measurement and behavioral changes. One day, one week and three weeks after injection, rat hindlimb footprints were measured and the sciatic nerve function index (SFI) was calculated, and after three weeks, all right sciatic nerves were exposed under anesthesia. Near neural stimulation of the rat sciatic nerve was calculated and nerve conduction velocity, latency and maximum amplitude recorded. Animals were sacrificed for pathology, and ipsilateral triceps surae were taken for wet weight. No serious behavioral abnormalities were observed in any animal. SFI comparison in the various times and various groups showed no significant differences (pozone concentrations from 10 μg/ml to 80 μg/ml injected around rat's peripheral nerve will not cause serious sequelae or serious damage to the structure and function of peripheral nerve. This finding provides evidence of the safety of ozone injected around the peripheral nerve.

  17. Intraneural perineurioma of the sciatic nerve in early childhood

    DEFF Research Database (Denmark)

    Østergaard, John R; Smith, Torben; Stausbøl-Grøn, Brian

    2009-01-01

    Intraneural perineurioma is an uncommon benign neoplasm characterized by focal perineural cell proliferation. The typical course is indolent, with gradual onset and slow progression of motor loss. In early childhood, uncertainty concerning the time of onset can lead to difficulty in distinguishing...... this potential treatable lesion from congenital and other causes of nerve palsy. In the present case, clinical presentation, electrophysiologic findings, and magnetic resonance imaging findings in a child were compatible with intraneural perineurioma of the lumbosacral trunk and sciatic nerve. Initially...

  18. Sonographic evaluation of sciatic nerves in patients with unilateral sciatica.

    Science.gov (United States)

    Kara, Murat; Özçakar, Levent; Tiftik, Tülay; Kaymak, Bayram; Özel, Sumru; Akkuş, Selami; Akinci, Ayşen

    2012-09-01

    To evaluate the sciatic nerves of patients with unilateral sciatica by using an ultrasound, and to determine whether ultrasonographic findings were related to clinical and electrophysiologic parameters. Cross-sectional study. Physical medicine and rehabilitation departments of a university hospital and a rehabilitation hospital. Consecutive patients (N=30; 10 men, 20 women) with complaints of low back pain and unilateral sciatica of more than 1 month of duration were enrolled. Not applicable. All patients underwent a substantial clinical assessment, and they were also evaluated by electromyogram and magnetic resonance imaging. Pain was evaluated by a visual analog scale and the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) Scale. A linear array probe (7.5-12MHz) was used to scan sciatic nerves bilaterally in the prone position. Sciatic nerve diameters-thickness (short axis) and width (long axis)-and cross-sectional areas were measured bilaterally at the same levels, proximal to the bifurcation and midthigh. The values pertaining to the unaffected limbs were taken as controls. When compared with the unaffected sides, mean values for sciatic nerve measurements-long axis at bifurcation level (P=.017) and cross-sectional area at midthigh level (P=.005)-were significantly larger on the affected sides. Swelling ratios negatively correlated with symptom duration (r=-.394, P=.038) and LANSS scores (r=-.451, P=.016) at only midthigh level. Sciatic nerves seem to be enlarged on the side of sciatica in patients with low back pain. Our preliminary results may provide insight into better understanding the lower limb radiating pain in this group of patients. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  19. Changes in contralateral protein metabolism following unilateral sciatic nerve section

    Energy Technology Data Exchange (ETDEWEB)

    Menendez, J.A.; Cubas, S.C.

    1990-03-01

    Changes in nerve biochemistry, anatomy, and function following injuries to the contralateral nerve have been repeatedly reported, though their significance is unknown. The most likely mechanisms for their development are either substances carried by axoplasmic flow or electrically transmitted signals. This study analyzes which mechanism underlies the development of a contralateral change in protein metabolism. The incorporation of labelled amino acids (AA) into proteins of both sciatic nerves was assessed by liquid scintillation after an unilateral section. AA were offered locally for 30 min to the distal stump of the sectioned nerves and at homologous levels of the intact contralateral nerves. At various times, from 1 to 24 h, both sciatic nerves were removed and the proteins extracted with trichloroacetic acid (TCA). An increase in incorporation was found in both nerves 14-24 h after section. No difference existed between sectioned and intact nerves, which is consistent with the contralateral effect. Lidocaine, but not colchicine, when applied previously to the nerves midway between the sectioning site and the spinal cord, inhibited the contralateral increase in AA incorporation. It is concluded that electrical signals, crossing through the spinal cord, are responsible for the development of the contralateral effect. Both the nature of the proteins and the significance of the contralateral effect are matters for speculation.

  20. Guinea pigs as an animal model for sciatic nerve injury

    Directory of Open Access Journals (Sweden)

    Malik Abu Rafee

    2017-01-01

    Full Text Available The overwhelming use of rat models in nerve regeneration studies is likely to induce skewness in treatment outcomes. To address the problem, this study was conducted in 8 adult guinea pigs of either sex to investigate the suitability of guinea pig as an alternative model for nerve regeneration studies. A crush injury was inflicted to the sciatic nerve of the left limb, which led to significant decrease in the pain perception and neurorecovery up to the 4th weak. Lengthening of foot print and shortening of toe spread were observed in the paw after nerve injury. A 3.49 ± 0.35 fold increase in expression of neuropilin 1 (NRP1 gene and 2.09 ± 0.51 fold increase in neuropilin 2 (NRP2 gene were recorded 1 week after nerve injury as compared to the normal nerve. Ratios of gastrocnemius muscle weight and volume of the experimental limb to control limb showed more than 50% decrease on the 30th day. Histopathologically, vacuolated appearance of the nerve was observed with presence of degenerated myelin debris in digestion chambers. Gastrocnemius muscle also showed degenerative changes. Scanning electron microscopy revealed loose and rough arrangement of connective tissue fibrils and presence of large spherical globules in crushed sciatic nerve. The findings suggest that guinea pigs could be used as an alternative animal model for nerve regeneration studies and might be preferred over rats due to their cooperative nature while recording different parameters.

  1. 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

  2. Sciatic Nerve Injury After Proximal Hamstring Avulsion and Repair

    Science.gov (United States)

    Wilson, Thomas J.; Spinner, Robert J.; Mohan, Rohith; Gibbs, Christopher M.; Krych, Aaron J.

    2017-01-01

    Background: Muscle bellies of the hamstring muscles are intimately associated with the sciatic nerve, putting the sciatic nerve at risk of injury associated with proximal hamstring avulsion. There are few data informing the magnitude of this risk, identifying risk factors for neurologic injury, or determining neurologic outcomes in patients with distal sciatic symptoms after surgery. Purpose: To characterize the frequency and nature of sciatic nerve injury and distal sciatic nerve–related symptoms after proximal hamstring avulsion and to characterize the influence of surgery on these symptoms. Study Design: Cohort study; Level of evidence, 3. Methods: This was a retrospective review of patients with proximal partial or complete hamstring avulsion. The outcome of interest was neurologic symptoms referable to the sciatic nerve distribution below the knee. Neurologic symptoms in operative patients were compared pre- and postoperatively. Results: The cohort consisted of 162 patients: 67 (41.4%) operative and 95 (58.6%) nonoperative. Sciatic nerve–related symptoms were present in 22 operative and 23 nonoperative patients, for a total of 45 (27.8%) patients (8 [4.9%] motor deficits, 11 [6.8%] sensory deficits, and 36 [22.2%] with neuropathic pain). Among the operative cohort, 3 of 3 (100.0%) patients showed improvement in their motor deficit postoperatively, 3 of 4 (75.0%) patients’ sensory symptoms improved, and 17 of 19 (89.5%) patients had improvement in pain. A new or worsening deficit occurred in 5 (7.5%) patients postoperatively (2 [3.1%] motor deficits, 1 [1.5%] sensory deficit, and 3 [4.5%] with new pain). Predictors of operative intervention included lower age (odds ratio [OR], 0.952; 95% CI, 0.921-0.982; P = .001) and complete avulsion (OR, 10.292; 95% CI, 2.526-72.232; P hamstring avulsion are underrecognized. Currently, neurologic symptoms are not considered when determining whether to pursue operative intervention. Given the high likelihood of

  3. Non-formation of the main trunk of the sciatic nerve and unusual relationships to the piriformis muscle

    Directory of Open Access Journals (Sweden)

    J. Stoyanov

    2017-09-01

    Full Text Available Background: The sciatic nerve is the largest branch of the sacral plexus. Variations of its origin, exit from the pelvis, emergence and branching in the posterior region of the thigh, especially in regards to the piriformis muscle, are an object of interest due to the possibility to be involved in the pathogenensis of clinically significant non-discogenic sciatica or piriformis syndrome. Case report: We present a case of variant anatomy of the sciatic nerve, discovered during routine dissection of the left gluteal region of an adult female cadaver. We observed a non-formation of the main trunk of the nerve; rather, the tibial nerve passed inferiorly to the piriformis muscle, while the common peroneal nerve went through the body of the bifid piriformis muscle, immediately next to its tendon. The two branches continued their course in the thigh without joining and forming a proper sciatic nerve. The medical records of the body donor did not reveal any neurological impairment which could be linked to this anatomical peculiarity. Conclusion: The anatomy of the sciatic nerve could be considered to be a factor of clinical significance. The high prevalence of similar anatomical variations should be kept in mind during the diagnostic process of clinical entities involving the sciatic nerve.

  4. Immune cell distribution and immunoglobulin levels change following sciatic nerve injury in a rat model

    Directory of Open Access Journals (Sweden)

    Wei Yuan

    2016-07-01

    Full Text Available Objective(s: To investigate the systemic and local immune status of two surgical rat models of sciatic nerve injury, a crushed sciatic nerve, and a sciatic nerve transection Materials and Methods:Twenty-four adult male Sprague-Dawley rats were randomly divided into three groups: sham-operation (control group, sciatic nerve crush, and sciatic nerve transaction. Sciatic nerve surgery was performed. The percentage of CD4+ cells and the CD4+/CD8+ratio were determined by flow cytometry. Serum IgM and IgG levels were analyzed by ELISA. T-cells (CD3 and macrophages (CD68 in sciatic nerve tissue sections were identified through immunohistochemistry. Results: Compared to sham-operated controls, in rats that underwent nerve injury, the percentage of CD4+ cells and the CD4+/CD8+ ratio in the peripheral blood were significantly  decreased 7 days after surgery, serum IgM levels were increased 14 days after surgery, and serum IgG levels were increased 21 days after surgery. There were a large number of CD3+ cells and a small number of CD68+ cells in sciatic nerve tissue sections 21 days after surgery, indicating T-cell and macrophage activation and infiltration. Local IgG deposition was also detected at the nerve injury site 21 days after surgery. Conclusion: Rat humoral and cellular immune status changed following sciatic nerve injury, particularly with regard to the cellular immune response at the nerve injury site.

  5. Sciatic nerve injuries following femoral shaft fractures: Does the time interval from injury to surgery matter?

    Science.gov (United States)

    Emamhadi, Mohammadreza; Saberi, Alia; Andalib, Sasan

    2016-08-01

    Sciatic nerve injuries following fractures of femoral shaft are uncommon complications. The patients with such deficits present with sciatic nerve palsy. A few cases of sciatic nerve injuries secondary to femoral shaft fractures have thus far been reported. If such patients fail to improve spontaneously, they may require surgical exploration. The present paper gives an account of surgical exploration in patients presenting with sciatic nerve injuries following femoral shaft fractures. Clinical outcomes were assessed in 14 patients undergoing surgical exploration of sciatic nerve injuries following femoral shaft fractures. There was a significant negative correlation between the time interval from injury to surgery and motor function recovery. Furthermore, a negative but non-significant correlation was seen between the time interval from injury to surgery and sensory recovery. Early exploration of sciatic nerve injuries following femoral shaft fractures can be beneficial if the nerve injury does not improve spontaneously. Copyright © 2016 Elsevier B.V. All rights reserved.

  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. 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

  8. Detection and prevalence of variant sciatic nerve anatomy in relation to the piriformis muscle on MRI

    Energy Technology Data Exchange (ETDEWEB)

    Varenika, Vanja; Bucknor, Matthew D. [University of California, San Francisco, Department of Radiology and Biomedical Imaging, San Francisco, CA (United States); Lutz, Amelie M.; Beaulieu, Christopher F. [Stanford University School of Medicine, Department of Radiology, Stanford, CA (United States)

    2017-06-15

    To determine whether known variant anatomical relationships between the sciatic nerve and piriformis muscle can be identified on routine MRI studies of the hip and to establish their imaging prevalence. Hip MRI studies acquired over a period of 4 years at two medical centers underwent retrospective interpretation. Anatomical relationship between the sciatic nerve and the piriformis muscle was categorized according to the Beaton and Anson classification system. The presence of a split sciatic nerve at the level of the ischial tuberosity was also recorded. A total of 755 consecutive scans were reviewed. Conventional anatomy (type I), in which an undivided sciatic nerve passes below the piriformis muscle, was identified in 87% of cases. The remaining 13% of cases demonstrated a type II pattern in which one division of the sciatic nerve passes through the piriformis whereas the second passes below. Only two other instances of variant anatomy were identified (both type III). Most variant cases were associated with a split sciatic nerve at the level of the ischial tuberosity (73 out of 111, 65.8%). By contrast, only 6% of cases demonstrated a split sciatic nerve at this level in the context of otherwise conventional anatomy. Anatomical variations of the sciatic nerve course in relation to the piriformis muscle are frequently identified on routine MRI of the hips, occurring in 12-20% of scans reviewed. Almost all variants identified were type II. The ability to recognize variant sciatic nerve courses on MRI may prove useful in optimal treatment planning. (orig.)

  9. Detection and prevalence of variant sciatic nerve anatomy in relation to the piriformis muscle on MRI.

    Science.gov (United States)

    Varenika, Vanja; Lutz, Amelie M; Beaulieu, Christopher F; Bucknor, Matthew D

    2017-06-01

    To determine whether known variant anatomical relationships between the sciatic nerve and piriformis muscle can be identified on routine MRI studies of the hip and to establish their imaging prevalence. Hip MRI studies acquired over a period of 4 years at two medical centers underwent retrospective interpretation. Anatomical relationship between the sciatic nerve and the piriformis muscle was categorized according to the Beaton and Anson classification system. The presence of a split sciatic nerve at the level of the ischial tuberosity was also recorded. A total of 755 consecutive scans were reviewed. Conventional anatomy (type I), in which an undivided sciatic nerve passes below the piriformis muscle, was identified in 87% of cases. The remaining 13% of cases demonstrated a type II pattern in which one division of the sciatic nerve passes through the piriformis whereas the second passes below. Only two other instances of variant anatomy were identified (both type III). Most variant cases were associated with a split sciatic nerve at the level of the ischial tuberosity (73 out of 111, 65.8%). By contrast, only 6% of cases demonstrated a split sciatic nerve at this level in the context of otherwise conventional anatomy. Anatomical variations of the sciatic nerve course in relation to the piriformis muscle are frequently identified on routine MRI of the hips, occurring in 12-20% of scans reviewed. Almost all variants identified were type II. The ability to recognize variant sciatic nerve courses on MRI may prove useful in optimal treatment planning.

  10. [Postoperative analgesia in knee arthroplasty using an anterior sciatic nerve block and a femoral nerve block].

    Science.gov (United States)

    del Fresno Cañiaveras, J; Campos, A; Galiana, M; Navarro-Martínez, J A; Company, R

    2008-11-01

    To evaluate the efficacy of a nerve block as an alternative technique for analgesia after knee arthroplasty and to indicate the usefulness and advantages of the anterior approach to the sciatic nerve block. Between April 2004 and March 2006, we studied a series of consecutive patients undergoing knee arthroplasty in which a subarachnoid block was used as the anesthetic technique and postoperative analgesia was provided by means of a combined peripheral femoral nerve block and an anterior sciatic nerve block. We evaluated the mean length of time free from pain, quality of analgesia, and length of stay in hospital. Seventy-eight patients were included in the study. The mean (SD) length of time free from pain for the group was 42.1 (3.9) hours. Patients reported mild pain after 34.8 (4.1) hours and moderate to severe pain after 42.4 (3.5) hours. By the third day, 62.8% of patients were able to bend the knee to 90 degrees. There were no complications resulting from the technique and the level of patient satisfaction was high. A combined femoral-sciatic nerve block is effective in knee arthroplasty. It controls postoperative pain and allows for early rehabilitation. The anterior approach to the sciatic nerve is relatively simple to perform without removing the pressure bandaging from the thigh after surgery. This approach also makes it unnecessary to move the patient.

  11. Electrospun nanofiber sheets incorporating methylcobalamin promote nerve regeneration and functional recovery in a rat sciatic nerve crush injury model.

    Science.gov (United States)

    Suzuki, Koji; Tanaka, Hiroyuki; Ebara, Mitsuhiro; Uto, Koichiro; Matsuoka, Hozo; Nishimoto, Shunsuke; Okada, Kiyoshi; Murase, Tsuyoshi; Yoshikawa, Hideki

    2017-04-15

    Peripheral nerve injury is one of common traumas. Although injured peripheral nerves have the capacity to regenerate, axon regeneration proceeds slowly and functional outcomes are often poor. Pharmacological enhancement of regeneration can play an important role in increasing functional recovery. In this study, we developed a novel electrospun nanofiber sheet incorporating methylcobalamin (MeCbl), one of the active forms of vitamin B12 homologues, to deliver it enough locally to the peripheral nerve injury site. We evaluated whether local administration of MeCbl at the nerve injury site was effective in promoting nerve regeneration. Electrospun nanofiber sheets gradually released MeCbl for at least 8weeks when tested in vitro. There was no adverse effect of nanofiber sheets on function in vivo of the peripheral nervous system. Local implantation of nanofiber sheets incorporating MeCbl contributed to the recovery of the motor and sensory function, the recovery of nerve conduction velocity, and the promotion of myelination after sciatic nerve injury, without affecting plasma concentration of MeCbl. Methylcobalamin (MeCbl) is a vitamin B12 analog and we previously reported its effectiveness in axonal outgrowth of neurons and differentiation of Schwann cells both in vitro and in vivo. Here we estimated the effect of local administered MeCbl with an electrospun nanofiber sheet on peripheral nerve injury. Local administration of MeCbl promoted functional recovery in a rat sciatic nerve crush injury model. These sheets are useful for nerve injury in continuity differently from artificial nerve conduits, which are useful only for nerve defects. We believe that the findings of this study are relevant to the scope of your journal and will be of interest to its readership. Copyright © 2017 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

  12. Ultrasound Detection of Arteria Comitans: A Novel Technique to Locate the Sciatic Nerve.

    Science.gov (United States)

    Elsharkawy, Hesham; Kashy, Babak Kateby; Babazade, Rovnat; Gray, Andrew T

    2018-01-01

    In the gluteal and thigh region, the arteria comitans accompanies the sciatic nerve for a short distance, then penetrates the nerve and runs to the lower part of the thigh. There is no study that recognizes this artery as a guide to the location of the sciatic nerve. In this report, we describe a series of 6 knee arthroplasty patients in whom ultrasound-guided sciatic nerve block was successfully performed using color Doppler and pulsed wave Doppler to visualize the arteria comitans as a guide to the location of the sciatic nerve. We have found that detecting the arteria comitans as a landmark is novel and may offer an additional tool with the existing methods for sciatic nerve block.

  13. Measurement of motor nerve conduction velocity of the sciatic nerve in patients with piriformis syndrome: a magnetic stimulation study.

    Science.gov (United States)

    Chang, Chein-Wei; Shieh, Shie-Fu; Li, Chih-Ming; Wu, Wei-Ting; Chang, Kai-Fong

    2006-10-01

    To assess the motor nerve conduction of the sciatic nerve by a magnetic stimulation method in patients with piriformis syndrome. Prospective study. An electrodiagnostic laboratory in a university hospital. Twenty-three patients with piriformis syndrome and 15 healthy persons for control. Not applicable. Motor nerve conduction velocity (MNCV) of the sciatic nerve was measured at the gluteal segment by magnetic stimulation proximally at L5 and S1 roots and distally at sciatic nerve at gluteal fold and recording at the corresponding muscles. Diagnostic sensitivities were measured in the magnetic stimulation method and the conventional nerve conduction, long latency reflex, and needle electromyography studies. The mean MNCV of the sciatic nerve +/- standard deviation at the gluteal segment in L5 component was 55.4+/-7.8 m/s in patients with piriformis syndrome, which was slower than the mean value of 68.1+/-10.3 m/s obtained in healthy controls (P=.014). The MNCV of the sciatic nerve in S1 component showed no significant difference between the patients and controls (P=.062). A negative relation was found between the disease duration and the MNCV values of sciatic nerves in patients with piriformis syndrome (r=-.68, Pmagnetic stimulation is .467. Magnetic nerve stimulation provides a painless, noninvasive, and objective method for evaluation of sciatic nerve function in patients with piriformis syndrome.

  14. Effect of electrical stimulation on motor nerve regeneration in sciatic nerve ligated-mice.

    Science.gov (United States)

    Samiee, Farzaneh; Zarrindast, Mohammad-Reza

    2017-06-27

    The purpose of this study was to investigate the effect of electrical stimulation on sciatic nerve regeneration and functional recovery of target muscles. Mice were randomly divided into 3 groups: ligated without electrical stimulation, ligated with electrical stimulation and control (non-ligated). The unilateral peripheral mononeuropathy was produced on the right hind limb. Sciatic nerve was then electrically stimulated daily for a period of 2 weeks (duration: 0.2 msec, frequency: 100Hz, amplitude: 15mA). Evoked surface EMG was recorded from biceps femoris (BF) and gluteus maximus (GM) muscles on the 3rd, 7th, 10th and 14th day after sciatic nerve ligation. Muscle force and sensitivity was determined by processing of the recorded EMG signals in time and frequency domains respectively. The results showed electrical stimulation (ES) produced a significant increase in the EMG response of BF, and muscle force significantly increased on the 14th day (pelectrical stimulation of sciatic nerve accelerates nerve repair and indirectly improves BF muscle force to a comparable level with control without effect on muscle sensitivity. However, ES had no effect on GM muscle force and sensitivity.

  15. Effects of Ozone on Sciatic Nerve in Rat

    OpenAIRE

    Lin, Q.; Chen, H.; Lu, C.; Wang, B.; Zhang, Y.; He, X.; Yu, B.

    2011-01-01

    This study evaluated the influence of ozone on rat sciatic nerve structure and function. Thirty Wistar rats were randomly divided into six groups (n = 5). In groups I to IV, 1ml of ozone (O3) 10 μg/ml, 30 μg/ml, 50 μg/ml, 8 0μg/ml was injected at the junction of gluteus maximus margin and lateral edge of the long head of biceps femoris respectively, in group V, 1 ml of pure O2 was injected at the same point, and group V had puncture without any injection. Ozone was manufactured by an ozone ge...

  16. Anti-nociceptive effects of taurine and caffeine in sciatic nerve ...

    African Journals Online (AJOL)

    ABSTRACT. In this study, we investigated the effects of co-administration of taurine and caffeine on thermally induced pain in sciatic nerve ligated rats as well as the roles of autonomic receptors. Rats were rendered neuropathic by unilateral sciatic nerve ligation. The anti-hyperalgesic effect of combined systemic (i.p.) ...

  17. Proteomics of the injured rat sciatic nerve reveals protein expression dynamics during regeneration

    NARCIS (Netherlands)

    Jiménez, Connie R; Stam, Floor J; Li, Ka Wan; Gouwenberg, Yvonne; Hornshaw, Martin P; De Winter, Fred; Verhaagen, J.; Smit, August B

    Using proteomics, we investigated the temporal expression profiles of proteins in rat sciatic nerve after experimental crush. Extracts of sciatic nerves collected at 5, 10, and 35 days after injury were analyzed by two-dimensional gel electrophoresis and quantitative image analysis. Of the

  18. Skin temperature measured by infrared thermography after ultrasound-guided blockade of the sciatic nerve

    NARCIS (Netherlands)

    Haren, F.G. van; Kadic, L.; Driessen, J.J.

    2013-01-01

    BACKGROUND: In the present study, we assessed the relationship between subgluteal sciatic nerve blocking and skin temperature by infrared thermography in the lower extremity. We hypothesized that blocking the sciatic nerve will lead to an increase in temperature, and that this will correlate with

  19. Up-regulation of Robo1 in dorsal root ganglia after sciatic nerve ...

    African Journals Online (AJOL)

    Yomi

    2012-01-05

    Jan 5, 2012 ... post-SNT. Neither normal, nor SNT DRG exhibited co-localization of Robo1 and 2, and this observation was independent of neuron diameter. These results suggest that Robo1 in DRG is upregulated following sciatic nerve transection in rats. Key words: Dorsal root ganglion, rat, roundabout 1, sciatic nerve ...

  20. Anti-nociceptive effects of taurine and caffeine in sciatic nerve ...

    African Journals Online (AJOL)

    In this study, we investigated the effects of co-administration of taurine and caffeine on thermally induced pain in sciatic nerve ligated rats as well as the roles of autonomic receptors. Rats were rendered neuropathic by unilateral sciatic nerve ligation. The anti-hyperalgesic effect of combined systemic (i.p.) administration of ...

  1. Acupuncture Treatment for Low Back Pain and Lower Limb Symptoms—The Relation between Acupuncture or Electroacupuncture Stimulation and Sciatic Nerve Blood Flow

    Directory of Open Access Journals (Sweden)

    Motohiro Inoue

    2008-01-01

    Full Text Available To investigate the clinical efficacy of acupuncture treatment for lumbar spinal canal stenosis and herniated lumbar disc and to clarify the mechanisms in an animal experiment that evaluated acupuncture on sciatic nerve blood flow. In the clinical trial, patients with lumbar spinal canal stenosis or herniated lumbar disc were divided into three treatment groups; (i Ex-B2 (at the disordered level, (ii electrical acupuncture (EA on the pudendal nerve and (iii EA at the nerve root. Primary outcome measurements were pain and dysesthesia [evaluated with a visual analogue scale (VAS] and continuous walking distance. In the animal study, sciatic nerve blood flow was measured with laser-Doppler flowmetry at, before and during three kinds of stimulation (manual acupuncture on lumber muscle, electrical stimulation on the pudendal nerve and electrical stimulation on the sciatic nerve in anesthetized rats. For the clinical trial, approximately half of the patients who received Ex-B2 revealed amelioration of the symptoms. EA on the pudendal nerve was effective for the symptoms which had not improved by Ex-B2. Considerable immediate and sustained relief was observed in patients who received EA at the nerve root. For the animal study, increase in sciatic nerve blood flow was observed in 56.9% of the trial with lumber muscle acupuncture, 100% with pudendal nerve stimulation and 100% with sciatic nerve stimulation. Sciatic nerve stimulation sustained the increase longer than pudendal nerve stimulation. One mechanism of action of acupuncture and electrical acupuncture stimulation could be that, in addition to its influence on the pain inhibitory system, it participates in causing a transient change in sciatic nerve blood blow, including circulation to the cauda equine and nerve root.

  2. Keratin gel filler for peripheral nerve repair in a rodent sciatic nerve injury model.

    Science.gov (United States)

    Lin, Yen-Chih; Ramadan, Mostafa; Van Dyke, Mark; Kokai, Lauren E; Philips, Brian J; Rubin, J Peter; Marra, Kacey G

    2012-01-01

    Restoration with sufficient functional recovery after long-gap peripheral nerve damage remains a clinical challenge. In vitro, keratins, which are derived from human hair, enhance activity and gene expression of Schwann cells. The specific aim of the authors' study was to examine keratin gel as conduit filler for peripheral nerve regeneration in a rat sciatic nerve injury model. Incorporation of glial cell line-derived, neurotrophic factor, double-walled microspheres into polycaprolactone nerve guides has demonstrated an off-the-shelf product alternative to promote nerve regeneration, and this conduit was filled with keratin gel and examined in a rat 15-mm sciatic nerve defect model. As an indicator of recovery, nerve sections were stained with S100 and protein gene product 9.5 antibody. The keratin-treated groups, compared with both saline and empty polycaprolactone (control) groups (p nerve conduits possess optimal mechanical and degradative properties, rendering the biocompatible conduits potentially useful in peripheral nerve repair. From their studies, the authors conclude that polycaprolactone nerve guides with glial cell line-derived, neurotrophic factor-loaded, double-walled microspheres filled with keratin gel represent a potentially viable guiding material for Schwann cell and axon migration and proliferation in the treatment of peripheral nerve regeneration.

  3. Anatomical variations in the level of bifurcation of the sciatic nerve in ...

    African Journals Online (AJOL)

    Background: The sciatic nerve, the largest nerve in the body is derived from the sacral plexus. It is composed of tibial and common fibular nerves; the division of this nerve varies; it may occur within the pelvis, gluteal region, upper, mid and lower part of thigh. Injury of the nerve may lead to loss of sensation in posterior thigh, ...

  4. Statin treatment reduces oxidative stress-associated apoptosis of sciatic nerve in diabetes mellitus.

    Science.gov (United States)

    Gürpınar, T; Ekerbiçer, N; Harzadın, N U; Barut, T; Tarakçı, F; Tuglu, M I

    2011-12-01

    Statins are lipid-lowering drugs that are widely used for treating hyperlipidemia, especially in diabetic patients. The aim of our study was to explore the effects of atorvastatin on oxidative stress and apoptosis in the sciatic nerve due to hyperglycemia. Diabetes was induced by streptozotocin. Atorvastatin was given orally for two weeks beginning from the sixth week. Microscopic examination of sciatic nerve revealed that normal tissue organization was disrupted in streptozotocin induced diabetic rats. Treatment with Atorvastatin reduced the histological damage and protected the morphological integrity of the sciatic nerve in streptozotocin induced diabetes. Increased expressions of transforming growth factor beta-1, endothelial nitric oxide synthase and TUNEL in sciatic nerve from streptozotocin induced diabetes were reduced by Atorvastatin. Atorvastatin could improve the effects of oxidative stress and apoptosis on the sciatic nerve due to diabetes.

  5. [Distal sciatic nerve blocks: randomized comparison of nerve stimulation and ultrasound guided intraepineural block].

    Science.gov (United States)

    Seidel, R; Natge, U; Schulz, J

    2013-03-01

    The design of this study is related to an important current issue: should local anesthetics be intentionally injected into peripheral nerves? Answering this question is not possible without better knowledge regarding classical methods of nerve localization (e.g. cause of paresthesias and nerve stimulation technique). Have intraneural injections ever been avoided? This prospective, randomized comparison of distal sciatic nerve block with ultrasound guidance tested the hypothesis that intraneural injection of local anesthetics using the nerve stimulation technique is common and associated with a higher success rate. In this study 250 adult patients were randomly allocated either to the nerve stimulation group (group NS, n = 125) or to the ultrasound guidance group (group US, n = 125). The sciatic nerve was anesthetized with 20 ml prilocaine 1% and 10 ml ropivacaine 0.75%. In the US group the goal was an intraepineural needle position. In the NS group progress of the block was observed by a second physician using ultrasound imaging but blinded for the investigator performing the nerve stimulation. The main outcome variables were time until readiness for surgery (performance time and onset time), success rate and frequency of paresthesias. In the NS group needle positions and corresponding stimulation thresholds were recorded. In both groups seven patients were excluded from further analysis because of protocol violation. In the NS group (n = 118) the following needle positions were estimated: intraepineural (NS 1, n = 51), extraparaneural (NS 2, n = 33), needle tip dislocation from intraepineural to extraparaneural while injecting local anesthetic (NS 3, n = 19) and other or not determined needle positions (n = 15). Paresthesias indicated an intraneural needle position with an odds ratio of 27.4 (specificity 98.8%, sensitivity 45.9%). The success rate without supplementation was significantly higher in the US group (94.9% vs. 61.9%, p

  6. N-Propionylmannosamine stimulates axonal elongation in a murine model of sciatic nerve injury

    Directory of Open Access Journals (Sweden)

    Christian Witzel

    2015-01-01

    Full Text Available Increasing evidence indicates that sialic acid plays an important role during nerve regeneration. Sialic acids can be modified in vitro as well as in vivo using metabolic oligosaccharide engineering of the N-acyl side chain. N-Propionylmannosamine (ManNProp increases neurite outgrowth and accelerates the reestablishment of functional synapses in vitro. We investigated the influence of systemic ManNProp application using a specific in vivo mouse model. Using mice expressing axonal fluorescent proteins, we quantified the extension of regenerating axons, the number of regenerating axons, the number of arborising axons and the number of branches per axon 5 days after injury. Sciatic nerves from non-expressing mice were grafted into those expressing yellow fluorescent protein. We began a twice-daily intraperitoneal application of either peracetylated ManNProp (200 mg/kg or saline solution 5 days before injury, and continued it until nerve harvest (5 days after transection. ManNProp significantly increased the mean distance of axonal regeneration (2.49 mm vs. 1.53 mm; P < 0.005 and the number of arborizing axons (21% vs. 16% P = 0.008 5 days after sciatic nerve grafting. ManNProp did not affect the number of regenerating axons or the number of branches per arborizing axon. The biochemical glycoengineering of the N-acyl side chain of sialic acid might be a promising approach for improving peripheral nerve regeneration.

  7. Chemogenetic enhancement of functional recovery after a sciatic nerve injury.

    Science.gov (United States)

    Jaiswal, Poonam B; English, Arthur W

    2017-05-01

    Designer receptors exclusively activated by designer drugs (DREADDs) are chemogenetic tools used to modulate neuronal excitability. We hypothesized that activation of excitatory (Gq) DREADD by its designer ligand, clozapine-N-oxide (CNO), would increase the excitability of neurons whose axons have been transected following peripheral nerve injury, and that this increase will lead to an enhanced functional recovery. The lateral gastrocnemius (LG) muscle of adult female Lewis rats was injected unilaterally with AAV9- hsyn- hM3Dq-mCherry (7.6 × 10 9 viral genomes/μL) to transduce Gq-DREADD expression in LG neurons. The contralateral LG muscle served as an uninjected control. No significant changes in either spontaneous EMG activity or electrically evoked direct muscle (M) responses were found in either muscle after injection of CNO (1 mg/kg, i.p.). The amplitude of monosynaptic H-reflexes in LG was increased after CNO treatment exclusively in muscles previously injected with virus, suggesting that Gq-DREADD activation increased neuronal excitability. After bilateral sciatic nerve transection and repair, additional rats were treated similarly with CNO for up to three days after injury. Electrophysiological data were collected at 2, 4 and 6 weeks after injury. Evoked EMG responses were observed as early as 2 weeks after injury only in Gq-DREADD expressing virus injected LG muscle. By 4 weeks after injury, both M-response and H-reflex amplitudes were significantly greater in muscles previously injected with viral vector than contralateral, uninjected muscles. Increases in the excitability of injured neurons produced by this novel use of Gq-DREADD were sufficient to promote an enhancement in functional recovery after a sciatic nerve injury. © 2017 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

  8. 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

  9. Effect of electrical stimulation on motor nerve regeneration in sciatic nerve ligated-mice

    Directory of Open Access Journals (Sweden)

    Farzaneh Samiee

    2017-09-01

    Full Text Available The purpose of this study was to investigate the effect of electrical stimulation on sciatic nerve regeneration and functional recovery of target muscles. Mice were randomly divided into 3 groups: ligated without electrical stimulation, ligated with electrical stimulation and control (non-ligated. The unilateral peripheral mononeuropathy was produced on the right hind limb. Sciatic nerve was then electrically stimulated daily for a period of 2 weeks (duration: 0.2 msec, frequency: 100Hz, amplitude: 15mA. Evoked surface EMG was recorded from biceps femoris (BF and gluteus maximus (GM muscles on the 3rd, 7th, 10th and 14th day after sciatic nerve ligation. Muscle force and sensitivity was determined by processing of the recorded EMG signals in time and frequency domains respectively. The results showed electrical stimulation (ES produced a significant increase in the EMG response of BF, and muscle force significantly increased on the 14th day (p<0.001, however no significant difference was found in GM muscle force between experimental groups. This may be due to possible innervation by inferior gluteal nerve. Frequency analysis of BF signals indicates that hyperalgesia remained after 14 days in both ligated groups. On the 14th day no difference in GM muscle sensitivity was found between groups. In conclusion, the results of this study have shown that the electrical stimulation of sciatic nerve accelerates nerve repair and indirectly improves BF muscle force to a comparable level with control without effect on muscle sensitivity. However, ES had no effect on GM muscle force and sensitivity.

  10. Effect of electrical stimulation on motor nerve regeneration in sciatic nerve ligated-mice

    Science.gov (United States)

    Samiee, Farzaneh; Zarrindast, Mohammad-Reza

    2017-01-01

    The purpose of this study was to investigate the effect of electrical stimulation on sciatic nerve regeneration and functional recovery of target muscles. Mice were randomly divided into 3 groups: ligated without electrical stimulation, ligated with electrical stimulation and control (non-ligated). The unilateral peripheral mononeuropathy was produced on the right hind limb. Sciatic nerve was then electrically stimulated daily for a period of 2 weeks (duration: 0.2 msec, frequency: 100Hz, amplitude: 15mA). Evoked surface EMG was recorded from biceps femoris (BF) and gluteus maximus (GM) muscles on the 3rd, 7th, 10th and 14th day after sciatic nerve ligation. Muscle force and sensitivity was determined by processing of the recorded EMG signals in time and frequency domains respectively. The results showed electrical stimulation (ES) produced a significant increase in the EMG response of BF, and muscle force significantly increased on the 14th day (p<0.001), however no significant difference was found in GM muscle force between experimental groups. This may be due to possible innervation by inferior gluteal nerve. Frequency analysis of BF signals indicates that hyperalgesia remained after 14 days in both ligated groups. On the 14th day no difference in GM muscle sensitivity was found between groups. In conclusion, the results of this study have shown that the electrical stimulation of sciatic nerve accelerates nerve repair and indirectly improves BF muscle force to a comparable level with control without effect on muscle sensitivity. However, ES had no effect on GM muscle force and sensitivity. PMID:29118955

  11. A unique quadrifurcation of the sciatic nerve in the lower leg | Russa ...

    African Journals Online (AJOL)

    Sciatic nerve is the largest nerve of the body supplying the entire posterior aspect of the lower limb. Taking its origin from the lumbosacral plexus, the nerve divides into its terminal branches at the superior angle of the popliteal fossa. Variant division patterns of the nerve especially those occurring in the thigh and the ...

  12. The effect of aloe vera on ischemia--Reperfusion injury of sciatic nerve in rats.

    Science.gov (United States)

    Guven, Mustafa; Gölge, Umut Hatay; Aslan, Esra; Sehitoglu, Muserref Hilal; Aras, Adem Bozkurt; Akman, Tarik; Cosar, Murat

    2016-04-01

    Aloe vera is compound which has strong antioxidant and anti-inflammatory effects. We investigated the neuroprotective role of aloe vera treatment in rats with experimental sciatic nerve ischemia/reperfusion injury. Twenty-eight male Wistar Albino rats were divided equally into 4 groups. Groups; Control group (no surgical procedure or medication), sciatic nerve ischemia/reperfusion group, sciatic nerve ischemia/reperfusion+aloe vera group and sciatic nerve ischemia/reperfusion+methylprednisolone group. Ischemia was performed by clamping the infrarenal abdominal aorta. 24 hours after ischemia, all animals were sacrificed. Sciatic nerve tissues were also examined histopathologically and biochemically. Ischemic fiber degeneration significantly decreased in the pre-treated with aloe vera and treated with methylprednisolone groups, especially in the pre-treated with aloe vera group, compared to the sciatic nerve ischemia/reperfusion group (paloe vera group was not statistically different compared to the MP group (p>0.05). Aloe vera is effective neuroprotective against sciatic nerve ischemia/reperfusion injury via antioxidant and anti-inflammatory properties. Also aloe vera was found to be as effective as MP. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  13. Position of the sciatic nerve and effect of gluteus maximus release during hip arthroplasty.

    Science.gov (United States)

    Kanawati, Andrew J; Narulla, Rajpal; Lorentzos, Peter; Graham, Edward

    2017-06-01

    Eight Thiel embalmed hips were dissected. The distance between the sciatic nerve and the femoral neck was measured before and after hip dislocation, and before and after release of the gluteus maximus tendon. There was a significant reduction in the mean distance between the neck of femur and the sciatic nerve in both the gluteus maximus tendon release and the unreleased groups at 60° and 90° of hip flexion, p < 0.05. The mean distance between the neck of femur and sciatic nerve was greater in the release group for all positions.

  14. Sciatic nerve blocks for diagnosis of piriformis syndrome

    International Nuclear Information System (INIS)

    Owashi, Kazuya; Harada, Mikio; Utsumi, Hideaki; Sugawara, Hirobumi; Oyama, Kaori; Takei, Isao

    2010-01-01

    We used sciatic nerve block (SNB) to make the differential diagnosis of piriformis syndrome in 188 consecutive patients with sciatica in whom it was impossible to make the diagnosis based on the lumbar MRI findings. We rated the effectiveness of SNB as excellent (60%), good (25%) and poor (15%). After performing SNBs, lumbar radicular blocks, and surgeries based on the initial diagnosis, the final diagnoses were piriformis syndrome (56%), piriformis syndrome complicated with lumbar degenerative disease (4%), lumbar degenerative disease (23%), others or unknown (16%). The prevalence of piriformis syndrome in the excellent effectiveness group was 81%. SNB was effective in all patients with piriformis syndrome and in 66% of the lumbar degeneration patients. The diagnostic value of SNB is of limited value for differentiating piriformis syndrome from lumbar degenerative disease. (author)

  15. A silk sericin/silicone nerve guidance conduit promotes regeneration of a transected sciatic nerve.

    Science.gov (United States)

    Xie, Hongjian; Yang, Wen; Chen, Jianghai; Zhang, Jinxiang; Lu, Xiaochen; Zhao, Xiaobo; Huang, Kun; Li, Huili; Chang, Panpan; Wang, Zheng; Wang, Lin

    2015-10-28

    Peripheral nerve gap defects lead to significant loss of sensory or motor function. Tissue engineering has become an important alternative to nerve repair. Sericin, a major component of silk, is a natural protein whose value in tissue engineering has just begun to be explored. Here, the first time use of sericin in vivo is reported as a long-term implant for peripheral nerve regeneration. A sericin nerve guidance conduit is designed and fabricated. This conduit is highly porous with mechanical strength matching peripheral nerve tissue. It supports Schwann cell proliferation and is capable of up-regulating the transcription of glial cell derived neurotrophic factor and nerve growth factor in Schwann cells. The sericin conduit wrapped with a silicone conduit (sericin/silicone double conduits) is used for bridging repair of a 5 mm gap in a rat sciatic nerve transection model. The sericin/silicone double conduits achieve functional recovery comparable to that of autologous nerve grafting as evidenced by drastically improved nerve function and morphology. Importantly, this improvement is mainly attributed to the sericin conduit as the silicone conduit alone only produces marginal functional recovery. This sericin/silicone-double-conduit strategy offers an efficient and valuable alternative to autologous nerve grafting for repairing damaged peripheral nerve. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  16. Recording nerve signals in canine sciatic nerves with a flexible penetrating microelectrode array

    Science.gov (United States)

    Byun, Donghak; Cho, Sung-Joon; Lee, Byeong Han; Min, Joongkee; Lee, Jong-Hyun; Kim, Sohee

    2017-08-01

    Objective. Previously, we presented the fabrication and characterization of a flexible penetrating microelectrode array (FPMA) as a neural interface device. In the present study, we aim to prove the feasibility of the developed FPMA as a chronic intrafascicular recording tool for peripheral applications. Approach. For recording from the peripheral nerves of medium-sized animals, the FPMA was integrated with an interconnection cable and other parts that were designed to fit canine sciatic nerves. The uniformity of tip exposure and in vitro electrochemical properties of the electrodes were characterized. The capability of the device to acquire in vivo electrophysiological signals was evaluated by implanting the FPMA assembly in canine sciatic nerves acutely as well as chronically for 4 weeks. We also examined the histology of implanted tissues to evaluate the damage caused by the device. Main results. Throughout recording sessions, we observed successful multi-channel recordings (up to 73% of viable electrode channels) of evoked afferent and spontaneous nerve unit spikes with high signal quality (SNR  >  4.9). Also, minor influences of the device implantation on the morphology of nerve tissues were found. Significance. The presented results demonstrate the viability of the developed FPMA device in the peripheral nerves of medium-sized animals, thereby bringing us a step closer to human applications. Furthermore, the obtained data provide a driving force toward a further study for device improvements to be used as a bidirectional neural interface in humans.

  17. Study of Transected Sciatic Nerve Repair by Amniotic Membrane with Betamethasone in Adult Albino Wistar Rats.

    Science.gov (United States)

    Sadraie, Seyed Homayoon; Parivar, Kazem; Arabi, Farzaneh; Moattari, Mehrnaz; Kaka, Gholamreza; Mansouri, Korosh

    2016-09-01

    The aim of this study was to determine the effects of amniotic membrane impregnated with betamethasone on regeneration of transected sciatic nerve injury in adult albino Wister rats. In this research, 42 male adult rats were divided into six equal groups. 1) Normal (intact) group: healthy rats without any injury; 2) CONTROL GROUP: sciatic nerve was cut and sutured; 3) Sham group: 0.2 mL culture medium was injected on the epineurium in the injury; 4) Amniotic membrane group (AM): Acellular amniotic membrane was used around the damaged sciatic nerve; 5) Betamethasone group (B): 0.2 mL Betamethasone (4 mg/mL) was injected in the site of damaged nerve and 6) Amniotic membrane group and Betamethasone (AM/B) group: Acellular amniotic membrane impregnated with 0.2 mL betamethasone was used around the damaged sciatic nerve. The rate of recovery was studied by Sciatic Functional Index (SFI), withdrawal reflex latency (WRL) test and electroctrophysiological assessments at 2, 4, 6 and 8 weeks after surgery. Histological assessment was done 8 weeks after surgery. At 8 weeks after surgery, SFI, WRL test and electrophysiological values in AM/B group were significantly improved compared to control and sham groups (P nerve regeneration of transected sciatic nerve in a rat model.

  18. 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...... in the non-existing extremity. This sensation was verbally described by the patient and thus used as an alternative to visual identification of motor response. After surgery the patient was pain free. The technique thus presents an alternative method for anesthesia and perioperative pain management in a high...

  19. Case Report: Sciatic nerve schwannoma - a rare cause of sciatica [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Sunil Munakomi

    2017-03-01

    Full Text Available Herein we report a rare case of a sciatic nerve schwannoma causing sciatica in a 69-year-old female. Sciatic nerve schwannoma is a rare entity. It should always be considered as a possible cause of sciatica in patients that present with symptoms of sciatica with no prolapsed disc in the lumbar spine and a negative crossed straight leg raise test. Timely diagnosis and complete excision of the lesion leads to complete resolution of the symptoms of such patients.

  20. Topographic anatomical study of the sciatic nerve relationship to the posterior portal in hip arthroscopy

    Directory of Open Access Journals (Sweden)

    Berliet Assad Gomes

    Full Text Available Objective: To evaluate the anatomic topographic relation between the sciatic nerve in relation to the piriform muscle and the posterior portal for the establishment of hip arthroscopy.Methods: We dissected 40 hips of 20 corpses of adult Brazilians, 17 male and three female, six black, six brown and eight white. We studied the anatomical relationship between the sciatic nerve and the piriform muscle with their variations and the distance between the lateral edge of the sciatic nerve and the posterior portal used in hip arthroscopy. We then classified the anatomical alterations found in the path of the sciatic nerve on the piriform muscle.Results: Seventeen corpses had bilateral relationship between the sciatic nerve and the piriform muscle, i.e., type A. We found the following anatomical variations: 12.5% of variant type B; and an average distance between the sciatic nerve and the portal for arthroscopy of 2.98cm. One body had type B anatomical variation on the left hip and type A on the right.Conclusion: the making of the posterior arthroscopic portal to the hip joint must be done with careful marking of the trochanter massive; should there be difficult to find it, a small surgical access is recommended. The access point to the portal should not exceed two centimeters towards the posterior superior aspect of the greater trochanter, and must be made with the limb in internal rotation of 15 degrees.

  1. Localized hypertrophic neuropathy of the sciatic nerve in children: MRI findings

    International Nuclear Information System (INIS)

    Roux, Adrien; Treguier, Catherine; Bruneau, Bertrand; Marin, Franck; Gandon, Yves; Gauvrit, Jean-Yves; Riffaud, Laurent; Violas, Philippe; Michel, Anne

    2012-01-01

    Localized hypertrophic neuropathy (LHN) of the sciatic nerve in children is a rare condition characterized by a painless neurological deficit in the sciatic nerve territory. To demonstrate the role of MRI using a specific protocol and describe the primary findings in LHN. Imaging in four children (age 2 years to 12 years) is presented. All children presented with lower limb asymmetry. Three had a steppage gait. LHN was confirmed by electrophysiological studies and by MRI of the whole sciatic nerve with a dedicated protocol covering the lumbar spine and the lower limb. There were four direct MRI findings: (1) linear and focal hypertrophy with progressive enlargement of a peripheral nerve or plexus diameter, (2) abnormal hyperintensity of the nerve on T2-weighted images, (3) preserved fascicular configuration, and (4) variable enhancement after intravenous gadolinium administration. In addition there were atrophy and fatty infiltration of innervated muscles. MRI was helpful for determining the extent of lesions and in excluding peripheral nerve compression or tumour. MRI of the whole sciatic nerve is the method of choice for diagnosing LHN of the sciatic nerve. (orig.)

  2. Localized hypertrophic neuropathy of the sciatic nerve in children: MRI findings

    Energy Technology Data Exchange (ETDEWEB)

    Roux, Adrien; Treguier, Catherine; Bruneau, Bertrand; Marin, Franck; Gandon, Yves; Gauvrit, Jean-Yves [University Hospital, Department of Radiology, Hopital Sud, 16 Boulevard de Bulgarie, BP 90347, Rennes cedex 2 (France); Riffaud, Laurent [University Hospital, Department of Pediatric Neurosurgery, Hopital Sud, Rennes (France); Violas, Philippe [University Hospital, Department of Pediatric Surgery, Hopital Sud, Rennes (France); Michel, Anne [University Hospital, Department of Neurological Functional Explorations, Hopital Sud, Rennes (France)

    2012-08-15

    Localized hypertrophic neuropathy (LHN) of the sciatic nerve in children is a rare condition characterized by a painless neurological deficit in the sciatic nerve territory. To demonstrate the role of MRI using a specific protocol and describe the primary findings in LHN. Imaging in four children (age 2 years to 12 years) is presented. All children presented with lower limb asymmetry. Three had a steppage gait. LHN was confirmed by electrophysiological studies and by MRI of the whole sciatic nerve with a dedicated protocol covering the lumbar spine and the lower limb. There were four direct MRI findings: (1) linear and focal hypertrophy with progressive enlargement of a peripheral nerve or plexus diameter, (2) abnormal hyperintensity of the nerve on T2-weighted images, (3) preserved fascicular configuration, and (4) variable enhancement after intravenous gadolinium administration. In addition there were atrophy and fatty infiltration of innervated muscles. MRI was helpful for determining the extent of lesions and in excluding peripheral nerve compression or tumour. MRI of the whole sciatic nerve is the method of choice for diagnosing LHN of the sciatic nerve. (orig.)

  3. 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.

  4. Sciatic nerve compression by neurogenic heterotopic ossification: use of CT to determine surgical indications

    Energy Technology Data Exchange (ETDEWEB)

    Salga, Marjorie [Hopital Raymond Poincare, APHP, CIC-IT 805, Department of Physical Medicine and Rehabilitation, Garches (France); Jourdan, Claire [Hopital Raymond Poincare, APHP, CIC-IT 805, Department of Physical Medicine and Rehabilitation, Garches (France); Universite de Versailles Saint Quentin en Yvelines, Handi-Resp, (EA4047), Versailles (France); Durand, Marie-Christine [Hopital Raymond Poincare, APHP, CIC-IT 805, Department of Neurophysiology, Garches (France); Universite de Versailles Saint Quentin en Yvelines, Groupement de Recherche Clinique et Technologique sur le Handicap (GRCTH, EA 4497), Versailles (France); Hangard, Chloe; Carlier, Robert-Yves [Hopital Raymond Poincare, APHP, CIC-IT 805, Department of Medical Imaging, Garches (France); Denormandie, Philippe [Universite de Versailles Saint Quentin en Yvelines, Groupement de Recherche Clinique et Technologique sur le Handicap (GRCTH, EA 4497), Versailles (France); Hopital Raymond Poincare, APHP, CIC-IT 805, Department of Orthopaedic Surgery, Garches (France); Genet, Francois [Hopital Raymond Poincare, APHP, CIC-IT 805, Department of Physical Medicine and Rehabilitation, Garches (France); Universite de Versailles Saint Quentin en Yvelines, Groupement de Recherche Clinique et Technologique sur le Handicap (GRCTH, EA 4497), Versailles (France); Military Medical Service, Hopital d' Instruction des Armees Percy, Department of Physical Medicine and Rehabilitation, Clamart (France)

    2014-09-14

    To describe the characteristics of neurogenic heterotopic ossification (NHO) based on clinical tests, electroneuromyography (ENMG) and CT in a database of patients with lesions of the central nervous system who required sciatic nerve neurolysis along with posterior hip NHO resection, and to determine the respective roles of ENMG and CT in the management of posterior hip NHOs in patients who are unable to communicate or express pain. The consistency of the ENMG results with clinical findings, CT results and macroscopic signs of lesions was retrospectively assessed after sciatic nerve neurolysis and ablation of 55 posterior hip NHOs. Sciatic nerve neurolysis was necessary in 55 cases (47.4 %; 55 out of 116). CT showed contact of the NHO with the nerve in all cases: 5 in contact with no deflection, 3 in contact with deflection, 21 moulded into a gutter and 26 entrapped in the NHO. There were clinical signs of sciatic nerve lesion in 21.8 % of cases (12 out of 55). ENMG showed signs of sciatic nerve lesions in only 55.6 % (10 out of 18), only 4 of whom presented with clinical signs of a nerve lesion. No significant relationship was found between clinical symptoms and ENMG findings of sciatic nerve compression (n = 13, p = 0.77). Nerve compression by NHO is likely an underdiagnosed condition, particularly in patients who are unable to communicate. Diagnosis of sciatic compression by NHO should be based on regular clinical examinations and CT. ENMG is not sufficiently sensitive to be used alone for surgical decision-making. (orig.)

  5. Sciatic nerve compression by neurogenic heterotopic ossification: use of CT to determine surgical indications

    International Nuclear Information System (INIS)

    Salga, Marjorie; Jourdan, Claire; Durand, Marie-Christine; Hangard, Chloe; Carlier, Robert-Yves; Denormandie, Philippe; Genet, Francois

    2015-01-01

    To describe the characteristics of neurogenic heterotopic ossification (NHO) based on clinical tests, electroneuromyography (ENMG) and CT in a database of patients with lesions of the central nervous system who required sciatic nerve neurolysis along with posterior hip NHO resection, and to determine the respective roles of ENMG and CT in the management of posterior hip NHOs in patients who are unable to communicate or express pain. The consistency of the ENMG results with clinical findings, CT results and macroscopic signs of lesions was retrospectively assessed after sciatic nerve neurolysis and ablation of 55 posterior hip NHOs. Sciatic nerve neurolysis was necessary in 55 cases (47.4 %; 55 out of 116). CT showed contact of the NHO with the nerve in all cases: 5 in contact with no deflection, 3 in contact with deflection, 21 moulded into a gutter and 26 entrapped in the NHO. There were clinical signs of sciatic nerve lesion in 21.8 % of cases (12 out of 55). ENMG showed signs of sciatic nerve lesions in only 55.6 % (10 out of 18), only 4 of whom presented with clinical signs of a nerve lesion. No significant relationship was found between clinical symptoms and ENMG findings of sciatic nerve compression (n = 13, p = 0.77). Nerve compression by NHO is likely an underdiagnosed condition, particularly in patients who are unable to communicate. Diagnosis of sciatic compression by NHO should be based on regular clinical examinations and CT. ENMG is not sufficiently sensitive to be used alone for surgical decision-making. (orig.)

  6. Acute sciatic nerve crush injuries in rabbits: MRI and pathological comparative study

    International Nuclear Information System (INIS)

    Li Xinchun; Chen Jianyu; Wang Xinlu; Shen Jun; Liu Qingyu; Liang Biling

    2004-01-01

    Objective: Simulating injury mechanism in human peripheral nerve, acute sciatic nerve crush injuries model was produced in rabbits to investigate the relationship between the manifestations of MRI and pathology in order to provide the information for clinical therapy and operative plan. Methods: Thirty-two adult rabbits were randomly divided into two groups: group A (n=16) and B (n=16). In group A, the left sciatic nerves were crushed with a stress of 3.61 kg; In group B, with a stress of 10.50 kg. 4 time intervals in each group were observed in 1, 2, 4, and 8 weeks, respectively, and each time interval contained 4 rabbits. Left sciatic nerves were served as injured sides, right sciatic nerves were regarded as control sides. MRI was performed at different time interval after crush injury. Then the nerves were examined pathologically. Results: There were no obvious changes on T 1 WI in injured sides, but the injured distal segment of sciatic nerve thickened and twisted, showing high signal intensity on 3D T 2 WI, T 2 WI/SPIR, B-FFE, and T 2 WI/STIR. MRI could show abnormality of 30 sciatic nerves, the correct diagnostic rate was 93.75% and false negative rate was 6.25%. The distal sciatic nerve/muscle signal intensity ratio (SIR) of the injured sides was significantly higher than that of the control sides (P 0.05). SIR in injured side increased at 1 week, reached the peak at 2 weeks, at this time, nerve axons disappeared and lots of myelin degenerated, abduction function disappeared. SIR decreased during 4-8 weeks, the myelin sheath breakdown and Schwann cell proliferated obviously, and abduction functions were observed. The control sciatic nerves showed no abnormality in MRI and pathology. Conclusion: MRI can make the diagnosis of crush injury of sciatic nerve, and dynamic SIR measurement of nerve injury correlates well with the pathological and functional recovery process. MRI is an effective method to monitor degeneration, regeneration, and prognosis after

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

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    Wenjie Sun

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

  8. Reduced inflammatory factor expression facilitates recovery after sciatic nerve injury in TLR4 mutant mice.

    Science.gov (United States)

    Tang, Guoqing; Yao, Jia; Shen, Ruowu; Ji, Aiyu; Ma, Kai; Cong, Beibei; Wang, Fang; Zhu, Lingyu; Wang, Xuan; Ding, Yingqiao; Zhang, Bei

    2018-02-01

    Toll-like receptors (TLRs) are extremely significant pattern recognition receptors. When nerve injury occurs, a variety of inflammatory factors are generated, leading to an exceedingly complex micro-environment. TLRs recognize damage-associated molecular patterns. To investigate the correlation between TLR4 and recovery after sciatic nerve injury, the model of sciatic nerve injury was conducted using TLR4-mutated mice (C3H/HeJ) and wild mice (C3H/HeN). Our goal was to identify short-stage and long-stage changes after sciatic nerve injury, mainly by checking the expression changes of inflammation factors in the short-stage and the differences in the recovery of the injured sciatic nerve in the long-stage. The results show that the increase of changes in the HeN group of IL-1β, IL-6, TNF-α and MCP-1 are more obvious than in the HeJ group, with caspase1 expression higher and Nlrp3 expression lower in the former group. Further results reveal intense inflammation occurred in the HeN group showing more neutrophils and macrophages. Nlrp3 and caspase1 showed little difference by Immunohistochemistry, with Nlrp6 expression differing between the HeJ group and the HeN group. The results led us to conclude that better recovery of the injured sciatic nerve occurred in the HeJ group because the expression of GAP-43 and p75NTR was higher and had a better SFI figure. TLR4 mutation can decrease the expression of inflammatory factors and enhance the speed of recovery after sciatic nerve injury. The changes in the expression of Nlrp6, which are related to the TLR4 mutation, may influence recovery of the injured sciatic nerve. Further studies will be conducted to confirm these results. Copyright © 2017. Published by Elsevier B.V.

  9. Different dose-dependent effects of ebselen in sciatic nerve ischemia-reperfusion injury in rats

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    Filiz Ozyigit

    2015-08-01

    Full Text Available Ebselen is an organoselenium compound which has strong antioxidant and anti-inflammatory effects. We investigated the neuroprotective role of ebselen pretreatment in rats with experimental sciatic nerve ischemia-reperfusion (I/R injury. Adult male Sprague Dawley rats were divided into four groups (N = 7 in each group. Before sciatic nerve I/R was induced, ebselen was injected intraperitoneally at doses of 15 and 30 mg/kg. After a 2 h ischemia and a 3 h reperfusion period, sciatic nerve tissues were excised. Tissue levels of malondialdehyde (MDA and nitric oxide (NO, and activities of superoxide dismutase (SOD, glutathione peroxidase (GPx, and catalase (CAT were measured. Sciatic nerve tissues were also examined histopathologically. The 15 mg/kg dose of ebselen reduced sciatic nerve damage and apoptosis (P < 0.01, levels of MDA, NO, and inducible nitric oxide synthase (iNOS positive cells (P < 0.01, P < 0.05, respectively, and increased SOD, GPx, and CAT activities (P < 0.001, P < 0.01, P < 0.05, respectively compared with the I/R group that did not receive ebselen. Conversely, the 30 mg/kg dose of ebselen increased sciatic nerve damage, apoptosis, iNOS positive cells (P < 0.01, P < 0.05, P < 0.001 and MDA and NO levels (P < 0.05, P < 0.01 and decreased SOD, GPx, and CAT activities (P < 0.05 compared with the sham group. The results of this study suggest that ebselen may cause different effects depending on the dose employed. Ebselen may be protective against sciatic nerve I/R injury via antioxidant and antiapoptotic activities at a 15 mg/kg dose, conversely higher doses may cause detrimental effects.

  10. Effects of graded mechanical compression of rabbit sciatic nerve on nerve blood flow and electrophysiological properties.

    Science.gov (United States)

    Yayama, Takafumi; Kobayashi, Shigeru; Nakanishi, Yoshitaka; Uchida, Kenzo; Kokubo, Yasuo; Miyazaki, Tsuyoshi; Takeno, Kenichi; Awara, Kosuke; Mwaka, Erisa S; Iwamoto, Yukihide; Baba, Hisatoshi

    2010-04-01

    Entrapment neuropathy is a frequent clinical problem that can be caused by, among other factors, mechanical compression; however, exactly how a compressive force affects the peripheral nerves remains poorly understood. In this study, using a rabbit model of sciatic nerve injury (n=12), we evaluated the time-course of changes in intraneural blood flow, compound nerve action potentials, and functioning of the blood-nerve barrier during graded mechanical compression. Nerve injury was applied using a compressor equipped with a custom-made pressure transducer. Cessation of intraneural blood flow was noted at a mean compressive force of 0.457+/-0.022 N (+/-SEM), and the compound action potential became zero at 0.486+/-0.031 N. Marked extravasation of Evans blue albumin was noted after 20 min of intraneural ischemia. The functional changes induced by compression are likely due to intraneural edema, which could subsequently result in impairment of nerve function. These changes may be critical factors in the development of symptoms associated with nerve compression. (c) 2009 Elsevier Ltd. All rights reserved.

  11. A conduction block in sciatic nerves can be detected by magnetic motor root stimulation.

    Science.gov (United States)

    Matsumoto, Hideyuki; Konoma, Yuko; Fujii, Kengo; Hanajima, Ritsuko; Terao, Yasuo; Ugawa, Yoshikazu

    2013-08-15

    Useful diagnostic techniques for the acute phase of sciatic nerve palsy, an entrapment neuropathy, are not well established. The aim of this paper is to demonstrate the diagnostic utility of magnetic sacral motor root stimulation for sciatic nerve palsy. We analyzed the peripheral nerves innervating the abductor hallucis muscle using both electrical stimulations at the ankle and knee and magnetic stimulations at the neuro-foramina and conus medullaris levels in a patient with sciatic nerve palsy at the level of the piriformis muscle due to gluteal compression related to alcohol consumption. On the fourth day after onset, magnetic sacral motor root stimulation using a MATS coil (the MATS coil stimulation method) clearly revealed a conduction block between the knee and the sacral neuro-foramina. Two weeks after onset, needle electromyography supported the existence of the focal lesion. The MATS coil stimulation method clearly revealed a conduction block in the sciatic nerve and is therefore a useful diagnostic tool for the abnormal neurophysiological findings associated with sciatic nerve palsy even at the acute phase. Copyright © 2013 Elsevier B.V. All rights reserved.

  12. A simple and successful sonographic technique to identify the sciatic nerve in the parasacral area.

    Science.gov (United States)

    Taha, Ahmad Muhammad

    2012-03-01

    The purpose of this study was to describe detailed sonographic anatomy of the parasacral area for rapid and successful identification of the sciatic nerve. Fifty patients scheduled for knee surgery were included in this observational study. An ultrasound-guided parasacral sciatic nerve block was performed in all patients. The ultrasound probe was placed on an axial plane 8 cm lateral to the uppermost point of the gluteal cleft. Usually, at this level the posterior border of the ischium (PBI), a characteristically curved hyperechoic line, could be identified. The sciatic nerve appeared as a hyperechoic structure just medial to the PBI. The nerve lies deep to the piriformis muscle lateral to the inferior gluteal vessels, and if followed caudally, it rests directly on the back of the ischium. After confirmation with electrical stimulation, a 20-mL mixture of 1% ropivacaine and 1% lidocaine with epinephrine was injected. The sciatic nerve was identified successfully in 48 patients (96%). In those patients, the median time required for its ultrasonographic identification was ten seconds [interquartile range, 8-13.7 sec], and the block success rate was 100%. The described sonographic details of the parasacral area allowed for rapid and successful identification of the sciatic nerve.

  13. Anatomical description of the sciatic nerve block at the subgluteal region in a neonatal cadaver population.

    Science.gov (United States)

    Acar, Adrienne A; Bösenberg, Adrian T; van Schoor, Albert-Neels

    2017-06-01

    Sciatic nerve blocks provide intraoperative and prolonged postoperative pain management after lower limb surgery (posterior knee, foot, skin graft surgery). Accurate needle placement requires sound anatomical knowledge. Anatomical studies on children are uncommon; most have been performed on adult cadavers. We studied the location of the sciatic nerve at the gluteal level in neonatal cadavers to establish useful anatomical landmarks. We identified the sciatic nerve in the gluteal and thigh region of 20 neonatal cadavers. The skin covering the gluteal and thigh region was reflected laterally, and the underlying structures and muscles were identified. We located the sciatic nerve and measured the distance from the nerve to the greater trochanter of the femur and to the tip of the coccyx with a mechanical dial caliper. The total distance between the two landmarks was then recorded. We combined measurements from both sides to form a sample size n = 40. The sciatic nerve was 14.9 ± 2.4 mm lateral to the tip of the coccyx. The total distance between the greater trochanter and the tip of the coccyx was 27.3 ± 4.0 mm. Our results provide anatomical evidence that the optimal needle insertion point is approximately halfway between the greater trochanter and the tip of the coccyx-a landmark readily palpable in neonates and infants. © 2017 John Wiley & Sons Ltd.

  14. Dexamethasone as Adjuvant to Bupivacaine Prolongs the Duration of Thermal Antinociception and Prevents Bupivacaine-Induced Rebound Hyperalgesia via Regional Mechanism in a Mouse Sciatic Nerve Block Model

    Science.gov (United States)

    An, Ke; Elkassabany, Nabil M.; Liu, Jiabin

    2015-01-01

    Background Dexamethasone has been studied as an effective adjuvant to prolong the analgesia duration of local anesthetics in peripheral nerve block. However, the route of action for dexamethasone and its potential neurotoxicity are still unclear. Methods A mouse sciatic nerve block model was used. The sciatic nerve was injected with 60ul of combinations of various medications, including dexamethasone and/or bupivacaine. Neurobehavioral changes were observed for 2 days prior to injection, and then continuously for up to 7 days after injection. In addition, the sciatic nerves were harvested at either 2 days or 7 days after injection. Toluidine blue dyeing and immunohistochemistry test were performed to study the short-term and long-term histopathological changes of the sciatic nerves. There were six study groups: normal saline control, bupivacaine (10mg/kg) only, dexamethasone (0.5mg/kg) only, bupivacaine (10mg/kg) combined with low-dose (0.14mg/kg) dexamethasone, bupivacaine (10mg/kg) combined with high-dose (0.5mg/kg) dexamethasone, and bupivacaine (10mg/kg) combined with intramuscular dexamethasone (0.5mg/kg). Results High-dose perineural dexamethasone, but not systemic dexamethasone, combined with bupivacaine prolonged the duration of both sensory and motor block of mouse sciatic nerve. There was no significant difference on the onset time of the sciatic nerve block. There was “rebound hyperalgesia” to thermal stimulus after the resolution of plain bupivacaine sciatic nerve block. Interestingly, both low and high dose perineural dexamethasone prevented bupivacaine-induced hyperalgesia. There was an early phase of axon degeneration and Schwann cell response as represented by S-100 expression as well as the percentage of demyelinated axon and nucleus in the plain bupivacaine group compared with the bupivacaine plus dexamethasone groups on post-injection day 2, which resolved on post-injection day 7. Furthermore, we demonstrated that perineural dexamethasone

  15. Influence of cisplatin on the sensitivity of the rat sciatic nerve to local hyperthermia

    NARCIS (Netherlands)

    Hoogeveen, J. F.; van der Kracht, A. H.; Wondergem, J.; Gonzalez Gonzalez, D.; Haveman, J.

    1993-01-01

    The influence of cisplatin on the sensitivity of the rat sciatic nerve to local hyperthermia was investigated. Rats received 1.7 mg/kg cisplatin i.p., twice a week for 6 weeks, up to a cumulative dose of 20.4 mg/kg. After termination of cisplatin treatment, a 5 mm segment of the nerve was locally

  16. 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

    2015-01-01

    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 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. PMID:26807123

  17. 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.

  18. PEMF fails to enhance nerve regeneration after sciatic nerve crush lesion.

    Science.gov (United States)

    Baptista, Abrahão Fontes; Goes, Bruno Teixeira; Menezes, Diego; Gomes, Flávia Carvalho Alcantara; Zugaib, João; Stipursky, Joice; Gomes, Joyce R S; Oliveira, Júlia Teixeira; Vannier-Santos, Marcos André; Martinez, Ana Maria Blanco

    2009-12-01

    The use of electromagnetic fields has been reported to enhance peripheral nerve regeneration. This study aimed to identify the effects of a prolonged protocol of low-frequency pulsed electromagnetic field (PEMF) on peripheral nerve regeneration. Thirty-four male Swiss mice (Mus musculus) were divided into PEMF (n = 17) and control (n = 17) groups. All animals underwent a unilateral sciatic-crush lesion, and the PEMF group was exposed to a 72-Hz, 2-G electromagnetic field for 30 min, five days a week, for three weeks. Functional analysis was carried out weekly. After three weeks, the animals were euthanized, and histological, morphometric, oxidative stress, and TGF-beta1 analyses were performed. Functional analysis showed no differences between the groups. Histological appearance was similar between PEMF and control nerves. Morphometric assessment showed that the PEMF nerves trended toward decreased regeneration. The levels of free radicals were more pronounced in PEMF nerves, but were not associated with an increase in the content of the TGF-beta1/Smad signaling pathway. Prolonged PEMF regimen leads to delayed histological peripheral nerve regeneration and increased oxidative stress but no loss of function recovery.

  19. 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.

  20. A Three-arm Randomized Clinical Trial Comparing Continuous Femoral Plus Single-injection Sciatic Peripheral Nerve Blocks versus Periarticular Injection with Ropivacaine or Liposomal Bupivacaine for Patients Undergoing Total Knee Arthroplasty.

    Science.gov (United States)

    Amundson, Adam W; Johnson, Rebecca L; Abdel, Matthew P; Mantilla, Carlos B; Panchamia, Jason K; Taunton, Michael J; Kralovec, Michael E; Hebl, James R; Schroeder, Darrell R; Pagnano, Mark W; Kopp, Sandra L

    2017-06-01

    Multimodal analgesia is standard practice for total knee arthroplasty; however, the role of regional techniques in improved perioperative outcomes remains unknown. The authors hypothesized that peripheral nerve blockade would result in lower pain scores and opioid consumption than two competing periarticular injection solutions. This three-arm, nonblinded trial randomized 165 adults undergoing unilateral primary total knee arthroplasty to receive (1) femoral catheter plus sciatic nerve blocks, (2) ropivacaine-based periarticular injection, or (3) liposomal bupivacaine-based periarticular injection. Primary outcome was maximal pain during postoperative day 1 (0 to 10, numerical pain rating scale) in intention-to-treat analysis. Additional outcomes included pain scores and opioid consumption for postoperative days 0 to 2 and 3 months. One hundred fifty-seven study patients received peripheral nerve block (n = 50), ropivacaine (n = 55), or liposomal bupivacaine (n = 52) and reported median maximal pain scores on postoperative day 1 of 3, 4, and 4.5 and on postoperative day 0 of 1, 4, and 5, respectively (average pain scores for postoperative day 0: 0.6, 1.7, and 2.4 and postoperative day 1: 2.5, 3.5, and 3.7). Postoperative day 1 median maximal pain scores were significantly lower for peripheral nerve blockade compared to liposomal bupivacaine-based periarticular injection (P = 0.016; Hodges-Lehmann median difference [95% CI] = -1 [-2 to 0]). After postanesthesia care unit discharge, postoperative day 0 median maximal and average pain scores were significantly lower for peripheral nerve block compared to both periarticular injections (ropivacaine: maximal -2 [-3 to -1]; P bupivacaine: maximal -3 [-4 to -2]; P bupivacaine over ropivacaine in periarticular injections for total knee arthroplasty.

  1. Prevention of Axonal Degeneration by Perineurium Injection of Mitochondria in a Sciatic Nerve Crush Injury Model.

    Science.gov (United States)

    Kuo, Chi-Chung; Su, Hong-Lin; Chang, Tzu-Lin; Chiang, Chien-Yi; Sheu, Meei-Ling; Cheng, Fu-Chou; Chen, Chun-Jung; Sheehan, Jason; Pan, Hung-Chuan

    2017-03-01

    Axon degeneration leads to cytoskeletal disassembly, metabolism imbalance, and mitochondrial dysfunction during neurodegeneration or nerve injury. In this study, we assess the possibility of mitigating axon degeneration by local injection of mitochondria in a crushed sciatic nerve. Sciatic nerve explants cocultured with mitochondria were assessed for the optimal dosage in local injection and nerve regeneration potential. The left sciatic nerve was crushed in Sprague-Dawley rats and then local injection of mitochondria into the distal end of the injured nerve was conducted for further assessment. Mitochondrial coculture attenuated cytoskeletal loss and oxidative stress in isolated nerve explants. In Vivo analyses also showed that mitochondrial transplantation improved animal neurobehaviors, electrophysiology of nerve conduction, and muscle activities. Mitochondria injection significantly attenuated the oxidative stress and increased the expression of neurotrophic factors both in injured nerves and denervated muscles, as well as restored muscular integrity, and increased the pool of muscular progenitor cells and total muscle weight. Mitochondria injection can protect injured nerves from axonal degeneration both in Vitro and in Vivo. This improvement was accompanied with the expression of neurotrophic factors as well as the reduction of oxidative stress, which may account for the functional recovery of both injured nerves and denervated muscles.

  2. Effects of acute exposure to magnetic field on ionic composition of frog sciatic nerve

    International Nuclear Information System (INIS)

    Salem, A.; Hafedh, A.; Mohsen, S.

    2004-01-01

    Objective: To evaluate the possible interaction between magnetic field and cadmium on ionic composition of frog sciatic nerve. Design: The combined effect of magnetic field and cadmium (1.5mg/kg; in lymphatic sac) were studied in frog sciatic nerves (Rana Esculenta). Sciatic nerve samples were extracted, weighed and mixed in bidistilled water in order to analyze by inductively coupled plasma (ICP) ionic composition. Setting: Frogs (Rana Esculenta) were reared in swimming-pool (Faculte des Sciences de Bizerte, Tunisia). Frogs were cared for under the Tunisian Code of Practice for the Care and Use of Animals for Scientific purpose and the Experimental Protocols were approved by the Ethics Committee. Subjects: Treated and control groups (n=6) weighing 50-100g at the time of experiments were housed in the same condition three weeks before the beginning of the experiments. Results: Acute exposure to magnetic field increased significantly the calcium (+298%, p<0.05) and iron (+50%, p<0.05) contents of frog sciatic nerve, whereas magnesium and copper contents remained unchanged. The association between magnetic field and cadmium, induced marked increase of calcium (+360%, p<0.05), whereas magnesium content remained stable. Conclusions: Magnetic field exposure alters the ionic composition in the frog sciatic nerve, especially calcium and iron. Magnetic field magnifies the effect of cadmium on calcium homeostasis. (author)

  3. Strain on the human sciatic nerve in vivo during movement of the hip and knee.

    Science.gov (United States)

    Fleming, P; Lenehan, B; O'Rourke, S; McHugh, P; Kaar, K; McCabe, J P

    2003-04-01

    Injuries to the sciatic nerve are an occasional complication of surgery to the hip and acetabulum, and traction is frequently the causative mechanism. In vitro and animal experiments have shown that increased tensile strain on peripheral nerves, when applied for prolonged periods, impairs nerve function. We have used video-extensometry to measure strain on the human sciatic nerve during total hip replacement (THR). Ten consecutive patients with a mean age of 72 years undergoing primary THR by the posterior approach were recruited, and strains in the sciatic nerve were measured in different combinations of flexion and extension of the hip and knee, before dislocation of the hip. Significant increases (p = 0.02) in strain in the sciatic nerve were observed in flexion of the hip and extension of the knee. The mean increase was 26% (19% to 30%). In animal studies increases of this magnitude have been shown to impair electrophysiological function in peripheral nerves. Our results suggest that excessive flexion of the hip and extension of the knee should be avoided during THR.

  4. Experimental chronic entrapment of the sciatic nerve in adult hamsters: an ultrastructural and morphometric study

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    Prinz R.A.D.

    2003-01-01

    Full Text Available Entrapment neuropathy is a group of clinical disorders involving compression of a peripheral nerve and interference with nerve function mostly through traction injury. We have investigated the chronic compression of peripheral nerves as an experimental procedure for detecting changes in ultrastructural nerve morphology. Adult hamsters (Mesocricetus auratus, N = 30 were anesthetized with a 25% pentobarbital solution and received a cuff around the right sciatic nerve. Left sciatic nerves were not operated (control group. Animals survived for varying times (up to 15 weeks, after which they were sacrificed and both sciatic nerves were immediately fixed with a paraformaldehyde solution. Experimental nerves were divided into segments based upon their distance from the site of compression (proximal, entrapment and distal. Semithin and ultrathin sections were obtained and examined by light and electron microscopy. Ultrastructural changes were qualitatively described and data from semithin sections were morphometrically analyzed both in control and in compressed nerves. We observed endoneurial edema along with both perineurial and endoneurial thickening and also the existence of whorled cell-sparse structures (Renaut bodies in the subperineurial space of compressed sciatic nerves. Morphometric analyses of myelinated axons at the compression sites displayed a remarkable increase in the number of small axons (up to 60% in comparison with the control axonal number. The distal segment of compressed nerves presented a distinct decrease in axon number (up to 40% comparatively to the control group. The present experimental model of nerve entrapment in adult hamsters was shown to promote consistent histopathologic alterations analogous to those found in chronic compressive neuropathies.

  5. The adductor part of the adductor magnus is innervated by both obturator and sciatic nerves.

    Science.gov (United States)

    Takizawa, Megumi; Suzuki, Daisuke; Ito, Hajime; Fujimiya, Mineko; Uchiyama, Eiichi

    2014-07-01

    The hip adductor group, innervated predominantly by the obturator nerve, occupies a large volume of the lower limb. However, case reports of patients with obturator nerve palsy or denervation have described no more than minimal gait disturbance. Those facts are surprising, given the architectural characteristics of the hip adductors. Our aim was to investigate which regions of the adductor magnus are innervated by the obturator nerve and by which sciatic nerve and to consider the clinical implications. Twenty-one lower limbs were examined from 21 formalin-fixed cadavers, 18 males and 3 females. The adductor magnus was dissected and was divided into four parts (AM1-AM4) based on the locations of the perforating arteries and the adductor hiatus. AM1 was supplied solely by the obturator nerve. AM2, AM3, and AM4 received innervation from both the posterior branch of the obturator nerve and the tibial nerve portion of the sciatic nerve in 2 (9.5%), 20 (95.2%), and 6 (28.6%) of the cadavers, respectively. The double innervation in more than 90% of the AM3s is especially noteworthy. Generally, AM1-AM3 corresponds to the adductor part, traditionally characterized as innervated by the obturator nerve, and AM4 corresponds to the hamstrings part, innervated by the sciatic nerve. Here, we showed that the sciatic nerve supplies not only the hamstrings part but also the adductor part. These two nerves spread more widely than has generally been believed, which could have practical implications for the assessment and treatment of motor disability. Copyright © 2013 Wiley Periodicals, Inc.

  6. Functional recovery from sciatic nerve crush lesion in the rat correlates with individual differences in responses to chronic intermittent stress

    NARCIS (Netherlands)

    Gispen, W.H.; Meeteren, N.L.U.; Brakkee, J.H.; Helders, P.J.M.; Wiegant, V.M.

    1997-01-01

    The aim of the present study was to monitor the influence of chronic stress on functional recovery from a sciatic nerve crush lesion in the rat. Male Wistar rats underwent standard unilateral sciatic nerve crush. Subsequently, chronic stress was induced during the recovery phase using a daily 30 min

  7. A disturbed macrocirculatory supply as a determinant for a reduced sciatic nerve blood flow in diabetic rats

    NARCIS (Netherlands)

    Gispen, W.H.; Buren, Th. van; Kappelle, A.C.; Kasbergen, C.M.; Wildt, D.J. de

    1996-01-01

    The aim of this study was to evaluate macrocirculatory disturbances in relation to the reduced sciatic nerve blood flow seen in diabetic rats. Therefore, both femoral blood flow, the macrocirculatory arterial blood supply to the sciatic nerve, and the microcirculatory neuronal blood flow were

  8. Galanin and its receptor system promote the repair of injured sciatic nerves in diabetic rats

    Directory of Open Access Journals (Sweden)

    Xiao-feng Xu

    2016-01-01

    Full Text Available Various studies have reported that galanin can promote axonal regeneration of dorsal root ganglion neurons in vitro and inhibit neuropathic pain. However, little is known about its effects on diabetic peripheral neuropathy, and in vivo experimental data are lacking. We hypothesized that repeated applications of exogenous galanin over an extended time frame may also repair nerve damage in diabetic peripheral neuropathy, and relieve pain in vivo. We found that neuropathic pain occurred in streptozotocin-induced diabetic rats and was more severe after sciatic nerve pinch injury at 14 and 28 days than in diabetic sham-operated rats. Treatment with exogenous galanin alleviated the neuropathic pain and promoted sciatic nerve regeneration more effectively in diabetic rats than in non-diabetic rats after sciatic nerve pinch injury. This was accompanied by changes in the levels of endogenous galanin, and its receptors galanin receptor 1 and galanin receptor 2 in the dorsal root ganglia and the spinal dorsal horn when compared with nerve pinch normal rats. Our results show that application of exogenous galanin daily for 28 days can promote the regeneration of injured sciatic nerves, and alleviate neuropathic pain in diabetic rats.

  9. Hyperthermic injury versus crush injury in the rat sciatic nerve: a comparative functional, histopathological and morphometrical study

    NARCIS (Netherlands)

    Hoogeveen, J. F.; Troost, D.; Wondergem, J.; van der Kracht, A. H.; Haveman, J.

    1992-01-01

    Functional and morphological changes of the rat sciatic nerve after local hyperthermia (30 min, 45 degrees C) and crush treatment were compared. After hyperthermic injury nerve function loss developed in a time period of about 7 h. Nerve crush led to an immediate loss of nerve function. Nerve

  10. Malnutrition and myelin structure: an X-ray scattering study of rat sciatic and optic nerves

    International Nuclear Information System (INIS)

    Vargas, V.; Vargas, R.; Marquez, G.; Vonasek, E.; Mateu, L.; Luzzati, V.; Borges, J.

    2000-01-01

    Taking advantage of the fast and accurate X-ray scattering techniques recently developed in our laboratory, we tackled the study of the structural alterations induced in myelin by malnutrition. Our work was performed on sciatic and optic nerves dissected from rats fed with either a normal or a low-protein caloric diet, as a function of age (from birth to 60 days). By way of electrophysiological controls we also measured (on the sciatic nerves) the height and velocity of the compound action potential. Malnutrition was found to decrease the amount of myelin and to impair the packing order of the membranes in the sheaths. (orig.)

  11. Far-Infrared Therapy Promotes Nerve Repair following End-to-End Neurorrhaphy in Rat Models of Sciatic Nerve Injury

    Directory of Open Access Journals (Sweden)

    Tai-Yuan Chen

    2015-01-01

    Full Text Available This study employed a rat model of sciatic nerve injury to investigate the effects of postoperative low-power far-infrared (FIR radiation therapy on nerve repair following end-to-end neurorrhaphy. The rat models were divided into the following 3 groups: (1 nerve injury without FIR biostimulation (NI/sham group; (2 nerve injury with FIR biostimulation (NI/FIR group; and (3 noninjured controls (normal group. Walking-track analysis results showed that the NI/FIR group exhibited significantly higher sciatic functional indices at 8 weeks after surgery (P<0.05 compared with the NI/sham group. The decreased expression of CD4 and CD8 in the NI/FIR group indicated that FIR irradiation modulated the inflammatory process during recovery. Compared with the NI/sham group, the NI/FIR group exhibited a significant reduction in muscle atrophy (P<0.05. Furthermore, histomorphometric assessment indicated that the nerves regenerated more rapidly in the NI/FIR group than in the NI/sham group; furthermore, the NI/FIR group regenerated neural tissue over a larger area, as well as nerve fibers of greater diameter and with thicker myelin sheaths. Functional recovery, inflammatory response, muscular reinnervation, and histomorphometric assessment all indicated that FIR radiation therapy can accelerate nerve repair following end-to-end neurorrhaphy of the sciatic nerve.

  12. Gait phase detection from sciatic nerve recordings in functional electrical stimulation systems for foot drop correction

    International Nuclear Information System (INIS)

    Chu, Jun-Uk; Song, Kang-Il; Han, Sungmin; Suh, Jun-Kyo Francis; Choi, Kuiwon; Youn, Inchan; Lee, Soo Hyun; Kang, Ji Yoon; Hwang, Dosik

    2013-01-01

    Cutaneous afferent activities recorded by a nerve cuff electrode have been used to detect the stance phase in a functional electrical stimulation system for foot drop correction. However, the implantation procedure was difficult, as the cuff electrode had to be located on the distal branches of a multi-fascicular nerve to exclude muscle afferent and efferent activities. This paper proposes a new gait phase detection scheme that can be applied to a proximal nerve root that includes cutaneous afferent fibers as well as muscle afferent and efferent fibers. To test the feasibility of this scheme, electroneurogram (ENG) signals were measured from the rat sciatic nerve during treadmill walking at several speeds, and the signal properties of the sciatic nerve were analyzed for a comparison with kinematic data from the ankle joint. On the basis of these experiments, a wavelet packet transform was tested to define a feature vector from the sciatic ENG signals according to the gait phases. We also propose a Gaussian mixture model (GMM) classifier and investigate whether it could be used successfully to discriminate feature vectors into the stance and swing phases. In spite of no significant differences in the rectified bin-integrated values between the stance and swing phases, the sciatic ENG signals could be reliably classified using the proposed wavelet packet transform and GMM classification methods. (paper)

  13. Dynamic observation of biomechanic properties of sciatic nerve at the suture site in rats following repairing.

    Science.gov (United States)

    Jiang, Baoguo; Zhang, Peixun; Yan, Jiazhi; Zhang, Hongbo

    2008-01-01

    To observe the biomechanic properties of the sciatic nerve at the suture site following repairing in rats. The right sciatic nerves of 40 white Sprague-Dawley 300~350 gm rats were exposed, cut and then repaired with 10-0 nylon sutures with four stitches, laced in the epineurium 0, 1, 3, and 6 weeks after operation, the tensile strength of the sciatic nerves were measured, and the data analyzed statistically. The load elongation curves for both the normal unoperated and operated nerves had similar shape. There were significant differences between the tensile strength of the 0th and the 1st, 3rd, and 6th weeks (P < 0.01). No significant difference was found among the 1st, 3rd, and 6th weeks. The tensile strength of the injured nerves recovered 48% of the normal nerve in the 1st week and 54% in 6 weeks after repairing. It may be concluded that the injured nerves can acquire mostly tensile strength stability in 1 week quickly and can maintain this relative tensile strength stability in 6 weeks.

  14. The percentage of macrophage numbers in rat model of sciatic nerve crush injury

    Directory of Open Access Journals (Sweden)

    Satrio Wicaksono

    2016-02-01

    Full Text Available ABSTRACT Excessive accumulation of macrophages in sciatic nerve fascicles inhibits regeneration of peripheral nerves. The aim of this study is to determine the percentage of the macrophages inside and outside of the fascicles at the proximal, at the site of injury and at the distal segment of rat model of sciatic nerve crush injury. Thirty male 3 months age Wistar rats of 200-230 g were divided into sham-operation group and crush injury group. Termination was performed on day 3, 7, and 14 after crush injury. Immunohistochemical examination was done using anti CD68 antibody. Counting of immunopositive and immunonegative cells was done on three representative fields for extrafascicular and intrafascicular area of proximal, injury and distal segments. The data was presented as percentage of immunopositive cells. The percentage of the macrophages was significantly increased in crush injury group compared to the sham-operated group in all segments of the peripheral nerves. While the percentage of macrophages outside fascicle in all segments of sciatic nerve and within the fascicle in the proximal segment reached its peak on day 3, the percentage of macrophages within the fascicles at the site of injury and distal segments reached the peak later at day 7. In conclusions, accumulation of macrophages outside the nerve fascicles occurs at the beginning of the injury, and then followed later by the accumulation of macrophages within nerve fascicles

  15. Correlation Among Ultrasound, Cross-Sectional Anatomy, and Histology of the Sciatic Nerve A Review

    NARCIS (Netherlands)

    Moayeri, Nizar; van Geffen, Geert J.; Bruhn, Jorgen; Chan, Vincent W.; Groen, Gerbrand J.

    2010-01-01

    Background and Objectives: Efficient identification of the sciatic nerve (SN) requires a thorough knowledge of its topography in relation to the surrounding structures. Anatomic cross sections in similar oblique planes as observed during SN ultrasonography are lacking. A survey of sonoanatomy

  16. Correlation among ultrasound, cross-sectional anatomy, and histology of the sciatic nerve: a review.

    NARCIS (Netherlands)

    Moayeri, N.; Geffen, G.J. van; Bruhn, J.; Chan, V.W.; Groen, G.J.

    2010-01-01

    BACKGROUND AND OBJECTIVES: Efficient identification of the sciatic nerve (SN) requires a thorough knowledge of its topography in relation to the surrounding structures. Anatomic cross sections in similar oblique planes as observed during SN ultrasonography are lacking. A survey of sonoanatomy

  17. Long-term reinnervation effects after sciatic nerve lesions in adult rats

    NARCIS (Netherlands)

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

    Transection of the sciatic nerve in adult rats induces drastic changes in hindleg muscles. Earlier, we demonstrated that the reinnervated soleus (SOL) muscle, 21 weeks after a transection mainly contains type II fibers. This is in striking contrast to normal muscle, which consists to 80% of type I

  18. injection-induced sciatic nerve injury among children managed in an

    African Journals Online (AJOL)

    user

    African Journal of Medicine and Medical Sciences37: 389–93. Fatunde, O.J. and Familusi J.B. 2001. Injection-induced sciatic nerve injury in Nigerian children. Central African Journal. Medicine 47.35-38. Halsey, N.A. 2003. Commentary: Poliomyelitis and unnecessary injections. International Journal of Epidemiology32, ...

  19. [Morphology research of the rat sciatic nerve bridged by collage-heparin sulfate scaffold].

    Science.gov (United States)

    Wang, Shu-sen; Hu, Yun-yu; Luo, Zhuo-jing; Chen, Liang-wei; Liu, Hui-ling; Meng, Guo-lin; Lü, Rong; Xu, Xin-zhi

    2005-04-15

    To observe the treating effect of collage-heparin sulfate after the 10 mm rat sciatic nerve defect was bridged by it. A new kind of nervous tissue engineering scaffold was produced by freeze-drying technique from collagen-heparin sulfate. Thirty-two SD rats were randomly divided into A, B, C and D groups. Sciatic nerve defect in group A was bridged by collagen-heparin sulfate. In group B, sciatic nerve was bridged by auto-nerve transplantation. Group C was the blank control group. Animals in group D were normal. And 10 mm sciatic nerve defect was bridged in the experiment. Thirty-six weeks after the operation, the experimental animals were detected by HRP labeled retrograde trace, HE staining, toluidine staining, silvering staining, S100, GAP-43 and NF immunohistological staining, MBP immunofluorescence staining and transmission electron microscope to observe the nerve regeneration inducing effect of this new scaffold. Nine months after operation, the collage-heparin sulfate scaffold was replaced by newly regenerated nerve. The number of HRP labeled spinal cord anterior horn cells and the area of sensation nerve fiber at the posterior horn were similar with that was repaired by auto-nerve. GAP-43, NF and S100 labeled regenerated nerve fiber had passed the total scaffold and entered the distal terminal. The regenerated nerve fibers were paralleled, lineage arranged, coincide with the prearranged regenerating "channel" in the collagen-heparin sulfate scaffold. MBP immunofluorescence staining also proved that the newly regenerated nerve fiber could be ensheathed. In the experimental group, the area of myelinated nerve fiber and the thickness of the myelin sheath had no obvious difference with that of the group repaired by auto-nerve, except that the density of the regenerated myelinated sheath fiber was lower than that of the control group. Nervous tissue engineering scaffold produced by collagen-heparin sulfate can guide the regeneration of nerve fibers. The nerve

  20. Sequential imaging of intraneural sciatic nerve endometriosis provides insight into symptoms of cyclical sciatica.

    Science.gov (United States)

    Capek, Stepan; Amrami, Kimberly K; Howe, Benjamin M; Collins, Mark S; Sandroni, Paola; Cheville, John C; Spinner, Robert J

    2016-03-01

    Endometriosis of the nerve often remains an elusive diagnosis. We report the first case of intraneural lumbosacral plexus endometriosis with sequential imaging at different phases of the menstrual cycle: during the luteal phase and menstruation. Compared to the first examination, the examination performed during the patient's period revealed the lumbosacral plexus larger and hyperintense on T2-weighted imaging. The intraneural endometriosis cyst was also larger and showed recent hemorrhage. Additionally, this case represents another example of perineural spread of endometriosis from the uterus to the lumbosacral plexus along the autonomic nerves and then distally to the sciatic nerve and proximally to the spinal nerves.

  1. Regulation of Schwann cell proliferation in cultured segments of the adult rat sciatic nerve

    DEFF Research Database (Denmark)

    Svenningsen, Åsa Fex; Kanje, M

    1998-01-01

    Schwann cell proliferation was studied in cultured segments of the rat sciatic nerve by measurement of [3H] thymidine incorporation or through bromodeoxyuridine-(BrdU)-labelling and immunocytochemistry. The aim was to delineate mechanisms involved in the injury-induced proliferative response...... through the cAMP system. Together, these results show that Schwann cells regulate proliferation differently in an integrated environment, e.g. the nerve structure, than in isolation as primary monocultures....

  2. Sciatic nerve transection in the adult rat : Abnormal EMG patterns during locomotion by aberrant innervation of hindleg muscles

    NARCIS (Netherlands)

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

    The effects of lesions in the sciatic nerve were studied in adult rats, In the left hindleg, a segment 12 mm long was resected from the proximal part of the nerve, before the bifurcation into the peroneal and tibial nerves, This segment in a reversed orientation was used as a nerve graft. EMG

  3. Effects of 940 nm light-emitting diode (led) on sciatic nerve regeneration in rats.

    Science.gov (United States)

    Serafim, Karla Guivernau Gaudens; Ramos, Solange de Paula; de Lima, Franciele Mendes; Carandina, Marcelo; Ferrari, Osny; Dias, Ivan Frederico Lupiano; Toginho Filho, Dari de Oliveira; Siqueira, Cláudia Patrícia Cardoso Martins

    2012-01-01

    The objective of the present study was to evaluate the effect of 940 nm wavelength light emitting diode (LED) phototherapy on nerve regeneration in rats. Forty male Wistar rats weighing approximately 300 g each were divided into four groups: control (C); control submitted to LED phototherapy (CLed); Sciatic Nerve Lesion without LED phototherapy (L); Sciatic Nerve Lesion with LED phototherapy (LLed). The lesion was caused by crushing the right sciatic nerve. A dose of 4 J/cm(2) was used for ten consecutive days beginning on the first postoperative day. Groups C and L were submitted to the same procedure as the LLed group, but the equipment was turned off. The LED phototherapy with 940 nm wavelength reduced the areas of edema, the number of mononuclear cells present in the inflammatory infiltration, and increased functional recovery scores at 7, 14 and 21 days. The results suggest that the use of phototherapy at 940 nm after nerve damage improves morphofunctional recovery and nerve regeneration.

  4. Resiniferatoxin combined with antidepressants preferentially prolongs sensory/nociceptive block in rat sciatic nerve.

    Science.gov (United States)

    Hung, Yu-Chun; Suzuki, Suzuko; Huang, Chun-Jen; Chen, Chien-Chuan; Pan, Yu-Yen; Wang, Chi-Fei; Srinavasan, Venkatesh; Gerner, Peter

    2010-07-01

    Current techniques of peripheral nerve block have major limitations, including lack of differentiation between motor and sensory fibers and potential toxicity of local anesthetics. Recent studies have suggested that a nociceptive-selective nerve block can be achieved via a transient receptor potential vanilloid type 1 activator (capsaicin) along with local anesthetics. We hypothesized that the combination of potent transient receptor potential vanilloid type 1 agonist resiniferatoxin (RTX) and selected antidepressants (amitriptyline, doxepin, and fluoxetine, also potent sodium channel blockers) would produce prolonged and predominantly sensory nerve block. Rats were anesthetized with isoflurane, and 0.2 mL of amitriptyline, doxepin, or fluoxetine was deposited next to the surgically exposed sciatic nerves (n = 8 per group). Some animals received a second injection containing RTX (n = 8 per group). The effect of nerve block was assessed by neurobehavioral tests of the motor function (extensor postural thrust) and the nocifensive reaction (mechanical pinch). A single application of RTX produced nociceptive-selective sciatic nerve block, whereas antidepressants produced nociceptive and motor block. The combined administration of RTX and antidepressant resulted in a predominantly nociceptive nerve block. Compared with antidepressants or RTX alone, the combination prolonged the nociceptive nerve block more than the motor block. The combined application of RTX and antidepressants produced a markedly prolonged nociceptive peripheral nerve block in rat sciatic nerves compared with either agent alone. However, the 2-drug regimen also elicited prolonged blockade of the motor function, although disproportionately less compared with the nociceptive modality, suggesting the existence of nontransient receptor potential vanilloid type 1-mediated mechanisms. The mechanisms through which RTX affects nociceptive signal transduction/transmission have yet to be fully elucidated.

  5. Evaluation of effects of sciatic and femoral nerve blocks in sheep undergoing stifle surgery.

    Science.gov (United States)

    Wagner, Ann E; Mama, Khursheed R; Ruehlman, Dana L; Pelkey, Sheila; Turner, A Simon

    2011-04-01

    The authors evaluated the effects of locally anesthetizing the sciatic and femoral nerves in sheep undergoing stifle (femorotibial) surgery (16 sheep received nerve blocks; 16 sheep underwent a nerve localization procedure but received no nerve blocks). Heart rate, mean arterial blood pressure and end-tidal isoflurane were recorded every 5 min while sheep were anesthetized. At some of the observed time points, the mean heart rate in the sheep that had received no nerve blocks was significantly higher than in the sheep that had received the nerve blocks. Postoperatively, each sheep was assigned scores for comfort and attitude, movement, flock behavior, feeding behavior and appetite and respiratory rate (based on predefined descriptions). Though the authors found no undesirable effects of this local anesthesia, beneficial effects of the nerve blocks were minimal or not readily apparent under the conditions of this study.

  6. The Spatial Relationship and Surface Projection of Canine Sciatic Nerve and Sacrotuberous Ligament: A Perineal Hernia Repair Perspective.

    Science.gov (United States)

    Khatri-Chhetri, Nabin; Khatri-Chhetri, Rupak; Chung, Cheng-Shu; Chern, Rey-Shyong; Chien, Chi-Hsien

    2016-01-01

    Sciatic nerve entrapment can occur as post-operative complication of perineal hernia repair when sacrotuberous ligament is incorporated during hernia deficit closure. This results in sciatic sensory loss and paralysis of the hind leg. This study investigated the spatial relationship of sciatic nerve and sacrotuberous ligament and their surface topographic projection of 68 cadavers (29 Beagles and 39 Taiwanese mongrels) with various heights (25-56 cm). By gross dissection, the sacrotuberous ligament and sciatic nerve were exposed and their distance in between was measured along four parts (A, B, C, D) of sacrotuberous ligament. The present study revealed that the C was the section of sacrotuberous ligament where the sciatic nerve and the sacrotuberous ligament are closest to each other. Furthermore, a positive correlation was observed between C and height of the dogs. From the present study, we found that the C in smaller dogs has the shortest distance between the sciatic nerve and the sacrotuberous ligament, and thus the most vulnerable to sciatic nerve entrapment, and needs to be avoided or approached cautiously during perineal hernia repair.

  7. The Spatial Relationship and Surface Projection of Canine Sciatic Nerve and Sacrotuberous Ligament: A Perineal Hernia Repair Perspective.

    Directory of Open Access Journals (Sweden)

    Nabin Khatri-Chhetri

    Full Text Available Sciatic nerve entrapment can occur as post-operative complication of perineal hernia repair when sacrotuberous ligament is incorporated during hernia deficit closure. This results in sciatic sensory loss and paralysis of the hind leg. This study investigated the spatial relationship of sciatic nerve and sacrotuberous ligament and their surface topographic projection of 68 cadavers (29 Beagles and 39 Taiwanese mongrels with various heights (25-56 cm. By gross dissection, the sacrotuberous ligament and sciatic nerve were exposed and their distance in between was measured along four parts (A, B, C, D of sacrotuberous ligament. The present study revealed that the C was the section of sacrotuberous ligament where the sciatic nerve and the sacrotuberous ligament are closest to each other. Furthermore, a positive correlation was observed between C and height of the dogs. From the present study, we found that the C in smaller dogs has the shortest distance between the sciatic nerve and the sacrotuberous ligament, and thus the most vulnerable to sciatic nerve entrapment, and needs to be avoided or approached cautiously during perineal hernia repair.

  8. Reinnervation of the tibialis anterior following sciatic nerve crush injury: a confocal microscopic study in transgenic mice.

    Science.gov (United States)

    Magill, Christina K; Tong, Alice; Kawamura, David; Hayashi, Ayato; Hunter, Daniel A; Parsadanian, Alexander; Mackinnon, Susan E; Myckatyn, Terence M

    2007-09-01

    Transgenic mice whose axons and Schwann cells express fluorescent chromophores enable new imaging techniques and augment concepts in developmental neurobiology. The utility of these tools in the study of traumatic nerve injury depends on employing nerve models that are amenable to microsurgical manipulation and gauging functional recovery. Motor recovery from sciatic nerve crush injury is studied here by evaluating motor endplates of the tibialis anterior muscle, which is innervated by the deep peroneal branch of the sciatic nerve. Following sciatic nerve crush, the deep surface of the tibialis anterior muscle is examined using whole mount confocal microscopy, and reinnervation is characterized by imaging fluorescent axons or Schwann cells (SCs). One week following sciatic crush injury, 100% of motor endplates are denervated with partial reinnervation at 2 weeks, hyperinnervation at 3 and 4 weeks, and restoration of a 1:1 axon to motor endplate relationship 6 weeks after injury. Walking track analysis reveals progressive recovery of sciatic nerve function by 6 weeks. SCs reveal reduced S100 expression within 2 weeks of denervation, correlating with regression to a more immature phenotype. Reinnervation of SCs restores S100 expression and a fully differentiated phenotype. Following denervation, there is altered morphology of circumscribed terminal Schwann cells demonstrating extensive process formation between adjacent motor endplates. The thin, uniformly innervated tibialis anterior muscle is well suited for studying motor reinnervation following sciatic nerve injury. Confocal microscopy may be performed coincident with other techniques of assessing nerve regeneration and functional recovery.

  9. Model study of combined electrical and near-infrared neural stimulation on the bullfrog sciatic nerve.

    Science.gov (United States)

    You, Mengxian; Mou, Zongxia

    2017-07-01

    This paper implemented a model study of combined electrical and near-infrared (808 nm) neural stimulation (NINS) on the bullfrog sciatic nerve. The model includes a COMSOL model to calculate the electric-field distribution of the surrounding area of the nerve, a Monte Carlo model to simulate light transport and absorption in the bullfrog sciatic nerve during NINS, and a NEURON model to simulate the neural electrophysiology changes under electrical stimulus and laser irradiation. The optical thermal effect is considered the main mechanism during NINS. Therefore, thermal change during laser irradiation was calculated by the Monte Carlo method, and the temperature distribution was then transferred to the NEURON model to stimulate the sciatic nerve. The effects on thermal response by adjusting the laser spot size, energy of the beam, and the absorption coefficient of the nerve are analyzed. The effect of the ambient temperature on the electrical stimulation or laser stimulation and the interaction between laser irradiation and electrical stimulation are also studied. The results indicate that the needed stimulus threshold for neural activation or inhibition is reduced by laser irradiation. Additionally, the needed laser energy for blocking the action potential is reduced by electrical stimulus. Both electrical and laser stimulation are affected by the ambient temperature. These results provide references for subsequent animal experiments and could be of great help to future basic and applied studies of infrared neural stimulation (INS).

  10. Piriformis muscle syndrome with assessment of sciatic nerve using diffusion tensor imaging and tractography: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Wada, Keizo; Goto, Tomohiro; Takasago, Tomoya; Hamada, Daisuke; Sairyo, Koichi [The University of Tokushima Graduate School, Department of Orthopedics, Institute of Health Biosciences, Tokushima (Japan)

    2017-10-15

    Piriformis muscle syndrome (PMS) is difficult to diagnose by objective evaluation of sciatic nerve injury. Here we report a case of PMS diagnosed by diffusion tensor imaging (DTI) and tractography of the sciatic nerve, which can assess and visualize the extent of nerve injury. The patient was a 53-year-old man with a 2-year history of continuous pain and numbness in the left leg. His symptoms worsened when sitting. Physical examination, including sensorimotor neurologic tests, the deep tendon reflex test, and the straight leg raise test, revealed no specific findings. The hip flexion adduction and internal rotation test and resisted contraction maneuvers for the piriformis muscle were positive. There were no abnormal findings on magnetic resonance imaging (MRI) of the lumbar spine. The transverse diameter of piriformis muscle was slightly thicker in affected side on MRI of the pelvis. A single DTI sequence was performed during MRI of the pelvis. Fractional anisotropy (FA) and the apparent diffusion coefficient (ADC) of the sciatic nerve were quantified at three levels using the fiber-tracking method. FA values were significantly lower and ADC values were significantly higher distal to the piriformis muscle. We performed endoscopic-assisted resection of the piriformis tendon. Intraoperatively, the motor-evoked potentials in the left gastrocnemius were improved by resection of the piriformis tendon. The patient's symptoms improved immediately after surgery. There was no significant difference in FA or ADC at any level between the affected side and the unaffected side 3 months postoperatively. MRI-DTI may aid the diagnosis of PMS. (orig.)

  11. Biological conduits combining bone marrow mesenchymal stem cells and extracellular matrix to treat long-segment sciatic nerve defects

    Directory of Open Access Journals (Sweden)

    Yang Wang

    2015-01-01

    Full Text Available The transplantation of polylactic glycolic acid conduits combining bone marrow mesenchymal stem cells and extracellular matrix gel for the repair of sciatic nerve injury is effective in some respects, but few data comparing the biomechanical factors related to the sciatic nerve are available. In the present study, rabbit models of 10-mm sciatic nerve defects were prepared. The rabbit models were repaired with autologous nerve, a polylactic glycolic acid conduit + bone marrow mesenchymal stem cells, or a polylactic glycolic acid conduit + bone marrow mesenchymal stem cells + extracellular matrix gel. After 24 weeks, mechanical testing was performed to determine the stress relaxation and creep parameters. Following sciatic nerve injury, the magnitudes of the stress decrease and strain increase at 7,200 seconds were largest in the polylactic glycolic acid conduit + bone marrow mesenchymal stem cells + extracellular matrix gel group, followed by the polylactic glycolic acid conduit + bone marrow mesenchymal stem cells group, and then the autologous nerve group. Hematoxylin-eosin staining demonstrated that compared with the polylactic glycolic acid conduit + bone marrow mesenchymal stem cells group and the autologous nerve group, a more complete sciatic nerve regeneration was found, including good myelination, regularly arranged nerve fibers, and a completely degraded and resorbed conduit, in the polylactic glycolic acid conduit + bone marrow mesenchymal stem cells + extracellular matrix gel group. These results indicate that bridging 10-mm sciatic nerve defects with a polylactic glycolic acid conduit + bone marrow mesenchymal stem cells + extracellular matrix gel construct increases the stress relaxation under a constant strain, reducing anastomotic tension. Large elongations under a constant physiological load can limit the anastomotic opening and shift, which is beneficial for the regeneration and functional reconstruction of sciatic nerve. Better

  12. The effect of hip position upon the location of the sciatic nerve: an MRI Study.

    Science.gov (United States)

    Birke, Oliver; Mitchell, Piers D; Onikul, Ella; Little, David G

    2011-03-01

    Allowance for the positional changes of the sciatic nerve is important when considering the safest position of the leg to perform hip operations, specifically the ischial osteotomy during a pelvic triple or periacetabular osteotomy. As for its proximity to the osteotomy site the sciatic nerve can be injured during these operations with the consequence of severe functional impairment. This is the first in-vivo study that demonstrates the effect of hip position upon the location of the sciatic nerve. We determined how altering the position of the hip moves the nerve toward or away from the infracotyloid groove, the desired starting point of the ischial osteotomy site just inferior to the acetabulum when performing a pelvic triple or periacetabular osteotomy. Magnetic resonance imaging scans of the left hip in 3 different positions (neutral/supine, 30 to 45 degrees flexion, 30 to 45 degrees flexion/abduction/external rotation) were performed in 11 healthy children (5 boys and 6 girls, age 7 to 17 y) without prior hip surgery. The distance between the sciatic nerve and the infracotyloid groove was measured on the magnetic resonance images. Distance ratios based on the neutral position were calculated for flexion and flexion/abduction/external rotation for each of the participants. The sciatic nerve moves toward the ischium osteotomy site in hip flexion without abduction (mean flexion: neutral ratio 0.79, Pexternally rotated (mean flexion/abduction/external rotation: neutral ratio 1.34), meaning the distance from nerve to infracotyloid groove increases significantly (Pmean distances were 14.8 mm (11 to 20 mm) in neutral, 11.8 mm (9 to 16 mm) in flexion, and 20.0 mm (9 to 30 mm) in flexion/abduction/external rotation. The likely safest position of the hip/leg to perform the ischium osteotomy as part of a pelvic triple or periacetabular osteotomy is in flexion, abduction, and external rotation. In this position the osteotomy can be performed via a medial or anterior

  13. Protective Effect of Alpha Lipoic Acid on Rat Sciatic Nerve Ischemia Reperfusion Damage

    Directory of Open Access Journals (Sweden)

    Ozan Turamanlar

    2015-06-01

    Full Text Available Background: Alpha lipoic acid is a potent antioxidant that plays numerous roles in human health. This study examined the effect of ALA on rat sciatic nerve ischemia reperfusion damage. Aims: Protective effect of alpha lipoic acid (ALA on sciatic nerve following ischemia-reperfusion in rats was investigated by using light microscopy and biochemical methods. Provided that the protective effect of ALA on sciatic nerve is proven, we think the damage to the sciatic nerve that has already occurred or might occur in patients for various reasons maybe prevented or stopped by giving ALA in convenient doses. Study Design: Animal experiment. Methods: Forty-two adult male Sprague-Dawley rats (250-300 grams were used in this study. Rats were randomly divided into six groups including one control (Group 1, one sham (Group 2, two ischemia-reperfusion (Groups 3 and 4 and two treatment groups (Groups5 and 6. Doses of 60 and 100 mg/kg ALA were given (Group 5 and 6 intra peritoneally twice, 1 and 24 hours before the ischemia to each treatment group. Ischemia was carried out the abdominal aorta starting from the distal part of the renal vein for two hours followed by reperfusion for three hours. In immunohistochemical methods, fibronectin immunoreactivity was analyzed. For biochemical analyses, the tissues were taken in eppendorf microtubes and superoxide dismutase (SOD and glutathione peroxidase (GSHPx enzyme activities as well as malondialdehyde (MDA and nitricoxide (NO levels were measured. Results: Fibronectin was observed to have increased significantly in the ischemia group; on the other hand, it was observed to have decreased in parallel to the doses in the ALA groups. Biochemical studies showed that SOD and GSHPx declined with ischemia-reperfusion, but the activities of these enzymes were increased in the treatment groups in parallel with the dose. It was found that increased MDA levels with ischemia-reperfusion were decreased in parallel with ALA dose

  14. A combination of Schwann-cell grafts and aerobic exercise enhances sciatic nerve regeneration.

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    Camila Oliveira Goulart

    Full Text Available Despite the regenerative potential of the peripheral nervous system, severe nerve lesions lead to loss of target-organ innervation, making complete functional recovery a challenge. Few studies have given attention to combining different approaches in order to accelerate the regenerative process.Test the effectiveness of combining Schwann-cells transplantation into a biodegradable conduit, with treadmill training as a therapeutic strategy to improve the outcome of repair after mouse nerve injury.Sciatic nerve transection was performed in adult C57BL/6 mice; the proximal and distal stumps of the nerve were sutured into the conduit. Four groups were analyzed: acellular grafts (DMEM group, Schwann cell grafts (3×105/2 µL; SC group, treadmill training (TMT group, and treadmill training and Schwann cell grafts (TMT + SC group. Locomotor function was assessed weekly by Sciatic Function Index and Global Mobility Test. Animals were anesthetized after eight weeks and dissected for morphological analysis.Combined therapies improved nerve regeneration, and increased the number of myelinated fibers and myelin area compared to the DMEM group. Motor recovery was accelerated in the TMT + SC group, which showed significantly better values in sciatic function index and in global mobility test than in the other groups. The TMT + SC group showed increased levels of trophic-factor expression compared to DMEM, contributing to the better functional outcome observed in the former group. The number of neurons in L4 segments was significantly higher in the SC and TMT + SC groups when compared to DMEM group. Counts of dorsal root ganglion sensory neurons revealed that TMT group had a significant increased number of neurons compared to DMEM group, while the SC and TMT + SC groups had a slight but not significant increase in the total number of motor neurons.These data provide evidence that this combination of therapeutic strategies can significantly improve functional

  15. US-Guided Femoral and Sciatic Nerve Blocks for Analgesia During Endovenous Laser Ablation

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    Yilmaz, Saim, E-mail: ysaim@akdeniz.edu.tr; Ceken, Kagan; Alimoglu, Emel; Sindel, Timur [Akdeniz University School of Medicine, Department of Radiology (Turkey)

    2013-02-15

    Endovenous laser ablation may be associated with significant pain when performed under standard local tumescent anesthesia. The purpose of this study was to investigate the efficacy of femoral and sciatic nerve blocks for analgesia during endovenous ablation in patients with lower extremity venous insufficiency. During a 28-month period, ultrasound-guided femoral or sciatic nerve blocks were performed to provide analgesia during endovenous laser ablation in 506 legs and 307 patients. The femoral block (n = 402) was performed at the level of the inguinal ligament, and the sciatic block at the posterior midthigh (n = 124), by injecting a diluted lidocaine solution under ultrasound guidance. After the blocks, endovenous laser ablations and other treatments (phlebectomy or foam sclerotherapy) were performed in the standard fashion. After the procedures, a visual analogue pain scale (1-10) was used for pain assessment. After the blocks, pain scores were 0 or 1 (no pain) in 240 legs, 2 or 3 (uncomfortable) in 225 legs, and 4 or 5 (annoying) in 41 legs. Patients never experienced any pain higher than score 5. The statistical analysis revealed no significant difference between the pain scores of the right leg versus the left leg (p = 0.321) and between the pain scores after the femoral versus sciatic block (p = 0.7). Ultrasound-guided femoral and sciatic nerve blocks may provide considerable reduction of pain during endovenous laser and other treatments, such as ambulatory phlebectomy and foam sclerotherapy. They may make these procedures more comfortable for the patient and easier for the operator.

  16. US-Guided Femoral and Sciatic Nerve Blocks for Analgesia During Endovenous Laser Ablation

    International Nuclear Information System (INIS)

    Yilmaz, Saim; Ceken, Kagan; Alimoglu, Emel; Sindel, Timur

    2013-01-01

    Endovenous laser ablation may be associated with significant pain when performed under standard local tumescent anesthesia. The purpose of this study was to investigate the efficacy of femoral and sciatic nerve blocks for analgesia during endovenous ablation in patients with lower extremity venous insufficiency. During a 28-month period, ultrasound-guided femoral or sciatic nerve blocks were performed to provide analgesia during endovenous laser ablation in 506 legs and 307 patients. The femoral block (n = 402) was performed at the level of the inguinal ligament, and the sciatic block at the posterior midthigh (n = 124), by injecting a diluted lidocaine solution under ultrasound guidance. After the blocks, endovenous laser ablations and other treatments (phlebectomy or foam sclerotherapy) were performed in the standard fashion. After the procedures, a visual analogue pain scale (1–10) was used for pain assessment. After the blocks, pain scores were 0 or 1 (no pain) in 240 legs, 2 or 3 (uncomfortable) in 225 legs, and 4 or 5 (annoying) in 41 legs. Patients never experienced any pain higher than score 5. The statistical analysis revealed no significant difference between the pain scores of the right leg versus the left leg (p = 0.321) and between the pain scores after the femoral versus sciatic block (p = 0.7). Ultrasound-guided femoral and sciatic nerve blocks may provide considerable reduction of pain during endovenous laser and other treatments, such as ambulatory phlebectomy and foam sclerotherapy. They may make these procedures more comfortable for the patient and easier for the operator.

  17. Chitosan-film associated with mesenchymal stem cells enhanced regeneration of peripheral nerves: A rat sciatic nerve model.

    Science.gov (United States)

    Moattari, Mehrnaz; Kouchesfehani, Homa Mohseni; Kaka, Gholamreza; Sadraie, Seyed Homayoon; Naghdi, Majid; Mansouri, Korosh

    2018-03-01

    Peripheral nerve injuries comprise significant portion of the nervous system injuries. Although peripheral nerves show some capacity of regeneration after injury, but the extent of regeneration is not remarkable. Regeneration might be through the activity of the mesenchymal stem cells (MSCs) which can release growth factors or extracellular matrix components or by the therapeutic effect of some material with the MSCs. The present study aimed to evaluate the regeneration of transected sciatic nerve by a therapeutic value of mesenchymal stem cells (MSCs) associated with chitosan-film (Cs) in rat. Male Wistar rats (n=42, 180-200g) were randomly divided into intact; control; sham; Cs; MSCs; MSCs + Cs groups. Functional recovery was evaluated at 2, 4, 6 and 8 weeks after surgery using sciatic functional index (SFI), hot water paw immersion test, electrophysiological, histological analyses. The rats in the MSCs+Cs group showed significant decrease in SFI and hot water paw immersion test during the 2nd to 8th weeks after surgery. Electrophysiological findings showed a significant decrease in latency time in the MSCs +Cs group. Amplitude of the nerve impulses also increased. Number of nerve fibers with more than 6 μm diameters increased significantly in MSCs+Cs. The number of nerve fibers with less than 4 μm diameters also increased significantly in MSCs+Cs group. Taken together, mesenchymal stem cells associated with Cs could improve functional and histomorphological properties of the sciatic nerve after injury which may have some clinical outcomes as well. Copyright © 2017 Elsevier B.V. All rights reserved.

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

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    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

  19. Biodegradable and biocompatible cationic polymer delivering microRNA-221/222 promotes nerve regeneration after sciatic nerve crush.

    Science.gov (United States)

    Song, Jialin; Li, Xueyang; Li, Yingli; Che, Junyi; Li, Xiaoming; Zhao, Xiaotian; Chen, Yinghui; Zheng, Xianyou; Yuan, Weien

    2017-01-01

    MicroRNA (miRNA) has great potential to treat a wide range of illnesses by regulating the expression of eukaryotic genes. Biomaterials with high transfection efficiency and low toxicity are needed to deliver miRNA to target cells. In this study, a biodegradable and biocompatible cationic polymer (PDAPEI) was synthetized from low molecular weight polyethyleneimine (PEI1.8kDa) cross-linked with 2,6-pyridinedicarboxaldehyde. PDAPEI showed a lower cytotoxicity and higher transfection efficiency than PEI25kDa in transfecting miR-221/222 into rat Schwann cells (SCs). The upregulation of miR-221/222 in SCs promoted the expression of nerve growth factor and myelin basic protein in vitro. The mouse sciatic nerve crush injury model was used to evaluate the effectiveness of PDAPEI/miR-221/222 complexes for nerve regeneration in vivo. The results of electrophysiological tests, functional assessments, and histological and immunohistochemistry analyses demonstrated that PDAPEI/miR-221/222 complexes significantly promoted nerve regeneration after sciatic nerve crush, specifically enhancing remyelination. All these results show that the use of PDAPEI to deliver miR-221/222 may provide a safe therapeutic means of treating nerve crush injury and may help to overcome the barrier of biomaterial toxicity and low efficiency often encountered during medical intervention.

  20. Extraskeletal Ewing’s Sarcoma Arising from the Sciatic Nerve: A Diagnostic Challenge

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    Aadhar Sharma

    2015-01-01

    Full Text Available Ewing’s sarcoma is a common bone tumour of childhood but is a rare occurrence in individuals over 20 years of age. Few cases are reported as originating from peripheral nerves. We present an unusual case of extraosseous Ewing’s sarcoma originating from the sciatic nerve in a 66-year-old patient which had the clinical hallmarks of a benign nerve sheath tumour. Following discussion at a multidisciplinary meeting, excision biopsy of the suspected benign nerve sheath tumour was planned. At operation, the mass had malignant features. Histology confirmed the presence of Ewing’s sarcoma. Due to the morbidity of nerve resection, radiotherapy and chemotherapy were commenced. Ewing’s sarcoma is known to mimic benign pathologies. In this case there were subtle signs of a malignant process in the form of unremitting pain. It is vital to keep in mind the less common tumours that can affect the peripheral nervous system in such cases.

  1. Arsenic-induced neurotoxicity in relation to toxicokinetics: effects on sciatic nerve proteins.

    Science.gov (United States)

    Vahidnia, A; Romijn, F; van der Voet, G B; de Wolff, F A

    2008-11-25

    In our previous study in rats acutely exposed to As, we observed an effect of As on neurofilaments in the sciatic nerve. This study deals with the effects of inorganic As in Wistar rats on the cytoskeletal protein composition of the sciatic nerve after subchronic intoxication. Sodium meta-arsenite (NaAsO2) dissolved in phosphate-buffered saline (PBS) was administered daily in doses of 0, 3 and 10 mg/kg body weight/day (n=9 rats/group) by intragastric route for 4, 8 and 12 week periods. Toxicokinetic measurements revealed a saturation of blood As in the 3- and 10-mg/kg dose groups at approximately 14 microg/ml, with an increase in renal clearance of As at increasing doses. After exsanguination, sciatic nerves were excised and the protein composition was analyzed. Analysis of the sciatic nerves showed compositional changes in their proteins. Protein expression of neurofilament Medium (NF-M) and High (NF-H) was unchanged. Neurofilament protein Low (NF-L) expression was reduced, while mu- and m-calpain protein expression was increased, both in a dose/time pattern. Furthermore, NF-H protein was hypophosphorylated, while NF-L and microtubule-associated protein tau (MAP-tau) proteins were (hyper)-phosphorylated. In conclusion, we show that expression of mu- and m-calpain protein is increased by exposure to As, possibly leading to increased NF-L degradation. In addition, hyperphosphorylation of NF-L and MAP-tau by As also contribute to destabilization and disruption of the cytoskeletal framework, which eventually may lead to axonal degeneration.

  2. Electron holography study of the charging effect in microfibrils of sciatic nerve tissues.

    Science.gov (United States)

    Kim, Ki Hyun; Akase, Zentaro; Shindo, Daisuke; Ohno, Nobuhiko; Fujii, Yasuhisa; Terada, Nobuo; Ohno, Shinichi

    2013-08-01

    The charging effects of microfibrils of sciatic nerve tissues due to electron irradiation are investigated using electron holography. The phenomenon that the charging effects are enhanced with an increase of electron intensity is visualized through direct observations of the electric potential distribution around the specimen. The electric potential at the surface of the specimen could be quantitatively evaluated by simulation, which takes into account the reference wave modulation due to the long-range electric field.

  3. Effect of non-autologous adipose-derived stem cells transplantation and nerve growth factor on the repair of crushed sciatic nerve in rats

    Directory of Open Access Journals (Sweden)

    Azadeh Tajik

    2014-02-01

    Conclusion: Transplantation of non-autologous of adipose-derived stem cells (ASDc is an appropriate therapeutic approach in repairing of neurological injuries and NGF has a positive effect in crushed sciatic nerve regeneration.

  4. Assessing Autophagy in Sciatic Nerves of a Rat Model that Develops Inflammatory Autoimmune Peripheral Neuropathies

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    Susana Brun

    2017-09-01

    Full Text Available The rat sciatic nerve has attracted widespread attention as an excellent model system for studying autophagy alterations in peripheral neuropathies. In our laboratory, we have developed an original rat model, which we used currently in routine novel drug screening and to evaluate treatment strategies for chronic inflammatory demyelinating polyneuropathy (CIDP and other closely related diseases. Lewis rats injected with the S-palmitoylated P0(180-199 peptide develop a chronic, sometimes relapsing-remitting type of disease. Our model fulfills electrophysiological criteria of demyelination with axonal degeneration, confirmed by immunohistopathology and several typical features of CIDP. We have set up a series of techniques that led us to examine the failures of autophagy pathways in the sciatic nerve of these model rats and to follow the possible improvement of these defects after treatment. Based on these newly introduced methods, a novel area of investigation is now open and will allow us to more thoroughly examine important features of certain autophagy pathways occurring in sciatic nerves.

  5. NEUROLOGIC OUTCOME AFTER INTRANEURAL AND PERINEURAL SCIATIC NERVE BLOCK IN PIGS

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    Eldan Kapur

    2013-02-01

    Full Text Available Studies in animals have suggested that intraneural application of local anesthetics may cause mechanical injury and pressure ischemia of nerve fascicles. Previous studies, however, have used small animal models and clinically irrelevant injection speed or equipment. Our hypothesis is that an intraneural injection is heralded by higher injection pressure and leads to neurologic impairment in pigs. Ten pigs of mixed breed were studied. After general anesthesia, the sciatic nerves (n = 20 were exposed bilaterally. Under direct vision, a 25-gauge insulated nerve block needle was placed either extraperineurally (n = 10 or subperineurially (n = 10, and 4 ml of preservative-free lidocaine 2% was injected using an automated infusion pump (15 ml / min. Injection pressure data were acquired using an in-line manometer coupled to a computer via an analog-to-digital conversion board. After injection, the animals were awakened and subjected to serial neurologic examinations during the 24 post-intervention hours. All but two perineural injections resulted in injection pressures below 20 psi. In contrast, intraneural injections resulted in significantly higher peak pressures. In 7 (70% intraneural injections, the injections pressures were over 20 psi (20-50 psi. Neurologic function returned to baseline within 24 hours in all sciatic nerve receiving perineural injections. In contrast, residual neurologic impairment was present in 7 sciatic nerves after intraneural injection; residual neurologic impairment was associated with injection pressures > 20 psi. The results indicate that high injection pressure during intraneural injection may be indicative of intrafascicular injection and may predict the development of neurologic injury.Key words: nerve block, injection pressure, neurologic injury, pigs

  6. [Dynamic observation of the biomechanic properties of sciatic nerve at the suture site in rats following repairing].

    Science.gov (United States)

    Yan, Jia-zhi; Jiang, Bao-guo; Zhao, Fu-qiang; Wei, Guang-ru; Shang, Yong-gang; Zhang, Pei-xun; Liu, Bo; Zhang, Hong-bo

    2005-06-15

    To observe the biomechanic properties of sciatic nerve at the suture site in rats following repairing. The right sciatic nerves of 40 white Sprague-Dawley 300-350 gm rats were exposed, cut and then repaired with 10-0 nylon sutures, laced in the epineurium. 0, 1, 3, 6 weeks after operation, the tensile strength of the sciatic nerves were measured, the data analyzed statistically. The load-elongation curves for both the normal unoperated and operated nerves had the similar shape. The tensile strength of the 0 week was significant difference to 1, 3 and 6 weeks (P < 0.01). No significant difference was found among 1, 3 and 6 weeks. The tensile strength of the injured nerves are recovered in the first week and resistant in 6 weeks after repairing.

  7. Electrical stimulation does not enhance nerve regeneration if delayed after sciatic nerve injury: the role of fibrosis

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    Na Han

    2015-01-01

    Full Text Available Electrical stimulation has been shown to accelerate and enhance nerve regeneration in sensory and motor neurons after injury, but there is little evidence that focuses on the varying degrees of fibrosis in the delayed repair of peripheral nerve tissue. In this study, a rat model of sciatic nerve transection injury was repaired with a biodegradable conduit at 1 day, 1 week, 1 month and 2 months after injury, when the rats were divided into two subgroups. In the experimental group, rats were treated with electrical stimuli of frequency of 20 Hz, pulse width 100 ms and direct current voltage of 3 V; while rats in the control group received no electrical stimulation after the conduit operation. Histological results showed that stained collagen fibers comprised less than 20% of the total operated area in the two groups after delayed repair at both 1 day and 1 week but after longer delays, the collagen fiber area increased with the time after injury. Immunohistochemical staining revealed that the expression level of transforming growth factor β (an indicator of tissue fibrosis decreased at both 1 day and 1 week after delayed repair but increased at both 1 and 2 months after delayed repair. These findings indicate that if the biodegradable conduit repair combined with electrical stimulation is delayed, it results in a poor outcome following sciatic nerve injury. One month after injury, tissue degeneration and distal fibrosis are apparent and are probably the main reason why electrical stimulation fails to promote nerve regeneration after delayed repair.

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

    KAUST Repository

    Morrison, Brett M.

    2015-01-01

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

  9. A prospective, randomized comparison between single- and multiple-injection techniques for ultrasound-guided subgluteal sciatic nerve block.

    Science.gov (United States)

    Yamamoto, Hiroto; Sakura, Shinichi; Wada, Minori; Shido, Akemi

    2014-12-01

    It is believed that local anesthetic injected to obtain circumferential spread around nerves produces a more rapid onset and successful blockade after some ultrasound-guided peripheral nerve blocks. However, evidence demonstrating this point is limited only to the popliteal sciatic nerve block, which is relatively easy to perform by via a high-frequency linear transducer. In the present study, we tested the hypothesis that multiple injections of local anesthetic to make circumferential spread would improve the rate of sensory and motor blocks compared with a single-injection technique for ultrasound-guided subgluteal sciatic nerve block, which is considered a relatively difficult block conducted with a low-frequency, curved-array transducer. Ninety patients undergoing knee surgery were divided randomly into 2 groups to receive the ultrasound-guided subgluteal approach to sciatic nerve block with 20 mL of 1.5% mepivacaine with epinephrine. For group M (the multiple-injection technique), the local anesthetic was injected to create circumferential spread around the sciatic nerve without limitation on the number of needle passes. For group S (the single-injection technique), the number of needle passes was limited to 1, and the local anesthetic was injected to create spread along the dorsal surface of the sciatic nerve, during which no adjustment of the needle tip was made. Sensory and motor blockade were assessed in double-blind fashion for 30 minutes after completion of the block. The primary outcome was sensory blockade of all sciatic components tested, including tibial, superficial peroneal, and sural nerves at 30 minutes after injection. Data from 86 patients (43 in each group) were analyzed. Block execution took more time for group M than group S. The proportion of patients with complete sensory blockade of all sciatic components at 30 minutes after injection was significantly larger for group M than group S (41.9% vs 16.3%, P = 0.018). Complete motor blockade of

  10. [AN EXPERIMENTAL STUDY ON REPAIR OF SCIATIC NERVE INJURY BY Schwann-LIKE CELLS DERIVED FROM UMBILICAL CORD BLOOD MESENCHYMAL STEM CELLS].

    Science.gov (United States)

    Wang, Xi; Wang, Sheng; Xiao, Yuzhou

    2015-02-01

    To evaluate the effect of using Schwann-like cells derived from human umbilical cord blood mesenchymal stem cells (hUCBMSCs) as the seed cells to repair large sciatic nerve defect in rats so as to provide the experimental evidence for clinical application of hUCBMSCs. Fourty-five male Sprague Dawley (SD) rats in SPF grade, weighing 200-250 g, were selected. The hUCBMSCs were harvested and cultured from umbilical cord blood using lymphocyte separating and high molecular weight hydroxyethyl starch, and then was identified. The hUCBMSCs of 3rd generation were induced to Schwann-like cells, and then was identified by chemical derivatization combined with cytokine. The acellular nerve basal membrane conduit was prepared as scaffold material by the sciatic nerve of SD rats through repeated freezing, thawing, and washing. The tissue engineered nerve was prepared after 7 days of culturing Schwann-like cells (1 x 10(7) cells/mL) on the acellular nerve basal membrane conduit using the multi-point injection. The 15 mm sciatic nerve defect model was established in 30 male SD rats, which were randomly divided into 3 groups (10 rats each group). Defect was repaired with tissue engineered nerve in group A, with acellular nerve basal membrane conduit in group B, and with autologous sciatic nerve in group C. The nerve repair was evaluated through general observation, sciatic function index (SFI), nerve electrophysiology, weight of gastrocnemius muscle, and Masson staining after operation. The hUCBMSCs showed higher expression of surface markers of mesenchymal stem cells, and Schwann-like cells showed positive expression of glia cell specific markers such as S100b, glial fibrillary acidic protein, and P75. At 8 weeks after operation, the acellular nerve basal membrane conduit had no necrosis and liquefaction, with mild adhesion, soft texture, and good continuity at nerve anastomosis site in group A; group B had similar appearance to group A; adhesion of group C was milder than that

  11. Expression of growth-associated protein B-50/GAP43 in dorsal root ganglia and sciatic nerve during regenerative sprouting

    NARCIS (Netherlands)

    Gispen, W.H.; Zee, C.E.E.M. van der; Nielander, H.B.; Vos, J.P.; Lopes da Silva, S.; Verhaagen, J.; Oestreicher, J.; Schrama, L.H.

    1989-01-01

    Recently it has been shown that B-50 is identical to the neuron- specific, growth-associated protein GAP43. The present study reports on the fate of B-50/GAP43 mRNA and B-50/GAP43 protein, determined by radioimmunoassay, in a rat model of peripheral nerve regeneration (sciatic nerve crush) over a

  12. Unusual case of sciatic nerve and deep pelvic endometriosis with lumbosacral plexus spread presenting with muscular atrophy and foot drop

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    Narvir Singh Chauhan

    2017-01-01

    Full Text Available Endometriosis is an important disorder which affects women in the childbearing age group. In addition to the commonly observed intrapelvic sites, it can very rarely affect extrapelvic location such as the sciatic nerve. We describe an uncommon case of sciatic endometriosis leading to gross muscular atrophy and foot drop. The patient additionally had perineural extension of endometriosis along the ipsilateral lumbosacral trunk and coexisting intrapelvic endometrial implants in retrocervical area, uterosacral ligament, and urinary bladder wall.

  13. Electrospun micro- and nanofiber tubes for functional nervous regeneration in sciatic nerve transections

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    Amadio Stefano

    2008-04-01

    Full Text Available Abstract Background Although many nerve prostheses have been proposed in recent years, in the case of consistent loss of nervous tissue peripheral nerve injury is still a traumatic pathology that may impair patient's movements by interrupting his motor-sensory pathways. In the last few decades tissue engineering has opened the door to new approaches;: however most of them make use of rigid channel guides that may cause cell loss due to the lack of physiological local stresses exerted over the nervous tissue during patient's movement. Electrospinning technique makes it possible to spin microfiber and nanofiber flexible tubular scaffolds composed of a number of natural and synthetic components, showing high porosity and remarkable surface/volume ratio. Results In this study we used electrospun tubes made of biodegradable polymers (a blend of PLGA/PCL to regenerate a 10-mm nerve gap in a rat sciatic nerve in vivo. Experimental groups comprise lesioned animals (control group and lesioned animals subjected to guide conduits implantated at the severed nerve stumps, where the tubular scaffolds are filled with saline solution. Four months after surgery, sciatic nerves failed to reconnect the two stumps of transected nerves in the control animal group. In most of the treated animals the electrospun tubes induced nervous regeneration and functional reconnection of the two severed sciatic nerve tracts. Myelination and collagen IV deposition have been detected in concurrence with regenerated fibers. No significant inflammatory response has been found. Neural tracers revealed the re-establishment of functional neuronal connections and evoked potential results showed the reinnervation of the target muscles in the majority of the treated animals. Conclusion Corroborating previous works, this study indicates that electrospun tubes, with no additional biological coating or drug loading treatment, are promising scaffolds for functional nervous regeneration. They

  14. Low-Level Laser-Accelerated Peripheral Nerve Regeneration within a Reinforced Nerve Conduit across a Large Gap of the Transected Sciatic Nerve in Rats

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    Chiung-Chyi Shen

    2013-01-01

    Full Text Available This study proposed a novel combination of neural regeneration techniques for the repair of damaged peripheral nerves. A biodegradable nerve conduit containing genipin-cross-linked gelatin was annexed using beta-tricalcium phosphate (TCP ceramic particles (genipin-gelatin-TCP, GGT to bridge the transection of a 15 mm sciatic nerve in rats. Two trigger points were irradiated transcutaneously using 660 nm of gallium-aluminum arsenide phosphide (GaAlAsP via laser diodes for 2 min daily over 10 consecutive days. Walking track analysis showed a significant improvement in sciatic functional index (SFI (P<0.01 and pronounced improvement in the toe spreading ability of rats undergoing laser stimulation. Electrophysiological measurements (peak amplitude and area illustrated by compound muscle action potential (CMAP curves demonstrated that laser stimulation significantly improved nerve function and reduced muscular atrophy. Histomorphometric assessments revealed that laser stimulation accelerated nerve regeneration over a larger area of neural tissue, resulting in axons of greater diameter and myelin sheaths of greater thickness than that observed in rats treated with nerve conduits alone. Motor function, electrophysiological reactions, muscular reinnervation, and histomorphometric assessments all demonstrate that the proposed therapy accelerated the repair of transected peripheral nerves bridged using a GGT nerve conduit.

  15. Low-Level Laser-Accelerated Peripheral Nerve Regeneration within a Reinforced Nerve Conduit across a Large Gap of the Transected Sciatic Nerve in Rats

    Science.gov (United States)

    Shen, Chiung-Chyi; Yang, Yi-Chin; Huang, Tsung-Bin; Chan, Shiuh-Chuan; Liu, Bai-Shuan

    2013-01-01

    This study proposed a novel combination of neural regeneration techniques for the repair of damaged peripheral nerves. A biodegradable nerve conduit containing genipin-cross-linked gelatin was annexed using beta-tricalcium phosphate (TCP) ceramic particles (genipin-gelatin-TCP, GGT) to bridge the transection of a 15 mm sciatic nerve in rats. Two trigger points were irradiated transcutaneously using 660 nm of gallium-aluminum arsenide phosphide (GaAlAsP) via laser diodes for 2 min daily over 10 consecutive days. Walking track analysis showed a significant improvement in sciatic functional index (SFI) (P < 0.01) and pronounced improvement in the toe spreading ability of rats undergoing laser stimulation. Electrophysiological measurements (peak amplitude and area) illustrated by compound muscle action potential (CMAP) curves demonstrated that laser stimulation significantly improved nerve function and reduced muscular atrophy. Histomorphometric assessments revealed that laser stimulation accelerated nerve regeneration over a larger area of neural tissue, resulting in axons of greater diameter and myelin sheaths of greater thickness than that observed in rats treated with nerve conduits alone. Motor function, electrophysiological reactions, muscular reinnervation, and histomorphometric assessments all demonstrate that the proposed therapy accelerated the repair of transected peripheral nerves bridged using a GGT nerve conduit. PMID:23737818

  16. Effects of Jinmaitong Capsule () on ciliary neurotrophic factor in sciatic nerves of diabetes mellitus rats.

    Science.gov (United States)

    Shi, Yue; Liang, Xiao-Chun; Wu, Qun-Li; Sun, Lian-Qing; Qu, Ling; Zhao, Li; Wang, Pu-Yan

    2013-02-01

    To study the effects of the Chinese medicine Jinmaitong Capsule (, JMT) on the pathomorphology of sciatic nerves, ciliary neurotrophic factor (CNTF), and the mRNA expressions of CNTF in rats with streptozotocin-induced diabetes mellitus (STZ-DM). The animal model was established by one time intraperitoneal injection of streptozotocin. The rats were simply divided by random into 5 groups including model group, low-dose JMT group (JL), medium-dose JMT group (JM), high-dose JMT group (JH) and neurotropin group. For each of the above 5 groups, a group of 10 normal Wistar rats matched in body weight, age and gender were set as normal group. Intragastric administrations were started after the animal model established. The JL group were administered with five times the JMT dose recommended for a human adult; the JM group were administered with ten times the JMT dose recommended for a human adult; the JH group were administered with twenty times the JMT dose recommended for a human adult. The neurotropin group was administered with ten times the neurotropin dose recommended for a human adult. All rats were given intragastric administration for 16 weeks and then killed. In the 4th, 8th, 12th, 16th week, body weight and blood glucose level were detected before and after the intervention. The morphologic changes of the sciatic nerves were observed by optical microscope and transmission electron microscope. The CNTFmRNA expressions were detected by real-time fluorescent quantitative polymerase chain protein, and the CNTF protein expressions were detected by immunohistochemical method. The blood glucose levels of the STZ-DM rats were much higher than normal group (P0.05). Before and after the intervention in the 4th, 8th, 12th, 16th week, there were no significant differences in the body weight among all the groups (P>0.05). The sciatic nerves of STZ-DM rats might have pathomorphological changes in axons, myelin sheaths, and interstitium. The levels of CNTF and CNTF

  17. Pulsed electromagnetic fields accelerate functional recovery of transected sciatic nerve bridged by chitosan conduit: an animal model study.

    Science.gov (United States)

    Mohammadi, Rahim; Faraji, Darab; Alemi, Hanieh; Mokarizadeh, Aram

    2014-12-01

    Effect of whole body exposure to pulsed electromagnetic fields (PEMF) on nerve regeneration in a rat sciatic nerve transection model was assessed. Sixty male white Wistar rats were divided into four experimental groups (n = 15), randomly: In transected group (TC) left sciatic nerve was transected and stumps were fixed in adjacent muscle. In chitosan group (CHIT) the defect was bridged using a chitosan conduit filled with phosphate-buffered saline. In treatment group (CHIT/PEMF) the whole body was exposed to PEMF (0.3 mT, 2 Hz) for 4 h/day within 1-5 days. In normal control group (NC) sciatic nerve was only dissected and manipulated. Each group was subdivided into three subgroups of five animals each and nerve fibers were studied 4, 8 and 12 weeks after surgery. Behavioral, functional, electrophysiological, biomechanical, gastrocnemius muscle mass findings and morphometric indices confirmed faster recovery of regenerated axons in CHIT/PEMF than in CHIT group (p PEMF were more positive than that in CHIT group. Whole body exposure to PEMF improved functional recovery and morphometric indices of sciatic nerve. Detailed mechanism of neuroprotective action remains to be investigated. PEMF combine with chitosan grafting could be considered as an effective, safe and tolerable treatment for peripheral nerve repair in clinical practice. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  18. First human experience with autologous Schwann cells to supplement sciatic nerve repair: report of 2 cases with long-term follow-up.

    Science.gov (United States)

    Gersey, Zachary C; Burks, S Shelby; Anderson, Kim D; Dididze, Marine; Khan, Aisha; Dietrich, W Dalton; Levi, Allan D

    2017-03-01

    OBJECTIVE Long-segment injuries to large peripheral nerves present a challenge to surgeons because insufficient donor tissue limits repair. Multiple supplemental approaches have been investigated, including the use of Schwann cells (SCs). The authors present the first 2 cases using autologous SCs to supplement a peripheral nerve graft repair in humans with long-term follow-up data. METHODS Two patients were enrolled in an FDA-approved trial to assess the safety of using expanded populations of autologous SCs to supplement the repair of long-segment injuries to the sciatic nerve. The mechanism of injury included a boat propeller and a gunshot wound. The SCs were obtained from both the sural nerve and damaged sciatic nerve stump. The SCs were expanded and purified in culture by using heregulin β1 and forskolin. Repair was performed with sural nerve grafts, SCs in suspension, and a Duragen graft to house the construct. Follow-up was 36 and 12 months for the patients in Cases 1 and 2, respectively. RESULTS The patient in Case 1 had a boat propeller injury with complete transection of both sciatic divisions at midthigh. The graft length was approximately 7.5 cm. In the postoperative period the patient regained motor function (Medical Research Council [MRC] Grade 5/5) in the tibial distribution, with partial function in peroneal distribution (MRC Grade 2/5 on dorsiflexion). Partial return of sensory function was also achieved, and neuropathic pain was completely resolved. The patient in Case 2 sustained a gunshot wound to the leg, with partial disruption of the tibial division of the sciatic nerve at the midthigh. The graft length was 5 cm. Postoperatively the patient regained complete motor function of the tibial nerve, with partial return of sensation. Long-term follow-up with both MRI and ultrasound demonstrated nerve graft continuity and the absence of tumor formation at the repair site. CONCLUSIONS Presented here are the first 2 cases in which autologous SCs were

  19. Effects of intraoperative irradiation and intraoperative hyperthermia on canine sciatic nerve: neurologic and electrophysiologic study

    International Nuclear Information System (INIS)

    Vujaskovic, Zeljko; Gillette, Sharon M.; Powers, Barbara E.; Stukel, Therese A.; LaRue, Susan M.; Gillette, Edward L.; Borak, Thomas B.; Scott, Robert J.; Weiss, Julia; Colacchio, Thomas A.

    1996-01-01

    Purpose: Late radiation injury to peripheral nerve may be the limiting factor in the clinical application of intraoperative radiation therapy (IORT). The combination of IORT with intraoperative hyperthermia (IOHT) raises specific concerns regarding the effects on certain normal tissues such as peripheral nerve, which might be included in the treatment field. The objective of this study was to compare the effect of IORT alone to the effect of IORT combined with IOHT on peripheral nerve in normal beagle dogs. Methods and Materials: Young adult beagle dogs were randomized into five groups of three to five dogs each to receive IORT doses of 16, 20, 24, 28, or 32 Gy to 5 cm of surgically exposed right sciatic nerve using 6 MeV electrons and six groups of four to five dogs each received IORT doses of 0, 12, 16, 20, 24, or 28 Gy simultaneously with 44 deg. C of IOHT for 60 min. IOHT was performed using a water circulating hyperthermia device with a multichannel thermometry system on the surgically exposed sciatic nerve. Neurologic and electrophysiologic examinations were done before and monthly after treatment for 24 months. Electrophysiologic studies included electromyographic (EMG) examinations of motor function, as well as motor nerve conduction velocities studies. Results: Two years after treatment, the effective dose for 50% complication (ED 50 ) for limb paresis in dogs exposed to IORT only was 22 Gy. The ED 50 for paresis in dogs exposed to IORT combined with IOHT was 15 Gy. The thermal enhancement ratio (TER) was 1.5. Electrophysiologic studies showed more prominent changes such as EMG abnormalities, decrease in conduction velocity and amplitude of the action potential, and complete conduction block in dogs that received the combination of IORT and IOHT. The latency to development of peripheral neuropathies was shorter for dogs exposed to the combined treatment. Conclusion: The probability of developing peripheral neuropathies in a large animal model was higher

  20. Cerebrolysin improves sciatic nerve dysfunction in a mouse model of diabetic peripheral neuropathy

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    Han-yu Dong

    2016-01-01

    Full Text Available To examine the effects of Cerebrolysin on the treatment of diabetic peripheral neuropathy, we first established a mouse model of type 2 diabetes mellitus by administering a high-glucose, high-fat diet and a single intraperitoneal injection of streptozotocin. Mice defined as diabetic in this model were then treated with 1.80, 5.39 or 8.98 mL/kg of Cerebrolysin via intraperitoneal injections for 10 consecutive days. Our results demonstrated that the number, diameter and area of myelinated nerve fibers increased in the sciatic nerves of these mice after administration of Cerebrolysin. The results of several behavioral tests showed that Cerebrolysin dose-dependently increased the slope angle in the inclined plane test (indicating an improved ability to maintain body position, prolonged tail-flick latency and foot-licking time (indicating enhanced sensitivity to thermal and chemical pain, respectively, and reduced pain thresholds, and increased an index of sciatic nerve function in diabetic mice compared with those behavioral results in untreated diabetic mice. Taken together, the anatomical and functional results suggest that Cerebrolysin ameliorated peripheral neuropathy in a mouse model of type 2 diabetes mellitus.

  1. Deep gluteal syndrome: anatomy, imaging, and management of sciatic nerve entrapments in the subgluteal space

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    Hernando, Moises Fernandez; Cerezal, Luis; Perez-Carro, Luis; Abascal, Faustino; Canga, Ana [Diagnostico Medico Cantabria (DMC), Department of Radiology, Santander, Cantabria (Spain); Valdecilla University Hospital, Orthopedic Surgery Department Clinica Mompia (L.P.C.), Santander, Cantabria (Spain); Valdecilla University Hospital, Department of Radiology, Santander, Cantabria (Spain)

    2015-03-05

    Deep gluteal syndrome (DGS) is an underdiagnosed entity characterized by pain and/or dysesthesias in the buttock area, hip or posterior thigh and/or radicular pain due to a non-discogenic sciatic nerve entrapment in the subgluteal space. Multiple pathologies have been incorporated in this all-included ''piriformis syndrome,'' a term that has nothing to do with the presence of fibrous bands, obturator internus/gemellus syndrome, quadratus femoris/ischiofemoral pathology, hamstring conditions, gluteal disorders and orthopedic causes. The concept of fibrous bands playing a role in causing symptoms related to sciatic nerve mobility and entrapment represents a radical change in the current diagnosis of and therapeutic approach to DGS. The development of periarticular hip endoscopy has led to an understanding of the pathophysiological mechanisms underlying piriformis syndrome, which has supported its further classification. A broad spectrum of known pathologies may be located nonspecifically in the subgluteal space and can therefore also trigger DGS. These can be classified as traumatic, iatrogenic, inflammatory/infectious, vascular, gynecologic and tumors/pseudo-tumors. Because of the ever-increasing use of advanced magnetic resonance neurography (MRN) techniques and the excellent outcomes of the new endoscopic treatment, radiologists must be aware of the anatomy and pathologic conditions of this space. MR imaging is the diagnostic procedure of choice for assessing DGS and may substantially influence the management of these patients. The infiltration test not only has a high diagnostic but also a therapeutic value. This article describes the subgluteal space anatomy, reviews known and new etiologies of DGS, and assesses the role of the radiologist in the diagnosis, treatment and postoperative evaluation of sciatic nerve entrapments, with emphasis on MR imaging and endoscopic correlation. (orig.)

  2. Topically-administered acetyl-L-carnitine increases sciatic nerve regeneration and improves functional recovery after tubulization of transected short nerve gaps.

    Science.gov (United States)

    Mohammadi, Rahim; Amini, Keyvan

    2017-08-01

    Peripheral nerve injuries repair is still among the most challenging and concern-raising tasks in neurosurgery. The effect of an acetyl-L-carnitin-loaded silicone tube as an in-situ delivery system in defects bridging was studied using a rat sciatic nerve regeneration model. A 10-mm sciatic nerve defect was bridged using a silicone tube (SIL/ALC) filled with 10 µL acetyl-L-carnitine (100 ng/mL). In the control group (SIL), the tube was filled with the same volume of the phosphate-buffered solution. The regenerated fibers were studied 4, 8, 12 and 16 weeks after surgery. The functional study confirmed faster recovery of the regenerated axons in acetyl-L-carnitine treated than control group (PL-carnitine, when loaded in a silicone tube, can bring to an improvement in functional recovery and quantitative morphometric indices of sciatic nerve.

  3. Autotaxin and lysophosphatidic acid1 receptor-mediated demyelination of dorsal root fibers by sciatic nerve injury and intrathecal lysophosphatidylcholine

    Directory of Open Access Journals (Sweden)

    Aoki Junken

    2010-11-01

    Full Text Available Abstract Background Although neuropathic pain is frequently observed in demyelinating diseases such as Guillain-Barré syndrome and multiple sclerosis, the molecular basis for the relationship between demyelination and neuropathic pain behaviors is poorly understood. Previously, we found that lysophosphatidic acid receptor (LPA1 signaling initiates sciatic nerve injury-induced neuropathic pain and demyelination. Results In the present study, we have demonstrated that sciatic nerve injury induces marked demyelination accompanied by myelin-associated glycoprotein (MAG down-regulation and damage of Schwann cell partitioning of C-fiber-containing Remak bundles in the sciatic nerve and dorsal root, but not in the spinal nerve. Demyelination, MAG down-regulation and Remak bundle damage in the dorsal root were abolished in LPA1 receptor-deficient (Lpar1-/- mice, but these alterations were not observed in sciatic nerve. However, LPA-induced demyelination in ex vivo experiments was observed in the sciatic nerve, spinal nerve and dorsal root, all which express LPA1 transcript and protein. Nerve injury-induced dorsal root demyelination was markedly attenuated in mice heterozygous for autotaxin (atx+/-, which converts lysophosphatidylcholine (LPC to LPA. Although the addition of LPC to ex vivo cultures of dorsal root fibers in the presence of recombinant ATX caused potent demyelination, it had no significant effect in the absence of ATX. On the other hand, intrathecal injection of LPC caused potent dorsal root demyelination, which was markedly attenuated or abolished in atx+/- or Lpar1-/- mice. Conclusions These results suggest that LPA, which is converted from LPC by ATX, activates LPA1 receptors and induces dorsal root demyelination following nerve injury, which causes neuropathic pain.

  4. Exposure of the sciatic nerve in the gluteal region without sectioning the gluteus maximus: an anatomical and microsurgical study.

    Science.gov (United States)

    Socolovsky, Mariano; Garategui, Lucas; Campero, Alvaro; Conesa, Horacio; Basso, Armando

    2011-01-01

    Complete sectioning of the gluteus maximus muscle is an extensive procedure when approaching the sciatic nerve in the buttock, resulting in significant morbidity and a prolonged postoperative recovery period. By contrast, dissecting through the muscle by splitting its fibers is faster, involves less damage to tissues and diminishes recovery time. The objective of the present work was to perform a cadaveric study to obtain measurements of the maximum, minimum and mean exposure that this minimally invasive approach can offer. Both gluteal regions from each of ten fresh cadavers were dissected via a transgluteal approach, using a transverse curvilinear incision. After exposure of the sciatic nerve, the maximum length of exposed nerve was measured. As a final step, a 6 cm long sural graft reconstruction was performed, aided by a surgical microscope and microscopic techniques. The mean sciatic nerve exposure obtained was 115.4 ± 17.9 mm, ranging from a maximum of 152 mm to a minimum of 90 mm. In all 20 cases, it was possible to perform microsurgical reconstruction under the microscope. We further illustrate these findings with three live patients in whom the transgluteal approach was employed to successfully expose and repair the sciatic nerve. The transgluteal approach is useful in the operative repair of lesions of the proximal sciatic nerve. It is a less invasive technique than classical complete sectioning of the gluteus maximus muscle, and yields better aesthetic results and a faster return to normal daily activities. Complex lesions, like nerve trauma requiring grafts and nerve tumours, can be treated with minimal risk. Nevertheless, it is less comfortable for the surgeon, and the entire extent of the exposed nerve might not be visualized simultaneously during surgery.

  5. Abductor dysfunction and related sciatic nerve palsy, a new complication of metal-on-metal arthroplasty.

    Science.gov (United States)

    Beaver, Walter B; Fehring, Thomas K

    2012-08-01

    The optimal bearing for use in young patients with hip arthritis remains elusive. Current options include metal-on-cross-linked polyethylene, ceramic-on-cross-linked polyethylene, ceramic on ceramic, and metal on metal. Each of these bearing couples has advantages and disadvantages. Metal-on-metal designs allow the use of large heads that decrease impingement and improve stability. This fact has made this bearing an attractive option for surgeons and patients alike. This case report will illustrate a severe adverse reaction to metal debris with necrosis of soft tissues and subsequent damage to the sciatic nerve. Copyright © 2012 Elsevier Inc. All rights reserved.

  6. Treatment with analgesics after mouse sciatic nerve injury does not alter expression of wound healing-associated genes

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    Matt C Danzi

    2016-01-01

    Full Text Available Animal models of sciatic nerve injury are commonly used to study neuropathic pain as well as axon regeneration. Administration of post-surgical analgesics is an important consideration for animal welfare, but the actions of the analgesic must not interfere with the scientific goals of the experiment. In this study, we show that treatment with either buprenorphine or acetaminophen following a bilateral sciatic nerve crush surgery does not alter the expression in dorsal root ganglion (DRG sensory neurons of a panel of genes associated with wound healing. These findings indicate that the post-operative use of buprenorphine or acetaminophen at doses commonly suggested by Institutional Animal Care and Use Committees does not change the intrinsic gene expression response of DRG neurons to a sciatic nerve crush injury, for many wound healing-associated genes. Therefore, administration of post-operative analgesics may not confound the results of transcriptomic studies employing this injury model.

  7. Effects of estragole on the compound action potential of the rat sciatic nerve

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    J.H. Leal-Cardoso

    2004-08-01

    Full Text Available Estragole, a relatively nontoxic terpenoid ether, is an important constituent of many essential oils with widespread applications in folk medicine and aromatherapy and known to have potent local anesthetic activity. We investigated the effects of estragole on the compound action potential (CAP of the rat sciatic nerve. The experiments were carried out on sciatic nerves dissected from Wistar rats. Nerves, mounted in a moist chamber, were stimulated at a frequency of 0.2 Hz, with electric pulses of 50-100-µs duration at 10-20 V, and evoked CAP were monitored on an oscilloscope and recorded on a computer. CAP control parameters were: peak-to-peak amplitude (PPA, 9.9 ± 0.55 mV (N = 15, conduction velocity, 92.2 ± 4.36 m/s (N = 15, chronaxy, 45.6 ± 3.74 µs (N = 5, and rheobase, 3.9 ± 0.78 V (N = 5. Estragole induced a dose-dependent blockade of the CAP. At 0.6 mM, estragole had no demonstrable effect. At 2.0 and 6.0 mM estragole, PPA was significantly reduced at the end of 180-min exposure of the nerve to the drug to 85.6 ± 3.96 and 13.04 ± 1.80% of control, respectively. At 4.0 mM, estragole significantly altered PPA, conduction velocity, chronaxy, and rheobase (P <= 0.05, ANOVA; N = 5 to 49.3 ± 6.21 and 77.7 ± 3.84, 125.9 ± 10.43 and 116.7 ± 4.59%, of control, respectively. All of these effects developed slowly and were reversible upon a 300-min wash-out. The data show that estragole dose-dependently blocks nerve excitability.

  8. Post-evaluation of the neurophaties treatment post-trauma with therapeutic laser. Model in sciatic nerve of frog

    International Nuclear Information System (INIS)

    Escobar, Antonio S.; Ocampo, Arcelia F. M.; Hernandez, Maria G. H.; Jasso, Jose L. C.; Lira, Maricela O. F.; Flores, Mariana A.; Balderrama, Vicente L.

    2010-01-01

    The purpose of this study was to evaluate the compound nerve action potential amplitude and latency measured to determine the degree of myelination and the number of fibers stimulated in a model of stimulated frog sciatic nerve laser at 810 nm as perioperative treatment after injury. It used 30 bullfrogs (Rana catesbeiana) to obtain 60 sciatic nerves forming four groups, groups 1 and 2 worked with nerves in vitro, were dissected in humid chambers for placing isolated organ, was recorded on compound nerve action potential, the second group laser was applied at 24, 48, 72, 96 and 120 hours and at the same time were placed in 10% formalin. Groups 3 and 4 are worked in vivo localizing the nerve and causing damage through compression, occurred over the compound nerve action potential to assess the degree of myelination and the number of fibers stimulated, the group 4 was applied to 810 nm laser (500 Hz, 10 J, 200 mW) after injury, after 48 hours, three frogs were sacrificed by introducing the nerves in 10% formalin. The latency recorded by stimulating the sciatic nerve of frog to 0.5 mA and 100 ms in groups 1 and 2 show significant differences (p 000), as to the extent, if any statistically significant difference. (p<0.001 and p<0.000). The laser produces a favorable response in the treatment of paresthesia (post-traumatic neuropathy).

  9. Post-evaluation of the neurophaties treatment post-trauma with therapeutic laser. Model in sciatic nerve of frog

    Science.gov (United States)

    Escobar, Antonio S.; Ocampo, Arcelia F. M.; Hernández, María G. H.; Jasso, José L. C.; Lira, Maricela O. F.; Flores, Mariana A.; Balderrama, Vicente L.

    2010-05-01

    The purpose of this study was to evaluate the compound nerve action potential amplitude and latency measured to determine the degree of myelination and the number of fibers stimulated in a model of stimulated frog sciatic nerve laser at 810 nm as perioperative treatment after injury. It used 30 bullfrogs (Rana catesbeiana) to obtain 60 sciatic nerves forming four groups, groups 1 and 2 worked with nerves in vitro, were dissected in humid chambers for placing isolated organ, was recorded on compound nerve action potential, the second group laser was applied at 24, 48, 72, 96 and 120 hours and at the same time were placed in 10% formalin. Groups 3 and 4 are worked in vivo localizing the nerve and causing damage through compression, occurred over the compound nerve action potential to assess the degree of myelination and the number of fibers stimulated, the group 4 was applied to 810 nm laser (500 Hz, 10 J, 200 mW) after injury, after 48 hours, three frogs were sacrificed by introducing the nerves in 10% formalin. The latency recorded by stimulating the sciatic nerve of frog to 0.5 mA and 100 ms in groups 1 and 2 show significant differences (p000), as to the extent, if any statistically significant difference. (p<0.001 and p<0.000). The laser produces a favorable response in the treatment of paresthesia (post-traumatic neuropathy).

  10. Regenerated Sciatic Nerve Axons Stimulated through a Chronically Implanted Macro-Sieve Electrode.

    Science.gov (United States)

    MacEwan, Matthew R; Zellmer, Erik R; Wheeler, Jesse J; Burton, Harold; Moran, Daniel W

    2016-01-01

    Sieve electrodes provide a chronic interface for stimulating peripheral nerve axons. Yet, successful utilization requires robust axonal regeneration through the implanted electrode. The present study determined the effect of large transit zones in enhancing axonal regeneration and revealed an intimate neural interface with an implanted sieve electrode. Fabrication of the polyimide sieve electrodes employed sacrificial photolithography. The manufactured macro-sieve electrode (MSE) contained nine large transit zones with areas of ~0.285 mm 2 surrounded by eight Pt-Ir metallized electrode sites. Prior to implantation, saline, or glial derived neurotropic factor (GDNF) was injected into nerve guidance silicone-conduits with or without a MSE. The MSE assembly or a nerve guidance conduit was implanted between transected ends of the sciatic nerve in adult male Lewis rats. At 3 months post-operation, fiber counts were similar through both implant types. Likewise, stimulation of nerves regenerated through a MSE or an open silicone conduit evoked comparable muscle forces. These results showed that nerve regeneration was comparable through MSE transit zones and an open conduit. GDNF had a minimal positive effect on the quality and morphology of fibers regenerating through the MSE; thus, the MSE may reduce reliance on GDNF to augment axonal regeneration. Selective stimulation of several individual muscles was achieved through monopolar stimulation of individual electrodes sites suggesting that the MSE might be an optimal platform for functional neuromuscular stimulation.

  11. Repeated bouts of fast eccentric contraction produce sciatic nerve damage in rats.

    Science.gov (United States)

    Kouzaki, Karina; Kobayashi, Masatoshi; Nakamura, Kei-Ichiro; Ohta, Keisuke; Nakazato, Koichi

    2016-11-01

    We evaluated sciatic nerve impairment after eccentric contractions (ECs) in rat triceps surae. Wistar rats were randomly assigned to different joint angular velocity: 180°/s (FAST), 30°/s (SLOW), or nontreated control (CNT). FAST and SLOW groups were subjected to multiple (1-4) bouts of 20 (5 reps, 4 sets) ECs. Nerve conduction velocity (NCV) and isometric tetanic ankle torque were measured 24 h after each ECs bout. We also assessed nerve morphology. After 4 ECs bouts, NCVs and isometric torque in the FAST group were significantly lower than those in the CNT (NCV: 42%, torque: 66%; P < 0.05). After 4 bouts, average nerve diameter was significantly smaller in the FAST group [2.39 ± 0.20 μm vs. 2.69 ± 0.20 μm (CNT) and 2.93 ± 0.24 μm (SLOW); P < 0.05] than that in other two groups. Chronic ECs with high angular velocity induce serious nerve damage. Muscle Nerve 54: 936-942, 2016. © 2016 Wiley Periodicals, Inc.

  12. Clinical, electrophysiological, and prognostic study of postinjection sciatic nerve injury: An avoidable cause of loss of limb in the peripheral medical service

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    Wani Maqbool

    2009-01-01

    Full Text Available Background: Post injection sciatic nerve injury is a common cause of sciatic nerve mononeuropathy in the developing world largely due to inadequate health care facilites in the rural regions. Objective: The study was conducted to analyse the pattern of this nerve lesion in clinical and electrophysiological parameters and also to study the outcome in a conservatively treated cohort. Materials and Methods: One hundred and six patients who underwent evaluation at our laboratory from 2000 to 2006 for post injection sciatic neuropathy formed the study population. Twenty two of these were followed up (mean 6.6 months for the outcome. Results: In the cases with full data, common peroneal division of the sciatic nerve was affected alone or predominantly. On follow up, 72% cases showed little or partial recovery. Thirty two percent patients had residual trophic changes and causalgia at their last visit. Conclusion: The majority of cases of postinjection sciatic nerve injury have poor prognosis on conservative treatment.

  13. Clinical, electrophysiological, and prognostic study of postinjection sciatic nerve injury: An avoidable cause of loss of limb in the peripheral medical service.

    Science.gov (United States)

    Maqbool, Wani; Sheikh, Saleem; Ahmed, Asrar

    2009-04-01

    Post injection sciatic nerve injury is a common cause of sciatic nerve mononeuropathy in the developing world largely due to inadequate health care facilites in the rural regions. The study was conducted to analyse the pattern of this nerve lesion in clinical and electrophysiological parameters and also to study the outcome in a conservatively treated cohort. One hundred and six patients who underwent evaluation at our laboratory from 2000 to 2006 for post injection sciatic neuropathy formed the study population. Twenty two of these were followed up (mean 6.6 months) for the outcome. In the cases with full data, common peroneal division of the sciatic nerve was affected alone or predominantly. On follow up, 72% cases showed little or partial recovery. Thirty two percent patients had residual trophic changes and causalgia at their last visit. The majority of cases of postinjection sciatic nerve injury have poor prognosis on conservative treatment.

  14. A randomized comparison between bifurcation and prebifurcation subparaneural popliteal sciatic nerve blocks.

    Science.gov (United States)

    Tran, De Q H; González, Andrea P; Bernucci, Francisca; Pham, Kevin; Finlayson, Roderick J

    2013-05-01

    In this prospective, randomized, observer-blinded trial, we compared ultrasound-guided subparaneural popliteal sciatic nerve blocks performed either at or proximal to the neural bifurcation (B). We hypothesized that the total anesthesia-related time (sum of performance and onset times) would be decreased with the prebifurcation (PB) technique. Ultrasound-guided posterior popliteal sciatic nerve block was performed in 68 patients. All subjects received an identical volume (30 mL) and mix of local anesthetic agent (1% lidocaine-0.25% bupivacaine-5 µg/mL epinephrine). In the PB group, the local anesthetic solution was deposited at the level of the common sciatic trunk, just distal to the intersection between its circular and elliptical sonographic appearances, inside the paraneural sheath. In the B group, the injection was performed inside the sheath between the tibial and peroneal divisions. A blinded observer recorded the success rate (complete tibial and peroneal sensory block at 30 minutes) and onset time. The performance time, number of needle passes, and adverse events (paresthesia, neural edema) were also recorded. All subjects were contacted 7 days after the surgery to inquire about the presence of persistent numbness or motor deficit. Both techniques resulted in comparable success rates (85%-88%; 95% confidence interval [CI] of the intergroup difference, -14% to 19%) and required similar performance times (8.1 minutes; 95% CI of the difference, -1.65 to 1.71 minutes), onset times (15.0-17.7 minutes; 95% CI of the difference, -7.65 to 2.31 minutes), and total anesthesia-related times (23.4-26.0 minutes; 95% CI of the difference, -7.83 to 2.74 minutes). The number of needle passes and incidence of paresthesia (25%-34%) were also similar between the 2 groups. Sonographic neural swelling was detected in 2 and 3 subjects in the PB and B groups, respectively. In all 5 cases, the needle was carefully withdrawn and the injection completed uneventfully. Patient

  15. Population pharmacokinetics of bupivacaine in combined lumbar and sciatic nerve block

    Science.gov (United States)

    Eljebari, Hanene; Jebabli, Nadia; Salouage, Issam; Gaies, Emna; Lakhal, Mohamed; Boussofara, Mehdi; Klouz, Anis

    2014-01-01

    Objectives: The primary aim of this study was to establish the population pharmacokinetic (PPK) model of bupivacaine after combined lumbar plexus and sciatic nerve blocks and secondary aim is to assess the effect of patient's characteristics including age, body weight and sex on pharmacokinetic parameters. Materials and Methods: A total of 31 patients scheduled for elective lower extremity surgery with combined lumbar and sciatic nerve block using plain bupivacaine 0.5% were included. The total bupivacaine plasma concentrations were measured before injection and after two blocks placement and at selected time points. Monitoring of bupivacaine was made by high performance liquid chromatography (HPLC) with ultraviolet detection. Non-linear mixed effects modeling was used to analyze the PPK of bupivacaine. Results: One compartment model with first order absorption, two input compartments and a central elimination was selected. The Shapiro-Wilks test of normality for normalized prediction distribution errors for this model (P = 0.156) showed this as a valid model. The selected model predicts a population clearance of 930 ml/min (residual standard error [RSE] = 15.48%, IC 95% = 930 ± 282.24) with inter individual variability of 75.29%. The central volume of distribution was 134 l (RSE = 12.76%, IC = 134 ± 33.51 L) with inter individual variability of 63.40%. The absorption of bupivacaine in two sites Ka1 and Ka2 were 0.00462/min for the lumbar site and 0.292/min for the sciatic site. Age, body weight and sex have no effect on the bupivacaine pharmacokinetics in this studied population. Conclusion: The developed model helps us to assess the systemic absorption of bupivacaine at two injections sites. PMID:24741194

  16. Possible role of antioxidative capacity of (-)-epigallocatechin-3-gallate treatment in morphological and neurobehavioral recovery after sciatic nerve crush injury.

    Science.gov (United States)

    Renno, Waleed M; Benov, Ludmil; Khan, Khalid M

    2017-11-01

    OBJECTIVE This study examined the capacity of the major polyphenolic green tea extract (-)-epigallocatechin-3-gallate (EGCG) to suppress oxidative stress and stimulate the recovery and prompt the regeneration of sciatic nerve after crush injury. METHODS Adult male Wistar rats were randomly assigned to one of 4 groups: 1) Naïve, 2) Sham (sham injury, surgical control group), 3) Crush (sciatic nerve crush injury treated with saline), and 4) Crush+EGCG (sciatic nerve crush injury treated with intraperitoneally administered EGCG, 50 mg/kg). All animals were tested for motor and sensory neurobehavioral parameters throughout the study. Sciatic nerve and spinal cord tissues were harvested and processed for morphometric and stereological analysis. For the biochemical assays, the time points were Day 1, Day 7, Day 14, and Day 28 after nerve injury. RESULTS After sciatic nerve crush injury, the EGCG-treated animals (Crush+EGCG group) showed significantly better recovery of foot position and toe spread and 50% greater improvement in motor recovery than the saline-treated animals (Crush group). The Crush+EGCG group displayed an early hopping response at the beginning of the 3rd week postinjury. Animals in the Crush+EGCG group also showed a significant reduction in mechanical allodynia and hyperalgesia latencies and significant improvement in recovery from nociception deficits in both heat withdrawal and tail flick withdrawal latencies compared with the Crush group. In both the Crush+EGCG and Crush groups, quantitative evaluation revealed significant morphological evidence of neuroregeneration according to the following parameters: mean cross-sectional area of axons, myelin thickness in the sciatic nerve (from Week 4 to Week 8), increase of myelin basic protein concentration and gene expression in both the injured sciatic nerve and spinal cord, and fiber diameter to axon diameter ratio and myelin thickness to axon diameter ratio at Week 2 after sciatic nerve injury. However

  17. Effects of 60Co gamma radiations on the conduction properties of frog sciatic nerve

    International Nuclear Information System (INIS)

    Nayar, G.N.A.; Srinivasan, S.

    1975-01-01

    The effect of Co 60 gamma radiations on the amplitude, detection period and duration of the action potential of sciatic nerves of Rana tigrina frogs have been studied. Dose levels of upto 120 kR were employed. Irradiation of the nerves with dose levels upto 30 kR does not seem to affect the action of potential profiles. The amplitude falls rapidly thereafter, registering less than 5% of the original value after irradiation by a dose of 120 kR. Qualitatively similar behaviour is seen in the case of detection period and duration of action potential. These results are examined in the light of data already collected through experiments on the effect of Co 60 gamma rays on the enzyme acetyl-cholinesterase (AchE). (author)

  18. Regulation of Schwann cell proliferation in cultured segments of the adult rat sciatic nerve

    DEFF Research Database (Denmark)

    Svenningsen, Åsa Fex; Kanje, M

    1998-01-01

    Schwann cell proliferation was studied in cultured segments of the rat sciatic nerve by measurement of [3H] thymidine incorporation or through bromodeoxyuridine-(BrdU)-labelling and immunocytochemistry. The aim was to delineate mechanisms involved in the injury-induced proliferative response...... together with morphological evaluation of myelin association showed that proliferation occurred in Schwann cells. The results are consistent with a model in which Schwann cell proliferation is enhanced by Ca2+ through activation of calmodulin-dependent and/or PKCdependent mechanisms. Inhibition is achieved...... through the cAMP system. Together, these results show that Schwann cells regulate proliferation differently in an integrated environment, e.g. the nerve structure, than in isolation as primary monocultures....

  19. Crosstalk between p38, Hsp25 and Akt in spinal motor neurons after sciatic nerve injury

    Science.gov (United States)

    Murashov, A. K.; Ul Haq, I.; Hill, C.; Park, E.; Smith, M.; Wang, X.; Wang, X.; Goldberg, D. J.; Wolgemuth, D. J.

    2001-01-01

    The p38 stress-activated protein kinase pathway is involved in regulation of phosphorylation of Hsp25, which in turn regulates actin filament dynamic in non-neuronal cells. We report that p38, Hsp25 and Akt signaling pathways were specifically activated in spinal motor neurons after sciatic nerve axotomy. The activation of the p38 kinase was required for induction of Hsp25 expression. Furthermore, Hsp25 formed a complex with Akt, a member of PI-3 kinase pathway that prevents neuronal cell death. Together, our observations implicate Hsp25 as a central player in a complex system of signaling that may both promote regeneration of nerve fibers and prevent neuronal cell death in the injured spinal cord.

  20. Evoked bioelectrical activity of efferent fibers of the sciatic nerve of white rats in experimental menopause

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    Rodinsky A.G.

    2016-03-01

    Full Text Available The aim of our work was analysis of the bioelectrical activity of efferent fibers of the sciatic nerve in experimental menopause condition. Experiments were performed on 25 female white rats, divided into experimental and control groups. Menopause was modeled by total ovariohysterectomy. In 120 days after modeling we had recorded evoked action potentials of fibers of isolated ventral root L5 induced by stimulation of sciatic nerve with rectangular pulses. Threshold, chronaxia, latency, amplitude and duration of the action potential (AP were analysed. Refractory phenomenon was investigated by applying paired stimuli at intervals of 2 to 20 ms. In the context of long-term hypoestrogenemy threshold of AP appearance was 55,32±7,69%, chronaxy – 115,09±2,67%, latent period – 112,62±1,74% as compared with the control animals (p<0.01. In conditions of paired stimuli applying the amplitude of response to the testing stimulus in animals with ovariohysterectomy at intervals 3 and 4 ms was 61,25±36,45% and 53,48±18,64% (p<0.05 respectively.

  1. Inhibition by TRPA1 agonists of compound action potentials in the frog sciatic nerve

    Energy Technology Data Exchange (ETDEWEB)

    Matsushita, Akitomo; Ohtsubo, Sena; Fujita, Tsugumi; Kumamoto, Eiichi, E-mail: kumamote@cc.saga-u.ac.jp

    2013-04-26

    Highlights: •TRPA1 agonists inhibited compound action potentials in frog sciatic nerves. •This inhibition was not mediated by TRPA1 channels. •This efficacy was comparable to those of lidocaine and cocaine. •We found for the first time an ability of TRPA1 agonists to inhibit nerve conduction. -- Abstract: Although TRPV1 and TRPM8 agonists (vanilloid capsaicin and menthol, respectively) at high concentrations inhibit action potential conduction, it remains to be unknown whether TRPA1 agonists have a similar action. The present study examined the actions of TRPA1 agonists, cinnamaldehyde (CA) and allyl isothiocyanate (AITC), which differ in chemical structure from each other, on compound action potentials (CAPs) recorded from the frog sciatic nerve by using the air-gap method. CA and AITC concentration-dependently reduced the peak amplitude of the CAP with the IC{sub 50} values of 1.2 and 1.5 mM, respectively; these activities were resistant to a non-selective TRP antagonist ruthenium red or a selective TRPA1 antagonist HC-030031. The CA and AITC actions were distinct in property; the latter but not former action was delayed in onset and partially reversible, and CA but not AITC increased thresholds to elicit CAPs. A CAP inhibition was seen by hydroxy-α-sanshool (by 60% at 0.05 mM), which activates both TRPA1 and TRPV1 channels, a non-vanilloid TRPV1 agonist piperine (by 20% at 0.07 mM) and tetrahydrolavandulol (where the six-membered ring of menthol is opened; IC{sub 50} = 0.38 mM). It is suggested that TRPA1 agonists as well as TRPV1 and TRPM8 agonists have an ability to inhibit nerve conduction without TRP activation, although their agonists are quite different in chemical structure from each other.

  2. Inhibition by TRPA1 agonists of compound action potentials in the frog sciatic nerve

    International Nuclear Information System (INIS)

    Matsushita, Akitomo; Ohtsubo, Sena; Fujita, Tsugumi; Kumamoto, Eiichi

    2013-01-01

    Highlights: •TRPA1 agonists inhibited compound action potentials in frog sciatic nerves. •This inhibition was not mediated by TRPA1 channels. •This efficacy was comparable to those of lidocaine and cocaine. •We found for the first time an ability of TRPA1 agonists to inhibit nerve conduction. -- Abstract: Although TRPV1 and TRPM8 agonists (vanilloid capsaicin and menthol, respectively) at high concentrations inhibit action potential conduction, it remains to be unknown whether TRPA1 agonists have a similar action. The present study examined the actions of TRPA1 agonists, cinnamaldehyde (CA) and allyl isothiocyanate (AITC), which differ in chemical structure from each other, on compound action potentials (CAPs) recorded from the frog sciatic nerve by using the air-gap method. CA and AITC concentration-dependently reduced the peak amplitude of the CAP with the IC 50 values of 1.2 and 1.5 mM, respectively; these activities were resistant to a non-selective TRP antagonist ruthenium red or a selective TRPA1 antagonist HC-030031. The CA and AITC actions were distinct in property; the latter but not former action was delayed in onset and partially reversible, and CA but not AITC increased thresholds to elicit CAPs. A CAP inhibition was seen by hydroxy-α-sanshool (by 60% at 0.05 mM), which activates both TRPA1 and TRPV1 channels, a non-vanilloid TRPV1 agonist piperine (by 20% at 0.07 mM) and tetrahydrolavandulol (where the six-membered ring of menthol is opened; IC 50 = 0.38 mM). It is suggested that TRPA1 agonists as well as TRPV1 and TRPM8 agonists have an ability to inhibit nerve conduction without TRP activation, although their agonists are quite different in chemical structure from each other

  3. Participation of neuronal nitric oxide synthase in experimental neuropathic pain induced by sciatic nerve transection

    Directory of Open Access Journals (Sweden)

    M. Chacur

    2010-04-01

    Full Text Available Nerve injury leads to a neuropathic pain state that results from central sensitization. This phenomenom is mediated by NMDA receptors and may involve the production of nitric oxide (NO. In this study, we investigated the expression of the neuronal isoform of NO synthase (nNOS in the spinal cord of 3-month-old male, Wistar rats after sciatic nerve transection (SNT. Our attention was focused on the dorsal part of L3-L5 segments receiving sensory inputs from the sciatic nerve. SNT resulted in the development of neuropathic pain symptoms confirmed by evaluating mechanical hyperalgesia (Randall and Selitto test and allodynia (von Frey hair test. Control animals did not present any alteration (sham-animals. The selective inhibitor of nNOS, 7-nitroindazole (0.2 and 2 µg in 50 µL, blocked hyperalgesia and allodynia induced by SNT. Immunohistochemical analysis showed that nNOS was increased (48% by day 30 in the lumbar spinal cord after SNT. This increase was observed near the central canal (Rexed’s lamina X and also in lamina I-IV of the dorsal horn. Real-time PCR results indicated an increase of nNOS mRNA detected from 1 to 30 days after SNT, with the highest increase observed 1 day after injury (1469%. Immunoblotting confirmed the increase of nNOS in the spinal cord between 1 and 15 days post-lesion (20%, reaching the greatest increase (60% 30 days after surgery. The present findings demonstrate an increase of nNOS after peripheral nerve injury that may contribute to the increase of NO production observed after peripheral neuropathy.

  4. Curcumin accelerates the repair of sciatic nerve injury in rats through reducing Schwann cells apoptosis and promoting myelinization.

    Science.gov (United States)

    Zhao, Zhiwei; Li, Xiaoling; Li, Qing

    2017-08-01

    Schwann cells (SCs) play an indispensable role in the repair and regeneration of injured peripheral nerve. Curcumin can reduce SCs apoptosis, and promote the regeneration and functional recovery of injured peripheral nerves. However, the corresponding mechanisms are not clear. The article was aimed to explore the effect and corresponding mechanisms of curcumin on the repair of sciatic nerve injury in rats. After surgery induced sciatic nerve injury, the model rats were divided into three groups and treated with curcumin, curcumin+PD98059 and curcumin+IGF-1 respectively for 4days. The phosphorylation of Erk1/2 and Akt, and the expression of LC3-II, Beclin 1 and p62 were measured using western blotting. After treatment for 60days, myelination of the injured sciatic nerve was evaluated by MBP immunohistochemical staining and the expression of PMP22, Fibrin and S100 were determined using qRT-PCR and western blotting. In vitro, RSC96 cells were starved for 12h to induce autophagy, and received DMSO, curcumin, PD98059+curcumin, IGF-1+curcumin and BFA1 respectively. The phosphorylation of Erk1/2、Akt and the expression of LC3-II, Beclin 1, p62, PMP22, Fibrin and S100 were measured using western blotting, and the cell apoptosis was detected by flow cytometry. Curcumin could promote injury-induced cell autophagy, remyelination and axon regeneration in sciatic nerve of rats. In vitro, curcumin could accelerate cell autophagy through regulating autophagy related Erk1/2 and Akt pathway, prevent cell apoptosis and promote expression of PMP22 and S100, and reduced deposition of Fibrin in cultured RSC96 SCs. Curcumin could accelerate injured sciatic nerve repair in rats through reducing SCs apoptosis and promoting myelinization. Copyright © 2017. Published by Elsevier Masson SAS.

  5. Effect of local administration of platelet-derived growth factor B on functional recovery of peripheral nerve regeneration: A sciatic nerve transection model.

    Science.gov (United States)

    Golzadeh, Atefeh; Mohammadi, Rahim

    2016-01-01

    Effects of platelet-derived growth factor B (PDGF-B) on peripheral nerve regeneration was studied using a rat sciatic nerve transection model. Forty-five male, white Wistar rats were divided into three experimental groups (n = 15), randomly: Normal control group (NC), silicon group (SIL), and PDGF-B treated group (SIL/PDGF). In NC group, left sciatic nerve was exposed through a gluteal muscle incision and after homeostasis muscle was sutured. In the SIL group, the left sciatic nerve was exposed in the same way and transected proximal to tibio-peroneal bifurcation leaving a 10-mm gap. Proximal and distal stumps were each inserted into a silicone conduit and filled with 10 μL phosphate buffered solution. In SIL/PDGF group, the silicon conduit was filled with 10 μL PDGF-B (0.5 ng/mL). Each group was subdivided into three subgroups of five and were studied in 4, 8, 12 weeks after surgery. Behavioral testing, sciatic nerve functional study, gastrocnemius muscle mass, and histomorphometric studies showed earlier regeneration of axons in SIL/PDGF than in SIL group (P recovery and may have clinical implications for the surgical management of patients after facial nerve transection.

  6. Biodegradable and biocompatible cationic polymer delivering microRNA-221/222 promotes nerve regeneration after sciatic nerve crush

    Directory of Open Access Journals (Sweden)

    Song J

    2017-06-01

    Full Text Available Jialin Song,1,2 Xueyang Li,3 Yingli Li,4,5 Junyi Che,6 Xiaoming Li,6 Xiaotian Zhao,6 Yinghui Chen,7,* Xianyou Zheng,1,* Weien Yuan6,* 1Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, 2Department of Orthopedics, Shanghai University of Medicine and Health, Shanghai, Sixth People’s Hospital East Campus, Shanghai, 3Department of Plastic and Reconstructive Surgery, Xuzhou Medical College Affiliated Hospital, Xuzhou, Jiangsu, 4Department of Plastic Surgery, The General Hospital of Jinan Military Command, Jinan, Shandong, 5Department of Plastic Surgery, Chang Hai Hospital, Second Military Medical University, 6School of Pharmacy, Shanghai Jiao Tong University, 7Department of Neurology, Jinshan Hospital, Fudan University, JinShan District, Shanghai, People’s Republic of China *These authors contributed equally to this work Abstract: MicroRNA (miRNA has great potential to treat a wide range of illnesses by regulating the expression of eukaryotic genes. Biomaterials with high transfection efficiency and low toxicity are needed to deliver miRNA to target cells. In this study, a biodegradable and biocompatible cationic polymer (PDAPEI was synthetized from low molecular weight polyethyleneimine (PEI1.8kDa cross-linked with 2,6-pyridinedicarboxaldehyde. PDAPEI showed a lower cytotoxicity and higher transfection efficiency than PEI25kDa in transfecting miR-221/222 into rat Schwann cells (SCs. The upregulation of miR-221/222 in SCs promoted the expression of nerve growth factor and myelin basic protein in vitro. The mouse sciatic nerve crush injury model was used to evaluate the effectiveness of PDAPEI/miR-221/222 complexes for nerve regeneration in vivo. The results of electrophysiological tests, functional assessments, and histological and immunohistochemistry analyses demonstrated that PDAPEI/miR-221/222 complexes significantly promoted nerve regeneration after sciatic nerve crush, specifically enhancing

  7. Proteins isolated from regenerating sciatic nerves of rats form aggregates following posttranslational amino acid modification

    International Nuclear Information System (INIS)

    Ingoglia, N.A.; Chakroborty, G.; Yu, M.; Luo, D.; Sturman, J.A.

    1991-01-01

    Soluble proteins of regenerating sciatic nerves of rats can be posttranslationally, covalently modified by a variety of radioactive amino acids. The present study shows that once modified by a mixture of 15 amino acids, many of those proteins form aggregates that are unable to pass through a 0.45-micron filter and pellet following 20,000g centrifugation (suggesting a size of greater than 2 x 10(6) Da). Aggregation of proteins also occurs following modification by Arg or Lys alone, but does not occur following protein modification in nonregenerating nerves or in brain. Aggregates are not disrupted by treatment with 100 mM beta mercaptoethanol or by exposure to 1.0 M NaCl, but aggregates are solubilized by treatment with urea and by boiling in 1.5% SDS. Amino acid analysis of proteins modified by a mixture of [3H]amino acids shows a similar proportion of posttranslationally incorporated Ser, Pro, Val, Ala, Leu, Phe, Lys, and Arg in the soluble and pelletable fractions. Two-dimensional PAGE profiles of soluble and pelletable modified proteins show that the modified proteins in both fractions are in similar pI and molecular weight ranges, except that the soluble modified proteins include a high-molecular-weight component that is absent in the pelleted modified proteins. Kinetic studies show that while half-maximal levels of protein modification occur within 30 seconds of incubation, the appearance of the pelletable modified protein fraction is delayed significantly. These results indicate that amino acid modification of soluble proteins in regenerating sciatic nerves of rats results in physical changes in those proteins so that they form high-molecular-weight aggregates

  8. Diabetes alters aromatase enzyme levels in sciatic nerve and hippocampus tissues of rats.

    Science.gov (United States)

    Burul-Bozkurt, Nihan; Pekiner, Can; Kelicen, Pelin

    2010-04-01

    Diabetes mellitus (DM) is associated with increased risk of impaired cognitive function. Diabetic neuropathy is one of the most common and important complications of DM. Estrogens prevent neuronal loss in experimental models of neurodegeneration and accelerate nerve regeneration. Aromatase catalyzes the conversion of androgens to estrogens and expressed in a variety of tissues including neurons. Although insulin is known to regulate the activity of aromatase there is no study about the effects of diabetes on this enzyme. Present study was designed to investigate the effects of experimental diabetes on aromatase expression in nervous system. Gender-based differences were also investigated. Rats were injected with streptozotocin to induce diabetes. At the end of 4 and 12 weeks sciatic nerve and hippocampus homogenates were prepared and evaluated for aromatase proteins. Aromatase expressions in sciatic nerves of both genders were decreased in 4 weeks of diabetes, but in 12 weeks the enzyme levels were increased in females and reached to control levels in male animals. Aromatase levels were not altered in hippocampus at 4 weeks but increased at 12 weeks in female diabetic rats. No significant differences were observed at enzyme levels of hippocampus in male diabetic rats. Insulin therapy prevented all diabetes-induced changes. In conclusion, these results indicated for the first time that, DM altered the expression of aromatase both in central and peripheral nervous systems. Peripheral nervous system is more vulnerable to damage than central nervous system in diabetes. These effects of diabetes differ with gender and compensatory neuroprotective mechanisms are more efficient in female rats.

  9. Partial epineural burying of nerve grafts with different sizes next to or distant from neurorrhaphy?s site: histological and electrophysiological studies in rat sciatic nerves

    Directory of Open Access Journals (Sweden)

    Cunha Marco Túlio Rodrigues da

    2001-01-01

    Full Text Available The aim of the present study was to compare and correlate histologically and electromyographically the effects of partial epineural burying of sural nerve segments in sectioned and sutured rat sciatic nerves. Sixty adult male Wistar rats were operated on 3 groups: Group 1, sural nerve graft, 9mm long, placed next to neurorrhaphy; Group 2, sural nerve graft, 9mm long, buryied 10mm distant from neurorrhaphy; Group 3, sural nerve graft, 18mm long, set next to neurorrhaphy. The morphological features were examined at light microscope after 3 months in 45 rats. The elements observed were: vascularization, vacuoles in nerve fibers, mastocytes and inflammatory infiltrate. The morphometry was made after 6 months in 15 rats from Group 1, 2 and 3, measuring external nerve fiber diameters and counting myelinated nerve fibers/mm². The electrophysiological study was perfomed after 6 months, registering maximum amplitude and frequency of EMG pontentials, at rest, in extensor digitorum longus muscle. Group 3 rats presented sciatic nerves better conserved morphologically and mean external nerve fiber diameters greater than those from Groups 1 and 2. There were no significant differences in density of nerve fibers/mm², and in the electrophysiological study in rats from Group 1, 2 and 3. The epineural burying of sural nerve grafts with greater length and placed next to the neurorrhaphy?s site had a significantly better regeneration of the histological features than the smaller ones distant from neurorrhaphy.

  10. Changes in excursion and strain in the rat sciatic nerve under cauda equina compression induced by epidural balloon inflation.

    Science.gov (United States)

    Tai, Ta-Wei; Su, Fong-Chin; Chien, Jui-Teng; Lee, Jung-Shun; Huang, Yi-Hung; Lin, Cheng-Li; Jou, I-Ming

    2015-02-01

    Healthy nerves are able to stretch and glide as responses to normal physiological movement. Injury to the nerve may alter the nerve's mechanical properties and result in neuropathy. Whether cauda equina compression alters the mechanical properties of the sciatic nerve is still unclear. The purpose of this study was to demonstrate the changes in excursions and strains of the sciatic nerve in vivo after acute cauda equina compression was induced by epidural balloon compression. An animal comparative study with induced cauda equina compression was designed for in situ measurements of nerve properties. Twenty-six adult Sprague-Dawley rats were divided into three groups. The balloon group (n=10) underwent epidural compression induced by inflation of an embolectomy balloon catheter that was inserted through an L6 laminotomy. The control group (n=10) underwent laminotomy but without compression. The normal group (n=6) received no back surgery. This model of neuropathy was confirmed with electrophysiological examination. The excursions and strains of the sciatic nerve in response to the modified straight leg-raising (SLR) test were measured in situ and analyzed. The scales of the excursions were lower in the balloon group than in the other two groups, in both 90° flexion and extension of the knee. The balloon group was more sensitive to positional changes. The strain was significantly higher under the condition of epidural balloon compression. We concluded that cauda equina compression decreased the excursion and increased the strain of the sciatic nerve in response to a modified SLR test. These findings might indicate one of the mechanisms of the pain provoked by the SLR test and also possibly contribute to an understanding of the pathogenesis of the neuropathy in the lower limbs of patients with cauda equina compression. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. [Femoral and sciatic nerve blocks for open reduction and internal fixation of a femoral condylar fracture in a patient with post-polio syndrome].

    Science.gov (United States)

    Nagaoka, Takehiko; Mizuno, Ju; Ino, Kentaro; Yoshimura, Tatsuya; Sakamoto, Hidetoshi; Morita, Shigeho

    2011-08-01

    The post polio symdrome (PPS) refers to the development of delayed neuromuscular symptoms among survivors, years after the initial presentation of acute poliomyelitis. The symptoms of PPS vary widely and include flaccid palsy, muscle weakness, scoliosis, osteoarthritis, gait disturbance, sleep apnea syndrome (SAS), dysphagia, chronic lung dysfunction, and others. We report the successful combination of peripheral nerve blocks, femoral and sciatic nerve blocks, for surgery on the lower extremity in a patient with PPS. A 51-year-old man with continuous positive airway pressure therapy for restrictive ventilatory impairment due to scoliosis and SAS as part of the PPS was scheduled for open reduction and internal fixation (OR-IF) for a right femoral condylar fracture. Respiratory function tests demonstrated a vital capacity (VC) 1.41l (41% predicted). Arterial blood gas analysis on room air was; pH 7.376, PaCO2 55.0 mmHg, and PaO2 77.9 mmHg. With the patient in the supine position, ultrasound-guided right femoral nerve block in the infra-inguinal region was performed using 1.5% mepivacaine 10 ml and 0.75% ropivacaine 5 ml, followed by sciatic nerve block in the popliteal fossa using 1.5% mepivacaine 8 ml and 0.75% ropivacaine 4 ml in the prone position. OR-IF of the fractured femoral condyle was then successfully performed with propofol under spontaneous ventilation. Postoperatively, there were no adverse events; respiratory function was adequate, and his pain was within manageable bounds. Femoral and sciatic nerve blocks are safe and effective anesthetic methods for lower extremity surgery in patients with restrictive ventilatory impairment and hypercapnia due to scoliosis and SAS as PPS.

  12. Sciatic Nerve Palsy following Total Hip Replacement: Are Patients Personal Characteristics More Important than Limb Lengthening? A Systematic Review

    Directory of Open Access Journals (Sweden)

    Marcello De Fine

    2017-01-01

    Full Text Available Sciatic nerve palsies are rare but potentially devastating complications, accounting for more than 90% of neurologic injuries following total hip replacement. A systematic literature screening was carried out searching papers evaluating an exclusive population of postarthroplasty sciatic nerve palsies to ascertain (1 the influence of limb lengthening itself on sciatic nerve palsy, (2 the most important risk factors, (3 the long-term prognosis, and (4 the outcomes of different treatments. Fourteen manuscripts were finally included. The wide prevalence of retrospective case series decreased the global methodological quality of the retrieved papers. A hazardous lengthening threshold cannot be surely identified. Developmental dysplasia of the hip and previous hip surgeries are the most frequently recognized risk factors. Rate of full nerve function restoration approximates two-thirds of the cases, independently of the extent of initial neural damage. Poor evidences are available about the best treatment strategy. Well-structured multicentric prospective comparative studies are needed to substantiate or contrast the finding of this review. Anyway, since the onset of palsies is probably due to a combination of individual factors, risk of nerve damage and potential for nerve recovery should be evaluated on an individual basis.

  13. Kinetics of Uptake and Washout of Lidocaine in Rat Sciatic Nerve In Vitro

    Science.gov (United States)

    Leeson, Stanley; Strichartz, Gary

    2012-01-01

    Background The potency and efficacy of local anesthetics injected clinically for peripheral nerve block depends strongly on the rate of neural drug uptake. However, since diffusion into surrounding tissues and removal by the vascular system are major factors in the overall distribution of lidocaine in vivo, true kinetics of drug/neural tissue interactions must be studied in the absence of those confounding factors. Methods Uptake: Ensheathed or desheathed isolated rat sciatic nerves were exposed to [14C]-lidocaine for 0-180min and then removed and the lidocaine content of nerve and sheath analyzed. Washout: Isolated nerves were soaked in [14C]-lidocaine for 60min and then placed in lidocaine-free solution for 0-30min, with samples removed at different times to assess the drug content. Experimental variables included the effects of the ensheathing epineurium, lidocaine concentration, pH, presence of CO2-bicarbonate, and incubation duration. Results The equilibrium uptake of lidocaine increased with incubation time, concentration and the fraction of molecules in the non-ionized form. The uptake rate was unaffected by drug concentration, but was about halved by the presence of the epineurial sheath, with the washout rate slowed less. Slight alkalinization, from pH 6.8 to pH 7.4, by bicarbonate-CO2 buffer or a non-bicarbonate buffer, enhanced the neural uptake, and to the same degree. The washout of lidocaine was faster after shorter incubations at high concentrations than when equal amounts of lidocaine were taken up after long incubations at low lidocaine concentrations. Conclusion Lidocaine enters a nerve by a process other than free diffusion, through an epineurial sheath that is a slight obstacle. Given the rapid entry in vitro compared to the much smaller and transient content measured in vivo, it seems highly unlikely that lidocaine equilibrates with the nerve during a peripheral blockade. PMID:23400993

  14. Traditional Japanese medicines inhibit compound action potentials in the frog sciatic nerve.

    Science.gov (United States)

    Matsushita, Akitomo; Fujita, Tsugumi; Ohtsubo, Sena; Kumamoto, Eiichi

    2016-02-03

    Traditional Japanese (Kampo) medicines have a variety of clinical effects including pain alleviation, but evidence for a mechanism for their pain relief has not yet been elucidated fully. Considering that Kampo medicine contains many plant-derived chemicals having an ability to inhibit nerve action potential conduction, it is possible that this medicine inhibits nerve conduction. The purpose of the present study was to know how various Kampo medicines affect nerve conduction. We examined the effects of Kampo and crude medicines on compound action potentials (CAPs) recorded from the frog sciatic nerve by using the air-gap method. Daikenchuto, rikkosan, kikyoto, rikkunshito, shakuyakukanzoto and kakkonto concentration-dependently reduced the peak amplitude of the CAP. Among the Kampo medicines, daikenchuto was the most effective in inhibiting CAPs. Daikenchuto is composed of three kinds of crude medicine, Japanese pepper, processed ginger and ginseng radix. When the crude medicines were tested, Japanese pepper and processed ginger reduced CAP peak amplitudes, while ginseng radix hardly affected CAPs. Moreover, there was an interaction between the Japanese pepper and processed ginger activities in such that one medicine at low but not high concentrations increased the extent of the inhibition by the other one that was co-applied. Kampo medicines have an ability to inhibit nerve conduction. This action of daikenchuto is due to Japanese pepper and processed ginger but not ginseng radix, probably through an interaction between Japanese pepper and processed ginger in a manner dependent on their concentrations. Nerve conduction inhibition could contribute to at least a part of Kampo medicine's clinical effects such as pain alleviation. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  15. A new analgesic method, two-minute sciatic nerve press, for immediate pain relief: a randomized trial

    Directory of Open Access Journals (Sweden)

    Zhang Fenglin

    2008-01-01

    Full Text Available Abstract Background Current analgesics have drawbacks such as delays in acquisition, lag-times for effect, and side effects. We recently presented a preliminary report of a new analgesic method involving a two-minute sciatic nerve press, which resulted in immediate short-term relief of pain associated with dental and renal diseases. The present study investigated whether this technique was effective for pain associated with other disease types, and whether the relief was effective for up to one hour. Methods This randomized, placebo-controlled, parallel-group trial was conducted in four hospitals in Anhui Province, China. Patients with pain were sequentially recruited by participating physicians during clinic visits, and 135 patients aged 15 – 80 years were enrolled. Dental disease patients included those with acute pulpitis and periapical abscesses. Renal disease patients included those with kidney infections and/or stones. Tumor patients included those with nose, breast, stomach and liver cancers, while Emergency Room patients had various pathologies. Patients were randomly assigned to receive a "sciatic nerve press" in which pressure was applied simultaneously to the sciatic nerves at the back of both thighs, or a "placebo press" in which pressure was applied to a parallel region on the front of the thighs. Each fist applied a pressure of 11 – 20 kg for 2 minutes. Patients rated their level of pain before and after the procedure. Results The "sciatic nerve press" produced immediate relief of pain in all patient groups. Emergency patients reported a 43.5% reduction in pain (p th minutes, and the relief decreased 47% by the 60th minutes. Conclusion Two minutes of pressure on both sciatic nerves produced immediate significant short-term conduction analgesia. This technique is a convenient, safe and powerful method for the short-term treatment of clinical pain associated with a diverse range of pathologies. Trial registration Current

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

    OpenAIRE

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

    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...

  17. Cytidine 5’-diphosphocholine administration prevents peripheral neuropathic pain after sciatic nerve crush injury in rats

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    Emril DR

    2016-05-01

    Full Text Available Dessy R Emril,1 Samekto Wibowo,2 Lucas Meliala,2 Rina Susilowati3 1Department of Neurology, Faculty of Medicine, Syiah Kuala University, Banda Aceh, 2Department of Neurology, 3Department of Histology and Cell Biology, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, IndonesiaBackground: Cytidine 5’-diphosphocholine (citicoline has been shown to have beneficial effects in central nervous system injury as well as in motoric functional recovery after peripheral nerve injury. This study aimed to examine the effect of citicoline on prevention of neuropathic pain in a rat model of sciatic nerve crush injury.Methods: Forty experimental rats were divided into four groups. In three groups, the right sciatic nerves were crushed in the mid-thigh region, and a gelatin sponge moistened with 0.4 or 0.8 mL of 100 µmol/L citicoline, or saline 0.4 mL in the control group, was applied. The fourth group of rats was sham-operated, ie the sciatic nerve was exposed with no crush. Functional assessments were performed 4 weeks after crush injury. von Frey filaments (100 g threshold were used to assess neuropathic pain. In addition, the sciatic functional index and extensor postural thrust (EPT tests were used to assess motoric function.Results: The crush/citicoline 0.4 mL group had a lower percentage of pain (23.53%, n=17 compared with the crush/saline group (53.33%, n=15, P<0.005. The crush/citicoline 0.4 mL group also showed better motoric recovery, as seen in stronger EPT results (P<0.001. However, the sciatic functional index analysis did not show significant differences between groups (P=0.35. The crush/citicoline 0.8 mL group showed a higher percentage of pain (66.67%, n=18 and less EPT recovery. These results may be explained by more severe nerve injury due to compression with a larger administered volume.Conclusion: In situ administration of 0.4 mL of 100 μmol/L citicoline prevents the occurrence of neuropathic pain and induces motoric recovery

  18. Cholera Toxin B Subunit Shows Transneuronal Tracing after Injection in an Injured Sciatic Nerve.

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    Bi-Qin Lai

    Full Text Available Cholera toxin B subunit (CTB has been extensively used in the past for monosynaptic mapping. For decades, it was thought to lack the ability of transneuronal tracing. In order to investigate whether biotin conjugates of CTB (b-CTB would pass through transneurons in the rat spinal cord, it was injected into the crushed left sciatic nerve. For experimental control, the first order afferent neuronal projections were defined by retrograde transport of fluorogold (FG, a non-transneuronal labeling marker as an experimental control injected into the crushed right sciatic nerve in the same rat. Neurons containing b-CTB or FG were observed in the dorsal root ganglia (DRG at the L4-L6 levels ipsilateral to the tracer injection. In the spinal cord, b-CTB labeled neurons were distributed in all laminae ipsilaterally between C7 and S1 segments, but labeling of neurons at the cervical segment was abolished when the T10 segment was transected completely. The interneurons, distributed in the intermediate gray matter and identified as gamma-aminobutyric acid-ergic (GABAergic, were labeled by b-CTB. In contrast, FG labeling was confined to the ventral horn neurons at L4-L6 spinal segments ipsilateral to the injection. b-CTB immunoreactivity remained to be restricted to the soma of neurons and often appeared as irregular patches detected by light and electron microscopy. Detection of monosialoganglioside (GM1 in b-CTB labeled neurons suggests that GM1 ganglioside may specifically enhance the uptake and transneuronal passage of b-CTB, thus supporting the notion that it may be used as a novel transneuronal tracer.

  19. Percutaneous sciatic nerve block with tramadol induces analgesia and motor blockade in two animal pain models

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    A.M. Sousa

    2012-02-01

    Full Text Available Local anesthetic efficacy of tramadol has been reported following intradermal application. Our aim was to investigate the effect of perineural tramadol as the sole analgesic in two pain models. Male Wistar rats (280-380 g; N = 5/group were used in these experiments. A neurostimulation-guided sciatic nerve block was performed and 2% lidocaine or tramadol (1.25 and 5 mg was perineurally injected in two different animal pain models. In the flinching behavior test, the number of flinches was evaluated and in the plantar incision model, mechanical and heat thresholds were measured. Motor effects of lidocaine and tramadol were quantified and a motor block score elaborated. Tramadol, 1.25 mg, completely blocked the first and reduced the second phase of the flinching behavior test. In the plantar incision model, tramadol (1.25 mg increased both paw withdrawal latency in response to radiant heat (8.3 ± 1.1, 12.7 ± 1.8, 8.4 ± 0.8, and 11.1 ± 3.3 s and mechanical threshold in response to von Frey filaments (459 ± 82.8, 447.5 ± 91.7, 320.1 ± 120, 126.43 ± 92.8 mN at 5, 15, 30, and 60 min, respectively. Sham block or contralateral sciatic nerve block did not differ from perineural saline injection throughout the study in either model. The effect of tramadol was not antagonized by intraperitoneal naloxone. High dose tramadol (5 mg blocked motor function as well as 2% lidocaine. In conclusion, tramadol blocks nociception and motor function in vivo similar to local anesthetics.

  20. Percutaneous sciatic nerve block with tramadol induces analgesia and motor blockade in two animal pain models

    Energy Technology Data Exchange (ETDEWEB)

    Sousa, A.M.; Ashmawi, H.A.; Costa, L.S.; Posso, I.P. [LIM-08 - Anestesiologia Experimental, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP (Brazil); Slullitel, A. [Departamento de Anestesiologia, Hospital Santa Paula, São Paulo, SP (Brazil)

    2011-12-23

    Local anesthetic efficacy of tramadol has been reported following intradermal application. Our aim was to investigate the effect of perineural tramadol as the sole analgesic in two pain models. Male Wistar rats (280-380 g; N = 5/group) were used in these experiments. A neurostimulation-guided sciatic nerve block was performed and 2% lidocaine or tramadol (1.25 and 5 mg) was perineurally injected in two different animal pain models. In the flinching behavior test, the number of flinches was evaluated and in the plantar incision model, mechanical and heat thresholds were measured. Motor effects of lidocaine and tramadol were quantified and a motor block score elaborated. Tramadol, 1.25 mg, completely blocked the first and reduced the second phase of the flinching behavior test. In the plantar incision model, tramadol (1.25 mg) increased both paw withdrawal latency in response to radiant heat (8.3 ± 1.1, 12.7 ± 1.8, 8.4 ± 0.8, and 11.1 ± 3.3 s) and mechanical threshold in response to von Frey filaments (459 ± 82.8, 447.5 ± 91.7, 320.1 ± 120, 126.43 ± 92.8 mN) at 5, 15, 30, and 60 min, respectively. Sham block or contralateral sciatic nerve block did not differ from perineural saline injection throughout the study in either model. The effect of tramadol was not antagonized by intraperitoneal naloxone. High dose tramadol (5 mg) blocked motor function as well as 2% lidocaine. In conclusion, tramadol blocks nociception and motor function in vivo similar to local anesthetics.

  1. Long-Standing Motor and Sensory Recovery following Acute Fibrin Sealant Based Neonatal Sciatic Nerve Repair

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    Natalia Perussi Biscola

    2016-01-01

    Full Text Available Brachial plexus lesion results in loss of motor and sensory function, being more harmful in the neonate. Therefore, this study evaluated neuroprotection and regeneration after neonatal peripheral nerve coaptation with fibrin sealant. Thus, P2 neonatal Lewis rats were divided into three groups: AX: sciatic nerve axotomy (SNA without treatment; AX+FS: SNA followed by end-to-end coaptation with fibrin sealant derived from snake venom; AX+CFS: SNA followed by end-to-end coaptation with commercial fibrin sealant. Results were analyzed 4, 8, and 12 weeks after lesion. Astrogliosis, microglial reaction, and synapse preservation were evaluated by immunohistochemistry. Neuronal survival, axonal regeneration, and ultrastructural changes at ventral spinal cord were also investigated. Sensory-motor recovery was behaviorally studied. Coaptation preserved synaptic covering on lesioned motoneurons and led to neuronal survival. Reactive gliosis and microglial reaction decreased in the same groups (AX+FS, AX+CFS at 4 weeks. Regarding axonal regeneration, coaptation allowed recovery of greater number of myelinated fibers, with improved morphometric parameters. Preservation of inhibitory synaptic terminals was accompanied by significant improvement in the motor as well as in the nociceptive recovery. Overall, the present data suggest that acute repair of neonatal peripheral nerves with fibrin sealant results in neuroprotection and regeneration of motor and sensory axons.

  2. Correlation among ultrasound, cross-sectional anatomy, and histology of the sciatic nerve: a review.

    Science.gov (United States)

    Moayeri, Nizar; van Geffen, Geert J; Bruhn, Jörgen; Chan, Vincent W; Groen, Gerbrand J

    2010-01-01

    Efficient identification of the sciatic nerve (SN) requires a thorough knowledge of its topography in relation to the surrounding structures. Anatomic cross sections in similar oblique planes as observed during SN ultrasonography are lacking. A survey of sonoanatomy matched with ultrasound views of the major SN block sites will be helpful in pattern recognition, especially when combined with images that show the internal architecture of the nerve. From 1 cadaver, consecutive parts of the upper leg corresponding to the 4 major blocks sites were sectioned and deeply frozen. Using cryomicrotomy, consecutive transverse sections were acquired and photographed at 78-microm intervals, along with histologic sections at 5-mm intervals. Multiplanar reformatting was done to reconstruct the optimal planes for an accurate comparison of ultrasonography and gross anatomy. The anatomic and histologic images were matched with ultrasound images that were obtained from 2 healthy volunteers. By simulating the exact position and angulation as in the ultrasonographic images, detailed anatomic overviews of SN and adjacent structures were reconstructed in the gluteal, subgluteal, midfemoral, and popliteal regions. Throughout its trajectory, SN contains numerous fascicles with connective and adipose tissues. In this study, we provide an optimal matching between histology, anatomic cross sections, and short-axis ultrasound images of SN. Reconstructing ultrasonographic planes with this high-resolution digitized anatomy not only enables an overview but also shows detailed views of the architecture of internal SN. The undulating course of the nerve fascicles within SN may explain its varying echogenic appearance during probe manipulation.

  3. The application of graphene oxidized combining with decellularized scaffold to repair of sciatic nerve injury in rats

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    Qiaoling Wang

    2017-05-01

    Full Text Available This paper combined the decellularized scaffold of sciatic nerve of rats with graphene oxidized (GO, studied and facilitated the regeneration of sciatic nerve of rats, and provided the basis for the clinical application of nanomaterials. GO was prepared through improving Hammer’s Method. Fourier Infrared Spectrum was used to scan and detect the functional groups in GO of sample by using the pellet method, the microcosmic morphological appearance of GO was observed by using the scanning electron microscope. The GO/decellularized scaffold were prepared and operation bridging of injured sciatic nerve was conducted by using the oscillation mixing method. BL-420F Biofunctional Experiment System was used to detect nerve action potential and the maximum tension value of muscles, and the fiber structure of nerve was observed under H-7650 Transmission Electron Microscope (TEM. Scanning electron microscope observed that GO presented a folded and curly single-layer sheet structure. It was soluble in water through ultrasound, brownish, the Fourier Transform Infrared Spectrometer detected the absorption peaks of carbonyl, hydroxy and carboxy, proving that the surface of GO material had many functional groups containing oxygen. Decellularized scaffold combining with GO was applied to repair injury of sciatic nerve, the nerve action potential, maximum tension value of muscle, wet weight value of gastrocnemius, thickness of gastrocnemius, thickness of myelin sheath and diameter of axon of the decellularized scaffold combining with GO group were obviously higher than the decellularized scaffold group and the self-rotating group, approaching to the normal value. All the data were represented by means ± standard deviation (x¯±s and processed by adopting SPSS 11.0 software. Comparisons among groups were analyzed by variance, and the comparison of two means was detected by student t. The detection level adopted α = 0.05, when P < 0.05, it could be

  4. Effect of acute and chronic administration of caffeine on pain-like behaviors in rats with partial sciatic nerve injury.

    Science.gov (United States)

    Wu, Wei-Ping; Hao, Jing-Xia; Fredholm, Bertil B; Wiesenfeld-Hallin, Zsuzsanna; Xu, Xiao-Jun

    2006-07-10

    Caffeine, used in many pain medications as an adjuvant analgesic, is an adenosine A1 and A2A receptor antagonist. Here we examined the effects of acute or chronic caffeine administration in rats after partial sciatic nerve injury. The hindpaw response to mechanical or cold stimulation was assessed following photochemically induced sciatic nerve injury which leads to hypersensitivity to these stimuli. Caffeine was administered i.p. acutely or in the drinking water chronically. The mechanical and cold hypersensitivity of sciatic nerve-injured rats was dose-dependently alleviated by acute systemic administration of caffeine (10-80 mg/kg). The effect of caffeine was, however, associated with side effects including locomotor stimulation or depression. Chronic oral administration (average daily doses 27.5 mg/kg/day or 61.5 mg/kg/day for 2 weeks) of caffeine starting at the time of nerve injury did not significantly affect the development of pain-like behaviors. Thus, acute, but not long term, caffeine intake reduced neuropathic pain state in nerve-injured rats, but only at very high doses. The potential hyperalgesic effect of chronic A1 adenosine receptor blockade may have been compensated for by an antinociceptive effect of caffeine through antagonism of A2A receptors and tolerance development.

  5. Nerve Wrapping of the Sciatic Nerve With Acellular Dermal Matrix in Chronic Complete Proximal Hamstring Ruptures and Ischial Apophyseal Avulsion Fractures

    Science.gov (United States)

    Haus, Brian M.; Arora, Danny; Upton, Joseph; Micheli, Lyle J.

    2016-01-01

    Background: Patients with chronic injuries of the proximal hamstring can develop significant impairment because of weakness of the hamstring muscles, sciatic nerve compression from scar formation, or myositis ossificans. Purpose: To describe the surgical outcomes of patients with chronic injury of the proximal hamstrings who were treated with hamstring repair and sciatic neurolysis supplemented with nerve wrapping with acellular dermal matrix. Study Design: Retrospective case series; Level of evidence, 4. Methods: Fifteen consecutive patients with a diagnosis of chronic complete proximal hamstring rupture or chronic ischial tuberosity apophyseal avulsion fracture (mean age, 39.67 years; range, 14-69 years) were treated with proximal hamstring repair and sciatic neurolysis supplemented with nerve wrapping with acellular dermal matrix. Nine patients had preoperative sciatica, and 6 did not. Retrospective chart review recorded clinical outcomes measured by the degree of pain relief, the rate of return to activities, and associated postoperative complications. Results: All 15 patients were followed in the postoperative period for an average of 16.6 months. Postoperatively, there were 4 cases of transient sciatic nerve neurapraxia. Four patients (26%) required postoperative betamethasone sodium phosphate (Celestone Soluspan) injectable suspension USP 6 mg/mL. Among the 9 patients with preoperative sciatica, 6 (66%) had a good or excellent outcome and were able to return to their respective activities/sports; 3 (33%) had persistent chronic pain. One of these had persistent sciatic neuropathy that required 2 surgical reexplorations and scar excision after development of recurrent extraneural scar formation. Among the 6 without preoperative sciatica, 100% had a good or excellent outcomes and 83% returned to their respective activities/sports. Better outcomes were observed in younger patients, as the 3 cases of persistent chronic sciatic pain were in patients older than 45

  6. COMP-angiopoietin-1 recovers molecular biomarkers of neuropathy and improves vascularisation in sciatic nerve of ob/ob mice.

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    Joanna Kosacka

    Full Text Available BACKGROUND: Leptin-deficient ob/ob mice are a model of type 2 diabetes induced peripheral neuropathy. Ob/ob mice exhibit obesity, insulin resistance, hyperglycaemia, and alterations of peripheral nerve fibres and endoneural microvessels. Here we test the hypothesis that cartilage oligomeric matrix protein (COMP-Ang-1, a soluble and stabile form of Ang-1 which promotes angiogenesis and nerve growth, improves regeneration of nerve fibres and endoneural microvessels in ob/ob mice. METHODS AND FINDINGS: COMP-Ang-1 (100 ng/ml or NaCl were intraperitoneally (i.p. injected into male (N = 184, 3-month old, ob/ob or ob/+ mice for 7 and 21 days. We measured expression of Nf68, GAP43, Cx32, Cx26, Cx43, and TNFα in sciatic nerves using Western blot analysis. To investigate the inflammation in sciatic nerves, numbers of macrophages and T-cells were counted after immunofluorescence staining. In ultrathin section, number of myelinated/non-mylinated nerve fibers, g-ratio, the thickness of Schwann cell basal lamina and microvessel endothelium were investigated. Endoneural microvessels were reconstructed with intracardial FITC injection. Treatment with COMP-Ang-1 over 21 days significantly reduced fasting blood glucose and plasma cholesterol concentrations compared to saline treated ob/ob mice. In addition, COMP-Ang-1 treatment: 1 up-regulated expression of Nf68 and GAP43; 2 improved expression of gap junction proteins including connexin 32 and 26; 3 suppressed the expression of TNFα and Cx43 and 4 led to decreased macrophage and T-cell infiltration in sciatic nerve of ob/ob mice. The significant changes of sciatic nerve ultrastructure were not observed after 21-day long COMP-Ang-1 treatment. COMP-Ang-1 treated ob/ob mice displayed regeneration of small-diameter endoneural microvessels. Effects of COMP-Ang-1 corresponded to increased phosphorylation of Akt and p38 MAPK upon Tie-2 receptor. CONCLUSIONS: COMP-Ang-1 recovers molecular biomarkers of neuropathy

  7. 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

  8. Protective effect of mulberry flavonoids on sciatic nerve in alloxan-induced diabetic rats

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    Ma Song-Tao

    2014-12-01

    Full Text Available Mulberry leaves (Morus alba L. are a traditional Chinese medicine for blood serum glucose reduction. This study evaluated the protective effects of mulberry flavonoids on sciatic nerve in alloxan-induced diabetic rats. In this study, 80 Sprague-Dawley rats were divided into five groups: A (control, B (diabetic treated with saline, C-D (diabetic treated with 0.3, 0.1 g/kg mulberry flavonoids once a day for 8 weeks and E (diabetic treated with 0.3 mg/kg methycobal. The diabetic condition was induced by intraperitoneal injection of 200 mg/kg alloxan dissolved in saline. At the end of the experimental period, blood, and tissue samples were obtained for biochemical and histopathological investigation. Treatment with 0.3 g/kg mulberry flavonoids significantly inhibited the elevated serum glucose (P< 0.01. The increased myelin sheath area (P< 0.01, myelinated fiber cross-sectional area and extramedullary fiber number (P< 0.05 were also reduced in alloxan-induced rats treated with 0.3 g/kg mulberry flavonoids. 0.3 g/kg mulberry flavonoids also markedly decreased onion-bulb type myelin destruction and degenerative changes of mitochondria and Schwann cells. These findings demonstrate that mulberry flavonoids may improve the recovery of a severe peripheral nerve injury in alloxan-induced diabetic rats and is likely to be useful as a potential treatment on peripheral neuropathy (PN in diabetic rats.

  9. Effects of terpineol on the compound action potential of the rat sciatic nerve

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    M.R. Moreira

    2001-10-01

    Full Text Available Terpineol, a volatile terpenoid alcohol of low toxicity, is widely used in the perfumery industry. It is an important chemical constituent of the essential oil of many plants with widespread applications in folk medicine and in aromatherapy. The effects of terpineol on the compound action potential (CAP of rat sciatic nerve were studied. Terpineol induced a dose-dependent blockade of the CAP. At 100 µM, terpineol had no demonstrable effect. At 300 µM terpineol, peak-to-peak amplitude and conduction velocity of CAP were significantly reduced at the end of 180-min exposure of the nerve to the drug, from 3.28 ± 0.22 mV and 33.5 ± 7.05 m/s, respectively, to 1.91 ± 0.51 mV and 26.2 ± 4.55 m/s. At 600 µM, terpineol significantly reduced peak-to-peak amplitude and conduction velocity from 2.97 ± 0.55 mV and 32.8 ± 3.91 m/s to 0.24 ± 0.23 mV and 2.72 ± 2.72 m/s, respectively (N = 5. All these effects developed slowly and were reversible upon 180-min washout.

  10. Ameliorative effect of ethyl pyruvate in neuropathic pain induced by chronic constriction injury of sciatic nerve

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    Varsha J. Bansode

    2014-01-01

    Full Text Available Objective: The present study was designed to investigate the ameliorative effects of ethyl pyruvate (EP in chronic constriction injury (CCI-induced painful neuropathy in rats. Materials and Methods: EP 50 and 100 mg/kg was administered for 21 consecutive days starting from the day of surgery. The effects of EP in the paw pressure, acetone drop, and tail heat immersion tests were assessed, reflecting the degree of mechanical hyperalgesia, cold allodynia, and spinal thermal sensation, respectively. Axonal degeneration of the sciatic nerve was assessed histopathologically. The levels of thiobarbituric acid reactive species, reduced glutathione (GSH, catalase (CAT, and superoxide dismutase (SOD were determined to assess oxidative stress. Key Findings: Administration of 50 and 100 mg/kg EP attenuated the reduction of nociceptive threshold in the paw pressure, acetone drop, and tail heat immersion tests. EP 100 mg/kg significantly attenuated reactive changes in histopathology and increase in oxidative stress. Conclusion: EP 100 mg/kg showed beneficial activity against nerve trauma-induced neuropathy. Hence, it can be used as a better treatment option in neuropathic pain (NP. The observed antinociceptive effects of EP may possibly be attributed to its antioxidant and anti-inflammatory activity.

  11. Trigger point-related sympathetic nerve activity in chronic sciatic leg pain: a case study.

    Science.gov (United States)

    Skorupska, Elżbieta; Rychlik, Michał; Pawelec, Wiktoria; Bednarek, Agata; Samborski, Włodzimierz

    2014-10-01

    Sciatica has classically been associated with irritation of the sciatic nerve by the vertebral disc and consequent inflammation. Some authors suggest that active trigger points in the gluteus minimus muscle can refer pain in similar way to sciatica. Trigger point diagnosis is based on Travel and Simons criteria, but referred pain and twitch response are significant confirmatory signs of the diagnostic criteria. Although vasoconstriction in the area of a latent trigger point has been demonstrated, the vasomotor reaction of active trigger points has not been examined. We report the case of a 22-year-old Caucasian European man who presented with a 3-year history of chronic sciatic-type leg pain. In the third year of symptoms, coexistent myofascial pain syndrome was diagnosed. Acupuncture needle stimulation of active trigger points under infrared thermovisual camera showed a sudden short-term vasodilatation (an autonomic phenomenon) in the area of referred pain. The vasodilatation spread from 0.2 to 171.9 cm(2) and then gradually decreased. After needling, increases in average and maximum skin temperature were seen as follows: for the thigh, changes were +2.6°C (average) and +3.6°C (maximum); for the calf, changes were +0.9°C (average) and +1.4°C (maximum). It is not yet known whether the vasodilatation observed was evoked exclusively by dry needling of active trigger points. The complex condition of the patient suggests that other variables might have influenced the infrared thermovision camera results. We suggest that it is important to check if vasodilatation in the area of referred pain occurs in all patients with active trigger points. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  12. In vivo DTI longitudinal measurements of acute sciatic nerve traction injury and the association with pathological and functional changes.

    Science.gov (United States)

    Li, Xinchun; Chen, Jingcong; Hong, Goubin; Sun, Congpeng; Wu, Xiaomen; Peng, Matthew Jianqiao; Zeng, Guangqiao

    2013-11-01

    To explore the feasibility of longitudinally measuring acute traction injury to the sciatic nerve using 1.5 T clinical MRI scanner of diffusion tensor imaging (DTI) and to analyze the associations of the measurements [regarding fractional anisotropy (FA), apparent diffusion coefficient (ADC), eigenvalue (λ|| and λ⊥)] with limb function and pathology. Acute traction injuries to the sciatic nerve were created in the right hind limbs of 32 New Zealand white rabbits, the left hind limbs were chosen as sham operation nerves. MRI scans were performed at intervals from pre-operation through 8 weeks post-operation follow up. Scanning sequences included T2WI, STIR, and single shot spin echo DTI with single shot EPI acquisition (SE-DTI-SSEPI). Parameters of FA, ADC, axial diffusivity (λ||) and radial diffusivity (λ⊥) were then calculated from the DTI. The limb functions and pathologic changes were evaluated and compared. Diffusion Tensor Tractography (DTT) only revealed the proximal portion of the injured nerves 1-3 days after traction injury but did not reveal the nerve of the distal and traction portions at all. Nerve fibers of the distal and traction portions were not revealed by DTT until after the 1st week. They were elongated gradually and recovered almost to the normal at 8th week. The value of FA and λ⊥of the injured nerves, which varied in different portions, were significantly different between the traction injury nerves and the sham operation nerves, whereas the value of ADC and λ|| were not significantly different. The curve lines of FA value-time for the proximal, traction and distal portions of the injured nerve correlated well to the functional and pathological changes of the limb affected, while the DTI parameters did not change that much in the sham-operated nerves. DTI obtained on a 1.5 T clinical MRI scanner can demonstrate early abnormal changes following traction injury to the sciatic nerve in rabbits. The curve lines of FA-time and

  13. An artery accompanying the sciatic nerve (arteria comitans nervi ischiadici) and the position of the hip joint: a comparative histological study using chick, mouse, and human foetal specimens.

    Science.gov (United States)

    Ishizawa, A; Hayashi, S; Nasu, H; Abe, H; Rodríguez-Vázquez, J F; Murakami, G

    2013-02-01

    Birds and reptiles always carry a long and thick artery accompanying the sciatic nerve (i.e., the sciatic artery), whereas mammals do not. We attempted to demonstrate a difference in courses of the nerve and artery in fetuses in relation with the hip joint posture. Eight mid-term human fetuses (15-18 weeks), five mouse fetuses (E18) and five chick embryos (11 days after incubation) were examined histologically. Thin feeding arteries in the sciatic nerve were consistently observed in human fetuses in spite of the long, inferiorly curved course of the nerve around the ischium. The tissue around the human sciatic nerve was not so tight because of the medial and inferior shift of the nerve away from the hip joint. The fetal hip joint position differed among the species, being highly flexed in humans and almost at right angle flexion in mice and chicks. Because of deep adduction of the hip joint in the mouse, the knee was located near the midline of the body. The mouse sciatic nerve ran through the tight tissue along the head of the femur, whereas the chick nerve ran through the loose space even in the gluteal region. In birds, evolution of the pelvis including the hip joint without adduction seemed to make the arterial development possible. In mammals, highly flexed or adducted hip joint seemed to be one of the disturbing factors against development of the long and thick artery. A slight change in posture may cause significant arterial variation.

  14. Effect of Pulsed Radiofrequency on Rat Sciatic Nerve Chronic Constriction Injury: A Preliminary Study

    Science.gov (United States)

    Li, Duo-Yi; Meng, Lan; Ji, Nan; Luo, Fang

    2015-01-01

    Background: Pulsed radiofrequency (PRF) application to the dorsal root ganglia can reduce neuropathic pain (NP) in animal models, but the effect of PRF on damaged peripheral nerves has not been examined. We investigated the effect of PRF to the rat sciatic nerve (SN) on pain-related behavior and SN ultrastructure following chronic constriction injury (CCI). Methods: The analgesic effect was measured by hindpaw mechanical withdrawal threshold (MWT) and thermal withdrawal latency (TWL). Twenty rats with NP induced by ligating the common SN were then randomly divided into a PRF treatment group and a sham group. The contralateral SN served as a control. The MWT and TWL were determined again 2, 4, 6, 8, 10, 12, and 14 days after the PRF or sham treatment. On day 14, ipsilateral and contralateral common SNs were excised and examined by electron microscopy. Results: Ipsilateral MWT was significantly reduced and TWL significantly shorter compared to the contralateral side 14 days after CCI (both P = 0.000). In the PRF group, MWT was significantly higher and TWL significantly longer 14 days after the PRF treatment compared to before PRF treatment (both P = 0.000), while no such difference was observed in the sham group (P > 0.05). Electron microscopy revealed extensive demyelination and collagen fiber formation in the ipsilateral SN of sham-treated rats but sparse demyelination and some nerve fiber regrowth in the PRF treatment group. Conclusions: Hyperalgesia is relieved, and ultrastructural damage ameliorated after direct PRF treatment to the SN in the CCI rat model of NP. PMID:25673460

  15. Calpain 3 Expression Pattern during Gastrocnemius Muscle Atrophy and Regeneration Following Sciatic Nerve Injury in Rats

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    Ronghua Wu

    2015-11-01

    Full Text Available Calpain 3 (CAPN3, also known as p94, is a skeletal muscle-specific member of the calpain family that is involved in muscular dystrophy; however, the roles of CAPN3 in muscular atrophy and regeneration are yet to be understood. In the present study, we attempted to explain the effect of CAPN3 in muscle atrophy by evaluating CAPN3 expression in rat gastrocnemius muscle following reversible sciatic nerve injury. After nerve injury, the wet weight ratio and cross sectional area (CSA of gastrocnemius muscle were decreased gradually from 1–14 days and then recovery from 14–28 days. The active form of CAPN3 (~62 kDa protein decreased slightly on day 3 and then increased from day 7 to 14 before a decrease from day 14 to 28. The result of linear correlation analysis showed that expression of the active CAPN3 protein level was negatively correlated with muscle wet weight ratio. CAPN3 knockdown by short interfering RNA (siRNA injection improved muscle recovery on days 7 and 14 after injury as compared to that observed with control siRNA treatment. Depletion of CAPN3 gene expression could promote myoblast differentiation in L6 cells. Based on these findings, we conclude that the expression pattern of the active CAPN3 protein is linked to muscle atrophy and regeneration following denervation: its upregulation during early stages may promote satellite cell renewal by inhibiting differentiation, whereas in later stages, CAPN3 expression may be downregulated to stimulate myogenic differentiation and enhance recovery. These results provide a novel mechanistic insight into the role of CAPN3 protein in muscle regeneration after peripheral nerve injury.

  16. Calpain 3 Expression Pattern during Gastrocnemius Muscle Atrophy and Regeneration Following Sciatic Nerve Injury in Rats.

    Science.gov (United States)

    Wu, Ronghua; Yan, Yingying; Yao, Jian; Liu, Yan; Zhao, Jianmei; Liu, Mei

    2015-11-11

    Calpain 3 (CAPN3), also known as p94, is a skeletal muscle-specific member of the calpain family that is involved in muscular dystrophy; however, the roles of CAPN3 in muscular atrophy and regeneration are yet to be understood. In the present study, we attempted to explain the effect of CAPN3 in muscle atrophy by evaluating CAPN3 expression in rat gastrocnemius muscle following reversible sciatic nerve injury. After nerve injury, the wet weight ratio and cross sectional area (CSA) of gastrocnemius muscle were decreased gradually from 1-14 days and then recovery from 14-28 days. The active form of CAPN3 (~62 kDa) protein decreased slightly on day 3 and then increased from day 7 to 14 before a decrease from day 14 to 28. The result of linear correlation analysis showed that expression of the active CAPN3 protein level was negatively correlated with muscle wet weight ratio. CAPN3 knockdown by short interfering RNA (siRNA) injection improved muscle recovery on days 7 and 14 after injury as compared to that observed with control siRNA treatment. Depletion of CAPN3 gene expression could promote myoblast differentiation in L6 cells. Based on these findings, we conclude that the expression pattern of the active CAPN3 protein is linked to muscle atrophy and regeneration following denervation: its upregulation during early stages may promote satellite cell renewal by inhibiting differentiation, whereas in later stages, CAPN3 expression may be downregulated to stimulate myogenic differentiation and enhance recovery. These results provide a novel mechanistic insight into the role of CAPN3 protein in muscle regeneration after peripheral nerve injury.

  17. Autologous nerve graft repair of different degrees of sciatic nerve defect: stress and displacement at the anastomosis in a three-dimensional fnite element simulation model

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    Cheng-dong Piao

    2015-01-01

    Full Text Available In the repair of peripheral nerve injury using autologous or synthetic nerve grafting, the magnitude of tensile forces at the anastomosis affects its response to physiological stress and the ultimate success of the treatment. One-dimensional stretching is commonly used to measure changes in tensile stress and strain however, the accuracy of this simple method is limited. Therefore, in the present study, we established three-dimensional finite element models of sciatic nerve defects repaired by autologous nerve grafts. Using PRO E 5.0 finite element simulation software, we calculated the maximum stress and displacement of an anastomosis under a 5 N load in 10-, 20-, 30-, 40-mm long autologous nerve grafts. We found that maximum displacement increased with graft length, consistent with specimen force. These findings indicate that three-dimensional finite element simulation is a feasible method for analyzing stress and displacement at the anastomosis after autologous nerve grafting.

  18. Gamma knife irradiation of injured sciatic nerve induces histological and behavioral improvement in the rat neuropathic pain model.

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    Yuki Yagasaki

    Full Text Available We examined the effects of gamma knife (GK irradiation on injured nerves using a rat partial sciatic nerve ligation (PSL model. GK irradiation was performed at one week after ligation and nerve preparations were made three weeks after ligation. GK irradiation is known to induce immune responses such as glial cell activation in the central nervous system. Thus, we determined the effects of GK irradiation on macrophages using immunoblot and histochemical analyses. Expression of Iba-1 protein, a macrophage marker, was further increased in GK-treated injured nerves as compared with non-irradiated injured nerves. Immunohistochemical study of Iba-1 in GK-irradiated injured sciatic nerves demonstrated Iba-1 positive macrophage accumulation to be enhanced in areas distal to the ligation point. In the same area, myelin debris was also more efficiently removed by GK-irradiation. Myelin debris clearance by macrophages is thought to contribute to a permissive environment for axon growth. In the immunoblot study, GK irradiation significantly increased expressions of βIII-tubulin protein and myelin protein zero, which are markers of axon regeneration and re-myelination, respectively. Toluidine blue staining revealed the re-myelinated fiber diameter to be larger at proximal sites and that the re-myelinated fiber number was increased at distal sites in GK-irradiated injured nerves as compared with non-irradiated injured nerves. These results suggest that GK irradiation of injured nerves facilitates regeneration and re-myelination. In a behavior study, early alleviation of allodynia was observed with GK irradiation in PSL rats. When GK-induced alleviation of allodynia was initially detected, the expression of glial cell line-derived neurotrophic factor (GDNF, a potent analgesic factor, was significantly increased by GK irradiation. These results suggested that GK irradiation alleviates allodynia via increased GDNF. This study provides novel evidence that GK

  19. Effects of Pulsed Electromagnetic Field with Predatory Stress on Functional and Histological Index of Injured-Sciatic Nerve in Rat.

    Science.gov (United States)

    Tasbih-Forosh, Maryam; Zarei, Leila; Saboory, Ehsan; Bahrami-Bukani, Mehran

    2017-04-01

    To assess the effect of combination of pulsed electromagnetic fields (PEMF) with predatory stress on transected sciatic nerve regeneration in rats. In sham- operated group (SOG) the nerve was manipulated and left intact. The 10-mm rat sciatic nerve gap was created in rats. In transected group (Transected) nerve stumps were sutured to adjacent muscle and in vein graft group (VG) the gap was bridged using an inside-out vein graft. In VG/PEMF group the transected nerve was bridged using vein graft, phosphate buffered saline was administered into the graft and the whole body was exposed to PEMF. In VG/PS group the transected nerve was bridged using vein graft, phosphate buffered saline was administered into the graft and the rats underwent predatory stress (PS).  In VG/PEMF/PS group the transected nerve was bridged using vein graft, phosphate buffered saline was administered into the graft, the whole body was exposed to PEMF and the rats underwent predatory stress. The regenerated nerve fibers were studied within 12 weeks after surgery. Functional, gastrocnemius muscle mass findings and morphometric indices confirmed faster recovery of regenerated axons in VG/PEMF and VG/PEMF/PS groups compared to those in the other groups ( p =0.001). The whole body exposure to PEMF improved functional recovery. Predatory stress did not affect nerve regeneration in the animals undergone predatory stress ( p =0.343). Pulsed electromagnetic fields could be considered as an effective, safe and tolerable treatment for peripheral nerve repair in clinical practice.

  20. Effects of Pulsed Electromagnetic Field with Predatory Stress on Functional and Histological Index of Injured-Sciatic Nerve in Rat

    Science.gov (United States)

    Tasbih -Forosh, Maryam; Zarei, Leila; Saboory, Ehsan; Bahrami-Bukani, Mehran

    2017-01-01

    Objective: To assess the effect of combination of pulsed electromagnetic fields (PEMF) with predatory stress on transected sciatic nerve regeneration in rats.  Methods: In sham- operated group (SOG) the nerve was manipulated and left intact. The 10-mm rat sciatic nerve gap was created in rats. In transected group (Transected) nerve stumps were sutured to adjacent muscle and in vein graft group (VG) the gap was bridged using an inside-out vein graft. In VG/PEMF group the transected nerve was bridged using vein graft, phosphate buffered saline was administered into the graft and the whole body was exposed to PEMF. In VG/PS group the transected nerve was bridged using vein graft, phosphate buffered saline was administered into the graft and the rats underwent predatory stress (PS).  In VG/PEMF/PS group the transected nerve was bridged using vein graft, phosphate buffered saline was administered into the graft, the whole body was exposed to PEMF and the rats underwent predatory stress. The regenerated nerve fibers were studied within 12 weeks after surgery. Results: Functional, gastrocnemius muscle mass findings and morphometric indices confirmed faster recovery of regenerated axons in VG/PEMF and VG/PEMF/PS groups compared to those in the other groups (p=0.001). The whole body exposure to PEMF improved functional recovery. Predatory stress did not affect nerve regeneration in the animals undergone predatory stress (p=0.343).  Conclusion: Pulsed electromagnetic fields could be considered as an effective, safe and tolerable treatment for peripheral nerve repair in clinical practice. PMID:28507996

  1. Reducing the length of hospital stay after total knee arthroplasty: influence of femoral and sciatic nerve block.

    Science.gov (United States)

    Carvalho Júnior, Lúcio Honório de; Temponi, Eduardo Frois; Paganini, Vinícius Oliveira; Costa, Lincoln Paiva; Soares, Luiz Fernando Machado; Gonçalves, Matheus Braga Jacques

    2015-01-01

    the aim of this study is to evaluate the change in length of hospital stay postoperatively for Total Knee Arthroplasty after using femoral and sciatic nerve block. the medical records of 287 patients were evaluated, taking into account the number of hours of admission, the percentage and the reason for re-hospitalization within 30 days, as well as associated complications. All patients were divided into two groups according or not to whether they were admitted to ICU or not. During the years 2009 and 2010, isolated spinal anesthesia was the method used in the procedure. From 2011 on, femoral and sciatic nerve blocking was introduced. between the years 2009 and 2012, the average length of stay ranged from 74 hours in 2009 to 75.2 hours in 2010. The average length of stay in 2011 was 56.52 hours and 53.72 hours in 2012, all in the group of patients who did not remain in the ICU postoperatively. In the same period, among those in the group that needed ICU admission, the average length of stay was 138.7 hours in 2009, 90.25 hours in 2010, 79.8 hours in 2011, and 52.91 hours in 2012. During 2009 and 2010, the rate of re-hospitalization was 0%, while in 2011 and 2012, were 3.44% and 1%, respectively. according to this study, the use of femoral and sciatic nerve blocking after total knee arthroplasty allowed significant reduction in hospital stay.

  2. The Effects of Epidermal Neural Crest Stem Cells on Local Inflammation Microenvironment in the Defected Sciatic Nerve of Rats

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    Yue Li

    2017-05-01

    Full Text Available Cell-based therapy is a promising strategy for the repair of peripheral nerve injuries (PNIs. epidermal neural crest stems cells (EPI-NCSCs are thought to be important donor cells for repairing PNI in different animal models. Following PNI, inflammatory response is important to regulate the repair process. However, the effects of EPI-NCSCs on regulation of local inflammation microenviroment have not been investigated extensively. In the present study, these effects were studied by using 10 mm defected sciatic nerve, which was bridged with 15 mm artificial nerve composed of EPI-NCSCs, extracellular matrix (ECM and poly (lactide-co-glycolide (PLGA. Then the expression of pro- and anti-inflammatory cytokines, polarization of macrophages, regulation of fibroblasts and shwann cells (SCs were assessed by western blot, immunohistochemistry, immunofluorescence staining at 1, 3, 7 and 21 days after bridging. The structure and the function of the bridged nerve were determined by observation under light microscope and by examination of right lateral foot retraction time (LFRT, sciatic function index (SFI, gastrocnemius wet weight and electrophysiology at 9 weeks. After bridging with EPI-NCSCs, the expression of anti-inflammatory cytokines (IL-4 and IL-13 was increased, but decreased for pro-inflammatory cytokines (IL-6 and TNF-α compared to the control bridging, which was consistent with increase of M2 macrophages and decrease of M1 macrophages at 7 days after transplantation. Likewise, myelin-formed SCs were significantly increased, but decreased for the activated fibroblasts in their number at 21 days. The recovery of structure and function of nerve bridged with EPI-NCSCs was significantly superior to that of DMEM. These results indicated that EPI-NCSCs could be able to regulate and provide more suitable inflammation microenvironment for the repair of defected sciatic nerve.

  3. Role of JNK isoforms in the development of neuropathic pain following sciatic nerve transection in the mouse

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    Manassero Giusi

    2012-05-01

    Full Text Available Abstract Background Current tools for analgesia are often only partially successful, thus investigations of new targets for pain therapy stimulate great interest. Consequent to peripheral nerve injury, c-Jun N-terminal kinase (JNK activity in cells of the dorsal root ganglia (DRGs and spinal cord is involved in triggering neuropathic pain. However, the relative contribution of distinct JNK isoforms is unclear. Using knockout mice for single isoforms, and blockade of JNK activity by a peptide inhibitor, we have used behavioral tests to analyze the contribution of JNK in the development of neuropathic pain after unilateral sciatic nerve transection. In addition, immunohistochemical labelling for the growth associated protein (GAP-43 and Calcitonin Gene Related Peptide (CGRP in DRGs was used to relate injury related compensatory growth to altered sensory function. Results Peripheral nerve injury produced pain–related behavior on the ipsilateral hindpaw, accompanied by an increase in the percentage of GAP43-immunoreactive (IR neurons and a decrease in the percentage of CGRP-IR neurons in the lumbar DRGs. The JNK inhibitor, D-JNKI-1, successfully modulated the effects of the sciatic nerve transection. The onset of neuropathic pain was not prevented by the deletion of a single JNK isoform, leading us to conclude that all JNK isoforms collectively contribute to maintain neuropathy. Autotomy behavior, typically induced by sciatic nerve axotomy, was absent in both the JNK1 and JNK3 knockout mice. Conclusions JNK signaling plays an important role in regulating pain threshold: the inhibition of all of the JNK isoforms prevents the onset of neuropathic pain, while the deletion of a single splice JNK isoform mitigates established sensory abnormalities. JNK inactivation also has an effect on axonal sprouting following peripheral nerve injury.

  4. H-reflex up-conditioning encourages recovery of EMG activity and H-reflexes after sciatic nerve transection and repair in rats.

    Science.gov (United States)

    Chen, Yi; Wang, Yu; Chen, Lu; Sun, Chenyou; English, Arthur W; Wolpaw, Jonathan R; Chen, Xiang Yang

    2010-12-01

    Operant conditioning of the spinal stretch reflex or its electrical analog, the H-reflex, produces spinal cord plasticity and can thereby affect motoneuron responses to primary afferent input. To explore whether this conditioning can affect the functional outcome after peripheral nerve injury, we assessed the effect of up-conditioning soleus (SOL) H-reflex on SOL and tibialis anterior (TA) function after sciatic nerve transection and repair. Sprague Dawley rats were implanted with EMG electrodes in SOL and TA and stimulating cuffs on the posterior tibial nerve. After control data collection, the sciatic nerve was transected and repaired and the rat was exposed for 120 d to continued control data collection (TC rats) or SOL H-reflex up-conditioning (TU rats). At the end of data collection, motoneurons that had reinnervated SOL and TA were labeled retrogradely. Putative primary afferent terminals [i.e., terminals containing vesicular glutamate transporter-1 (VGLUT1)] on SOL motoneurons were studied immunohistochemically. SOL (and probably TA) background EMG activity recovered faster in TU rats than in TC rats, and the final recovered SOL H-reflex was significantly larger in TU than in TC rats. TU and TC rats had significantly fewer labeled motoneurons and higher proportions of double-labeled motoneurons than untransected rats. VGLUT1 terminals were significantly more numerous on SOL motoneurons of TU than TC rats. Combined with the larger H-reflexes in TU rats, this anatomical finding supports the hypothesis that SOL H-reflex up-conditioning strengthened primary afferent reinnervation of SOL motoneurons. These results suggest that H-reflex up-conditioning may improve functional recovery after nerve injury and repair.

  5. Comparing the effects of single shot sciatic nerve block versus posterior capsule local anesthetic infiltration on analgesia and functional outcome after total knee arthroplasty: a prospective, randomized, double-blinded, controlled trial.

    Science.gov (United States)

    Safa, Ben; Gollish, Jeffrey; Haslam, Lynn; McCartney, Colin J L

    2014-06-01

    Peripheral nerve blocks appear to provide effective analgesia for patients undergoing total knee arthroplasty. Although the literature supports the use of femoral nerve block, addition of sciatic nerve block is controversial. In this study we investigated the value of sciatic nerve block and an alternative technique of posterior capsule local anesthetic infiltration analgesia. 100 patients were prospectively randomized into three groups. Group 1: sciatic nerve block; Group 2: posterior local anesthetic infiltration; Group 3: control. All patients received a femoral nerve block and spinal anesthesia. There were no differences in pain scores between groups. Sciatic nerve block provided a brief clinically insignificant opioid sparing effect. We conclude that sciatic nerve block and posterior local anesthetic infiltration do not provide significant analgesic benefits. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Thermographic evaluation of hind paw skin temperature and functional recovery of locomotion after sciatic nerve crush in rats

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    Viviane Z. Sacharuk

    2011-01-01

    Full Text Available INTRODUCTION: Peripheral nerves are often damaged by direct mechanical injury, diseases, and tumors. The peripheral nerve injuries that result from these conditions can lead to a partial or complete loss of motor, sensory, and autonomic functions, which in turn are related to changes in skin temperature, in the involved segments of the body. The aim of this study was to evaluate the changes in hind paw skin temperature after sciatic nerve crush in rats in an attempt to determine whether changes in skin temperature correlate with the functional recovery of locomotion. METHODS: Wistar rats were divided into three groups: control (n = 7, sham (n = 25, and crush (n = 25. All groups were subjected to thermographic, functional, and histological assessments. RESULTS: ΔT in the crush group was different from the control and sham groups at the 1st, 3rd and 7rd postoperative days (p<0.05. The functional recovery from the crush group returned to normal values between the 3rd and 4th week post-injury, and morphological analysis of the nerve revealed incomplete regeneration at the 4th week after injury. DISCUSSION: This study is the first demonstration that sciatic nerve crush in rats induces an increase in hind paw skin temperature and that skin temperature changes do not correlate closely with functional recovery

  7. Microencapsulation improves inhibitory effects of transplanted olfactory ensheathing cells on pain after sciatic nerve injury

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    Hao Zhao

    2015-01-01

    Full Text Available Olfactory bulb tissue transplantation inhibits P2X2/3 receptor-mediated neuropathic pain. However, the olfactory bulb has a complex cellular composition, and the mechanism underlying the action of purified transplanted olfactory ensheathing cells (OECs remains unclear. In the present study, we microencapsulated OECs in alginic acid, and transplanted free and microencapsulated OECs into the region surrounding the injured sciatic nerve in rat models of chronic constriction injury. We assessed mechanical nociception in the rat models 7 and 14 days after surgery by measuring paw withdrawal threshold, and examined P2X2/3 receptor expression in L 4-5 dorsal root ganglia using immunohistochemistry. Rats that received free and microencapsulated OEC transplants showed greater withdrawal thresholds than untreated model rats, and weaker P2X2/3 receptor immunoreactivity in dorsal root ganglia. At 14 days, paw withdrawal threshold was much higher in the microencapsulated OEC-treated animals. Our results confirm that microencapsulated OEC transplantation suppresses P2X2/3 receptor expression in L 4-5 dorsal root ganglia in rat models of neuropathic pain and reduces allodynia, and also suggest that transplantation of microencapsulated OECs is more effective than transplantation of free OECs for the treatment of neuropathic pain.

  8. Carbon dioxide laser-assisted nerve repair: effect of solder and suture material on nerve regeneration in rat sciatic nerve

    NARCIS (Netherlands)

    Menovsky, Tomas; Beek, Johan F.

    2003-01-01

    In order to further improve and explore the role of lasers for nerve reconstruction, this study was designed to investigate regeneration of sharply transected peripheral nerves repaired with a CO(2) milliwatt laser in combination with three different suture materials and a bovine albumin protein

  9. Evaluation of Morphological and Functional Nerve Recovery of Rat Sciatic Nerve with a Hyaff11-Based Nerve Guide

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    K. Jansen

    2006-01-01

    Full Text Available Application of a Hyaff11-based nerve guide was studied in rats. Functional tests were performed to study motor nerve recovery. A withdrawal reflex test was performed to test sensory recovery. Morphology was studied by means of histology on explanted tissue samples. Motor nerve recovery was established within 7 weeks. Hereafter, some behavioral parameters like alternating steps showed an increase in occurence, while others remained stable. Sensory function was observed within the 7 weeks time frame. Nerve tissue had bridged the 10-mm gap within 7 weeks. The average nerve fiber surface area increased significantly in time. In situ degradation of the nerve conduit was fully going on at week 7 and tubes had collapsed by then. At weeks 15 and 21, the knitted tube wall structure was completely surrounded by macrophages and giant cells, and matrix was penetrating the tube wall. We conclude that a Hyaff11-based nerve guide can be used to bridge short peripheral nerve defects in rat. However, adaptations need to be made.

  10. The efficacy of a scaffold-free Bio 3D conduit developed from human fibroblasts on peripheral nerve regeneration in a rat sciatic nerve model.

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    Hirofumi Yurie

    Full Text Available Although autologous nerve grafting is the gold standard treatment of peripheral nerve injuries, several alternative methods have been developed, including nerve conduits that use supportive cells. However, the seeding efficacy and viability of supportive cells injected in nerve grafts remain unclear. Here, we focused on a novel completely biological, tissue-engineered, scaffold-free conduit.We developed six scaffold-free conduits from human normal dermal fibroblasts using a Bio 3D Printer. Twelve adult male rats with immune deficiency underwent mid-thigh-level transection of the right sciatic nerve. The resulting 5-mm nerve gap was bridged using 8-mm Bio 3D conduits (Bio 3D group, n = 6 and silicone tube (silicone group, n = 6. Several assessments were conducted to examine nerve regeneration eight weeks post-surgery.Kinematic analysis revealed that the toe angle to the metatarsal bone at the final segment of the swing phase was significantly higher in the Bio 3D group than the silicone group (-35.78 ± 10.68 versus -62.48 ± 6.15, respectively; p < 0.01. Electrophysiological studies revealed significantly higher compound muscle action potential in the Bio 3D group than the silicone group (53.60 ± 26.36% versus 2.93 ± 1.84%; p < 0.01. Histological and morphological studies revealed neural cell expression in all regions of the regenerated nerves and the presence of many well-myelinated axons in the Bio 3D group. The wet muscle weight of the tibialis anterior muscle was significantly higher in the Bio 3D group than the silicone group (0.544 ± 0.063 versus 0.396 ± 0.031, respectively; p < 0.01.We confirmed that scaffold-free Bio 3D conduits composed entirely of fibroblast cells promote nerve regeneration in a rat sciatic nerve model.

  11. Combined Fascia Iliaca and Sciatic Nerve Block for Hip Surgery in the Presence of Severe Ankylosing Spondylitis: A Case-Based Literature Review.

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    Chen, Lingmin; Liu, Jin; Yang, Jing; Zhang, Yanzi; Liu, Yue

    2016-01-01

    Selecting an appropriate anesthetic technique for patients with ankylosing spondylitis undergoing hip surgery is challenging because of a potentially difficult airway, the risk of cardiovascular and respiratory complications, and the technical difficulty of performing central neuraxial blocks in patients with ankylosing spondylitis. Our objective was to report a case in which combination neural blockade was used successfully in an elderly patient with ankylosing spondylitis undergoing hip fracture surgery. In addition, a literature review of the anesthetic techniques reported for these patients was conducted. A 70-year-old man with severe ankylosing spondylitis and respiratory dysfunction was scheduled for a closed intertrochanteric fracture reduction and internal fixation. Combined fascia iliaca block and parasacral sciatic nerve block were used successfully for the surgery. Postoperative analgesia was accomplished by continuous fascia iliaca block. According to the literature review, general anesthesia is the most commonly performed anesthetic technique for patients with ankylosing spondylitis undergoing hip surgeries. Special intubation techniques and cautious airway management were very important for these patients. Although both general anesthesia and central neuraxial blockade pose considerable risks to the patients, this case report suggests that combined fascia iliaca block and sciatic nerve block might be a promising option.

  12. Neuroprotective effect of tempol (4 hydroxy-tempo) on neuronal death induced by sciatic nerve transection in neonatal rats.

    Science.gov (United States)

    Chiarotto, Gabriela Bortolança; Drummond, Luisa; Cavarretto, Gabriela; Bombeiro, André Luis; de Oliveira, Alexandre Leite Rodrigues

    2014-07-01

    Peripheral nerve injury in newborn rats triggers extensive neuronal death within the spinal cord. Because most neurodegeneration is related to oxidative stress and apoptosis, the use of antioxidants may be of therapeutic interest. Tempol is promising because of its ability to chelate reactive oxygen species and to minimize or even prevent tissue damage. Here, we evaluated neuroprotective effects of tempol following neonatal sciatic nerve transection. Two-day-old pups underwent sciatic nerve axotomy followed by tempol (12, 24 and 48 mg/kg) treatment (i.p.) at 10 min, 6 h, and every 24 h up to 1 week after injury. The rats were then killed for lumbar intumescence analysis. Nissl staining, TUNEL, synaptophysin immunolabeling and qRT-PCR (Caspase 3, Bax and Bcl2) were carried out. The results indicated that tempol treatment, at 24 mg/kg, increased up to 21% spinal cord motoneuron survival (ptempol-treated animals. qRT-PCR results indicated differential increase in Caspase 3 (3-fold), Bax (13-fold) and Bcl2 (28-fold) gene expression, after 12 h following axotomy and tempol treatment. In conclusion, tempol administration has proven to be neuroprotective after neonatal nerve injury, leading to improved motoneuron survival, synapse preservation and minimizing apoptosis. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Evaluation of PVA biodegradable electric conductive membranes for nerve regeneration in axonotmesis injuries: the rat sciatic nerve animal model.

    Science.gov (United States)

    Ribeiro, Jorge; Caseiro, Ana Rita; Pereira, Tiago; Armada-da-Silva, Paulo Alexandre; Pires, Isabel; Prada, Justina; Amorim, Irina; Leal Reis, Inês; Amado, Sandra; Santos, José Domingos; Bompasso, Simone; Raimondo, Stefania; Varejão, Artur Severo Proença; Geuna, Stefano; Luís, Ana Lúcia; Maurício, Ana Colette

    2017-05-01

    The therapeutic effect of three polyvinyl alcohol (PVA) membranes loaded with electrically conductive materials - carbon nanotubes (PVA-CNTs) and polypyrrole (PVA-PPy) - were tested in vivo for neuro-muscular regeneration after an axonotmesis injury in the rat sciatic nerve. The membranes electrical conductivity measured was 1.5 ± 0.5 × 10 -6 S/m, 579 ± 0.6 × 10 -6 S/m, and 1837.5 ± 0.7 × 10 -6 S/m, respectively. At week-12, a residual motor and nociceptive deficit were present in all treated groups, but at week-12, a better recovery to normal gait pattern of the PVA-CNTs and PVA-PPy treated groups was observed. Morphometrical analysis demonstrated that PVA-CNTs group presented higher myelin thickness and lower g-ratio. The tibialis anterior muscle, in the PVA-PPy and PVA-CNTs groups showed a 9% and 19% increase of average fiber size area and a 5% and 10% increase of the "minimal Feret's diameter," respectively. No inflammation, degeneration, fibrosis or necrosis were detected in lung, liver, kidneys, spleen, and regional lymph nodes and absence of carbon deposits was confirmed with Von Kossa and Masson-Fontana stains. In conclusion, the membranes of PVA-CNTs and PVA-PPy are biocompatible and have electrical conductivity. The higher electrical conductivity measured in PVA-CNTs membrane might be responsible for the positive results on maturation of myelinated fibers. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 1267-1280, 2017. © 2017 Wiley Periodicals, Inc.

  14. Preliminary investigation on use of high-resolution optical coherence tomography to monitor injury and repair in the rat sciatic nerve.

    Science.gov (United States)

    Chlebicki, Cara A; Lee, Alice D; Jung, Woonggyu; Li, Hongrui; Liaw, Lih-Huei; Chen, Zhongping; Wong, Brian J

    2010-04-01

    Optical coherence tomography (OCT) has been used in limited settings to study peripheral nerve injury. The purpose of the study is to determine whether high-resolution OCT can be used to monitor nerve injury and regeneration in the rat sciatic nerve following crush injury, ligation, and transection with microsurgical repair. Forty-five rats were segregated into three groups. The right sciatic nerve was suture ligated (n = 15), cut then microsurgically repaired (n = 15), or crushed (n = 15). The left sciatic nerve served as the control; only surgical exposure and skin closure were performed. Each group was further divided into three subgroups where they were assigned survival durations of 4, 15, or 24 weeks. Following euthanasia, nerves were harvested, fixed in formalin, and imaged at the injury site, as well as proximal and distal ends. The OCT system resolution was approximately 7 microm in tissue with a 1,060 nm central wavelength. Control (uninjured) nerve tissue showed homogenous signal distribution to a relatively uniform depth; in contrast, damaged nerves showed irregular signal distribution and intensity. Changes in signal distribution were most significant at the injury site and distal regions. Increases in signal irregularity were evident during longer recovery times. Histological analysis determined that OCT imaging was limited to the surrounding perineurium and scar tissue. OCT has the potential to be a valuable tool for monitoring nerve injury and repair, and the changes that accompany wound healing, providing clinicians with a non-invasive tool to treat nerve injuries. (c) 2010 Wiley-Liss, Inc.

  15. Reducing the length of hospital stay after total knee arthroplasty: influence of femoral and sciatic nerve block

    Directory of Open Access Journals (Sweden)

    Lúcio Honório de Carvalho Júnior

    2015-02-01

    Full Text Available Objective: the aim of this study is to evaluate the change in length of hospital stay postoperatively for Total Knee Arthroplasty after using femoral and sciatic nerve block. Materials and methods: the medical records of 287 patients were evaluated, taking into account the number of hours of admission, the percentage and the reason for re-hospitalization within 30 days, as well as associated complications. All patients were divided into two groups according or not to whether they were admitted to ICU or not. During the years 2009 and 2010, isolated spinal anesthesia was the method used in the procedure. From 2011 on, femoral and sciatic nerve blocking was introduced. Results: between the years 2009 and 2012, the average length of stay ranged from 74 hours in 2009 to 75.2 hours in 2010. The average length of stay in 2011 was 56.52 hours and 53.72 hours in 2012, all in the group of patients who did not remain in the ICU postoperatively. In the same period, among those in the group that needed ICU admission, the average length of stay was 138.7 hours in 2009, 90.25 hours in 2010, 79.8 hours in 2011, and 52.91 hours in 2012. During 2009 and 2010, the rate of re-hospitalization was 0%, while in 2011 and 2012, were 3.44% and 1%, respectively. Conclusion: according to this study, the use of femoral and sciatic nerve blocking after total knee arthroplasty allowed significant reduction in hospital stay.

  16. Gelatin-methacrylamide gel loaded with microspheres to deliver GDNF in bilayer collagen conduit promoting sciatic nerve growth.

    Science.gov (United States)

    Zhuang, Hai; Bu, Shoushan; Hua, Lei; Darabi, Mohammad A; Cao, Xiaojian; Xing, Malcolm

    2016-01-01

    In this study, we fabricated glial cell-line derived neurotrophic factor (GDNF)-loaded microspheres, then seeded the microspheres in gelatin-methacrylamide hydrogel, which was finally integrated with the commercial bilayer collagen membrane (Bio-Gide(®)). The novel composite of nerve conduit was employed to bridge a 10 mm long sciatic nerve defect in a rat. GDNF-loaded gelatin microspheres had a smooth surface with an average diameter of 3.9±1.8 μm. Scanning electron microscopy showed that microspheres were uniformly distributed in both the GelMA gel and the layered structure. Using enzyme-linked immunosorbent assay, in vitro release studies (pH 7.4) of GDNF from microspheres exhibited an initial burst release during the first 3 days (18.0%±1.3%), and then, a prolonged-release profile extended to 32 days. However, in an acidic condition (pH 2.5), the initial release percentage of GDNF was up to 91.2%±0.9% within 4 hours and the cumulative release percentage of GDNF was 99.2%±0.2% at 48 hours. Then the composite conduct was implanted in a 10 mm critical defect gap of sciatic nerve in a rat. We found that the nerve was regenerated in both conduit and autograft (AG) groups. A combination of electrophysiological assessment and histomorphometry analysis of regenerated nerves showed that axonal regeneration and functional recovery in collagen tube filled with GDNF-loaded microspheres (GM + CT) group were similar to AG group (P>0.05). Most myelinated nerves were matured and arranged densely with a uniform structure of myelin in a neat pattern along the long axis in the AG and GM + CT groups, however, regenerated nerve was absent in the BLANK group, left the 10 mm gap empty after resection, and the nerve fiber exhibited a disordered arrangement in the collagen tube group. These results indicated that the hybrid system of bilayer collagen conduit and GDNF-loaded gelatin microspheres combined with gelatin-methacrylamide hydrogels could serve as a new biodegradable

  17. Ultrasound-Guided Femoral and Sciatic Nerve Blocks for Repair of Tibia and Fibula Fractures in a Bennett's Wallaby (Macropus rufogriseus).

    Science.gov (United States)

    Monticelli, Paolo; Campoy, Luis; Adami, Chiara

    2016-01-01

    Locoregional anesthetic techniques may be a very useful tool for the anesthetic management of wallabies with injuries of the pelvic limbs and may help to prevent capture myopathies resulting from stress and systemic opioids' administration. This report describes the use of ultrasound-guided femoral and sciatic nerve blocks in Bennett's wallaby ( Macropus rufogriseus ) referred for orthopaedic surgery. Ultrasound-guided femoral and sciatic nerve blocks were attempted at the femoral triangle and proximal thigh level, respectively. Whilst the sciatic nerve could be easily visualised, the femoral nerve could not be readily identified. Only the sciatic nerve was therefore blocked with ropivacaine, and methadone was administered as rescue analgesic. The ultrasound images were stored and sent for external review. Anesthesia and recovery were uneventful and the wallaby was discharged two days postoperatively. At the time of writing, it is challenging to provide safe and effective analgesia to Macropods. Detailed knowledge of the anatomy of these species is at the basis of successful locoregional anesthesia. The development of novel analgesic techniques suitable for wallabies would represent an important step forward in this field and help the clinicians dealing with these species to improve their perianesthetic management.

  18. Ultrasound-Guided Femoral and Sciatic Nerve Blocks for Repair of Tibia and Fibula Fractures in a Bennett’s Wallaby (Macropus rufogriseus

    Directory of Open Access Journals (Sweden)

    Paolo Monticelli

    2016-01-01

    Full Text Available Locoregional anesthetic techniques may be a very useful tool for the anesthetic management of wallabies with injuries of the pelvic limbs and may help to prevent capture myopathies resulting from stress and systemic opioids’ administration. This report describes the use of ultrasound-guided femoral and sciatic nerve blocks in Bennett’s wallaby (Macropus rufogriseus referred for orthopaedic surgery. Ultrasound-guided femoral and sciatic nerve blocks were attempted at the femoral triangle and proximal thigh level, respectively. Whilst the sciatic nerve could be easily visualised, the femoral nerve could not be readily identified. Only the sciatic nerve was therefore blocked with ropivacaine, and methadone was administered as rescue analgesic. The ultrasound images were stored and sent for external review. Anesthesia and recovery were uneventful and the wallaby was discharged two days postoperatively. At the time of writing, it is challenging to provide safe and effective analgesia to Macropods. Detailed knowledge of the anatomy of these species is at the basis of successful locoregional anesthesia. The development of novel analgesic techniques suitable for wallabies would represent an important step forward in this field and help the clinicians dealing with these species to improve their perianesthetic management.

  19. Tubulation repair mitigates misdirection of regenerating motor axons across a sciatic nerve gap in rats

    OpenAIRE

    Liu, Dan; Mi, Daguo; Zhang, Tuanjie; Zhang, Yanping; Yan, Junying; Wang, Yaxian; Tan, Xuefeng; Yuan, Ying; Yang, Yumin; Gu, Xiaosong; Hu, Wen

    2018-01-01

    The repair of peripheral nerve laceration injury to obtain optimal function recovery remains a big challenge in the clinic. Misdirection of regenerating axons to inappropriate target, as a result of forced mismatch of endoneurial sheaths in the case of end-to-end nerve anastomosis or nerve autografting, represents one major drawback that limits nerve function recovery. Here we tested whether tubulation repair of a nerve defect could be beneficial in terms of nerve regeneration accuracy and ne...

  20. A self-administered method of acute pressure block of sciatic nerves for short-term relief of dental pain: a randomized study.

    Science.gov (United States)

    Wang, Xiaolin; Zhao, Wanghong; Wang, Ye; Hu, Jiao; Chen, Qiu; Yu, Juncai; Wu, Bin; Huang, Rong; Gao, Jie; He, Jiman

    2014-08-01

    While stimulation of the peripheral nerves increases the pain threshold, chronic pressure stimulation of the sciatic nerve is associated with sciatica. We recently found that acute pressure block of the sciatic nerve inhibits pain. Therefore, we propose that, the pain pathology-causing pressure is chronic, not acute. Here, we report a novel self-administered method: acute pressure block of the sciatic nerves is applied by the patients themselves for short-term relief of pain from dental diseases. This was a randomized, single-blind study. Hospital patients. Patients aged 16-60 years with acute pulpitis, acute apical periodontitis, or pericoronitis of the third molar of the mandible experiencing pain ≥3 on the 11-point numerical pain rating scale. Three-minute pressure to sciatic nerves was applied by using the hands (hand pressure method) or by having the patients squat to force the thigh and shin as tightly as possible on the sandwiched sciatic nerve bundles (self-administered method). The primary efficacy variable was the mean difference in pain scores from the baseline. One hundred seventy-two dental patients were randomized. The self-administered method produced significant relief from pain associated with dental diseases (P ≤ 0.001). The analgesic effect of the self-administered method was similar to that of the hand pressure method. The self-administered method is easy to learn and can be applied at any time for pain relief. We believe that patients will benefit from this method. © 2014 The Authors. Pain Medicine published by Wiley Periodicals, Inc. on behalf of American Academy of Pain Medicine.

  1. Dynamic effects of TNF-α on synaptic transmission in mice over time following sciatic nerve chronic constriction injury.

    Science.gov (United States)

    Zhang, Hongmei; Zhang, Haijun; Dougherty, Patrick M

    2013-10-01

    Nerve injury-induced central sensitization can manifest as an increase in excitatory synaptic transmission and/or as a decrease in inhibitory synaptic transmission in spinal dorsal horn neurons. Cytokines such as tumor necrosis factor-α (TNF-α) are induced in the spinal cord under various injury conditions and contribute to neuropathic pain. In this study we examined the effect of TNF-α in modulating excitatory and inhibitory synaptic input to spinal substantia gelatinosa (SG) neurons over time in mice following chronic constriction injury (CCI) of the sciatic nerve. Whole cell patch-clamp studies from SG neurons showed that TNF-α enhanced overall excitability of the spinal cord early in time following nerve injury 3 days after CCI compared with that in sham control mice. In contrast, the effects of TNF were blunted 14 days after CCI in nerve-injured mice compared with sham surgery mice. Immunohistochemical staining showed that the expression of TNF-α receptor 1 (TNFR1) was increased at 3 days but decreased at 14 days following CCI in the ipsilateral vs. the contralateral spinal cord dorsal horn. These results suggest that TNF-α acting at TNFR1 is important in the development of neuropathic pain by facilitating excitatory synaptic signaling in the acute phases after nerve injury but has a reduced effect on spinal neuron signaling in the later phases of nerve injury-induced pain. Failure of the facilatory effects of TNF-α on excitatory synaptic signaling in the dorsal horn to resolve following nerve injury may be an important component in the transition between acute and chronic pain conditions.

  2. Effects of Lippia sidoides essential oil, thymol, p-cymene, myrcene and caryophyllene on rat sciatic nerve excitability

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    R. Barbosa

    2017-10-01

    Full Text Available Lippia sidoides Cham is a typical herb species of Northeast Brazil with widespread use in folk medicine. The major constituents of the essential oil of L. sidoides (EOLs are thymol, p-cymene, myrcene, and caryophyllene. Several studies have shown that the EOLs and its constituents have pharmacological effects, including antibacterial, anti-inflammatory, antioxidant and neuroprotective activity. Therefore, this work aimed to investigate the effects of the EOLs and their main constituents on rat sciatic nerve excitability. The sciatic nerves of adult Wistar rats were dissected and mounted in a moist chamber. Nerves were stimulated by square wave pulses, with an amplitude of 40 V, duration of 100 μs to 0.2 Hz. Both EOLs and thymol inhibited compound action potential (CAP in a concentration-dependent manner. Half maximal inhibitory concentration for CAP peak-to-peak amplitude blockade were 67.85 and 40 µg/mL for EOLs and thymol, respectively. CAP peak-to-peak amplitude was significantly reduced by concentrations ≥60 µg/mL for EOLs and ≥30 µg/mL for thymol. EOLs and thymol in the concentration of 60 µg/mL significantly increased chronaxie and rheobase. The conduction velocities of 1st and 2nd CAP components were also concentration-dependently reduced by EOLs and thymol in the range of 30-100 µg/mL. Differently from EOLs and thymol, p-cymene, myrcene and caryophyllene did not reduce CAP in the higher concentrations of 10 mM. These data demonstrated that EOLs and thymol inhibited neuronal excitability and were promising agents for the development of new drugs for therapeutic use.

  3. The effect of weight-bearing exercise and non-weight-bearing exercise on gait in rats with sciatic nerve crush injury.

    Science.gov (United States)

    Kim, Ki-Hyun; Hwangbo, Gak; Kim, Seong-Gil

    2015-04-01

    [Purpose] The purpose of this study was to access the effect of weight bearing exercise (treadmill exercise) and non-weight-bearing exercise (swimming exercise) on gait in the recovery process after a sciatic nerve crush injury. [Subjects and Methods] Rats were randomly divided into a swimming group (n=3) with non-weight-bearing exercise after a sciatic nerve crush and a treadmill group (n=3) with weight bearing exercise after a sciatic nerve crush. Dartfish is a program that can analyze and interpret motion through video images. The knee lateral epicondyle, lateral malleolus, and metatarsophalangeal joint of the fifth toe were marked by black dots before recording. [Results] There were significant differences in TOK (knee angle toe off) and ICK (knee angle at initial contact) in the swimming group and in TOK, ICA (ankle angle at initial contact), and ICK in the treadmill group. In comparison between groups, there were significant differences in TOA (ankle angle in toe off) and ICA at the 7th day. [Conclusion] There was no difference between weight bearing and non-weight-bearing exercise in sciatic nerve damage, and both exercises accelerated the recovery process in this study.

  4. H-REFLEX UP-CONDITIONING ENCOURAGES RECOVERY OF EMG ACTIVITY AND H-REFLEXES AFTER SCIATIC NERVE TRANSECTION AND REPAIR IN RATS

    OpenAIRE

    Chen, Yi; Wang, Yu; Chen, Lu; Sun, Chenyuo; English, Arthur W.; Wolpaw, Jonathan R.; Chen, Xiang Yang

    2010-01-01

    Operant conditioning of the spinal stretch reflex or its electrical analog, the H-reflex, produces spinal cord plasticity and can thereby affect motoneuron responses to primary afferent input. To explore whether this conditioning can affect the functional outcome after peripheral nerve injury, we assessed the effect of up-conditioning soleus (SOL) H-reflex on SOL and tibialis anterior (TA) function after sciatic nerve transection and repair. Sprague-Dawley rats were implanted with EMG electro...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-08-15

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

  6. Sciatic nerve excursion during a modified passive straight leg raise test in asymptomatic participants and participants with spinally referred leg pain.

    Science.gov (United States)

    Ridehalgh, Colette; Moore, Ann; Hough, Alan

    2015-08-01

    Minimal data exists on in-vivo sciatic nerve motion during straight leg raise (SLR), particularly in symptomatic participants. Such data could help clinicians to better understand nerve mechanic changes following nerve dysfunction. Cross-sectional, controlled laboratory study. To investigate whether individuals with spinally referred leg pain have different nerve excursion patterns compared to healthy participants. The sciatic nerve was scanned using ultrasound imaging in the posterior thigh in asymptomatic participants, and individuals with spinally referred leg pain sub-grouped into somatic pain, radicular pain or radiculopathy. Nerve excursion was measured in transverse and longitudinal planes during a side-lying modified SLR. The ultrasound data was analysed off-line using cross correlation software. Longitudinal plane data was collected from 16 asymptomatic and 60 symptomatic participants and transverse plane data from 16 asymptomatic and 56 symptomatic participants. There was no significant difference in longitudinal nerve excursion between the 4 groups. The direction of transverse plane motion altered between groups. These varied movements may be related to protective muscle activation between the groups, although this is speculative at present. Longitudinal sciatic nerve excursion at the posterior thigh during a modified SLR is not different between asymptomatic participants and those with spinally referred leg pain. Transverse plane movement appears to be more varied. This may suggest that in individuals with nerve root pain, there is no restriction in nerve excursion. However, as it was not possible to measure excursion at the nerve root, more research is needed to confirm these findings. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Injury-Dependent and Disability-Specific Lumbar Spinal Gene Regulation following Sciatic Nerve Injury in the Rat.

    Directory of Open Access Journals (Sweden)

    Paul J Austin

    Full Text Available Allodynia, hyperalgesia and spontaneous pain are cardinal sensory signs of neuropathic pain. Clinically, many neuropathic pain patients experience affective-motivational state changes, including reduced familial and social interactions, decreased motivation, anhedonia and depression which are severely debilitating. In earlier studies we have shown that sciatic nerve chronic constriction injury (CCI disrupts social interactions, sleep-wake-cycle and endocrine function in one third of rats, a subgroup reliably identified six days after injury. CCI consistently produces allodynia and hyperalgesia, the intensity of which was unrelated either to the altered social interactions, sleep-wake-cycle or endocrine changes. This decoupling of the sensory consequences of nerve injury from the affective-motivational changes is reported in both animal experiments and human clinical data. The sensory changes triggered by CCI are mediated primarily by functional changes in the lumbar dorsal horn, however, whether lumbar spinal changes may drive different affective-motivational states has never been considered. In these studies, we used microarrays to identify the unique transcriptomes of rats with altered social behaviours following sciatic CCI to determine whether specific patterns of lumbar spinal adaptations characterised this subgroup. Rats underwent CCI and on the basis of reductions in dominance behaviour in resident-intruder social interactions were categorised as having Pain & Disability, Pain & Transient Disability or Pain alone. We examined the lumbar spinal transcriptomes two and six days after CCI. Fifty-four 'disability-specific' genes were identified. Sixty-five percent were unique to Pain & Disability rats, two-thirds of which were associated with neurotransmission, inflammation and/or cellular stress. In contrast, 40% of genes differentially regulated in rats without disabilities were involved with more general homeostatic processes (cellular

  8. Behavioral and cellular consequences of high-electrode count Utah Arrays chronically implanted in rat sciatic nerve

    Science.gov (United States)

    Wark, H. A. C.; Mathews, K. S.; Normann, R. A.; Fernandez, E.

    2014-08-01

    Objective. Before peripheral nerve electrodes can be used for the restoration of sensory and motor functions in patients with neurological disorders, the behavioral and histological consequences of these devices must be investigated. These indices of biocompatibility can be defined in terms of desired functional outcomes; for example, a device may be considered for use as a therapeutic intervention if the implanted subject retains functional neurons post-implantation even in the presence of a foreign body response. The consequences of an indwelling device may remain localized to cellular responses at the device-tissue interface, such as fibrotic encapsulation of the device, or they may affect the animal more globally, such as impacting behavioral or sensorimotor functions. The objective of this study was to investigate the overall consequences of implantation of high-electrode count intrafascicular peripheral nerve arrays, High Density Utah Slanted Electrode Arrays (HD-USEAs; 25 electrodes mm-2). Approach. HD-USEAs were implanted in rat sciatic nerves for one and two month periods. We monitored wheel running, noxious sensory paw withdrawal reflexes, footprints, nerve morphology and macrophage presence at the tissue-device interface. In addition, we used a novel approach to contain the arrays in actively behaving animals that consisted of an organic nerve wrap. A total of 500 electrodes were implanted across all ten animals. Main results. The results demonstrated that chronic implantation (⩽8 weeks) of HD-USEAs into peripheral nerves can evoke behavioral deficits that recover over time. Morphology of the nerve distal to the implantation site showed variable signs of nerve fiber degeneration and regeneration. Cytology adjacent to the device-tissue interface also showed a variable response, with some electrodes having many macrophages surrounding the electrodes, while other electrodes had few or no macrophages present. This variability was also seen along the length

  9. The morphological and functional effects of exercise in the aquatic environment, performed before and/or after sciatic nerve compression in Wistar rats.

    Science.gov (United States)

    Kakihata, Camila Mayumi Martin; Malanotte, Jéssica Aline; Karvat, Jhenifer; Brancalhão, Rose Meire Costa; de Fátima Chasko Ribeiro, Lucinéia; Bertolini, Gladson Ricardo Flor

    2016-10-01

    The aim of this study was to evaluate the effects of exercise in the aquatic environment, performed before and/or after sciatic nerve compression in Wistar rats on morphological and functional parameters. Twenty-five Wistar rats were divided into the following groups: control (C), lesion (L), trained+lesion (TL), lesion+exercise (LE), and training+lesion+exercise (TLE), who underwent right sciatic nerve compression on day 21 of the experiment. The TL and TLE groups were submitted to a jumping exercise in a water environment for 20 days prior to injury and the LE and TLE groups after injury. The functional analysis was carried out using the sciatic functional index (SFI). On the last day of the experiment, the right sciatic nerves were collected, processed and analysed according to morphology and morphometry. The C group showed higher SFI in relation to the other groups. In the morphometric analysis, in comparison to C, all groups showed a decrease in the diameter of the injured nerve fibre, the myelin sheath and an increase in the percentage of connective tissue. There was a decrease in axon diameter in L, TL, and LE groups and a decrease in the density of nerve fibres in the TL and LE groups. The exercise did not affect functional recovery. However, the exercise prior to the injury improved morphology of the nervous tissue, and when performed pre- and postinjury, there was also an improvement in nerve regeneration, but this was not the case with exercise performed after the injury demonstrating worse results.

  10. Effects of intraoperative irradiation (IORT) and intraoperative hyperthermia (IOHT) on canine sciatic nerve: histopathological and morphometric studies

    International Nuclear Information System (INIS)

    Vujaskovic, Zeljko; Powers, Barbara E.; Paardekoper, Gabriel; Gillette, Sharon M.; Gillette, Edward L.; Colacchio, Thomas A.

    1999-01-01

    Purpose/Objective: Peripheral neuropathies have emerged as the major dose-limiting complication reported after intraoperative radiation therapy (IORT). The combination of IORT with hyperthermia may further increase the risk of peripheral nerve injury. The objective of this study was to evaluate histopathological and histomorphometric changes in the sciatic nerve of dogs, after IORT with or without hyperthermia treatment. Methods and Materials: Young adult beagle dogs were randomized into five groups of 3-5 dogs each to receive IORT doses of 16, 20, 24, 28, or 32 Gy. Six groups of 4-5 dogs each received IORT doses of 12, 16, 20, 24, or 28 Gy simultaneously with 44 deg. C of intraoperative hyperthermia (IOHT) for 60 min. One group of dogs acted as hyperthermia-alone controls. Two years after the treatment, dogs were euthanized, and histopathological and morphometric analyses were performed. Results: Qualitative histological analysis showed prominant changes such as focal necrosis, mineralization, fibrosis, and severe fiber loss in dogs which received combined treatment. Histomorphometric results showed a significantly higher decrease in axon and myelin and small blood vessels, with a corresponding increase in connective tissue in dogs receiving IORT plus hyperthermia treatment. The effective dose for 50% of nerve fiber loss (ED 50 ) in dogs exposed to IORT only was 25.3 Gy. The ED 50 for nerve fiber loss in dogs exposed to IORT combined with IOHT was 14.8 Gy. The thermal enhancement ratio (TER) was 1.7. Conclusion: The probability of developing peripheral neuropathies in a large animal model is higher when IORT is combined with IOHT, when compared to IORT application alone. To minimize the risk of peripheral neuropathy, clinical treatment protocols for the combination of IORT and hyperthermia should not assume a thermal enhancement ratio (TER) to be lower than 1.5

  11. Exposure of the sciatic nerve in the gluteal region without sectioning the gluteus maximus: Analysis of a series of 18 cases.

    Science.gov (United States)

    Socolovsky, Mariano; Masi, Gilda Di

    2012-01-01

    Dissecting through the gluteus maximus muscle by splitting its fibers, instead of complete sectioning of the muscle, is faster, involves less damage to tissues, and diminishes recovery time. The objective of the current paper is to present a clinical series of sciatic nerve lesions where the nerve was sufficiently exposed via the transgluteal approach. We retrospectively selected 18 traumatic sciatic nerve lesions within the buttock, operated upon from January 2005 to December 2009, with a minimum follow-up of 2 years. In all patients, a transgluteal approach was employed to explore and reconstruct the nerve. Ten males and eight females, with a mean age of 39.7 years, were studied. The etiology of the nerve lesion was previous hip surgery (n = 7), stab wound (n = 4), gunshot wound (n = 3), injection (n = 3), and hip dislocation (n = 1). In 15 (83.3%) cases, a motor deficit was present; in 12 (66.6%) cases neuropathic pain and in 12 (66.6%) cases sensory alterations were present. In all cases, the transgluteal approach was adequate to expose the injury and treat it by neurolysis alone (10 cases), neurolysis and neurorrhaphy (4 cases), and reconstruction with grafts (4 cases; three of these paired with neurolysis). The mean pre- and postoperative grades for the tibial nerve (LSUHSC scale) were 1.6 and 3.6, respectively; meanwhile, for the peroneal division, preoperative grade was 1.2 and postoperative grade was 2.4. The transgluteal approach adequately exposes sciatic nerve injuries of traumatic origin in the buttock and allows for adequate nerve reconstruction without sectioning the gluteus maximus muscle.

  12. Origin and distribution of the sciatic nerve in pig fetuses (Sus scrofa domesticus – Linnaeus, 1758 from the lineage Pen Ar Lan

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    Lázaro Antônio dos Santos

    2013-03-01

    Full Text Available The origin and distribution of the sciatic nerve was studied in 31 pig fetuses from the lineage Pen Ar Lan, being 22 males and 9 females, after being fixed in a 10% formaldehyde aqueous solution. In these animals, the lumbar vertebrae ranged from 5 to 7, with a predominance of 6, something which contributed to variations in the origin of this nerve. The sciatic nerve originated in 80.64% of the antimeres from the ventral branch of the fifth lumbar spinal nerve (L5; in 96.77 % of L6; in 6.45% of L7; in 100% of S1; and in 64.51% of S2. The composition of this nerve took place in 45.16% of the animals due to the union of L5, L6, S1 and S2; in 32.25% of L5, L6 and S1; in 12.90% of L6, S1 and S2; in 6.45% of L6, L7 and S1; and in 3.22% L5, S1 and S2. There was symmetry in the origin of the sciatic nerve in all specimens under study. This nerve sent branches to the superficial gluteal, semitendinosus, semimembranosus and biceps femoris muscles in all specimens, and, in a lesser frequency, to the twins, quadratus femoris, adductors, as well as the middle, accessory, and deep gluteal muscles. In 74.19% of the sample, a branch communicating to the pudendal nerve was observed.

  13. Modest enhancement of sensory axon regeneration in the sciatic nerve with conditional co-deletion of PTEN and SOCS3 in the dorsal root ganglia of adult mice.

    Science.gov (United States)

    Gallaher, Zachary R; Steward, Oswald

    2018-05-01

    Axons within the peripheral nervous system are capable of regeneration, but full functional recovery is rare. Recent work has shown that conditional deletion of two key signaling inhibitors of the PI3K and Jak/Stat pathways-phosphatase and tensin homolog (PTEN) and suppressor of cytokine signaling-3 (SOCS3), respectively-promotes regeneration of normally non-regenerative central nervous system axons. Moreover, in studies of optic nerve regeneration, co-deletion of both PTEN and SOCS3 has an even greater effect. Here, we test the hypotheses (1) that PTEN deletion enhances axon regeneration following sciatic nerve crush and (2) that PTEN/SOCS3 co-deletion further promotes regeneration. PTEN fl/fl and PTEN/SOCS3 fl/fl mice received direct injections of AAV-Cre into the fourth and fifth lumbar dorsal root ganglia (DRG) two weeks prior to sciatic nerve crush. Western blot analysis of whole cell lysates from DRG using phospho-specific antibodies revealed that PTEN deletion did not enhance or prolong PI3K signaling following sciatic nerve crush. However, PTEN/SOCS3 co-deletion activated PI3K for at least 7 days post-injury in contrast to controls, where activation peaked at 3 days. Quantification of SCG10-expressing regenerating sensory axons in the sciatic nerve after crush injury revealed longer distance regeneration at 3 days post-injury with both PTEN and PTEN/SOCS3 co-deletion. Additionally, analysis of noxious thermosensation and mechanosensation with PTEN/SOCS3 co-deletion revealed enhanced sensation at 14 and 21 days after crush, respectively, after which all treatment groups reached the same functional plateau. These findings indicate that co-deletion of PTEN and SOCS3 results in modest but measureable enhancement of early regeneration of DRG axons following crush injury. Copyright © 2018 Elsevier Inc. All rights reserved.

  14. Effects of Cantharellus Cibarius Hydro-Alcoholic Extract on NT3, NGF Gene Expression after Sciatic Nerve Compression in Rats

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    AR Ajami

    2016-11-01

    Full Text Available Introduction: The expression of neurotrophic factors, which cause increasing of the survival and regeneration of neurons, is changed in response to nerve injury. Cantharellus cibarius has antioxidant and anti-inflammatory effects. So, the aim of present study was to determine the effects of hydro-alcoholic extract of Cantharellus cibarius on expression level of NT3 gene after sciatic nerve compression in rats. Methods: First the hydro-alcoholic extract of Cantharellus cibarius was prepared by the Soxhlet method. In this study, 36 Wistar male rats , 250-300 gr, were randomly divided into 3 groups consisted of 12 rats in each group. They were control, compression (1, 7, 14 and 28 days and experimental (1, 7, 14 and 28 days groups. Experimental groups were treated by 75 mg / kg of hydro-alcoholic extract of Cantharellus cibarius and to induce the stress in control group, saline serum was injected. In compression and experimental groups, the sciatic nerve of right leg was compressed for 60 seconds. The first injection of extract in the experimental group was performed intraperitoneally and immediately after the compression and the second one was injected 7 days later. Then, the sampling was performed of lumbar spinal cord on 1, 7, 14 and 28 days in compression and experimental groups and the total RNA was extracted from the spinal cord segments, cDNA was synthesized and after that the alteration of gene expression of NT3 and NGF samples was studied real time PCR method and Data were analyzed by Tukey test and SPSS 16 softwere. Results: The expression of NT3 and NGF showed significant increase in compression group compared to the control group, (p<0.05. Also, it is shown significant increase of expression of NT3 and NGF in the experimental group compared to the compression group, (p<0.05. Conclusion: According to these findings, hydro alcoholic extract of Cantharellus cibarius has an anti oxidant and anti-inflammatory effects that increase the

  15. Circadian Rhythm Influences the Promoting Role of Pulsed Electromagnetic Fields on Sciatic Nerve Regeneration in Rats

    Science.gov (United States)

    Zhu, Shu; Ge, Jun; Liu, Zhongyang; Liu, Liang; Jing, Da; Ran, Mingzi; Wang, Meng; Huang, Liangliang; Yang, Yafeng; Huang, Jinghui; Luo, Zhuojing

    2017-01-01

    Circadian rhythm (CR) plays a critical role in the treatment of several diseases. However, the role of CR in the treatment of peripheral nerve defects has not been studied. It is also known that the pulsed electromagnetic fields (PEMF) can provide a beneficial microenvironment to quicken the process of nerve regeneration and to enhance the quality of reconstruction. In this study, we evaluate the impact of CR on the promoting effect of PEMF on peripheral nerve regeneration in rats. We used the self-made “collagen-chitosan” nerve conduits to bridge the 15-mm nerve gaps in Sprague-Dawley rats. Our results show that PEMF stimulation at daytime (DPEMF) has most effective outcome on nerve regeneration and rats with DPEMF treatment achieve quickly functional recovery after 12 weeks. These findings indicate that CR is an important factor that determines the promoting effect of PEMF on peripheral nerve regeneration. PEMF exposure in the daytime enhances the functional recovery of rats. Our study provides a helpful guideline for the effective use of PEMF mediations experimentally and clinically. PMID:28360885

  16. The functional and morphological characteristics of sciatic nerve degeneration and regeneration after crush injury in rats

    NARCIS (Netherlands)

    Sta, M.; Cappaert, N.L.M.; Ramekers, D.; Baas, F.; Wadman, W.J.

    2014-01-01

    BACKGROUND: Peripheral nerve damage induces a sequence of degeneration and regeneration events with a specific time course that leads to (partial) functional recovery. Quantitative electrophysiological analysis of degeneration and recovery over time is essential to understand the process. NEW

  17. Sciatic nerve ligation causes impairment of mitochondria associated with changes in distribution, respiration, and cardiolipin composition in related spinal cord neurons in rats.

    Science.gov (United States)

    Keilhoff, Gerburg; Becker, Axel; Kropf, Siegfried; Schild, Lorenz

    2016-10-01

    Sciatic nerve irritation is often associated with disturbed Ca(2+) homeostasis in related neurons of the spinal cord. Since mitochondria substantially contribute to Ca(2+) homeostasis and little information is available, we studied the effects of loose sciatic nerve ligation, a chronic constriction injury (CCI), on neuronal mitochondria of the L3-L6 regions. Three groups of rats (untreated, sham operated, and ligated) were explored. For the characterization of mitochondria, specimens of the L3-L6 spinal cord regions were evaluated with respect to intracellular localization using pyruvate dehydrogenase immunohistochemistry and Mitotracker Red, and the ATP producing machinery by LC-MS/MS technique for the analysis of cardiolipin and high-resolution respirometry for the measurement of oxygen consumption. Therefore, the phospholipid cardiolipin supports electron transfer within the respiratory chain as part of mitochondrial respiration and is of high impact on the physical properties of the mitochondrial membrane system. Histological analysis of spinal cord motor neurons revealed clustering of mitochondria in ipsilateral samples from ligated animals 14 days after the insult. This phenomenon was similarly evident in the respective contralateral side. The intensity of MT-Red staining was enhanced exclusively at the ipsilateral side, indicating increased mitochondrial activity. CCI of the sciatic nerve caused massive changes in the composition of cardiolipin reflecting mitochondrial impairment in the early phase followed by regeneration processes as late response. Sciatic nerve CCI caused decrease in the capacity of mitochondrial ATP production that recovered within 14 days after treatment. In conclusion, we provide evidence that clustering of mitochondria, already verified for the spinal cord sensory neurons after CCI, also occurs in the respective motor neurons. Further we have demonstrated transient impairment of the capacity of mitochondrial ATP production in tissue

  18. Effects of insulin-like growth factor-I and platelet-rich plasma on sciatic nerve crush injury in a rat model.

    Science.gov (United States)

    Emel, Erhan; Ergün, Selma Sönmez; Kotan, Dilcan; Gürsoy, Esra Başar; Parman, Yeşim; Zengin, Asli; Nurten, Asiye

    2011-02-01

    Local administration of insulin-like growth factor-I (IGF-I) has been shown to increase the rate of axon regeneration in crush-injured and freeze-injured rat sciatic nerves. Local administration of platelet-rich plasma (PRP) has been also shown to have a measurable effect on facial nerve regeneration after transection in a rat model. The objective of the study was to compare the effects of locally administered IGF-I and PRP on the parameters of the Sciatic Function Index (SFI), sensory function (SF), axon count, and myelin thickness/axon diameter ratio (G-ratio) in a rat model of crush-injured sciatic nerves. The right sciatic nerve of Wistar albino rats (24 animals) was crushed using a Yasargil-Phynox aneurysm clip for 45 minutes. All animals were randomly divided into 3 groups: Group 1 (control group) was treated with saline, Group 2 was treated with IGF-I, and Group 3 was treated with PRP. Injections were performed using the tissue expander's injection port with a connecting tube directed at the crush-injured site. Functional recovery was assessed with improvement in the SFI. Recovery of sensory function was using the pinch test. Histopathological examination was performed 3 months after the injury. The SFI showed an improved functional recovery in the IGF-I-treated animals (Group 2) compared with the saline-treated animals (Group 1) 30 days after the injury. In IGF-I-treated rats, sensory function returned to the baseline level significantly faster than in saline-treated and PRP-treated rats as shown in values between SF-2 and SF-7. The G-ratios were found to be significantly higher in both experimental groups than in the control group. This study suggests that the application of IGF-I to the crush-injured site may expedite the functional recovery of paralyzed muscle by increasing the rate of axon regeneration.

  19. Effect of electroacupuncture on the expression of agrin and acetylcholine receptor subtypes in rats with tibialis anterior muscular atrophy induced by sciatic nerve injection injury.

    Science.gov (United States)

    Yu, Jianqi; Wang, Meng; Liu, Junying; Zhang, Xiaoming; Yang, Shengbo

    2017-08-01

    To investigate the effects of electroacupuncture (EA) on mRNA and protein expression of agrin, acetylcholine receptor (AChR)-ε and AChR-γ in a rat model of tibialis anterior muscle atrophy induced by sciatic nerve injection injury, and to examine the underlying mechanism of action. Fifty-four adult Sprague-Dawley rats were divided into four groups: healthy control group (CON, n=6); sciatic nerve injury group (SNI, n=24), comprising rats euthanased at 1, 2, 4 and 6 weeks, respectively, after penicillin injection-induced SNI (n=6 each); CON+EA group (n=12), comprising healthy rats euthanased at 4 and 6 weeks (after 2 and 4 weeks, respectively, of EA at GB30 and ST36); and SNI+EA group, comprising rats euthanased at 4 and 6 weeks (after 2 and 4 weeks, respectively, of EA). The sciatic nerve functional index (SFI), tibialis anterior muscle weight, muscle fibre cross-sectional area (CSA), and changes in agrin, AChR-ε, and AChR-γ expression levels were analysed. Compared with the control group (CON), SNI rats showed decreased SFI. The weight of the tibialis anterior muscle and muscle fibre CSA decreased initially and recovered slightly over time. mRNA/protein expression of agrin and AChR-ε were downregulated and AChR-γ expression was detectable (vs zero expression in the CON/CON+EA groups). There were no significant differences in CON+EA versus CON groups. However, the SNI+EA group exhibited significant improvements compared with the untreated SNI group (patrophy induced by sciatic nerve injection injury by upregulating agrin and AChR-ε and downregulating AChR-γ. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  20. Sam68 promotes Schwann cell proliferation by enhancing the PI3K/Akt pathway and acts on regeneration after sciatic nerve crush

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Weijie, E-mail: 459586768@qq.com; Liu, Yuxi, E-mail: 924013616@qq.com; Wang, Youhua, E-mail: wyouhua1516@163.com

    2016-05-13

    Sam68 (Src-associated in mitosis of 68 kD), a KH domain RNA-binding protein, is not only important in signaling transduction cascades, but crucial in a variety of cellular processes. Sam68 is reported to be involved in the phospoinositide3-kinase (PI3K) and nuclear factor-kappa B (NF-κB) signaling pathways, and it is closely associated with cell proliferation, RNA metabolism, and tumor progression. However, we know little about the role of Sam68 during peripheral nervous system injury and regeneration. In this study, we investigated the expression of Sam68 and its biological significances in sciatic nerve crush. Interestingly, we found Sam68 had a co-localization with S100 (Schwann cell marker). Moreover, after crush, Sam68 had a spatiotemporal protein expression, which was in parallel with proliferation cell nuclear antigen (PCNA). In vitro, we also observed increased expression of Sam68 during the process of TNF-α-induced Schwann cell proliferation model. Besides, flow cytometry analyses, CCK-8, and EDU were all performed with the purpose of investigating the role of Sam68 in the regulation of Schwann cell proliferation. Even more importantly, we discovered that Sam68 could enhance the phosphorylation of Akt while LY294002 (a PI3K inhibitor) obviously reversed Sam68-induced cell proliferation. Finally, we detected the variance during regeneration progress through the rat walk footprint test. In summary, all these evidences demonstrated that Sam68 might participate in Schwann cell proliferation partially via PI3K/Akt pathway and also regulate regeneration after sciatic nerve crush. -- Highlights: •The dynamic changes and location of Sam68 after sciatic nerve crush. •Sam68 promoted Schwann cell proliferation via PI3K/Akt pathway. •Sam68 modulated functional recovery after sciatic nerve crush.

  1. Escalated regeneration in sciatic nerve crush injury by the combined therapy of human amniotic fluid mesenchymal stem cells and fermented soybean extracts, Natto

    Directory of Open Access Journals (Sweden)

    Pan Hung-Chuan

    2009-08-01

    Full Text Available Abstract Attenuation of inflammatory cell deposits and associated cytokines prevented the apoptosis of transplanted stem cells in a sciatic nerve crush injury model. Suppression of inflammatory cytokines by fermented soybean extracts (Natto was also beneficial to nerve regeneration. In this study, the effect of Natto on transplanted human amniotic fluid mesenchymal stem cells (AFS was evaluated. Peripheral nerve injury was induced in SD rats by crushing a sciatic nerve using a vessel clamp. Animals were categorized into four groups: Group I: no treatment; Group II: fed with Natto (16 mg/day for 7 consecutive days; Group III: AFS embedded in fibrin glue; Group IV: Combination of group II and III therapy. Transplanted AFS and Schwann cell apoptosis, inflammatory cell deposits and associated cytokines, motor function, and nerve regeneration were evaluated 7 or 28 days after injury. The deterioration of neurological function was attenuated by AFS, Natto, or the combined therapy. The combined therapy caused the most significantly beneficial effects. Administration of Natto suppressed the inflammatory responses and correlated with decreased AFS and Schwann cell apoptosis. The decreased AFS apoptosis was in line with neurological improvement such as expression of early regeneration marker of neurofilament and late markers of S-100 and decreased vacuole formation. Administration of either AFS, or Natto, or combined therapy augmented the nerve regeneration. In conclusion, administration of Natto may rescue the AFS and Schwann cells from apoptosis by suppressing the macrophage deposits, associated inflammatory cytokines, and fibrin deposits.

  2. The Role of Continuous Peripheral Nerve Blocks

    OpenAIRE

    José Aguirre; Alicia Del Moral; Irina Cobo; Alain Borgeat; Stephan Blumenthal

    2012-01-01

    A continuous peripheral nerve block (cPNB) is provided in the hospital and ambulatory setting. The most common use of CPNBs is in the peri- and postoperative period but different indications have been described like the treatment of chronic pain such as cancer-induced pain, complex regional pain syndrome or phantom limb pain. The documented benefits strongly depend on the analgesia quality and include decreasing baseline/dynamic pain, reducing additional analgesic requirements, decrease of po...

  3. Dysregulated expression of death, stress and mitochondrion related genes in the sciatic nerve of presymptomatic SOD1G93A mouse model of Amyotrophic Lateral Sclerosis

    Directory of Open Access Journals (Sweden)

    Chrystian Junqueira Alves

    2015-09-01

    Full Text Available Schwann cells are the main source of paracrine support to motor neurons. Oxidative stress and mitochondrial dysfunction have been correlated to motor neuron death in Amyotrophic Lateral Sclerosis (ALS. Despite the involvement of Schwann cells in early neuromuscular disruption in ALS, detailed molecular events of a dying-back triggering are unknown. Sciatic nerves of presymptomatic (60-day-old SOD1G93A mice were submitted to a high-density oligonucleotide microarray analysis. DAVID demonstrated the deregulated genes related to death, stress and mitochondrion, which allowed the identification of Cell cycle, ErbB signaling, Tryptophan metabolism and Rig-I-like receptor signaling as the most representative KEGG pathways. The protein-protein interaction networks based upon deregulated genes have identified the top hubs (TRAF2, H2AFX, E2F1, FOXO3, MSH2, NGFR, TGFBR1 and bottlenecks (TRAF2, E2F1, CDKN1B, TWIST1, FOXO3. Schwann cells were enriched from the sciatic nerve of presymptomatic mice using flow cytometry cell sorting. qPCR showed the up regulated (Ngfr, Cdnkn1b, E2f1, Traf2 and Erbb3, H2afx, Cdkn1a, Hspa1, Prdx, Mapk10 and down-regulated (Foxo3, Mtor genes in the enriched Schwann cells. In conclusion, molecular analyses in the presymptomatic sciatic nerve demonstrated the involvement of death, oxidative stress, and mitochondrial pathways in the Schwann cell non-autonomous mechanisms in the early stages of ALS.

  4. Chronic morphine treatment enhances sciatic nerve stimulation-induced immediate early gene expression in the rat dorsal horn.

    Science.gov (United States)

    Bojovic, Ognjen; Bramham, Clive R; Tjølsen, Arne

    2015-01-01

    Synaptic plasticity is a property of neurons that can be induced by conditioning electrical stimulation (CS) of afferent fibers in the spinal cord. This is a widely studied property of spinal cord and hippocampal neurons. CS has been shown to trigger enhanced expression of immediate early gene proteins (IEGPs), with peak increases observed 2 hour post stimulation. Chronic morphine treatment has been shown to promoteinduce opioid-induced hyperalgesia, and also to increase CS-induced central sensitization in the dorsal horn. As IEGP expression may contribute to development of chronic pain states, we aimed to determine whether chronic morphine treatment affects the expression of IEGPs following sciatic nerve CS. Changes in expression of the IEGPs Arc, c-Fos or Zif268 were determined in cells of the lumbar dorsal horn of the spinal cord. Chronic Morphine pretreatment over 7 days led to a significant increase in the number of IEGP positive cells observed at both 2 h and 6 h after CS. The same pattern of immunoreactivity was obtained for all IEGPs, with peak increases occurring at 2 h post CS. In contrast, morphine treatment alone in sham operated animals had no effect on IEGP expression. We conclude that chronic morphine treatment enhances stimulus-induced expression of IEGPs in the lumbar dorsal horn. These data support the notion that morphine alters gene expression responses linked to nociceptive stimulation and plasticity.

  5. Essential Oil of Ocimum basilicum L. and (−-Linalool Blocks the Excitability of Rat Sciatic Nerve

    Directory of Open Access Journals (Sweden)

    Antonio Medeiros Venancio

    2016-01-01

    Full Text Available The racemate linalool and its levogyrus enantiomer [(−-LIN] are present in many essential oils and possess several pharmacological activities, such as antinociceptive and anti-inflammatory. In this work, the effects of essential oil obtained from the cultivation of the Ocimum basilicum L. (EOOb derived from Germplasm Bank rich in (−-LIN content in the excitability of peripheral nervous system were studied. We used rat sciatic nerve to investigate the EOOb and (−-LIN effects on neuron excitability and the extracellular recording technique was used to register the compound action potential (CAP. EOOb and (−-LIN blocked the CAP in a concentration-dependent way and these effects were reversible after washout. EOOb blocked positive amplitude of 1st and 2nd CAP components with IC50 of 0.38±0.2 and 0.17±0.0 mg/mL, respectively. For (−-LIN, these values were 0.23±0.0 and 0.13±0.0 mg/mL. Both components reduced the conduction velocity of CAP and the 2nd component seems to be more affected than the 1st component. In conclusion EOOb and (−-LIN inhibited the excitability of peripheral nervous system in a similar way and potency, revealing that the effects of EOOb on excitability are due to the presence of (−-LIN in the essential oil.

  6. Analgesic effect of piracetam on peripheral neuropathic pain induced by chronic constriction injury of sciatic nerve in rats.

    Science.gov (United States)

    Mehta, Ashish K; Bhati, Yogendra; Tripathi, Chakra D; Sharma, Krishna K

    2014-08-01

    Despite immense advances in the treatment strategies, management of neuropathic pain remains unsatisfactory. Piracetam is a prototype of nootropic drugs, used to improve cognitive impairment. The present study was designed to investigate the effect of piracetam on peripheral neuropathic pain in rats. Neuropathic pain was induced by the chronic constriction injury of the sciatic nerve. Following this, piracetam was intraperitoneally administered for 2 weeks in doses of 50, 100 and 200 mg/kg, and pain was assessed by employing the behavioural tests for thermal hyperalgesia (hot plate and tail flick tests) and cold allodynia (acetone test). After the induction of neuropathic pain, significant development of thermal hyperalgesia and cold allodynia was observed. The administration of piracetam (50 mg/kg) did not have any significant effect on all the behavioural tests. Further, piracetam (100 mg/kg) also had no effect on the hot plate and tail flick tests; however it significantly decreased the paw withdrawal duration in the acetone test. Piracetam in a dose of 200 mg/kg significantly modulated neuropathic pain as observed from the increased hot plate and tail flick latencies, and decreased paw withdrawal duration (in acetone test). Therefore, the present study suggests the potential use of piracetam in the treatment of neuropathic pain, which merits further clinical investigation.

  7. Up-regulation of Robo1 in dorsal root ganglia after sciatic nerve ...

    African Journals Online (AJOL)

    Roundabout (Robo) receptors have many important roles including mediating the migration of the growth cone and neurons, promoting axonal growth and development of nerve fascicles, and guiding the growth direction of central nervous system by binding Slit. To better understand the role of Robo in peripheral nervous ...

  8. The functional and morphological characteristics of sciatic nerve degeneration and regeneration after crush injury in rats

    NARCIS (Netherlands)

    Sta, M.; Cappaert, N. L. M.; Ramekers, D.; Baas, F.; Wadman, W. J.

    2014-01-01

    Peripheral nerve damage induces a sequence of degeneration and regeneration events with a specific time course that leads to (partial) functional recovery. Quantitative electrophysiological analysis of degeneration and recovery over time is essential to understand the process. The presented ex vivo

  9. Essential oil of Lippia alba and its main constituent citral block the excitability of rat sciatic nerves

    Directory of Open Access Journals (Sweden)

    D.G. Sousa

    2015-08-01

    Full Text Available Lippia alba is empirically used for infusions, teas, macerates, and hydroalcoholic extracts because of its antispasmodic, analgesic, sedative, and anxiolytic effects. Citral is a mixture of trans-geranial and cis-neral and is the main constituent of L. alba essential oil and possesses analgesic, anxiolytic, anticonvulsant, and sedative effects. The present study evaluated the effects of the essential oil of L. alba (EOLa and citral on compound action potentials (CAPs in Wistar rat sciatic nerves. Both drugs inhibited CAP in a concentration-dependent manner. The calculated half-maximal inhibitory concentrations (IC50 of peak-to-peak amplitude were 53.2 µg/mL and 35.00 µg/mL (or 230 µM for EOLa and citral, respectively. Peak-to-peak amplitude of the CAP was significantly reduced by 30 µg/mL EOLa and 10 µg/mL citral. EOLa and citral (at 60 and 30 µg/mL, values close to their respective IC50 for CAP blockade significantly increased chronaxy and rheobase. The conduction velocity of the first and second CAP components was statistically reduced to ∼86% of control with 10 µg/mL EOLa and ∼90% of control with 3 µg/mL citral. This study showed that EOLa inhibited nerve excitability and this effect can be explained by the presence of citral in its composition. Both EOLa and citral showed inhibitory actions at lower concentrations compared with other essential oils and constituents with local anesthetic activity. In conclusion, these data demonstrate that EOLa and citral are promising agents in the development of new drugs with local anesthetic activity.

  10. Essential oil of Lippia alba and its main constituent citral block the excitability of rat sciatic nerves

    Science.gov (United States)

    Sousa, D.G.; Sousa, S.D.G.; Silva, R.E.R.; Silva-Alves, K.S.; Ferreira-da-Silva, F.W.; Kerntopf, M.R.; Menezes, I.R.A.; Leal-Cardoso, J.H.; Barbosa, R.

    2015-01-01

    Lippia alba is empirically used for infusions, teas, macerates, and hydroalcoholic extracts because of its antispasmodic, analgesic, sedative, and anxiolytic effects. Citral is a mixture of trans-geranial and cis-neral and is the main constituent of L. alba essential oil and possesses analgesic, anxiolytic, anticonvulsant, and sedative effects. The present study evaluated the effects of the essential oil of L. alba (EOLa) and citral on compound action potentials (CAPs) in Wistar rat sciatic nerves. Both drugs inhibited CAP in a concentration-dependent manner. The calculated half-maximal inhibitory concentrations (IC50) of peak-to-peak amplitude were 53.2 µg/mL and 35.00 µg/mL (or 230 µM) for EOLa and citral, respectively. Peak-to-peak amplitude of the CAP was significantly reduced by 30 µg/mL EOLa and 10 µg/mL citral. EOLa and citral (at 60 and 30 µg/mL, values close to their respective IC50 for CAP blockade) significantly increased chronaxy and rheobase. The conduction velocity of the first and second CAP components was statistically reduced to ∼86% of control with 10 µg/mL EOLa and ∼90% of control with 3 µg/mL citral. This study showed that EOLa inhibited nerve excitability and this effect can be explained by the presence of citral in its composition. Both EOLa and citral showed inhibitory actions at lower concentrations compared with other essential oils and constituents with local anesthetic activity. In conclusion, these data demonstrate that EOLa and citral are promising agents in the development of new drugs with local anesthetic activity. PMID:26132093

  11. Effect of Electroacupuncture on the Expression of Glycyl-tRNA Synthetase and Ultrastructure Changes in Atrophied Rat Peroneus Longus Muscle Induced by Sciatic Nerve Injection Injury

    Directory of Open Access Journals (Sweden)

    Meng Wang

    2016-01-01

    Full Text Available Glycyl-tRNA synthetase (GlyRS is one of the key enzymes involved in protein synthesis. Its mutations have been reported to cause Charcot-Marie-Tooth disease which demonstrates muscular atrophy in distal extremities, particularly manifested in peroneus muscles. In this situation, the dysfunctions of mitochondria and sarcoplasmic reticulum (SR affect energy supply and excitation-contraction coupling of muscle fibers, therefore resulting in muscular atrophy. Although the treatment of muscular atrophy is a global urgent problem, it can be improved by electroacupuncture (EA treatment. To investigate the mechanism underlying EA treatment improving muscular atrophy, we focused on the perspective of protein synthesis by establishing a penicillin injection-induced sciatic nerve injury model. In our model, injured rats without treatment showed decreased sciatic functional index (SFI, decreased peroneus longus muscle weight and muscle fiber cross-sectional area, aggregated mitochondria with vacuoles appearing, swollen SR, and downregulated mRNA and protein expression levels of GlyRS and myosin heavy chain IIb (MHC-IIb. The injured rats with EA treatment showed significant recovery. These results indicated that EA stimulation can alleviate peroneus longus muscular atrophy induced by iatrogenic sciatic nerve injury through promoting the recovery of GlyRS and muscle ultrastructure and increasing muscle protein synthesis.

  12. Effects of umbilical cord tissue mesenchymal stem cells (UCX® on rat sciatic nerve regeneration after neurotmesis injuries

    Directory of Open Access Journals (Sweden)

    Gärtner A

    2013-04-01

    Full Text Available Peripheral nerves have the intrinsic capacity of self-regeneration after traumatic injury but the extent of the regeneration is often very poor. Increasing evidence demonstrates that mesenchymal stem/stromal cells (MSCs may play an important role in tissue regeneration through the secretion of soluble trophic factors that enhance and assist in repair by paracrine activation of surrounding cells. In the present study, the therapeutic value of a population of umbilical cord tissue-derived MSCs, obtained by a proprietary method (UCX®, was evaluated on end-to-end rat sciatic nerve repair. Furthermore, in order to promote both, end-to-end nerve fiber contacts and MSC cell-cell interaction, as well as reduce the flush away effect of the cells after administration, a commercially available haemostatic sealant, Floseal®, was used as vehicle. Both, functional and morphologic recoveries were evaluated along the healing period using extensor postural thrust (EPT, withdrawal reflex latency (WRL, ankle kinematics analysis, and either histological analysis or stereology, in the hyper-acute, acute and chronic phases of healing. The histological analysis of the hyper-acute and acute phase studies revealed that in the group treated with UCX ® alone the Wallerian degeneration was improved for the subsequent process of regeneration, the fiber organization was higher, and the extent of fibrosis was lower. The chronic phase experimental groups revealed that treatment with UCX® induced an increased number of regenerated fibers and thickening of the myelin sheet. Kinematics analysis showed that the ankle joint angle determined for untreated animals was significantly different from any of the treated groups at the instant of initial contact (IC. At opposite toe off (OT and heel rise (HR, differences were found between untreated animals and the groups treated with either UCX® alone or UCX® administered with Floseal®. Overall, the UCX® application presented

  13. Vasculitic peripheral neuropathy induced by ischemia-reperfusion in the rat femoral artery involves activation of proinflammatory signaling pathway in the sciatic nerve.

    Science.gov (United States)

    Chung, Chih-Yang; Chang, Yi-Wei; Huang, Chun-Jen; Wang, Po-Kai; Wan, Hung-Chieh; Lin, Yi-Ying; Kao, Ming-Chang

    2017-08-24

    Ischemia-reperfusion (IR) in the rat femoral artery has been proposed as an experimental model of vasculitic peripheral neuropathy (VPN) which presents neuropathic pain and peripheral nerve injury patterns observed clinically. This study investigates the involvement of the proinflammatory signaling pathway underlying the peripheral mechanisms of VPN. Male Sprague-Dawley rats were allocated to receive either a sham operation or IR. IR was induced by occluding the right femoral artery for 4h followed by reperfusion periods from 0 to 72h. The behavioral parameters were assessed at baseline as well as at days 1, 2 and 3 after reperfusion. The time-course analyses of proinflammatory mediators in the sciatic nerves were also performed on rats of the sham group or IR groups with reperfusion periods of 0, 2, 4, 24 and 72h, respectively. The behavioral data confirmed that this VPN model induced hindpaw mechano-allodynia and heat hyperalgesia as well as impaired hindpaw grip strength. The molecular data revealed that IR in the femoral artery activated the expression of nuclear factor-κB (NF-κB) in the sciatic nerve indicating a neuroinflammatory response. Moreover, IR in the femoral artery increased the expression of proinflammatory cytokines TNF-α and IL-1β in the sciatic nerve. This study elucidated the novel time-course expression profiles of NF-κB and proinflammatory cytokines in VPN induced by IR which may be involved in the development of neuropathic pain. Since NF-κB is a key element during neuroinflammation, strategies targeting the NF-κB signaling pathway may provide therapeutic potential against VPN induced by IR. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Investigation into Regeneration Mechanism of Hydroalcoholic Lavender (Lavandula officianalis Extract through the Evaluation of NT3 Gene Expression after Sciatic Nerve Compression in Rats

    Directory of Open Access Journals (Sweden)

    Fereshteh Naderi Allaf

    2017-05-01

    Full Text Available Abstract Background: Retrograde transport to the alpha motoneurons causes spinal degeneration. The neurotrophic factor (NT3 increases the number of myelinated axons in the dorsal root, leads to differentiation and survival of sensory neurons, parasympathetic motoneurons and prevents cell death. Lavender is a plant in the family Lamiaceae which is reported to have antioxidant, antispasmodic, diuretic, anti-asthmatic, refrigerant, and antipyretic effects. This study examined NT3 gene expression changes after sciatic nerve compression in rats, in the presence of Lavandula officinalis extract. Materials and Methods: Lavender Soxhlet hydroalcoholic extraction was prepared. 36 male Wistar rats were randomly divided into 3 groups including control, compression and treatment (compression group + hydroalcoholic extract of Lavender injections 75mg/kg groups. In controls the muscle was opened without damage to gain access to the sciatic nerve. In compression and treatment groups, the sciatic nerve (right leg was compressed. The extract was injected intraperitoneally in two occasions. A biopsy was taken from the spinal cord segments L4-L6 on day 28, total RNA was extracted and cDNA was synthesized and NT3 gene expression changes were analyzed by ANOVA test by using SPSS software. Results: The results showed that NT3 gene expression had a significant reduction in compression group compared to the control group (p<0.001 and it had a significant increase in treatment group compared with the compression group (p<0.001. Conclusion: A significant increase in gene expression shows that Lavandula officinalis hydroalcoholic extract improves nerve regeneration via NT3 gene expression.

  15. Contribution of myelunated fibers from spinal L4, L5 and L6 nerves to the sciatic nerve and its main branches in the adult rat Contribución de fibras mielínicas provenientes de los nervios espinales lumbares L4, L5 y L6 al nervio ciático de rata adulta y sus ramas principales

    OpenAIRE

    Juan D. Robles; Marlen Arias; Miguel Baldovino; Jeanelle Ariza; José V. Montoya Guarín; John J. Sutachán; Hernán Hurtado

    2000-01-01

    The rat sciatic nerve is composed by the L4, L5 and L6 lumbar spinal nerves. However, the contribution in myelinated fibers originating from these nerves along this nervous trunk has not yet been defined. In the present study, the L4, L5 and L4-L5 spinal nerves were selectively transected. After one week the sciatic, tibial, sural and peroneal nerves were dissected. These samples were fixed and processed for optical microscopy, and both degenerated and normal myelinated fibers were counted in...

  16. Sciatic and femoral nerve blockade using bupivacaine alone, or in combination with dexmedetomidine or buprenorphine in cats.

    Science.gov (United States)

    Evangelista, M C; Doodnaught, G M; Fantoni, D T; Steagall, P V M

    2017-06-17

    The aim of this study was to determine the onset and offset of antinociception after sciatic (ScN) and femoral (FN) nerve blocks. Six healthy adult cats (4.8±1.3years; 4.3±0.4 kg) were included in a randomised, crossover, blinded and controlled study. Following sedation with dexmedetomidine (25 µg/kg, intramuscular), each ScN and FN injection was performed using 0.1 ml/kg of saline (CONTROL), bupivacaine (0.46 per cent, 0.46 mg/kg; BUPI), bupivacaine and dexmedetomidine (1 µg/kg; BUPI-DEX) or bupivacaine and buprenorphine (2.5 µg/kg; BUPI-BUPRE). Atipamezole (250 µg/kg) was administered after injections. Paw withdrawal thresholds (PWT) and motor blockade were evaluated before sedation and up to 24 hours. The PWT were significantly increased at half an hour in CONTROL, from two to four hours in BUPI and BUPI-DEX when compared with baseline. Motor blockade was observed between one and three hours in treatments using bupivacaine. Ability to walk was significantly impaired in BUPI at half an hour to two hours, BUPI-DEX at one to two hours and BUPI-BUPRE at two hours. Antinociception was observed in BUPI between one and eight hours, and in BUPI-DEX and BUPI-BUPRE between one and four hours. This study could not demonstrate a benefit of administering bupivacaine with dexmedetomidine or buprenorphine in cats. Results in BUPI-DEX may have been biased by the administration of atipamezole. British Veterinary Association.

  17. Displacement of popliteal sciatic nerve catheters after major foot and ankle surgery: a randomized controlled double-blinded magnetic resonance imaging study(aEuro)

    DEFF Research Database (Denmark)

    Wulff Hauritz, Rasmus; Pedersen, E. M.; Linde, F. S.

    2016-01-01

    Popliteal sciatic nerve catheters (PSNCs) are associated with a high frequency of displacement. We aimed to estimate the frequency of catheter displacement after 48 h with magnetic resonance imaging (MRI) in patients with PSNCs after major foot and ankle surgery randomized to catheter insertion...... either with a short-axis in-plane (SAX-IP) approach perpendicular to the nerve or with a short-axis out-of-plane (SAX-OOP) approach parallel to the nerve. Forty patients were randomly allocated to SAX-IP or SAX-OOP PSNC. Ropivacaine 0.75% 20 ml was injected via the catheter followed by ropivacaine 0...... percentage points, 95% CI: 3-53 percentage points). The relative risk of displacement was four times larger (95% CI: 0.8-10, P foot...

  18. The use of laminin modified linear ordered collagen scaffolds loaded with laminin-binding ciliary neurotrophic factor for sciatic nerve regeneration in rats.

    Science.gov (United States)

    Cao, Jiani; Sun, Changkai; Zhao, Hui; Xiao, Zhifeng; Chen, Bing; Gao, Jian; Zheng, Tiezheng; Wu, Wei; Wu, Shuang; Wang, Jingyu; Dai, Jianwu

    2011-06-01

    Nerve conduit provides a promising strategy for nerve injury repair in the peripheral nervous system (PNS). However, simply bridging the transected nerve with an empty conduit is hard to satisfy functional recovery. The regenerated axons may disperse during regeneration in the empty lumen, limiting the functional recovery. Our previous work had reported that linear ordered collagen scaffold (LOCS) could be used as a nerve guidance material. Here we cross-linked LOCS fibers with laminin which was a major component of the extracellular matrix in nervous system. Ciliary neurotrophic factor (CNTF) plays a critical role in peripheral nerve regeneration. But the lack of efficient CNTF delivery approach limits its clinical applications. To retain CNTF on the scaffold, a laminin binding domain (LBD) was fused to the N-terminal of CNTF. Compared with NAT-CNTF, LBD-CNTF exhibited specific laminin-binding ability and comparable neurotrophic bioactivity. We combined LBD-CNTF with the laminin modified LOCS fibers to construct a double-functional bio-scaffold. The functional scaffold was filled in silicon conduit and tested in the rat sciatic nerve transection model. Results showed that this functional biomaterial could guide the axon growth, retain more CNTF on the scaffolds and enhance the nerve regeneration as well as functional recovery. Copyright © 2011 Elsevier Ltd. All rights reserved.

  19. Localization and expression of ciliary neurotrophic factor (CNTF) in postmortem sciatic nerve from patients with motor neuron disease and diabetic neuropathy

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    Lee, D.A. [Univ. Medical Center, New Orleans, LA (United States); Gross, L.; Wittrock, D.A.; Windebank, A.J. [Mayo Clinic, Rochester, MN (United States)

    1996-08-01

    Ciliary neurotrophic factor (CNTF) is thought to play an important role in the maintenance of the mature motor system. The factor is found most abundantly in myelinating Schwann cells in the adult sciatic nerve. Lack of neuronal growth factors has been proposed as one possible etiology of amyotrophic lateral sclerosis (ALS) and spinal muscular atrophy (SMA). Growth factor replacement therapies are currently being evaluated as a treatment for motor neuron disease. In this report we determined whether the expression of CNTF in sciatic nerve differed in patients with motor neuron disease compared to controls or patients with another form of axonopathy. We identified 8 patients (7 with ALS and 1 with SMA) with motor neuron disease and 6 patients with diabetic motor neuropathy who had autopsy material available. Immunoperoxidase staining showed reduced CNTF expression in nerves of patients with motor neuron disease but not in patients with diabetic motor neuropathy. Decreased CNTF appears be associated with primary motor neuron disease rather than a generalized process of axon loss. This result supports suggestions that CNTF deficiency may be an important factor in the development of motor neuron disease. 20 refs., 4 figs., 1 tab.

  20. Ameliorating Role of Caffeic Acid Phenethyl Ester (CAPE Against Methotrexate-Induced Oxidative Stress in the Sciatic Nerve, Spinal Cord and Brain Stem Tissues of Rats

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    Ertuğrul Uzar

    2010-03-01

    Full Text Available OBJECTIVE: Methotrexate (MTX-associated neurotoxicity is an important clinical problem in cancer patients, but the mechanisms of MTX-induced neurotoxicity are not yet known exactly. The aims of this study were (1 to investigate the possible role of malondialdehyde (MDA, superoxide dismutase (SOD enzyme, glutathione peroxidase (GSH-Px and catalase (CAT in the pathogenesis of MTX-induced neurotoxicity and (2 to determine whether there is a putative protective effect of caffeic acid phenethyl ester (CAPE on MTX-induced neurotoxicity in the spinal cord, brainstem and sciatic nerve of rats. METHODS: A total of 19 adult Wistar male rats were divided into three experimental groups. Group I, control group; Group II, MTX-treated group; and Group III, MTX + CAPE-treated group. MTX was administered to the MTX and MTX + CAPE groups intraperitoneally (IP with a single dose of 20 mg/kg on the second day of the experiment. CAPE was administered to the MTX + CAPE group IP with a dose of 10 μmol/kg for 7 days. RESULTS: In the sciatic nerve and spinal cord tissue, CAT and GSH-Px activities were increased in the MTX group in comparison with the control group. CAPE treatment with MTX significantly decreased CAT and GSH-Px activities in the neuronal tissues of rats in comparison with the MTX group. In the spinal cord and brainstem tissues, SOD activity in the MTX group was decreased in comparison with the control group, but in the sciatic nerve, there was no significant difference. In the spinal cord and brainstem of rats, SOD activity was increased in the CAPE + MTX group when compared with the MTX group. The level of MDA was higher in the MTX group than in the control group. CAPE administration with MTX injection caused a significant decrease in MDA level when compared with the MTX group. CONCLUSION: These results reveal that MTX increases oxidative stress in the sciatic nerve, spinal cord and brainstem of rats and that CAPE has a preventive effect on the

  1. Electrical characteristics of rat skeletal muscle in immaturity, adulthood and after sciatic nerve injury, and their relation to muscle fiber size

    International Nuclear Information System (INIS)

    A Ahad, Mohammad; Fogerson, P Michelle; D Rosen, Glenn; Narayanaswami, Pushpa; Rutkove, Seward B

    2009-01-01

    Localized impedance methods can provide useful approaches for assessing neuromuscular disease. The mechanism of these impedance changes remains, however, uncertain. In order to begin to understand the relation of muscle pathology to surface impedance values, 8 immature rats, 12 mature rats and 8 mature rats that had undergone sciatic crush were killed. Measurement was made on tissue from the gastrocnemius muscle from each animal in an impedance cell, and the conductivity and relative permittivity of the tissue were calculated in both the longitudinal and transverse directions for frequencies of 2 kHz to 1 MHz. In addition, quantitative histological analysis was performed on the tissue. Significant elevations in transverse conductivity and transverse relative permittivity were found with animal growth, but longitudinal values showed no difference. After sciatic crush, both transverse and longitudinal conductivity increased significantly, with no change in the relative permittivity in either direction. The frequency dependence of the values also changed after nerve injury. In the healthy animals, there was a strong linear relation between measured conductivity and relative permittivity with cell area, but not for the sciatic crush animals. These results provide a first step toward developing a comprehensive understanding of how the electrical properties of muscle alter in neuromuscular disease states

  2. A dose-ranging study of 0.5% bupivacaine or ropivacaine on the success and duration of the ultrasound-guided, nerve-stimulator-assisted sciatic nerve block: a double-blind, randomized clinical trial.

    Science.gov (United States)

    Nader, Antoun; Kendall, Mark C; De Oliveira, Gildasio S; Puri, Lalit; Tureanu, Luminita; Brodskaia, Alina; Asher, Yogen; Parimi, Vamsi; McCarthy, Robert J

    2013-01-01

    Before bifurcation, the sciatic nerve is composed of 2 component nerves encased in a common investing extraneural layer (CIEL). We examined the effect of various volumes injected beneath the CIEL on the success and duration of sciatic nerve block. Ultrasound-guided nerve-stimulator-assisted sciatic nerve blocks were performed on 142 subjects. Subjects were randomized into 14 groups (0.5% ropivacaine or bupivacaine) with epinephrine 1:300,000 in volumes ranging from 2.5 to 30 mL. Successful block was defined as a complete sensory and motor block at 60 minutes. The minimum threshold current, time to complete block, duration of sensory and motor block, postoperative pain, and analgesic requirements were recorded. The mean threshold current external to the CIEL was 0.52 (0.15) mA compared to 0.19 (0.09) mA beneath the CIEL (P block was achieved in 30 of 40 subjects that received 5 mL or less of ropivacaine or bupivacaine compared with 97 of 99 that received 10 mL or greater volume (P = 0.006). Injection volumes greater than or equal to 10 mL produced complete sensory and motor block within 30 minutes. Volumes greater than 10 mL did not extend the duration of the sensory or motor block. Injection volumes of 2.5 and 5 mL were associated with delayed onset and decreased block duration and a greater fraction of subjects experiencing pain behind the knee. Injecting 10 mL of 0.5% bupivacaine or ropivacaine below the CIEL produces comparable onset and duration of sensory and motor blockade as volumes as large as 30 mL.

  3. Neural Progenitor-Like Cells Induced from Human Gingiva-Derived Mesenchymal Stem Cells Regulate Myelination of Schwann Cells in Rat Sciatic Nerve Regeneration.

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    Zhang, Qunzhou; Nguyen, Phuong; Xu, Qilin; Park, Wonse; Lee, Sumin; Furuhashi, Akihiro; Le, Anh D

    2017-02-01

    Regeneration of peripheral nerve injury remains a major clinical challenge. Recently, mesenchymal stem cells (MSCs) have been considered as potential candidates for peripheral nerve regeneration; however, the underlying mechanisms remain elusive. Here, we show that human gingiva-derived MSCs (GMSCs) could be directly induced into multipotent NPCs (iNPCs) under minimally manipulated conditions without the introduction of exogenous genes. Using a crush-injury model of rat sciatic nerve, we demonstrate that GMSCs transplanted to the injury site could differentiate into neuronal cells, whereas iNPCs could differentiate into both neuronal and Schwann cells. After crush injury, iNPCs, compared with GMSCs, displayed superior therapeutic effects on axonal regeneration at both the injury site and the distal segment of the injured sciatic nerve. Mechanistically, transplantation of GMSCs, especially iNPCs, significantly attenuated injury-triggered increase in the expression of c-Jun, a transcription factor that functions as a major negative regulator of myelination and plays a central role in dedifferentiation/reprogramming of Schwann cells into a progenitor-like state. Meanwhile, our results also demonstrate that transplantation of GMSCs and iNPCs consistently increased the expression of Krox-20/EGR2, a transcription factor that governs the expression of myelin proteins and facilitates myelination. Altogether, our findings suggest that transplantation of GMSCs and iNPCs promotes peripheral nerve repair/regeneration, possibly by promoting remyelination of Schwann cells mediated via the regulation of the antagonistic myelination regulators, c-Jun and Krox-20/EGR2. Stem Cells Translational Medicine 2017;6:458-470. © 2016 The Authors Stem Cells Translational Medicine published by Wiley Periodicals, Inc. on behalf of AlphaMed Press.

  4. A comparison of the onset time of complete blockade of the sciatic nerve in the application of ropivacaine and its equal volumes mixture with lidocaine: a double-blind randomized study

    OpenAIRE

    Valery, Piacherski; Aliaksei, Marochkov

    2013-01-01

    Background The purpose of the current study is to create a new mixture of local anesthetics-one with a short time of block development and short action term (5 ml of 1% lidocaine solution) and another with a longer time of anesthesia development and a long analgetic effect (5 ml of 0.75% ropivacaine)-for use during surgical operations on extremities. The primary end point was the development of the complete sensory block of the sciatic nerve. Methods Sixty blocks of sciatic nerve were used in...

  5. [A Randomized Controlled Clinical Trial of Treatment of Lumbar Disc Herniation-induced Sciatica by Acupuncture Stimulation of Sciatic Nerve Trunk].

    Science.gov (United States)

    Qiu, Ling; Hu, Xiao-Li; Zhao, Xue-Yu; Zheng, Xu; Zhang, Ji; Zhang, Min; He, Liu

    2016-10-25

    To observe the efficacy of acupuncture stimulation of the sciatic nerve trunk in the treatment of patients suffering from sciatica induced by lumbar disc herniation (LDH). A total of 60 LDH sciatica patients met the inclusion criteria were randomly divided into treatment group and control group, with 30 cases in each. Patients of the treatment group were treated by directly needling the sciatic nerve and routine acupuncture of Ashi -points, Lumbar Jiaji (EX-B 2), Dachangshu (BL 28), etc., and those of the control group treated by simple routine acupuncture. The treatment was conducted once a day, 5 times a week, 4 weeks altogether. The clinical effect was evaluated according to the "Standards for Diagnosis and Therapeutic Effect Evaluation of Syndromes of Chinese Medicine" and the pain intensity was assessed by using simplified Short-Form McGill Pain Questionnaire (SF-MPQ) containing pain rating index (PRI), visual analogue scale (VAS) and present pain intensity (PPI). After the treatment, of the two 30 cases of LDH sciatica patients in the control and treatment groups, 11 and 18 were cured, 7 and 7 experienced marked improvement, 10 and 4 were effective, 2 and 1 was invalid, with the effective rate being 93.3% and 96.7%, respectively. The cured+markedly effective rate of the treatment group was significantly higher than that of the control group ( P sciatica in LDH patients, and is superior to simple routine acupuncture in the clinical efficacy.

  6. Comparative analysis of the number of neurofilaments in rat sciatic nerve undergoing neuropraxia treated by low-level laser and therapeutic ultrasound

    International Nuclear Information System (INIS)

    Matamala, F; Cornejo, R; Paredes, M; Farfan, E; Garrido, O. S; Alves, N

    2014-01-01

    Therapy by low-level laser (LLL) or ultrasound (US) are commonly used as treatment after nerve crush. The aim of this study was to determine the effectiveness of such treatments to repair the neuronal cytoskeleton evaluating the variation in the number of neurofilaments. For this an experimental design was performed, which involved 30 rats divided into 6 groups: 1 - control healthy; 2 - control injured; 3 - irradiated by LLL 2 J/cm2; 4 - irradiated by LLL 10 J/cm2; 5 - irradiated by US 0.5 W/cm2 and 6 - irradiated by US 1W/cm2. With the exception of group 1 all specimens were anesthetized and underwent right sciatic nerve compression using 40N pressure for 45 seconds. Twenty-four hours after compression irradiation was started by LLL and US according protocol. In our research we found that the increase in the number of neurofilaments was related to the applied dose of LLL and US. The average value of neurofilaments / 0.25 mm2 obtained in each group was: 1 - 128; 2-100; 3-156; 4-140; 5-100; 6-148. We concluded that the application of LLL and therapeutic US increases the number of neurofilaments in rat sciatic nerve undergoing neuropraxia, with LLL being more effective compared to the US. Furthermore we concluded that the effectiveness of therapies to induce regeneration of injured nerve is related to the type of protocol used, demonstrating the need to establish an adequate radiation dose with the purpose of obtaining the best therapeutic response, thus achieving successful treatment [es

  7. Human Induced Pluripotent Stem Cell-Derived Motor Neuron Transplant for Neuromuscular Atrophy in a Mouse Model of Sciatic Nerve Injury.

    Science.gov (United States)

    Pepper, Jon-Paul; Wang, Tiffany V; Hennes, Valerie; Sun, Soo Yeon; Ichida, Justin K

    2017-05-01

    Human motor neurons may be reliably derived from induced pluripotent stem cells (iPSCs). In vivo transplant studies of human iPSCs and their cellular derivatives are essential to gauging their clinical utility. To determine whether human iPSC-derived motor neurons can engraft in an immunodeficient mouse model of sciatic nerve injury. This nonblinded interventional study with negative controls was performed at a biomedical research institute using an immunodeficient, transgenic mouse model. Induced pluripotent stem cell-derived motor neurons were cultured and differentiated. Cells were transplanted into 32 immunodeficient mice with sciatic nerve injury aged 6 to 15 weeks. Tissue analysis was performed at predetermined points after the mice were killed humanely. Animal experiments were performed from February 24, 2015, to May 2, 2016, and data were analyzed from April 7, 2015, to May 27, 2016. Human iPSCs were used to derive motor neurons in vitro before transplant. Evidence of engraftment based on immunohistochemical analysis (primary outcome measure); evidence of neurite outgrowth and neuromuscular junction formation (secondary outcome measure); therapeutic effect based on wet muscle mass preservation and/or electrophysiological evidence of nerve and muscle function (exploratory end point). In 13 of the 32 mice undergoing the experiment, human iPSC-derived motor neurons successfully engrafted and extended neurites to target denervated muscle. Human iPSC-derived motor neurons reduced denervation-induced muscular atrophy (mean [SD] muscle mass preservation, 54.2% [4.0%]) compared with negative controls (mean [SD] muscle mass preservation, 33.4% [2.3%]) (P = .04). No electrophysiological evidence of muscle recovery was found. Human iPSC-derived motor neurons may have future use in the treatment of peripheral motor nerve injury, including facial paralysis. NA.

  8. Disruption of spinal cord white matter and sciatic nerve geometry inhibits axonal growth in vitro in the absence of glial scarring

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    Crutcher Keith A

    2001-05-01

    Full Text Available Abstract Background Axons within the mature mammalian central nervous system fail to regenerate following injury, usually resulting in long-lasting motor and sensory deficits. Studies involving transplantation of adult neurons into white matter implicate glial scar-associated factors in regeneration failure. However, these studies cannot distinguish between the effects of these factors and disruption of the spatial organization of cells and molecular factors (disrupted geometry. Since white matter can support or inhibit neurite growth depending on the geometry of the fiber tract, the present study sought to determine whether disrupted geometry is sufficient to inhibit neurite growth. Results Embryonic chick sympathetic neurons were cultured on unfixed longitudinal cryostat sections of mature rat spinal cord or sciatic nerve that had been crushed with forceps ex vivo then immediately frozen to prevent glial scarring. Neurite growth on uncrushed portions of spinal cord white matter or sciatic nerve was extensive and highly parallel with the longitudinal axis of the fiber tract but did not extend onto crushed portions. Moreover, neurite growth from neurons attached directly to crushed white matter or nerve tissue was shorter and less parallel compared with neurite growth on uncrushed tissue. In contrast, neurite growth appeared to be unaffected by crushed spinal cord gray matter. Conclusions These observations suggest that glial scar-associated factors are not necessary to block axonal growth at sites of injury. Disruption of fiber tract geometry, perhaps involving myelin-associated neurite-growth inhibitors, may be sufficient to pose a barrier to regenerating axons in spinal cord white matter and peripheral nerves.

  9. Linear ordered collagen scaffolds loaded with collagen-binding basic fibroblast growth factor facilitate recovery of sciatic nerve injury in rats.

    Science.gov (United States)

    Ma, Fukai; Xiao, Zhifeng; Chen, Bing; Hou, Xianglin; Dai, Jianwu; Xu, Ruxiang

    2014-04-01

    Natural biological functional scaffolds, consisting of biological materials filled with promoting elements, provide a promising strategy for the regeneration of peripheral nerve defects. Collagen conduits have been used widely due to their excellent biological properties. Linear ordered collagen scaffold (LOCS) fibers are good lumen fillers that can guide nerve regeneration in an ordered direction. In addition, basic fibroblast growth factor (bFGF) is important in the recovery of nerve injury. However, the traditional method for delivering bFGF to the lesion site has no long-term effect because of its short half-life and rapid diffusion. Therefore, we fused a specific collagen-binding domain (CBD) peptide to the N-terminal of native basic fibroblast growth factor (NAT-bFGF) to retain bFGF on the collagen scaffolds. In this study, a natural biological functional scaffold was constructed using collagen tubes filled with collagen-binding bFGF (CBD-bFGF)-loaded LOCS to promote regeneration in a 5-mm rat sciatic nerve transection model. Functional evaluation, histological investigation, and morphometric analysis indicated that the natural biological functional scaffold retained more bFGF at the injury site, guided axon growth, and promoted nerve regeneration as well as functional restoration.

  10. Nuclear factor erythroid 2-related factor 2 antibody attenuates thermal hyperalgesia in the dorsal root ganglion: Neurochemical changes and behavioral studies after sciatic nerve-pinch injury.

    Science.gov (United States)

    Xiang, Qiong; Yu, Chao; Zhu, Yao-Feng; Li, Chun-Yan; Tian, Rong-Bo; Li, Xian-Hui

    2016-08-01

    Oxidative stress is generated in several peripheral nerve injury models.Nuclear factor erythroid 2-related factor 2 (Nrf2) is activated to have a role in antioxidant effect. After nerve injury, the severely painful behavior is also performed. However, little has been explored regarding the function of Nrf2 in this painful process. Therefore, in this study, we compared the effects of Nrf2 antibody administration following sciatic nerve-pinch injury on painful behavior induced in young mice and neurochemical changes in dorsal root ganglion neurons. After pinch nerve injury, we found that the magnitude of the thermal allodynia was significantly decreased after application of Nrf2 antibody (5ul, 1mg/ml) in such injured animals and phosphorylated ERK(p-ERK) as well as the apoptotic protein (i.e., Bcl-6) in DRG neurons were also down-regulated in the anti-Nrf2-treated injured groups compared to the saline-treated groups. Taken collectively, these data suggested that the Nrf2 antibody reduced thermal hyperalgesia via ERK pathway and the down regulation of Bcl-6 protein from the apoptosis pathway might be protecting against the protein deletions caused by anti-Nrf2 effect and suggested the new therapeutic strategy with Nrf2 inhibitor following nerve injury. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. The effect of sub-epineural platelet-rich plasma (PRP on regeneration of the sciatic nerve in a rat model

    Directory of Open Access Journals (Sweden)

    Mohammad Javad Fatemi

    2016-01-01

    Full Text Available Background: Peripheral nerve injury is one of the most challenging of modern surgical problem. Recent advances in understanding the physiological and molecular pathways demonstrated the important role of growth factors in peripheral nerve regeneration. Platelet-rich plasma (PRP is a biological product that has many growth factors. The aim of this study was to investigate the effect of PRP in the regeneration of sciatic nerve crush in the rat model. Methods: In this experimental study that established in the animal lab of the Hazrat Fatemeh Hospital in Tehran from September to October 2013, Twenty-four healthy male Sprague-Dawley rats (200-250 g were randomly divided into two groups. In all rats the sciatic nerve was cut and then carefully repaired by the tension free method under a light microscope. In group 1, after the repair, 0.05 µL of PRP was injected below the epineurium to the proximal and distal parts of the repaired area. In group 2 the same amount of normal saline was injected to the proximal and distal of the repaired area. After six weeks footprint analysis, neurophysiologic and histopathology evaluations were performed. Results: Significant differences existed between the two groups footprint analysis (P= 0.001. Also the nerve conduction latency test was significantly shorter in PRP group. (1.0233 ms in PRP group and 1.7375 ms in control (P< 0.001. The average amplitude in the first group and the second group was 7.6250 mv (control 6.3667 mv that does not show a statistically significant difference (P= 0.093. Significant differences between the two groups in the number of axons of the proximal portion of the study was not seen (P= 0.29. The parameters included number of axons of the proximal and the distal part of axons, the diameter of the distal and proximal axons in the two groups were compared. In the two groups there was statistically significant difference between the above parameters. (P= 0.298. Conclusion: It seems that PRP

  12. The effects of dexketoprofen on duration of analgesia to a thermal stimulus when compared with a systemic control in a rat sciatic nerve block with levobupivacaine.

    Science.gov (United States)

    Kara, Inci; Apiliogullari, Seza; Bagcı Taylan, Sengal; Bariskaner, Hulagu; Celik, Jale Bengi

    2014-04-01

    This study was designed to investigate whether dexketoprofen added to perineuraly or subcutaneously alters the effects of levobupivacaine in a rat model of sciatic nerve blockade. Thirty-six rats received unilateral sciatic nerve blocks along with a subcutaneous injection by a blinded investigator assigned at random. Combinations were as follows: Group 1 (sham) perineural and subcutaneous saline; Group 2, perineural levobupivacaine alone and subcutaneous saline; Group 3, perineural levobupivacaine plus dexketoprofen and subcutaneous saline; Group 4, perineural levobupivacaine and subcutaneous dexketoprofen; Group 5, perineural dexketoprofen and subcutaneous saline; and Group 6, perineural saline and subcutaneous dexketoprofen. The levobupivacaine concentration was fixed at 0.05%, and the dose of dexketoprofen was 1 mg kg(-1) . Sensory analgesia was assessed by paw withdrawal latency to a thermal stimulus every 30 min. The unblocked paw served as the control for the assessment of systemic, centrally mediated analgesia. Perineural and subcutaneous dexketoprofen coadministered with perineural levobupivacaine did not enhance the duration of sensory blockade when compared with levobupivacaine alone. There were significant differences between the operative and control paws for time points 30-90 min in the perineural levobupivacaine alone, levobupivacaine + dexketoprofen and subcutaneous dexketoprofen added levobupivacaine group. Significant differences were not determined between the levobupivacaine alone group and dexketoprofen added groups in operative paw. The effects of dexketoprofen are unknown for perineural administration. There is no significant difference between the analgesic effects of peripheral nerve blocks using levobupivacaine alone and plus subcutaneous or perineural dexketoprofen. © 2012 The Authors Fundamental and Clinical Pharmacology © 2012 Société Française de Pharmacologie et de Thérapeutique.

  13. The Neuroprotective Effect of Alcoholic Extract of Cannabis Sativa on Neuronal Density of Spinal Cord Alpha Motoneurons after Sciatic Nerve Injury in Rats

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    M Tehranipour

    2011-07-01

    Full Text Available Introduction: Injuries of the peripheral nerve system affect the neurons cell body leading to axon injury. Cannabis sativa plant has anti oxidant and anti apoptotic effects. Therefore the aim of present study was to study the neuroprotective effect of alcoholic extract of cannabis sativa leaves on neuronal density of alpha motoneurons in spinal cord after sciatic nerve injury in rats. Methods: In this experimental research, animals were divided into four groups; A: control, B: compression, C: compression+ treatment with 25 mg/kg alcoholic extract, D: compression + treatment with 50 mg/kg extract (n=8. At first, sciatic nerve compression in B, C and D groups was achieved for 60 seconds using locker pincers. Alcoholic extract was injected intra peritoneally in the first and second weeks after compression. Then 28 days after compression, under profusion method, the lumbar spinal cord was sampled and the numerical density in each group was compared with the compression group. The data was analyzed with the use of Minitab 14 software and ANOVA statistical test. Results: Neuronal density showed a meaningful difference in the compression and control groups(P<0.001. Neuronal density in treatment groups(25, 50 mg/kg also had a meaningful increase(P<0.001 as compared to the compression group. Conclusion: Alcoholic extract of cannabis sativa leaves has a neuroprotective effect on spinal cord alpha motoneurons after injury. This could be due to growth and regeneration factors present in the alcoholic extract of cannabis sativa leaves that induce regeneration process in injured neurons or prevent degeneration.

  14. Neurolymphomatosis of the sciatic nerve and F.D.G. PET: case report and review; Neurolymphomatose du nerf sciatique en TEP au FDG: a propos d'un cas et revue de la litterature

    Energy Technology Data Exchange (ETDEWEB)

    Bruna-Muraille, C.; Papathanassiou, D.; Cuif-Job, A.; Liehn, J.C. [Institut Jean-Godinot, Service de Medecine Nucleaire, 51 - Reims (France); Job, L. [CHU Robert-Debre, Service de Radiologie, 51 - Reims (France); Kolb, B.; Himberlin, C.; Delmer, A. [CHU Robert-Debre, Service d' Hematologie Clinique, 51 - Reims (France)

    2009-12-15

    We are reporting the case of a woman who has been suffering from sciatica for several months. A neurolymphomatosis of the sciatic nerve was found. In this report, we present the characteristics of this lesion in conventional imaging and in F.D.G. PET. (authors)

  15. “Three Methods and Three Points” regulates p38 mitogen-activated protein kinase in the dorsal horn of the spinal cord in a rat model of sciatic nerve injury

    Directory of Open Access Journals (Sweden)

    Xin Guo

    2016-01-01

    Full Text Available Tuina is a traditional Chinese treatment for sensory disturbances caused by peripheral nerve injury and related diseases. Our previous studies showed that tuina regulates relevant regions and indices of the spinal dorsal horn using the Dian, Bo, and Rou method in Yinmen (BL37, Yanglingquan (GB34, and Weizhong (BL40. Treatment prevents muscle atrophy, protects spinal cord neurons, and promotes sciatic nerve repair. The mechanisms of action of tuina for treating peripheral nerve injury remain poorly understood. This study established rat models of sciatic nerve injury using the crushing method. Rats received Chinese tuina in accordance with the principle of “Three Methods and Three Points,” once daily for 20 days. Tuina intervention reduced paw withdrawal latency and improved wet weight of the gastrocnemius muscle, as well as promoting morphological recovery of sciatic nerve fibers, Schwann cells, and axons. The protein expression levels of phospho-p38 mitogen-activated protein kinase, tumor necrosis factor-α, and interleukin-1β also decreased. These findings indicate that “Three Methods and Three Points” promoted morphological recovery and improved behavior of rats with peripheral nerve injury.

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

    Directory of Open Access Journals (Sweden)

    Barzegar-Fallah Anita

    2008-12-01

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

  17. Behavioral and anatomical characterization of the bilateral sciatic nerve chronic constriction (bCCI) injury: correlation of anatomic changes and responses to cold stimuli.

    Science.gov (United States)

    Datta, Sukdeb; Chatterjee, Koel; Kline, Robert H; Wiley, Ronald G

    2010-01-27

    Unilateral constrictive sciatic nerve injury (uCCI) is a common neuropathic pain model. However, the bilateral constrictive injury (bCCI) model is less well studied, and shows unique characteristics. In the present study, we sought to correlate effects of bCCI on nocifensive responses to cold and mechanical stimuli with selected dorsal horn anatomic markers. bCCI or sham ligation of both rat sciatic nerves were followed up to 90 days of behavioural testing. Additional rats sacrificed at 15, 30 and 90 days were used for anatomic analyses. Behavioural tests included hindpaw withdrawal responses to topical acetone, cold plate testing, an operant thermal preference task and hindpaw withdrawal thresholds to mechanical probing. All nocifensive responses to cold increased and remained enhanced for >45 days. Mechanical withdrawal thresholds decreased for 25 days only. Densitometric analyses of immunoperoxidase staining in the superficial dorsal horn at L4-5 revealed decreased cholecystokinin (CCK) staining at all times after bCCI, decreased mu opiate receptor (MOR) staining, maximal at 15 days, increased neuropeptide Y (NPY) staining only at days 15 and 30, and increased neurokinin-1 receptor (NK-1R) staining at all time points, maximal at 15 days. Correlation analyses at 45 days post-bCCI, were significant for individual rat nocifensive responses in each cold test and CCK and NK-1R, but not for MOR or NPY. These results confirm the usefulness of cold testing in bCCI rats, a new approach using CCI to model neuropathic pain, and suggest a potential value of studying the roles of dorsal horn CCK and substance P in chronic neuropathic pain. Compared to human subjects with neuropathic pain, responses to cold stimuli in rats with bCCI may be a useful model of neuropathic pain.

  18. Time course of immediate early gene protein expression in the spinal cord following conditioning stimulation of the sciatic nerve in rats.

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    Bojovic, Ognjen; Panja, Debabrata; Bittins, Margarethe; Bramham, Clive R; Tjølsen, Arne

    2015-01-01

    Long-term potentiation induced by conditioning electrical stimulation of afferent fibers is a widely studied form of synaptic plasticity in the brain and the spinal cord. In the spinal cord dorsal horn, long-term potentiation is induced by a series of high-frequency trains applied to primary afferent fibers. Conditioning stimulation (CS) of sciatic nerve primary afferent fibers also induces expression of immediate early gene proteins in the lumbar spinal cord. However, the time course of immediate early gene expression and the rostral-caudal distribution of expression in the spinal cord have not been systematically studied. Here, we examined the effects of sciatic nerve conditioning stimulation (10 stimulus trains, 0.5 ms stimuli, 7.2 mA, 100 Hz, train duration 2 s, 8 s intervals between trains) on cellular expression of immediate early genes, Arc, c-Fos and Zif268, in anesthetized rats. Immunohistochemical analysis was performed on sagittal sections obtained from Th13- L5 segments of the spinal cord at 1, 2, 3, 6 and 12 h post-CS. Strikingly, all immediate early genes exhibited a monophasic increase in expression with peak increases detected in dorsal horn neurons at 2 hours post-CS. Regional analysis showed peak increases at the location between the L3 and L4 spinal segments. Both Arc, c-Fos and Zif268 remained significantly elevated at 2 hours, followed by a sharp decrease in immediate early gene expression between 2 and 3 hours post-CS. Colocalization analysis performed at 2 hours post-CS showed that all c-Fos and Zif268 neurons were positive for Arc, while 30% and 43% of Arc positive neurons were positive for c-Fos and Zif268, respectively. The present study identifies the spinal cord level and time course of immediate early gene (IEGP) expression of relevance for analysis of IEGPs function in neuronal plasticity and nociception.

  19. Co-treatment effect of pulsed electromagnetic field (PEMF) with human dental pulp stromal cells and FK506 on the regeneration of crush injured rat sciatic nerve.

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    Kim, Yoon-Tae; Hei, Wei-Hong; Kim, Soochan; Seo, Young-Kwon; Kim, Soung-Min; Jahng, Jeong-Won; Lee, Jong-Ho

    2015-01-01

    The purpose of this study was to determine whether crush injured rat sciatic nerve could be benefit from pulsed electromagnetic field (PEMF) combined with human dental pulp stromal cells (hDPSCs), with FK506 (Tacrolimus) for immune suppression and neuropromotion. Male Sprague-Dawley rats (200-250 g, 6 week old) were distributed into 6 groups (n = 18 each): control, PEMF, FK506, PEMF + hDPSCs, PEMF + FK506, and PEMF + hDPSCs + FK506 groups. hDPSCs (cell = 1 × 106/10 μl/rat) were injected at the crush site immediate after injury. FK506 was administered 3 weeks in FK506 group (0.5 mg/kg/d) while pre-op 1 d and post-op 7 d in PEMF + FK506 and PEMF + hDPSCs + FK506 group; cell tracking was done with PKH26-labeled hDPSCs (cell = 1 × 106/10 μl/rat). The rats were follow-up for 3 weeks. PEMF + FK506 and PEMF + hDPSCs + FK506 group showed a sharp increase in sciatic function index (SFI), axon counts, densities, and labeled neurons in dorsal root ganglia (DRG) than control at 3 weeks. Other three treatment groups also showed higher axon counts, densities, and labeled neurons than control. Higher axon counts and densities were found in PEMF + FK506 and PEMF + hDPSCs + FK506 groups comparing with PEMF group. Brain-derived neurotrophic factor (BDNF) mRNA expression pattern in nerve segment and DRG was almost same. Higher expression level in all the treatment groups was discovered in the follow-up period, but there was no significant difference. All treatment groups can improve regeneration of neurons following crushed injury, PEMF + FK506 and PEMF + hDPSCs + FK506 groups showed higher regeneration ability than other three groups. FK506 plays an important role during hDPSCs transplantation.

  20. Cold bupivacaine versus magnesium sulfate added to room temperature bupivacaine in sonar-guided femoral and sciatic nerve block in arthroscopic anterior cruciate ligament reconstruction surgery.

    Science.gov (United States)

    Alzeftawy, Ashraf Elsayed; El-Daba, Ahmad Ali

    2016-01-01

    Cooling of local anesthetic potentiates its action and increases its duration. Magnesium sulfate (MgSo 4 ) added to local anesthetic prolongs the duration of anesthesia and postoperative analgesia with minimal side effects. The aim of this prospective, randomized, double-blind study was to compare the effect of cold to 4°C bupivacaine 0.5% and Mg added to normal temperature (20-25°C) bupivacaine 0.5% during sonar-guided combined femoral and sciatic nerve blocks on the onset of sensory and motor block, intraoperative anesthesia, duration of sensory and motor block, and postoperative analgesia in arthroscopic anterior cruciate ligament (ACL) reconstruction surgery. A total of 90 American Society of Anesthesiologists classes I and II patients who were scheduled to undergo elective ACL reconstruction were enrolled in the study. The patients were randomly allocated to 3 equal groups to receive sonar-guided femoral and sciatic nerve blocks. In Group I, 17 ml of room temperature (20-25°C) 0.5% bupivacaine and 3 ml of room temperature saline were injected for each nerve block whereas in Group II, 17 ml of cold (4°C) 0.5% bupivacaine and 3 ml of cold saline were injected for each nerve block. In Group III, 17 ml of room temperature 0.5% bupivacaine and 3 ml of MgSo 4 5% were injected for each nerve block. The onset of sensory and motor block was evaluated every 3 min for 30 min. Surgery was started after complete sensory and motor block were achieved. Intraoperatively, the patients were evaluated for heart rate and mean arterial pressure, rescue analgesic and sedative requirements plus patient and surgeon satisfaction. Postoperatively, hemodynamics, duration of analgesia, resolution of motor block, time to first analgesic, total analgesic consumption, and the incidence of side effects were recorded. There was no statistically significant difference in demographic data, mean arterial pressure, heart rate, and duration of surgery. Onset of both sensory and motor block was

  1. Ca2+ involvement in activation of extracellular-signal-regulated-kinase 1/2 and m-calpain after axotomy of the sciatic nerve

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    Lisa B Mårtensson

    2017-01-01

    Full Text Available Detailed mechanisms behind regeneration after nerve injury, in particular signal transduction and the fate of Schwann cells (SCs, are poorly understood. Here, we investigated axotomy-induced activation of extracellular-signal-regulated kinase-1/2 (ERK1/2; important for proliferation and m-calpain in vitro , and the relation to Ca2+ deletion and Schwann cell proliferation and death after rat sciatic nerve axotomy. Nerve segments were cultured for up to 72 hours with and without ethylene glycol-bis(β-aminoethyl ether-N, N, N', N'-tetraacetic acid (EGTA. In some experiments, 5-bromo-2′-deoxyuridine (BrdU was added during the last 24 hours to detect proliferating cells and propidium iodide (PI was added at the last hour to detect dead and/or dying cells. Immunohistochemistry of sections of the cultured nerve segments was performed to label m-calpain and the phosphorylated and activated form of ERK1/2. The experiments revealed that immunoreactivity for p-ERK1/2 increased with time in organotypically cultured SCs. p-ERK1/2 and m-calpain were also observed in axons. A significant increase in the number of dead or dying SCs was observed in nerve segments cultured for 24 hours. When deprived of Ca2+, activation of axonal m-calpain was reduced, whereas p-ERK1/2 was increased in SCs. Ca2+ deprivation also significantly reduced the number of proliferating SCs, and instead increased the number of dead or dying SCs. Ca2+ seems to play an important role in activation of ERK1/2 in SCs and in SC survival and proliferation. In addition, extracellular Ca2+ levels are also required for m-calpain activation and up-regulation in axons. Thus, regulation of Ca2+ levels is likely to be a useful method to promote SC proliferation.

  2. Combination of Local Transplantation of In Vitro Bone-marrow Stromal Cells and Pulsed Electromagnetic Fields Accelerate Functional Recovery of Transected Sciatic Nerve Regeneration: A Novel Approach in Transected Nerve Repair.

    Science.gov (United States)

    Mohammadi, Rahim; Mahmoodzadeh, Sirvan

    2015-01-01

    Effect of combination of undifferentiated bone marrow stromal cells (BMSCs) and pulsed electromagnetic fields (PEMF) on transected sciatic nerve regeneration was assessed in rats. A 10 mm nerve segment was excised and a vein graft was used to bridge the gap. Twenty microliter undifferentiated BMSCs (2× 107 cells /mL) were administered into the graft inBMSC group with no exposure to PEMF. In BMSC/PEMF group the whole body was exposed to PEMF (0.3 mT, 2Hz) for 4h/day within 1-5 days. In PEMF group the transected nerve was bridged and phosphate buffered saline was administered into the graft. In authograft group (AUTO), the transected nervesegments were reimplanted reversely and the whole body was exposed to PEMF. The regenerated nerve fibers were studied within 12 weeks after surgery. Behavioral, functional, electrophysiological, biomechanical, gastrocnemius muscle mass findings, morphometric indices and immuonohistochemical reactions confirmed faster recovery of regenerated axons in BMSC/PEMF group compared to those in the other groups (PPEMF improved functional recovery. Combination of local transplantation of in vitro bone-marrow stromal cells and pulsed electromagnetic fields could be considered as an effective, safe and tolerable treatment for peripheral nerve repair in clinical practice.

  3. Effects of sciatic nerve transection on ultrastructure, NADPH-diaphorase reaction and serotonin-, tyrosine hydroxylase-, c-Fos-, glucose transporter 1- and 3-like immunoreactivities in frog dorsal root ganglion

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    F. Rigon

    Full Text Available Frogs have been used as an alternative model to study pain mechanisms. Since we did not find any reports on the effects of sciatic nerve transection (SNT on the ultrastructure and pattern of metabolic substances in frog dorsal root ganglion (DRG cells, in the present study, 18 adult male frogs (Rana catesbeiana were divided into three experimental groups: naive (frogs not subjected to surgical manipulation, sham (frogs in which all surgical procedures to expose the sciatic nerve were used except transection of the nerve, and SNT (frogs in which the sciatic nerve was exposed and transected. After 3 days, the bilateral DRG of the sciatic nerve was collected and used for transmission electron microscopy. Immunohistochemistry was used to detect reactivity for glucose transporter (Glut types 1 and 3, tyrosine hydroxylase, serotonin and c-Fos, as well as nicotinamide adenine dinucleotide phosphate diaphorase (NADPH-diaphorase. SNT induced more mitochondria with vacuolation in neurons, satellite glial cells (SGCs with more cytoplasmic extensions emerging from cell bodies, as well as more ribosomes, rough endoplasmic reticulum, intermediate filaments and mitochondria. c-Fos immunoreactivity was found in neuronal nuclei. More neurons and SGCs surrounded by tyrosine hydroxylase-like immunoreactivity were found. No change occurred in serotonin- and Glut1- and Glut3-like immunoreactivity. NADPH-diaphorase occurred in more neurons and SGCs. No sign of SGC proliferation was observed. Since the changes of frog DRG in response to nerve injury are similar to those of mammals, frogs should be a valid experimental model for the study of the effects of SNT, a condition that still has many unanswered questions.

  4. Effects of sciatic nerve transection on ultrastructure, NADPH-diaphorase reaction and serotonin-, tyrosine hydroxylase-, c-Fos-, glucose transporter 1- and 3-like immunoreactivities in frog dorsal root ganglion

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    F. Rigon

    2013-06-01

    Full Text Available Frogs have been used as an alternative model to study pain mechanisms. Since we did not find any reports on the effects of sciatic nerve transection (SNT on the ultrastructure and pattern of metabolic substances in frog dorsal root ganglion (DRG cells, in the present study, 18 adult male frogs (Rana catesbeiana were divided into three experimental groups: naive (frogs not subjected to surgical manipulation, sham (frogs in which all surgical procedures to expose the sciatic nerve were used except transection of the nerve, and SNT (frogs in which the sciatic nerve was exposed and transected. After 3 days, the bilateral DRG of the sciatic nerve was collected and used for transmission electron microscopy. Immunohistochemistry was used to detect reactivity for glucose transporter (Glut types 1 and 3, tyrosine hydroxylase, serotonin and c-Fos, as well as nicotinamide adenine dinucleotide phosphate diaphorase (NADPH-diaphorase. SNT induced more mitochondria with vacuolation in neurons, satellite glial cells (SGCs with more cytoplasmic extensions emerging from cell bodies, as well as more ribosomes, rough endoplasmic reticulum, intermediate filaments and mitochondria. c-Fos immunoreactivity was found in neuronal nuclei. More neurons and SGCs surrounded by tyrosine hydroxylase-like immunoreactivity were found. No change occurred in serotonin- and Glut1- and Glut3-like immunoreactivity. NADPH-diaphorase occurred in more neurons and SGCs. No sign of SGC proliferation was observed. Since the changes of frog DRG in response to nerve injury are similar to those of mammals, frogs should be a valid experimental model for the study of the effects of SNT, a condition that still has many unanswered questions.

  5. Isotropic resolution diffusion tensor imaging of lumbosacral and sciatic nerves using a phase-corrected diffusion-prepared 3D turbo spin echo.

    Science.gov (United States)

    Cervantes, Barbara; Van, Anh T; Weidlich, Dominik; Kooijman, Hendrick; Hock, Andreas; Rummeny, Ernst J; Gersing, Alexandra; Kirschke, Jan S; Karampinos, Dimitrios C

    2018-08-01

    To perform in vivo isotropic-resolution diffusion tensor imaging (DTI) of lumbosacral and sciatic nerves with a phase-navigated diffusion-prepared (DP) 3D turbo spin echo (TSE) acquisition and modified reconstruction incorporating intershot phase-error correction and to investigate the improvement on image quality and diffusion quantification with the proposed phase correction. Phase-navigated DP 3D TSE included magnitude stabilizers to minimize motion and eddy-current effects on the signal magnitude. Phase navigation of motion-induced phase errors was introduced before readout in 3D TSE. DTI of lower back nerves was performed in vivo using 3D TSE and single-shot echo planar imaging (ss-EPI) in 13 subjects. Diffusion data were phase-corrected per k z plane with respect to T 2 -weighted data. The effects of motion-induced phase errors on DTI quantification was assessed for 3D TSE and compared with ss-EPI. Non-phase-corrected 3D TSE resulted in artifacts in diffusion-weighted images and overestimated DTI parameters in the sciatic nerve (mean diffusivity [MD] = 2.06 ± 0.45). Phase correction of 3D TSE DTI data resulted in reductions in all DTI parameters (MD = 1.73 ± 0.26) of statistical significance (P ≤ 0.001) and in closer agreement with ss-EPI DTI parameters (MD = 1.62 ± 0.21). DP 3D TSE with phase correction allows distortion-free isotropic diffusion imaging of lower back nerves with robustness to motion-induced artifacts and DTI quantification errors. Magn Reson Med 80:609-618, 2018. © 2018 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine. This is an open access article under the terms of the Creative Commons Attribution NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. © 2018 The Authors Magnetic Resonance

  6. Sciatica due to Schwannoma at the Sciatic Notch

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    Yavuz Haspolat

    2013-01-01

    Full Text Available Schwannomas are rarely seen on the sciatic nerve and can cause sciatica. In this case report we aimed to present an unusual location of schwannoma along sciatic nerve that causes sciatica. A 60-years-old-man was admitted to us with complaints of pain on his thigh and paresthesia on his foot. Radiography of the patient revealed a solitary lesion on the sciatic nerve. The lesion was excised and the symptoms resolved after surgery.

  7. Functional recovery after transection of the sciatic nerve at an early age : a pilot study in rats

    NARCIS (Netherlands)

    Meek, Marcel F.; IJkema-Paassen, Jos; Gramsbergen, Albert

    It is often clinically noted that peripheral nerve transections in infants and very young children seem to show better functional recovery after nerve repair compared with adult patients. There can be several reasons for this (e.g. outgrowing axons might have maintained their potential to locate

  8. Poly(ADP-ribosylation is present in murine sciatic nerve fibers and is altered in a Charcot-Marie-Tooth-1E neurodegenerative model

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    Laura I. Lafon Hughes

    2017-05-01

    Full Text Available Background Poly-ADP-ribose (PAR is a polymer synthesized by poly-ADP-ribose polymerases (PARPs as a postranslational protein modification and catabolized mainly by poly-ADP-ribose glycohydrolase (PARG. In spite of the existence of cytoplasmic PARPs and PARG, research has been focused on nuclear PARPs and PAR, demonstrating roles in the maintenance of chromatin architecture and the participation in DNA damage responses and transcriptional regulation. We have recently detected non-nuclear PAR structurally and functionally associated to the E-cadherin rich zonula adherens and the actin cytoskeleton of VERO epithelial cells. Myelinating Schwann cells (SC are stabilized by E-cadherin rich autotypic adherens junctions (AJ. We wondered whether PAR would map to these regions. Besides, we have demonstrated an altered microfilament pattern in peripheral nerves of Trembler-J (Tr-J model of CMT1-E. We hypothesized that cytoplasmic PAR would accompany such modified F-actin pattern. Methods Wild-type (WT and Tr-J mice sciatic nerves cryosections were subjected to immunohistofluorescence with anti-PAR antibodies (including antibody validation, F-actin detection with a phalloidin probe and DAPI/DNA counterstaining. Confocal image stacks were subjected to a colocalization highlighter and to semi-quantitative image analysis. Results We have shown for the first time the presence of PAR in sciatic nerves. Cytoplasmic PAR colocalized with F-actin at non-compact myelin regions in WT nerves. Moreover, in Tr-J, cytoplasmic PAR was augmented in close correlation with actin. In addition, nuclear PAR was detected in WT SC and was moderately increased in Tr-J SC. Discussion The presence of PAR associated to non-compact myelin regions (which constitute E-cadherin rich autotypic AJ/actin anchorage regions and the co-alterations experienced by PAR and the actin cytoskeleton in epithelium and nerves, suggest that PAR may be a constitutive component of AJ/actin anchorage

  9. A comparison of the onset time of complete blockade of the sciatic nerve in the application of ropivacaine and its equal volumes mixture with lidocaine: a double-blind randomized study.

    Science.gov (United States)

    Valery, Piacherski; Aliaksei, Marochkov

    2013-07-01

    The purpose of the current study is to create a new mixture of local anesthetics-one with a short time of block development and short action term (5 ml of 1% lidocaine solution) and another with a longer time of anesthesia development and a long analgetic effect (5 ml of 0.75% ropivacaine)-for use during surgical operations on extremities. The primary end point was the development of the complete sensory block of the sciatic nerve. Sixty blocks of sciatic nerve were used in a double-blind randomized research, under ultrasonic guidance, using an electric stimulator with the peripheral nerves. Sixty patients were divided into 3 equal groups. In the first group, a sciatic nerve block was performed with 5 ml of 0.75% ropivacaine solution (37.5 mg); in the second group, 10 ml of 0.75% ropivacaine solution (75 mg) was used and, in the third group, a mixture of 5 ml of 0.75% ropivacaine (as above) and 5 ml of 1% lidocaine solution (50 mg) was used. The assessment of the time required for developing sensory and motor blocks was carried out from the beginning of local anesthetic solution injection in the fascial sheath of the sciatic nerve. Demographic data of patients were identical in the three sample groups. The time required for achieving a complete motor and sensory block was reduced due to the mix of the 1% lidocaine solution with the 0.75% ropivacaine solution. The time required for achieving a complete sensory block in groups treated with 5 and 10 ml ropivacaine was 45 (40-48) and 30 (28-30) min, respectively, in contrast with 12 (10-13) min when the mixture of anesthetics was applied (P 0.05. The mixture of 5 ml of 1% lidocaine with 5 ml of 0.75% ropivacaine leads to a reduction in the time required for the development of complete sensory and motor blocks of the sciatic nerve, without reducing postoperative analgesia time.

  10. Workup and Management of Persistent Neuralgia following Nerve Block

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    Paul David Weyker

    2016-01-01

    Full Text Available Neurological injuries following peripheral nerve blocks are a relatively rare yet potentially devastating complication depending on the type of lesion, affected extremity, and duration of symptoms. Medical management continues to be the treatment modality of choice with multimodal nonopioid analgesics as the cornerstone of this therapy. We report the case of a 28-year-old man who developed a clinical common peroneal and lateral sural cutaneous neuropathy following an uncomplicated popliteal sciatic nerve block. Workup with electrodiagnostic studies and magnetic resonance neurography revealed injury to both the femoral and sciatic nerves. Diagnostic studies and potential mechanisms for nerve injury are discussed.

  11. Workup and Management of Persistent Neuralgia following Nerve Block.

    Science.gov (United States)

    Weyker, Paul David; Webb, Christopher Allen-John; Pham, Thoha M

    2016-01-01

    Neurological injuries following peripheral nerve blocks are a relatively rare yet potentially devastating complication depending on the type of lesion, affected extremity, and duration of symptoms. Medical management continues to be the treatment modality of choice with multimodal nonopioid analgesics as the cornerstone of this therapy. We report the case of a 28-year-old man who developed a clinical common peroneal and lateral sural cutaneous neuropathy following an uncomplicated popliteal sciatic nerve block. Workup with electrodiagnostic studies and magnetic resonance neurography revealed injury to both the femoral and sciatic nerves. Diagnostic studies and potential mechanisms for nerve injury are discussed.

  12. Morphological study on the pressure ulcer-like dermal lesions formed in the rat heel skin after transection of the sciatic nerves.

    Science.gov (United States)

    Haba, Daijiro; Minami, Chie; Miyagawa, Miki; Arakawa, Takamitsu; Miki, Akinori

    2017-01-01

    Due to transection of bilateral sciatic nerves, pressure ulcer-like dermal lesion occurred in the hairy skin covering of the heel skin in almost all rats. In the present study, chronological changes of the rat heel skin after the transection were morphologically and immunohistochemically examined. In the heel skin, redness and swelling began by 3days after the operation, and open wound formed by 17days. At the redness and swelling stage, edema extensively occurred in the dermis. At the thickening stage, the epidermis at the pressed site became transiently thicker, and at the whitening stage, rapidly thinner. At these stages, the epidermis in the skin surrounding the pressed site became gradually thicker. At the yellow scar stage, the skin was covered only by necrotic tissues and horny layer. These layers were scratched during walking and turning, and the yellow scar stage became the open wound stage. Inflammatory reaction began at the thickening stage, and at the yellow scar and open wound stages, necrosis, infiltration of inflammatory cells and dilation of small blood vessels were observed. These morphological features are quite similar to those in the human pressure ulcer. These findings suggest that these dermal injuries could compare the human pressure ulcer for medical treatment and depressurization in future study. Copyright © 2016 Elsevier GmbH. All rights reserved.

  13. Neuropathic pain in rats with a partial sciatic nerve ligation is alleviated by intravenous injection of monoclonal antibody to high mobility group box-1.

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    Yoki Nakamura

    Full Text Available High mobility group box-1 (HMGB1 is associated with the pathogenesis of inflammatory diseases. A previous study reported that intravenous injection of anti-HMGB1 monoclonal antibody significantly attenuated brain edema in a rat model of stroke, possibly by attenuating glial activation. Peripheral nerve injury leads to increased activity of glia in the spinal cord dorsal horn. Thus, it is possible that the anti-HMGB1 antibody could also be efficacious in attenuating peripheral nerve injury-induced pain. Following partial sciatic nerve ligation (PSNL, rats were treated with either anti-HMGB1 or control IgG. Intravenous treatment with anti-HMGB1 monoclonal antibody (2 mg/kg significantly ameliorated PSNL-induced hind paw tactile hypersensitivity at 7, 14 and 21 days, but not 3 days, after ligation, whereas control IgG had no effect on tactile hypersensitivity. The expression of HMGB1 protein in the spinal dorsal horn was significantly increased 7, 14 and 21 days after PSNL; the efficacy of the anti-HMGB1 antibody is likely related to the presence of HMGB1 protein. Also, the injury-induced translocation of HMGB1 from the nucleus to the cytosol occurred mainly in dorsal horn neurons and not in astrocytes and microglia, indicating a neuronal source of HMGB1. Markers of astrocyte (glial fibrillary acidic protein (GFAP, microglia (ionized calcium binding adaptor molecule 1 (Iba1 and spinal neuron (cFos activity were greatly increased in the ipsilateral dorsal horn side compared to the sham-operated side 21 days after PSNL. Anti-HMGB1 monoclonal antibody treatment significantly decreased the injury-induced expression of cFos and Iba1, but not GFAP. The results demonstrate that nerve injury evokes the synthesis and release of HMGB1 from spinal neurons, facilitating the activity of both microglia and neurons, which in turn leads to symptoms of neuropathic pain. Thus, the targeting of HMGB1 could be a useful therapeutic strategy in the treatment of chronic

  14. Effects of sciatic nerve transection on glucose uptake in the presence and absence of lactate in the frog dorsal root ganglia and spinal cord

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    F Rigon

    Full Text Available Frogs have been used as an alternative model to study pain mechanisms because the simplicity of their nervous tissue and the phylogenetic aspect of this question. One of these models is the sciatic nerve transection (SNT, which mimics the clinical symptoms of “phantom limb”, a condition that arises in humans after amputation or transverse spinal lesions. In mammals, the SNT increases glucose metabolism in the central nervous system, and the lactate generated appears to serve as an energy source for nerve cells. An answerable question is whether there is elevated glucose uptake in the dorsal root ganglia (DRG after peripheral axotomy. As glucose is the major energy substrate for frog nervous tissue, and these animals accumulate lactic acid under some conditions, bullfrogs Lithobates catesbeianus were used to demonstrate the effect of SNT on DRG and spinal cord 1-[14C] 2-deoxy-D-glucose (14C-2-DG uptake in the presence and absence of lactate. We also investigated the effect of this condition on the formation of 14CO2 from 14C-glucose and 14C-L-lactate, and plasmatic glucose and lactate levels. The 3-O-[14C] methyl-D-glucose (14C-3-OMG uptake was used to demonstrate the steady-state tissue/medium glucose distribution ratio under these conditions. Three days after SNT, 14C-2-DG uptake increased, but 14C-3-OMG uptake remained steady. The increase in 14C-2-DG uptake was lower when lactate was added to the incubation medium. No change was found in glucose and lactate oxidation after SNT, but lactate and glucose levels in the blood were reduced. Thus, our results showed that SNT increased the glucose metabolism in the frog DRG and spinal cord. The effect of lactate on this uptake suggests that glucose is used in glycolytic pathways after SNT.

  15. Treatment with Riluzole Restores Normal Control of Soleus and Extensor Digitorum Longus Muscles during Locomotion in Adult Rats after Sciatic Nerve Crush at Birth.

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    Zmysłowski, Wojciech; Cabaj, Anna M; Sławińska, Urszula

    2017-01-01

    The effects of sciatic nerve crush (SNC) and treatment with Riluzole on muscle activity during unrestrained locomotion were identified in an animal model by analysis of the EMG activity recorded from soleus (Sol) and extensor digitorum longus (EDL) muscles of both hindlimbs; in intact rats (IN) and in groups of rats treated for 14 days with saline (S) or Riluzole (R) after right limb nerve crush at the 1st (1S and 1R) or 2nd (2S and 2R) day after birth. Changes in the locomotor pattern of EMG activity were correlated with the numbers of survived motor units (MUs) identified in investigated muscles. S rats with 2-8 and 10-28 MUs that survived in Sol and EDL muscles respectively showed increases in the duration and duty factor of muscle EMG activity and a loss of correlation between the duty factors of muscle activity, and abnormal flexor-extensor co-activation 3 months after SNC. R rats with 5, 6 (Sol) and 15-29 MUs (EDL) developed almost normal EMG activity of both Sol and control EDL muscles, whereas EDL muscles with SNC showed a lack of recovery. R rats with 8 (Sol) and 23-33 (EDL) MUs developed almost normal EMG activities of all four muscles. A subgroup of S rats with a lack of recovery and R rats with almost complete recovery that had similar number of MUs (8 and 24-28 vs 8 and 23-26), showed that the number of MUs was not the only determinant of treatment effectiveness. The results demonstrated that rats with SNC failed to develop normal muscle activity due to malfunction of neuronal circuits attenuating EDL muscle activity during the stance phase, whereas treatment with Riluzole enabled almost normal EMG activity of Sol and EDL muscles during locomotor movement.

  16. Treatment with Riluzole Restores Normal Control of Soleus and Extensor Digitorum Longus Muscles during Locomotion in Adult Rats after Sciatic Nerve Crush at Birth.

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    Wojciech Zmysłowski

    Full Text Available The effects of sciatic nerve crush (SNC and treatment with Riluzole on muscle activity during unrestrained locomotion were identified in an animal model by analysis of the EMG activity recorded from soleus (Sol and extensor digitorum longus (EDL muscles of both hindlimbs; in intact rats (IN and in groups of rats treated for 14 days with saline (S or Riluzole (R after right limb nerve crush at the 1st (1S and 1R or 2nd (2S and 2R day after birth. Changes in the locomotor pattern of EMG activity were correlated with the numbers of survived motor units (MUs identified in investigated muscles. S rats with 2-8 and 10-28 MUs that survived in Sol and EDL muscles respectively showed increases in the duration and duty factor of muscle EMG activity and a loss of correlation between the duty factors of muscle activity, and abnormal flexor-extensor co-activation 3 months after SNC. R rats with 5, 6 (Sol and 15-29 MUs (EDL developed almost normal EMG activity of both Sol and control EDL muscles, whereas EDL muscles with SNC showed a lack of recovery. R rats with 8 (Sol and 23-33 (EDL MUs developed almost normal EMG activities of all four muscles. A subgroup of S rats with a lack of recovery and R rats with almost complete recovery that had similar number of MUs (8 and 24-28 vs 8 and 23-26, showed that the number of MUs was not the only determinant of treatment effectiveness. The results demonstrated that rats with SNC failed to develop normal muscle activity due to malfunction of neuronal circuits attenuating EDL muscle activity during the stance phase, whereas treatment with Riluzole enabled almost normal EMG activity of Sol and EDL muscles during locomotor movement.

  17. Origem e distribuição do nervo isquiático no veado-catingueiro (Mazama gouazoubira Origin and distribution of the sciatic nerve in catingueiro-deer (Mazama gouazoubira

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    Tracy Martina M. Martins

    2013-02-01

    úteo superficial, gluteobíceps, bíceps da coxa, semitendinoso, semimembranoso, adutor e gastrocnêmio. Distalmente o nervo isquiático bifurca-se Em nervo tibial e fibular comum, os quais inervam a porção distal do membro pélvico.This study aimed to describe the origin and distribution of the sciatic nerve in catingueiro-deer (Mazama gouazoubira. Two animals of the species, obtained post mortem by trampling on the highway, were used for the study meeting the requirements of the Governing Law (1.153/95. By dissection the skin was completely removed and the animals were fixed in aqueous 10% formaldehyde solution. Through dorsolateral access, superficial gluteal muscle, biceps femoris muscle and gluteus medius muscle were cut at their insertion and folded, to view the origin and distribution of the sciatic nerve on both sides of the animals. Images were recorded with a digital camera (Sony a200 Camera, 10.2mpx and results were described based on Veterinary Anatomical Nomina. The source data of the sciatic nerve in both specimens showed that the nerve originates from the ventral branches of S1 and L6, and could have contribution from S2. After its emergence through the greater sciatic foramen on both the sides, the sciatic nerve supplies branches to gluteus medius muscle, gluteus deep muscle, superficial gluteal muscle, gluteobiceps muscle, biceps femoris muscle, semimembranosus muscle, semitendinosus muscle and gastrocnemius muscle. Near the mid-thigh the sciatic nerve divides into the tibial nerve and common peroneal nerve which innervate the muscles of the distal hind limb. Moreover, the cutaneous nerve flow can cause the common peroneal nerve or tibial nerve. In conclusion, in Mazama gouazoubira specimens studied, the sciatic nerve originated from the ventral branch of spinal L6 and S1, which may or may not have the contribution from S2. In its distribution stem originate the gluteal nerve, the caudal femoral cutaneous nerve and muscular branches, which together innervate the

  18. Malignant Triton Tumor of the Sciatic Nerve as a Secondary Malignancy after Extended Field Radiotherapy and Chemotherapy of Hodgkin's Disease

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    Mirko Nitsche

    2014-03-01

    Full Text Available Late effects of therapy for Hodgkin's disease include secondary malignancies like leukemia, lymphoma or solid tumors developing after long periods of latency. Ionizing radiation often causes the last group. The highest risks have been described for induced breast and lung cancers. We are the first to report a malignant triton tumor (MTT as a secondary malignancy after radiotherapy and chemotherapy for Hodgkin's lymphoma. MTT is a very rare subtype of malignant peripheral nerve sheath tumors with rhabdomyoblastic differentiation and an aggressive course of disease.

  19. Methylcobalamin promotes the differentiation of Schwann cells and remyelination in lysophosphatidylcholine-induced demyelination of the rat sciatic nerve

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    Shunsuke eNishimoto

    2015-08-01

    Full Text Available Schwann cells (SCs are constituents of the peripheral nervous system. The differentiation of SCs in injured peripheral nerves is critical for regeneration after injury. Methylcobalamin (MeCbl is a vitamin B12 analog that is necessary for the maintenance of the peripheral nervous system. In this study, we estimated the effect of MeCbl on SCs. We showed that MeCbl downregulated the activity of Erk1/2 and promoted the expression of the myelin basic protein in SCs. In a dorsal root ganglion neuron–SC coculture system, myelination was promoted by MeCbl. In a focal demyelination rat model, MeCbl promoted remyelination and motor and sensory functional regeneration. MeCbl promoted the in vitro differentiation of SCs and in vivo myelination in a rat demyelination model and may be a novel therapy for several types of nervous disorders.

  20. Effects of systemic administration of ciliary neurotrophic factor on Bax and Bcl-2 proteins in the lumbar spinal cord of neonatal rats after sciatic nerve transection

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    A.C.S. Rezende

    2008-11-01

    Full Text Available Ciliary neurotrophic factor (CNTF is a cytokine that plays a neuroprotective role in relation to axotomized motoneurons. We determined the effect of daily subcutaneous doses of CNTF (1.2 µg/g for 5 days; N = 13 or PBS (N = 13 on the levels of mRNA for Bcl-2 and Bax, as well as the expression and inter-association of Bcl-2 and Bax proteins, and the survival of motoneurons in the spinal cord lumbar enlargement of 2-day-old Wistar rats after sciatic nerve transection. Five days after transection, the effects were evaluated on histological and molecular levels using Nissl staining, immunoprecipitation, Western blot analysis, and reverse transcriptase-polymerase chain reaction. The motoneuron survival ratio, defined as the ratio between the number of motoneurons counted on the lesioned side vs those on the unlesioned side, was calculated. This ratio was 0.77 ± 0.02 for CNTF-treated rats vs 0.53 ± 0.02 for the PBS-treated controls (P < 0.001. Treatment with CNTF modified the level of mRNA, with the expression of Bax RNA decreasing 18% (with a consequent decrease in the level of Bax protein, while the expression of Bcl-2 RNA was increased 87%, although the level of Bcl-2 protein was unchanged. The amount of Bcl-2/Bax heterodimer increased 91% over that found in the PBS-treated controls. These data show, for the first time, that the neuroprotective effect of CNTF on neonatal rat axotomized motoneurons is associated with a reduction in free Bax, due to the inhibition of Bax expression, as well as increased Bcl-2/Bax heterodimerization. Thus, the neuroprotective action of the CNTF on axotomized motoneurons can be related to the inhibition of this apoptotic pathway.

  1. Toward a Broader View of Ube3a in a Mouse Model of Angelman Syndrome: Expression in Brain, Spinal Cord, Sciatic Nerve and Glial Cells.

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    Mark D Grier

    Full Text Available Angelman Syndrome (AS is a devastating neurodevelopmental disorder characterized by developmental delay, speech impairment, movement disorder, sleep disorders and refractory epilepsy. AS is caused by loss of the Ube3a protein encoded for by the imprinted Ube3a gene. Ube3a is expressed nearly exclusively from the maternal chromosome in mature neurons. While imprinting in neurons of the brain has been well described, the imprinting and expression of Ube3a in other neural tissues remains relatively unexplored. Moreover, given the overwhelming deficits in brain function in AS patients, the possibility of disrupted Ube3a expression in the infratentorial nervous system and its consequent disability have been largely ignored. We evaluated the imprinting status of Ube3a in the spinal cord and sciatic nerve and show that it is also imprinted in these neural tissues. Furthermore, a growing body of clinical and radiological evidence has suggested that myelin dysfunction may contribute to morbidity in many neurodevelopmental syndromes. However, findings regarding Ube3a expression in non-neuronal cells of the brain have varied. Utilizing enriched primary cultures of oligodendrocytes and astrocytes, we show that Ube3a is expressed, but not imprinted in these cell types. Unlike many other neurodevelopmental disorders, AS symptoms do not become apparent until roughly 6 to 12 months of age. To determine the temporal expression pattern and silencing, we analyzed Ube3a expression in AS mice at several time points. We confirm relaxed imprinting of Ube3a in neurons of the postnatal developing cortex, but not in structures in which neurogenesis and migration are more complete. This furthers the hypothesis that the apparently normal window of development in AS patients is supported by an incompletely silenced paternal allele in developing neurons, resulting in a relative preservation of Ube3a expression during this crucial epoch of early development.

  2. Insulin and the insulin-like growth factors I and II are mitogenic to cultured rat sciatic nerve segments and stimulate [3H]thymidine incorporation through their respective receptors

    DEFF Research Database (Denmark)

    Svenningsen, Åsa Fex; Kanje, M

    1996-01-01

    , on [3H]thymidine incorporation into cultured nerve segments from the rat sciatic nerve. Segments cultured in nM (0.1-1.7 nM) concentrations of insulin, truncated IGF-I (tIGF-I), long R3IGF-I, or IGF-II exhibited an increase in [3H]thymidine incorporation compared with control segments. IGF-II was most...... potent. JB1, an IGF-I antagonist, counteracted the effects of tIGF-I and insulin. The results suggest that non-neuronal cells in the nerve segment, probably Schwann cells, possess distinct receptors for insulin, IGF-I, and IGF-II and that these receptors may be involved in the control of Schwann cell...

  3. Investigations into the analysis of the rate of decay of the compound action potentials recorded from the rat sciatic nerve after death: significance for the prediction of the post-mortem period.

    Science.gov (United States)

    Nokes, L D; Daniel, D; Flint, T; Barasi, S

    1991-01-01

    There have been a number of papers that have reported the investigations of electrical stimulation of muscle groups in order to determine the post-mortem period. To the authors knowledge, no techniques have been described that analyse the compound action potentials (CAP) of various nerve fibre groups after death. This paper reports the monitoring of both the amplitude and latency changes of the CAP recorded from a stimulated rat sciatic nerve after death. Initial results suggest that the method my be useful in determining the early post-mortem period within 1 or 2 h after death. It may also be of use in measuring nerve conduction delay in various pathological conditions that can affect the neural network; for example diabetes.

  4. Treating intractable phantom limb pain with ambulatory continuous peripheral nerve blocks: a pilot study.

    Science.gov (United States)

    Ilfeld, Brian M; Moeller-Bertram, Tobias; Hanling, Steven R; Tokarz, Kyle; Mariano, Edward R; Loland, Vanessa J; Madison, Sarah J; Ferguson, Eliza J; Morgan, Anya C; Wallace, Mark S

    2013-06-01

    There is currently no reliable treatment for phantom limb pain (PLP). Chronic PLP and associated cortical abnormalities may be maintained from abnormal peripheral input, raising the possibility that a continuous peripheral nerve block (CPNB) of extended duration may permanently reorganize cortical pain mapping, thus providing lasting relief. Three men with below-the-knee (2) or -elbow (1) amputations and intractable PLP received femoral/sciatic or infraclavicular perineural catheter(s), respectively. Subjects were randomized in a double-masked fashion to receive perineural ropivacaine (0.5%) or normal saline for over 6 days as outpatients using portable electronic infusion pumps. Four months later, subjects returned for repeated perineural catheter insertion and received an ambulatory infusion with the alternate solution ("crossover"). Subjects were followed for up to 1 year. By chance, all three subjects received saline during their initial infusion and reported little change in their PLP. One subject did not receive crossover treatment, but the remaining two subjects reported complete resolution of their PLP during and immediately following treatment with ropivacaine. One subject experienced no PLP recurrence through the 52-week follow-up period and the other reported mild PLP occurring once each week of just a small fraction of his original pain (pretreatment: continuous PLP rated 10/10; posttreatment: no PLP at baseline with average of one PLP episode each week rated 2/10) for 12 weeks (lost to follow-up thereafter). A prolonged ambulatory CPNB may be a reliable treatment for intractable PLP. The results of this pilot study suggest that a large, randomized clinical trial is warranted. Wiley Periodicals, Inc.

  5. Macrophage presence is essential for the regeneration of ascending afferent fibres following a conditioning sciatic nerve lesion in adult rats

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    Smith Malcolm

    2011-01-01

    Full Text Available Abstract Background Injury to the peripheral branch of dorsal root ganglia (DRG neurons prior to injury to the central nervous system (CNS DRG branch results in the regeneration of the central branch. The exact mechanism mediating this regenerative trigger is not fully understood. It has been proposed that following peripheral injury, the intraganglionic inflammatory response by macrophage cells plays an important role in the pre-conditioning of injured CNS neurons to regenerate. In this study, we investigated whether the presence of macrophage cells is crucial for this type of regeneration to occur. We used a clodronate liposome technique to selectively and temporarily deplete these cells during the conditioning phase of DRG neurons. Results Retrograde and anterograde tracing results indicated that in macrophage-depleted animals, the regenerative trigger characteristic of pre-conditioned DRG neurons was abolished as compared to injury matched-control animals. In addition, depletion of macrophage cells led to: (i a reduction in macrophage infiltration into the CNS compartment even after cellular repopulation, (ii astrocyte up-regulation at rostral regions and down-regulation in brain derived neurotrophic factor (BDNF concentration in the serum. Conclusion Activation of macrophage cells in response to the peripheral nerve injury is essential for the enhanced regeneration of ascending sensory neurons.

  6. Adenovirus vector-mediated ex vivo gene transfer of brain-derived neurotrophic factor (BDNF) tohuman umbilical cord blood-derived mesenchymal stem cells (UCB-MSCs) promotescrush-injured rat sciatic nerve regeneration.

    Science.gov (United States)

    Hei, Wei-Hong; Almansoori, Akram A; Sung, Mi-Ae; Ju, Kyung-Won; Seo, Nari; Lee, Sung-Ho; Kim, Bong-Ju; Kim, Soung-Min; Jahng, Jeong Won; He, Hong; Lee, Jong-Ho

    2017-03-16

    This study was designed toinvestigate the efficacy of adenovirus vector-mediated brain-derived neurotrophic factor (BDNF) ex vivo gene transfer to human umbilical cord blood-derived mesenchymal stem cells (UCB-MSCs) in a rat sciatic nerve crush injury model. BDNF protein and mRNA expression after infection was checked through an enzyme-linked immunosorbent assay (ELISA) and quantitative real-time polymerase chain reaction (qRT-PCR). Male Sprague-Dawley rats (200-250g, 6 weeks old) were distributed into threegroups (n=20 each): the control group, UCB-MSC group, and BDNF-adenovirus infected UCB-MSC (BDNF-Ad+UCB-MSC) group. UCB-MSCs (1×10 6 cells/10μl/rat) or BDNF-Ad+UCB-MSCs (1×10 6 cells/10μl/rat)were transplantedinto the rats at the crush site immediately after sciatic nerve injury. Cell tracking was done with PKH26-labeled UCB-MSCs and BDNF-Ad+UCB-MSCs (1×10 6 cells/10μl/rat). The rats were monitored for 4 weeks post-surgery. Results showed that expression of BDNF at both the protein and mRNA levels was higher inthe BDNF-Ad+UCB-MSC group compared to theUCB-MSC group in vitro.Moreover, BDNF mRNA expression was higher in both UCB-MSC group and BDNF-Ad+ UCB-MSC group compared tothe control group, and BDNF mRNA expression in theBDNF-Ad+UCB-MSC group was higher than inboth other groups 5days after surgeryin vivo. Labeled neurons in the dorsal root ganglia (DRG), axon counts, axon density, and sciatic function index were significantly increased in the UCB-MSC and BDNF-Ad+ UCB-MSCgroupscompared to the controlgroup four weeksaftercell transplantation. Importantly,the BDNF-Ad+UCB-MSCgroup exhibited more peripheral nerve regeneration than the other two groups.Our results indicate thatboth UCB-MSCs and BDNF-Ad+UCB-MSCscan improve rat sciatic nerve regeneration, with BDNF-Ad+UCB-MSCsshowing a greater effectthan UCB-MSCs. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. A novel concept for continuous peripheral nerve blocks. Presentation of a new ultrasound-guided device.

    Science.gov (United States)

    Rothe, C; Steen-Hansen, C; Madsen, M H; Lange, K H W

    2015-02-01

    Existing techniques for placing and maintaining the position of peripheral nerve catheters are associated with variable success rates and frequent secondary failures. These factors may affect the clinical efficacy and usefulness of peripheral nerve catheters. We developed a new concept and prototype for ultrasound-guided in-plane positioning and readjustment of peripheral nerve catheters (patent pending). The integrated catheter-needle prototype comprises three parts: a curved needle, a catheter with clear echogenic markings attached to the needle tail and a detachable hub allowing injection of local anesthetic while advancing the needle in the tissue. The system works like a suture and is introduced through the skin, passes in close relation to the nerve and exits through the skin. This allows in-plane ultrasound guidance throughout the procedure both during initial positioning as well as during later in-plane readjustment of the catheter. We tested the system in the popliteal region of two fresh cadavers in a preliminary proof of concept study. Both initial placement and secondary readjustment were precise, judged by the catheter orifices placed close to the sciatic nerve in the popliteal fossa. Circumferential spread of 3-ml isotonic saline around the sciatic nerve was observed on ultrasound images in both conditions. Preliminary proof of concept of this novel method demonstrates that precise in-plane ultrasound-guided initial placement and secondary in-plane readjustment is possible in fresh cadavers. Future studies should address the clinical efficacy and usefulness of this novel concept. © 2014 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  8. Contribution of myelunated fibers from spinal L4, L5 and L6 nerves to the sciatic nerve and its main branches in the adult rat Contribución de fibras mielínicas provenientes de los nervios espinales lumbares L4, L5 y L6 al nervio ciático de rata adulta y sus ramas principales

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    Juan D. Robles

    2000-04-01

    Full Text Available The rat sciatic nerve is composed by the L4, L5 and L6 lumbar spinal nerves. However, the contribution in myelinated fibers originating from these nerves along this nervous trunk has not yet been defined. In the present study, the L4, L5 and L4-L5 spinal nerves were selectively transected. After one week the sciatic, tibial, sural and peroneal nerves were dissected. These samples were fixed and processed for optical microscopy, and both degenerated and normal myelinated fibers were counted in toluidine blue-stained semi-thin sections. L4 contributed with myelinated fibers mainly to the peroneal nerve, and L5 to the sciatic, tibial and sural nerves. In general, the contribution of L6 was smaller and variable along the nervous trunk in comparison to the other two spinal branches. Our results give key information for further studies looking to correlate the contribution of spinal nerves making part of the sciatic nerve and its main branches with hind limb function. El nervio ciático de la rata está formado por los nervios espinales (ne lumbares L4, L5 y L6. Sin embargo, aún no se ha definido el aporte en fibras mielínicas de estos nervios espinales a lo largo del tronco nervioso. En este estudio se transectaron selectivamente los NE L4, L5 y L4-L5. Luego de una semana se disecaron los nervios ciático, tibial, sural y peroneal. Estas muestras se fijaron y procesaron para microscopía óptica y a partir de cortes coloreados con azul de toluidina se contaron las fibras mielínicas degeneradas y normales. L4 contribuyó con fibras mielínicas principalmente al nervio peroneal y L5 a los nervios ciático, tibial y sural. En general, el aporte de L6 fue menor y variable a lo largo del tronco nervioso comparado con las otras dos ramas espinales. Nuestros resultados brindan información valiosa para posteriores estudios que busquen correlacionar la contribución de los nervios espinales que componen el ciático y sus ramas principales con la funci

  9. The effect of exercise frequency on neuropathic pain and pain-related cellular reactions in the spinal cord and midbrain in a rat sciatic nerve injury model

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    Sumizono M

    2018-02-01

    Full Text Available Megumi Sumizono,1,2 Harutoshi Sakakima,1 Shotaro Otsuka,1 Takuto Terashi,1 Kazuki Nakanishi,1,2 Koki Ueda,1,2 Seiya Takada,1,2 Kiyoshi Kikuchi3 1Course of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima, Japan; 2Kirishima Orthopedics, Kirishima, Japan; 3Division of Brain Science, Department of Physiology, Kurume University School of Medicine, Kurume, Japan Background: Exercise regimens are established methods that can relieve neuropathic pain. However, the relationship between frequency and intensity of exercise and multiple cellular responses of exercise-induced alleviation of neuropathic pain is still unclear. We examined the influence of exercise frequency on neuropathic pain and the intracellular responses in a sciatic nerve chronic constriction injury (CCI model. Materials and methods: Rats were assigned to four groups as follows: CCI and high-frequency exercise (HFE group, CCI and low-frequency exercise (LFE group, CCI and no exercise (No-Ex group, and naive animals (control group. Rats ran on a treadmill, at a speed of 20 m/min, for 30 min, for 5 (HFE or 3 (LFE days a week, for a total of 5 weeks. The 50% withdrawal threshold was evaluated for mechanical sensitivity. The activation of glial cells (microglia and astrocytes, expression of brain-derived neurotrophic factor (BDNF and μ-opioid receptor in the spinal dorsal horn and endogenous opioid in the midbrain were examined using immunohistochemistry. Opioid receptor antagonists (naloxone were administered using intraperitoneal injection. Results: The development of neuropathic pain was related to the activation of glial cells, increased BDNF expression, and downregulation of the μ-opioid receptor in the ipsilateral spinal dorsal horn. In the No-Ex group, neuropathic pain showed the highest level of mechanical hypersensitivity at 2 weeks, which improved slightly until 5 weeks after CCI. In both exercise groups, the alleviation of

  10. Newer N-phthaloyl GABA derivatives with antiallodynic and antihyperalgesic activities in both sciatic nerve and spinal nerve ligation models of neuropathic pain.

    Science.gov (United States)

    Yogeeswari, Perumal; Ragavendran, Jegadeesan Vaigunda; Sriram, Dharmarajan; Kavya, Ramkumar; Vanitha, Kaliappan; Neelakantan, Harshini

    2008-01-01

    There is considerable research evidence supporting a palliative role for gamma-aminobutyric acid (GABA)-ergic neurotransmission and voltage-gated sodium channel blockade in neuropathic pain conditions. Hence, the present study was undertaken to assess the peripheral analgesic, antiallodynic and antihyperalgesic activities of the synthesized structural analogues of GABA. The screening study included acute tissue injury, chronic constriction injury (CCI), and spinal nerve ligation (SNL) models of neuropathic pain. All of the tested compounds sup-pressed the acetic acid-induced writhing response significantly in comparison to the control. In particular, compound JVP-8 was observed to be the most active compound with percent inhibition greater than that of the standard drug aspirin (97.8% inhibition of writhing response as against 97.0% shown by aspirin). In neuropathic pain studies, compound JVP-5 (100 mg/kg i.p.) emerged as the most active compound affording maximum protection against dynamic allodynia and mechanical hyperalgesia in the CCI model, and against spontaneous pain and mechanical hyperalgesia in SNL rats. In this study, we have demonstrated that combining phthalimide pharmacophore with GABA has evolved compounds effective for the treatment of neuropathic pain. (c) 2008 S. Karger AG, Basel.

  11. Disuse Induced Changes in the Cholinergic System of Sciatic Nerve and Slow and Fast Twitch Muscle of Rats

    Science.gov (United States)

    Dettbarn, W. D.; Gupta, R. C.; Misulis, K. E.

    1985-01-01

    Hindlimb suspension was used as a model of disuse in experiments studing the effects of reduced muscle activity on AChE and its molecular forms, choline acetyltransferase and nicotinic receptor binding in innervated slow and fast muscle. The weight of SOL was reduced to 64% within one week and continued to decrease progressively up to the third week when the weight was reduced to 40% as compared to controls. EDL showed a significant decrease in its weight only at the end of three weeks hypokinesia when it was reduced to 71% of control. Biochemical and histochemical findings are summarized. From these data and from morphological findings it is evident that some properties of skeletal muscles are strongly dependent on patterns and level of loadbearing and on motor unit activiy. With suspension-induced disuse, the usually slow SOL appeared to change its characteristics such as fiber type distribution and AChE activity to one that more resembled a faster muscle. It is important to note that hypokinesia induced changes either physiological, biochemical or morphological, are totally reversible as the induced changes returned to control levels within a week after cessation of disuse.

  12. The Study of Effects of Aqueous and Alcoholic Extracts of Portulaca oleracea Leaves on NT3 Gene Expression in Degeneration of Alpha Neurons after Sciatic Nerve Compression in Rats

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    Shokoufe Hejazi

    2017-03-01

    Full Text Available Abstract Background: The injuries of peripheral nervous system cause the death of a number of motor cells of the spinal cord. Neurotrophins family genes such as NT3 involve in neuronal survive after nerve injury and their expression changes after it. With due attention to the expansion of portulaca pleracea in the world study was conducted to determine the effects of alcoholic and aqueous extracts of Potulaca oleracea on the NT3 gene expression after sciatic nerve compression in rat. Materials and Methods: This study was performed on 88 male wistar rats that randomly were divided in 13 groups of 6 each. They consisted of control group, 4 compression groups (The sciatic nerve was compressed with locker pincer and 8 treatment groups: compression + treatment with dose of 75 mg/kg of alcoholic and aqueous extract of Portulaca oleracea on days 1 and 7 (never compression was done on the first day. In all groups, Total RNA was extracted from the lumbar spinal cord segment in 1, 7, 14, 28 days and cDNA was synthesized, then NT3 expression changes were compared in groups. Results: There was a significant increase in NT3 gene expression in the compression group compared to control (p<0.001. The NT3 gene expression shows significant increase (p<0.05 in the treatment groups with alcoholic extract (except 1& 28 days. Also, there was no significant difference in gene expression between treatment group with acqueous extract and compression group in 1 and 7 days. A significant decrease was seen in the treatment groups with aqueous extract of purslane compared to compression (p<0.05. The NT3 gene expression shows significant increase in the treatment groups with alcoholic extract compared to treatment groups with aqueous extract in all days (p<0.05. Conclusion: The results reveal the Portulaca oleracea leaves extracts increase the NT3 gene expression after sciatic nerve injury. This effect is more in alcoholic extract than aqueous extract.

  13. Treating Intractable Post Amputation Phantom Limb Pain with Ambulatory Continuous Peripheral Nerve Blocks

    Science.gov (United States)

    2018-01-01

    Award Number: W81XWH-13-2-0009 TITLE: Treating Intractable Post-Amputation Phantom Limb Pain with Ambulatory Continuous Peripheral Nerve Blocks...26 Dec 2016 – 25 Dec 2017 4. TITLE AND SUBTITLE Treating Intractable Post-Amputation Phantom Limb Pain with Ambulatory Continuous Peripheral Nerve...trial to determine if ambulatory continuous peripheral nerve block (CPNB) is an effective treatment for intractable phantom limb pain following a

  14. A comparison of the pharmacodynamics and pharmacokinetics of bupivacaine, ropivacaine (with epinephrine) and their equal volume mixtures with lidocaine used for femoral and sciatic nerve blocks: a double-blind randomized study.

    Science.gov (United States)

    Cuvillon, Philippe; Nouvellon, Emmanuel; Ripart, Jacques; Boyer, Jean-Christophe; Dehour, Laurence; Mahamat, Aba; L'hermite, Joel; Boisson, Christophe; Vialles, Nathalie; Lefrant, Jean Yves; de La Coussaye, Jean Emmanuel

    2009-02-01

    Mixtures of lidocaine with a long-acting local anesthetic are commonly used for peripheral nerve block. Few data are available regarding the safety, efficacy, or pharmacokinetics of mixtures of local anesthetics. In the current study, we compared the effects of bupivacaine 0.5% or ropivacaine 0.75% alone or in a mixed solution of equal volumes of bupivacaine 0.5% and lidocaine 2% or ropivacaine 0.75% and lidocaine 2% for surgery after femoral-sciatic peripheral nerve block. The primary end point was onset time. In a double-blind, randomized study, 82 adults scheduled for lower limb surgery received a sciatic (20 mL) and femoral (20 mL) peripheral nerve block with 0.5% bupivacaine (200 mg), a mixture of 0.5% bupivacaine 20 mL (100 mg) with 2% lidocaine (400 mg), 0.75% ropivacaine (300 mg) or a mixture of 0.75% ropivacaine 20 mL (150 mg) with 2% lidocaine (400 mg). Each solution contained epinephrine 1:200,000. Times to perform blocks, onset times (end of injection to complete sensory and motor block), duration of sensory and motor block, and morphine consumption via IV patient-controlled analgesia were compared. Venous blood samples of 5 mL were collected for determination of drug concentration at 0, 5, 15, 30, 45, 60, and 90 min after placement of the block. Patient demographics and surgical times were similar for all four groups. Sciatic onset times (sensory and motor block) were reduced by combining lidocaine with the long-acting local anesthetic. The onset of bupivacaine-lidocaine was 16 +/- 9 min versus 28 +/- 12 min for bupivacaine alone. The onset of ropivacaine-lidocaine was 16 +/- 12 min versus 23 +/- 12 for ropivacaine alone. Sensory blocks were complete for all patients within 40 min for those receiving bupivacaine-lidocaine versus 60 min for those receiving bupivacaine alone and 30 min for those receiving ropivacaine-lidocaine versus 40 min for those receiving ropivacaine alone (P block was significantly shorter in mixture groups. There was no difference

  15. Acute sciatic neuropathy: "Saturday night palsy"

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    Manigoda Miodrag

    2005-01-01

    Full Text Available This is a case report of 25-year old, unemployed male, admitted to hospital due to acute onset of the left foot drop, subsequent walking difficulty and numbness of the left calf and foot. Symptoms began after prolonged sleep with previous heroin abuse by sniffing. During neurological examination, mild weakness of knee flexors, moderate weakness of plantar flexors and paralysis of foot dorsiflexors, together with hypesthesia of the left calf, foot and fingers, predominantly in the innervation area of common peroneal nerve on the same side, were observed. The electrophysiologic examination revealed predominant involvement of peroneal division within the sciatic nerve, together with recorded conduction block indicating the compression as possible mechanism of nerve injury. The patient was administered corticosteroid therapy during two months, what resulted in almost complete recovery. The peculiarity of this case report is in the presence of the sciatic nerve "Saturday night palsy" with possible effect of former heroin abuse.

  16. Ultrasound and nerve stimulator guided continuous femoral nerve block analgesia after total knee arthroplasty: a multicenter randomized controlled study

    Directory of Open Access Journals (Sweden)

    Fen Wang

    2015-02-01

    Full Text Available BACKGROUND AND OBJECTIVES: Postoperative analgesia is crucial for early functional excise after total knee arthroplasty. To investigate the clinical efficacy of ultrasound and nerve stimulator guided continuous femoral nerve block analgesia after total knee arthroplasty. METHODS: 46 patients with ASA grade I-III who underwent total knee arthroplasty received postoperative analgesia from October 2012 to January 2013. In 22 patients, ultrasound and nerve stimulator guided continuous femoral nerve block were performed for analgesia (CFNB group; in 24 patients, epidural analgesia was done (PCEA group. The analgesic effects, side effects, articular recovery and complications were compared between two groups. RESULTS: At 6 h and 12 h after surgery, the knee pain score (VAS score during functional tests after active exercise and after passive excise in CFNB were significantly reduced when compared with PCEA group. The amount of parecoxib used in CFNB patients was significantly reduced when compared with PCEA group. At 48 h after surgery, the muscle strength grade in CFNB group was significantly higher, and the time to ambulatory activity was shorter than those in PCEA group. The incidence of nausea and vomiting in CFNB patients was significantly reduced when compared with PCEA group. CONCLUSION: Ultrasound and nerve stimulator guided continuous femoral nerve block provide better analgesia at 6 h and 12 h, demonstrated by RVAS and PVAS. The amount of parecoxib also reduces, the incidence of nausea and vomiting decreased, the influence on muscle strength is compromised and patients can perform ambulatory activity under this condition.

  17. Estudo das relações anatômicas e suas variações entre o nervo ciático e o músculo piriforme Study on anatomical relationships and variations between the sciatic nerve and piriform muscle

    Directory of Open Access Journals (Sweden)

    EJD Vicente

    2007-06-01

    Full Text Available CONTEXTO: A síndrome do músculo piriforme pode ter como causa a passagem anormal do nervo ciático ou de uma de suas partes pelo ventre do músculo piriforme. OBJETIVO: Analisar as relações anatômicas e métricas entre o músculo piriforme e o nervo ciático, contribuindo com o conhecimento anátomo-clínico da região glútea. MÉTODO: Foram utilizados 20 cadáveres adultos de ambos os sexos. O nervo ciático e o músculo piriforme foram dissecados, medidos e fotodocumentados. RESULTADOS: Observou-se que 85% das 40 regiões glúteas apresentaram o nervo como tronco único, passando pela borda inferior do músculo piriforme, e 15% mostraram uma variação bilateral, caracterizada pela passagem do nervo fibular comum através do músculo piriforme. Os dados obtidos não revelaram diferenças estatisticamente significantes.CONTEXT: Piriform muscle syndrome can be caused by abnormal passage of the sciatic nerve or one of its parts through the belly of the piriform muscle. OBJECTIVE: To analyze the anatomical and measurement relationships between the piriform muscle and the sciatic nerve in order to contribute towards better anatomoclinical understanding of the gluteal region. METHOD: Twenty adult cadavers of both sexes were used. The sciatic nerve and piriform muscle were dissected, measured and photodocumented. RESULTS: The sciatic nerve was seen to be a single trunk passing through the lower margin of the piriform muscle in 85% of the 40 gluteal regions, and 15% showed bilateral variation characterized by the passage of the common fibular nerve through the piriform muscle. The data obtained did not show any statistically significant differences.

  18. Efeitos da aplicação do laser de baixa potência na regeneração do nervo isquiático de ratos Effects of low-power laser on injured rat sciatic nerve regeneration

    Directory of Open Access Journals (Sweden)

    Renata Batagini Gonçalves

    2010-03-01

    Full Text Available Os nervos periféricos sofrem constantes lesões de origem traumática, o que resulta em perdas funcionais. A terapia com laser de baixa potência vem sendo utilizada para minimizar os efeitos maléficos da inflamação e acelerar o processo de cicatrização dos tecidos lesados. Este estudo teve como objetivo verificar o efeito da irradiação do laser 830 nm no comportamento do nervo isquiático de ratos submetido a esmagamento. Foram utilizados 20 ratos, todos tendo tido o nervo isquiático esmagado, divididos em 4 grupos (n=5: P7 e P14, tratamento placebo por 7 e 14 dias; L7 e L14, tratamento por laser (dosagem de 4 J/cm² por 7 e 14 dias. Os animais dos grupos P7 e P14 foram submetidos aos mesmos procedimentos, mas com o laser desligado. Os parâmetros analisados foram presença de infiltrado inflamatório e fibroblastos, destruição da bainha de mielina e degeneração axonal. Na análise estatística foi observada diferença estatística com relação a três parâmetros: os animais do grupo L14 apresentaram maior quantidade de fibroblastos (p=0,0001, menor degeneração da bainha de mielina (p=0,007 e menor quantidade de infiltrado inflamatório (p=0,001. A aplicação do laser de baixa potência contribuiu para a redução do processo inflamatório decorrente da lesão do nervo isquiático de ratos.Peripheral nerves are commonly subject to traumatic injuries, leading to functional loss. Low-power laser therapy has been used in order to minimize harmful effects of inflammation and to accelerate healing of injured tissues. The purpose of this study was to assess the effect of 830 nm-laser irradiation on rat sciatic nerves submitted to crush. Twenty male Wistar rats had their sciatic nerve crushed and were divided into 4 groups (n=5: Sham7 and Sham14, placebo-treated for 7 and 14 days; L7 and L14, laser-treated (at 4 J/cm² for 7 and 14 days. Sham group animals were submitted to the same procedures, but with the laser turned off. Assessed

  19. Ultrasound-guided continuous femoral nerve block vs continuous fascia iliaca compartment block for hip replacement in the elderly

    Science.gov (United States)

    Yu, Bin; He, Miao; Cai, Guang-Yu; Zou, Tian-Xiao; Zhang, Na

    2016-01-01

    Abstract Background: Continuous femoral nerve block and fascia iliaca compartment block are 2 traditional anesthesia methods in orthopedic surgeries, but it is controversial which method is better. The objective of this study was to compare the practicality, efficacy, and complications of the 2 modalities in hip replacement surgery in the elderly and to assess the utility of a novel cannula-over-needle set. Methods: In this prospective, randomized controlled clinical investigation, 60 elderly patients undergoing hip replacement were randomly assigned to receive either continuous femoral nerve block or continuous fascia iliaca compartment block. After ultrasound-guided nerve block, all patients received general anesthesia for surgery and postoperative analgesia through an indwelling cannula. Single-factor analysis of variance was used to compare the outcome variables between the 2 groups. Results: There was a significant difference between the 2 groups in the mean visual analog scale scores (at rest) at 6 hours after surgery: 1.0 ± 1.3 in the femoral nerve block group vs 0.5 ± 0.8 in the fascia iliaca compartment block group (P fascia iliaca compartment block group had better analgesia on the lateral aspect of the thigh. There were no other significant differences between the groups. Conclusions: Both ultrasound-guided continuous femoral nerve block and fascia iliaca compartment block with the novel cannula-over-needle provide effective anesthesia and postoperative analgesia for elderly hip replacement patients. PMID:27759633

  20. Bilateral changes in IL-6 protein, but not in its receptor gp130, in rat dorsal root ganglia following sciatic nerve ligature

    Czech Academy of Sciences Publication Activity Database

    Brázda, Václav; Klusáková, I.; Svíženská, I.; Veselková, Z.; Dubový, P.

    2009-01-01

    Roč. 29, 6-7 (2009), s. 1053-1062 ISSN 0272-4340 Grant - others:GA ČR(CZ) GA309/07/0121 Institutional research plan: CEZ:AV0Z50040507; CEZ:AV0Z50040702 Keywords : unilateral nerve injury * neuropathic pain * IL-6 signaling Subject RIV: BO - Biophysics Impact factor: 2.107, year: 2009

  1. Bilateral elevation of interleukin-6 protein and mRNA in both lumbar and cervical dorsal root ganglia following unilateral chronic compression injury of the sciatic nerve

    Czech Academy of Sciences Publication Activity Database

    Dubový, P.; Brázda, Václav; Klusáková, I.; Hradilová-Svíženská, I.

    2013-01-01

    Roč. 10, č. 55 (2013) E-ISSN 1742-2094 R&D Projects: GA MŠk(CZ) ED1.1.00/02.0068 Institutional support: RVO:68081707 Keywords : Unilateral nerve injury * Contralateral reaction * Remote ganglia Subject RIV: BO - Biophysics Impact factor: 4.902, year: 2013

  2. Rhabdomyolysis and truncular sciatic pain. MRI study of 2 cases

    International Nuclear Information System (INIS)

    Le Friant, G.; Brinquin, L.; Soulie, D.; Sarrazin, J.L.; Cosnard, G.; Cordoliani, Y.S.

    1995-01-01

    We report two cases of acute rhabdomyolysis in pelvic girdle muscles with sciatic palsy secondary to compression of the sciatic nerve trunk, with clinical and MRI correlation. The diagnosis of rhabdomyolysis is based on clinical and biological data, but diagnosis of compression complications secondary to swelling of the muscles, especially the compression of nerve trunk, is done by imaging. T2 weighted images give a definite anatomical evaluation. They show enlarged high signal intensity muscles and anatomic relationship with the sciatic nerve from its emergence out of pelvis, giving a good correlation between rhabdomyolysis and the compressed nervous trunk. It helps for planning a possible surgical fasciotomy. However, MRI provides only morphological informations, but not differentiates edema from necrosis in involved muscles. (authors). 7 refs., 2 figs

  3. Sciatic (Popliteal Fossa) Catheter for Pediatric Pain Management of Sickle Cell Crisis: A Case Report.

    Science.gov (United States)

    Weber, Garret; Liao, Sherry; Burns, Micah Alexander

    2017-11-15

    Sickle cell crisis, or vaso-occlusive crisis (VOC), is a major cause of hospitalizations for adults and children with sickle cell disease, and is associated with increased morbidity and mortality. Despite prompt pharmacological treatment and multimodal pain management, acute pain during a VOC is often not adequately controlled in the pediatric population. We placed a continuous popliteal sciatic nerve block under ultrasound guidance in a pediatric patient for localized refractory pain during a VOC, resulting in improved pain control with preserved sensorimotor function.

  4. Determination of Nerve Fiber Diameter Distribution From Compound Action Potential: A Continuous Approach.

    Science.gov (United States)

    Un, M Kerem; Kaghazchi, Hamed

    2018-01-01

    When a signal is initiated in the nerve, it is transmitted along each nerve fiber via an action potential (called single fiber action potential (SFAP)) which travels with a velocity that is related with the diameter of the fiber. The additive superposition of SFAPs constitutes the compound action potential (CAP) of the nerve. The fiber diameter distribution (FDD) in the nerve can be computed from the CAP data by solving an inverse problem. This is usually achieved by dividing the fibers into a finite number of diameter groups and solve a corresponding linear system to optimize FDD. However, number of fibers in a nerve can be measured sometimes in thousands and it is possible to assume a continuous distribution for the fiber diameters which leads to a gradient optimization problem. In this paper, we have evaluated this continuous approach to the solution of the inverse problem. We have utilized an analytical function for SFAP and an assumed a polynomial form for FDD. The inverse problem involves the optimization of polynomial coefficients to obtain the best estimate for the FDD. We have observed that an eighth order polynomial for FDD can capture both unimodal and bimodal fiber distributions present in vivo, even in case of noisy CAP data. The assumed FDD distribution regularizes the ill-conditioned inverse problem and produces good results.

  5. Ethidium bromide-induced demyelination in the sciatic nerve of diabetic rats Desmielinização induzida pelo brometo de etídio no nervo ciático de ratos diabéticos

    Directory of Open Access Journals (Sweden)

    Eduardo Fernandes Bondan

    2009-12-01

    Full Text Available This study aims to observe the process of myelin loss and repair following the injection of the gliotoxic agent ethidium bromide (EB in the sciatic nerve of rats previously induced to diabetes mellitus by streptozotocin. Injection of EB was also done in non-diabetic rats. The animals were euthanatized from 3 to 31 days after intraneural injection and nerve sections were collected for ultrastructural study. In non-diabetic rats, Schwann cells (CS showed signs of intoxication 3 days after, with cytoplasmic vacuolization and rejection of their myelin sheaths. Myelin debris were removed by macrophages in the endoneurium and mast cells were abundant in the lesions. From 14 days following EB injection, supernumerary CS were seen in the expanded endoneurium as well as thin myelin sheaths indicating remyelination. Diabetic rats presented a more extensive myelin vesiculation and segmentar demyelination, with delayed activities from both macrophages and remyelinating SC. No mast cells were noted.O estudo visa à observação do processo de perda e reparo mielínico pós-injeção do gliotóxico brometo de etídio (BE no nervo ciático de ratos previamente induzidos a diabetes mellitus pela estreptozotocina. Injeção de BE foi igualmente realizada em ratos não-diabéticos. Os animais foram eutanasiados dos 3 aos 31 dias pós-injeção intraneural, com colheita de amostras neurais para estudo ultra-estrutural. Nos animais não-diabéticos, as células de Schwann (CS mostraram sinais de intoxicação a partir dos 3 dias pós-gliotóxico, com vacuolização citoplasmática e rejeição de suas bainhas de mielina. Restos mielínicos eram removidos por macrófagos no interior do endoneuro e mastócitos eram abundantes nas lesões. A partir dos 14 dias, CS supranumerárias foram encontradas no endoneuro expandido, além de finas bainhas de mielina indicativas de remielinização. Os ratos diabéticos apresentaram vesiculação mielínica e desmieliniza

  6. Common peroneal nerve entrapment with the communication ...

    African Journals Online (AJOL)

    Sciatic nerve divides into tibial nerve and common peroneal nerve at the level of superior angle of popliteal fossa and variations in its branching pattern are common. The most common nerve entrapment syndrome in the lower limbs is common peroneal nerve entrapment at fibular head. Invariably it can also be trapped in ...

  7. POST-INJECTION SCIATIC NEUROPATHY: A FIVE-YEAR REVIEW ...

    African Journals Online (AJOL)

    Alonge Ibidunni

    Journal of Medicine and Rehabilitation. 1(1): 22-24. Fatunde, O.J. and J.B. Familusi. 2001. Injection-induced sciatic nerve injury in Nigerian children. Central Africa Journal of. Medicine 47(2): 35-38. Halsey, N.A. 2003. Commentary: Poliomyelitis and unnecessary injections. International Journal of Epidemiology 32: 278-9.

  8. 4.7-T diffusion tensor imaging of acute traumatic peripheral nerve injury.

    Science.gov (United States)

    Boyer, Richard B; Kelm, Nathaniel D; Riley, D Colton; Sexton, Kevin W; Pollins, Alonda C; Shack, R Bruce; Dortch, Richard D; Nanney, Lillian B; Does, Mark D; Thayer, Wesley P

    2015-09-01

    Diagnosis and management of peripheral nerve injury is complicated by the inability to assess microstructural features of injured nerve fibers via clinical examination and electrophysiology. Diffusion tensor imaging (DTI) has been shown to accurately detect nerve injury and regeneration in crush models of peripheral nerve injury, but no prior studies have been conducted on nerve transection, a surgical emergency that can lead to permanent weakness or paralysis. Acute sciatic nerve injuries were performed microsurgically to produce multiple grades of nerve transection in rats that were harvested 1 hour after surgery. High-resolution diffusion tensor images from ex vivo sciatic nerves were obtained using diffusion-weighted spin-echo acquisitions at 4.7 T. Fractional anisotropy was significantly reduced at the injury sites of transected rats compared with sham rats. Additionally, minor eigenvalues and radial diffusivity were profoundly elevated at all injury sites and were negatively correlated to the degree of injury. Diffusion tensor tractography showed discontinuities at all injury sites and significantly reduced continuous tract counts. These findings demonstrate that high-resolution DTI is a promising tool for acute diagnosis and grading of traumatic peripheral nerve injuries.

  9. 4.7-T diffusion tensor imaging of acute traumatic peripheral nerve injury

    Science.gov (United States)

    Boyer, Richard B.; Kelm, Nathaniel D.; Riley, D. Colton; Sexton, Kevin W.; Pollins, Alonda C.; Shack, R. Bruce; Dortch, Richard D.; Nanney, Lillian B.; Does, Mark D.; Thayer, Wesley P.

    2015-01-01

    Diagnosis and management of peripheral nerve injury is complicated by the inability to assess microstructural features of injured nerve fibers via clinical examination and electrophysiology. Diffusion tensor imaging (DTI) has been shown to accurately detect nerve injury and regeneration in crush models of peripheral nerve injury, but no prior studies have been conducted on nerve transection, a surgical emergency that can lead to permanent weakness or paralysis. Acute sciatic nerve injuries were performed microsurgically to produce multiple grades of nerve transection in rats that were harvested 1 hour after surgery. High-resolution diffusion tensor images from ex vivo sciatic nerves were obtained using diffusion-weighted spin-echo acquisitions at 4.7 T. Fractional anisotropy was significantly reduced at the injury sites of transected rats compared with sham rats. Additionally, minor eigenvalues and radial diffusivity were profoundly elevated at all injury sites and were negatively correlated to the degree of injury. Diffusion tensor tractography showed discontinuities at all injury sites and significantly reduced continuous tract counts. These findings demonstrate that high-resolution DTI is a promising tool for acute diagnosis and grading of traumatic peripheral nerve injuries. PMID:26323827

  10. Early and continued manual stimulation is required for long-term recovery after facial nerve injury.

    Science.gov (United States)

    Grosheva, Maria; Rink, Svenja; Jansen, Ramona; Bendella, Habib; Pavlov, Stoyan P; Sarikcioglu, Levent; Angelov, Doychin N; Dunlop, Sarah A

    2018-01-01

    We previously have shown that manual stimulation (MS) of vibrissal muscles for 2 months after facial nerve injury in rats improves whisking and reduces motor end plate polyinnervation. Here, we seek to determine whether discontinuing or delaying MS after facial-facial anastomosis (FFA) leads to similar results. Rats were subjected to FFA and received MS for (1) 4 months (early and continued), (2) the first but not the last 2 months (discontinued), or (3) the last 2 months (delayed). Intact animals and those not receiving MS (no MS) were also examined. Early and continued MS restored whisking amplitude to 43°, a value significantly higher compared with the discontinued, delayed, and no MS groups (32°, 24°, and 10°, respectively). Motor end plate polyinnervation occurred in all experimental groups but was significantly higher in the delayed group. Early and continued MS results in better recovery than when it is either discontinued or delayed. Muscle Nerve 57: 100-106, 2018. © 2017 Wiley Periodicals, Inc.

  11. Comparison of nerve regenerative efficacy between decellularized nerve graft and nonwoven chitosan conduit.

    Science.gov (United States)

    Kusaba, Hiroki; Terada-Nakaishi, Michiko; Wang, Wei; Itoh, Soichiro; Nozaki, Kosuke; Nagai, Akiko; Ichinose, Shizuko; Takakuda, Kazuo

    2016-05-12

    Recently decellularized nerves with various methods are reported as highly functional nerve grafts for the treatment of nerve defects. To evaluate the efficacy of decellularized allogeneic nerve, compared with oriented chitosan mesh tube, and an autologous nerve. Sciatic nerves harvested from Sprague-Dawley (SD) rats were decellularized in combination with Sodium dodecyl sulfate and Triton X-100. A graft into the sciatic nerve in Wistar rats was performed with the decellularized SD rat sciatic nerves or oriented chitosan nonwoven nanofiber mesh tubes (15 mm in length, N=5 in each group). A portion of sciatic nerve of Wistar rat was cut, reversed and re-sutured in-situ as a control. Nerve functional and histological evaluations were performed 25 weeks postoperatively. It was revealed that functional, electrophysiological and histological recoveries in the decellularized nerve group match those in the autograft group. Recovery of sensory function and nerve maturation in the decellularized nerve group were superior to those in the chitosan mesh tube group. Nerve regeneration in the decellularized nerves could match that in the autografts and is somehow superior to artificial chitosan mesh tube. Detergents wash of SDS and Triton X-100 could obtain highly functional nerve grafts from allografts.

  12. Ultrasound-guided bilateral combined inguinal femoral and subgluteal sciatic nerve blocks for simultaneous bilateral below-knee amputations due to bilateral diabetic foot gangrene unresponsive to peripheral arterial angioplasty and bypass surgery in a coagulopathic patient on antiplatelet therapy with a history of percutaneous coronary intervention for ischemic heart disease: A case report.

    Science.gov (United States)

    Byun, Sung Hye; Lee, Jonghoon; Kim, Jong Hae

    2016-07-01

    Patients on antiplatelet therapy following percutaneous coronary intervention can become coagulopathic due to infection. Performing regional anesthesia for bilateral surgery in such cases is challenging. We report a case of successful combined inguinal femoral and subgluteal sciatic nerve blocks (CFSNBs) for simultaneous bilateral below-knee amputations in a coagulopathic patient on antiplatelet therapy. A 70-year-old male patient presented with pain in both feet due to diabetic foot syndrome. The condition could not be managed by open amputations of the toes at the metatarsal bones and subsequent antibiotic therapy. Computed tomographic angiography showed significant stenosis in the arteries supplying the lower limbs, indicating atherosclerotic gangrene in both feet. Balloon angioplasty and bypass surgery with subsequent debridements with application of negative-pressure wound therapy and additional open amputations did not improve the patient's clinical condition: his leukocyte counts and C-reactive protein levels were above the normal range, and his prothrombin and activated partial thromboplastin times were increased. Simultaneous bilateral below-knee amputations were performed under ultrasound-guided CFSNBs. Following left CFSNBs using 45 mL of a local anesthetic mixture (1:1 ratio of 1.0% mepivacaine and 0.75% ropivacaine), the left below-knee amputation was performed for 76 minutes. Subsequently, under right CFSNBs using 47 mL of the local anesthetic mixture, the right below-knee amputation proceeded for 85 minutes. Throughout each surgery, dexmedetomidine was continuously administered, and a sensory blockade was well maintained in both limbs. The patient did not complain of pain due to regression of the first CFSNBs during the second surgery. The CFSNBs successfully prevented tourniquet pain. Local anesthetic systemic toxicity (LAST) and hemodynamic instability due to tourniquet deflation and administration of dexmedetomidine did not occur. No

  13. The Chitranjan Ranawat Award: Periarticular injections and femoral & sciatic blocks provide similar pain relief after TKA: a randomized clinical trial.

    Science.gov (United States)

    Spangehl, Mark J; Clarke, Henry D; Hentz, Joseph G; Misra, Lopa; Blocher, Joshua L; Seamans, David P

    2015-01-01

    Two of the more common methods of pain management after TKA are peripheral nerve blocks and intraarticular/periarticular injections. However, we are not aware of any study directly comparing the commonly used combination of a continuous femoral block given with a single-shot sciatic block with that of a periarticular injection after TKA. This randomized clinical trial compared a combined femoral and sciatic nerve block with periarticular injection as part of a multimodal pain protocol after total knee arthroplasty with respect to (1) pain; (2) narcotic use; (3) quadriceps function and length of stay; and (4) peripheral nerve complications. One hundred sixty patients completed randomization into two treatment arms: (1) peripheral nerve blocks (PNB; n=79) with an indwelling femoral nerve catheter and a single shot sciatic block; or (2) periarticular injection (PAI; n=81) using ropivacaine, epinephrine, ketorolac, and morphine. All patients received standardized general anesthesia and oral medications. The primary outcome was postoperative pain, on a 0 to 10 scale, measured on the afternoon of postoperative day 1 (POD 1). Secondary outcomes were narcotic use, quadriceps function, length of stay, and peripheral nerve complications. Mean pain scores on the afternoon of POD 1 were not different between groups (PNB group: 2.9 [SD 2.4]; PAI group: 3.0 [SD 2.2]; 95% confidence interval, -0.8 to 0.6; p=0.76). Mean pain scores taken at three times points on POD 1 were also similar between groups. Hospital length of stay was shorter for the PAI group (2.44 days [SD 0.65] versus 2.84 days [SD 1.34] for the PNB group; p=0.02). Narcotic consumption was higher the day of surgery for the PAI group (PAI group: 11.7 mg morphine equivalents [SD 13.1]; PNB group: 4.6 mg [SD 9.1]; pblocks. Periarticular injections provide adequate pain relief, are simple to use, and avoid the potential complications associated with nerve blocks. Level I, therapeutic study. See Guidelines for Authors for

  14. Ultrasound-guided continuous femoral nerve block vs continuous fascia iliaca compartment block for hip replacement in the elderly: A randomized controlled clinical trial (CONSORT).

    Science.gov (United States)

    Yu, Bin; He, Miao; Cai, Guang-Yu; Zou, Tian-Xiao; Zhang, Na

    2016-10-01

    Continuous femoral nerve block and fascia iliaca compartment block are 2 traditional anesthesia methods in orthopedic surgeries, but it is controversial which method is better. The objective of this study was to compare the practicality, efficacy, and complications of the 2 modalities in hip replacement surgery in the elderly and to assess the utility of a novel cannula-over-needle set. In this prospective, randomized controlled clinical investigation, 60 elderly patients undergoing hip replacement were randomly assigned to receive either continuous femoral nerve block or continuous fascia iliaca compartment block. After ultrasound-guided nerve block, all patients received general anesthesia for surgery and postoperative analgesia through an indwelling cannula. Single-factor analysis of variance was used to compare the outcome variables between the 2 groups. There was a significant difference between the 2 groups in the mean visual analog scale scores (at rest) at 6 hours after surgery: 1.0 ± 1.3 in the femoral nerve block group vs 0.5 ± 0.8 in the fascia iliaca compartment block group (P fascia iliaca compartment block group had better analgesia on the lateral aspect of the thigh. There were no other significant differences between the groups. Both ultrasound-guided continuous femoral nerve block and fascia iliaca compartment block with the novel cannula-over-needle provide effective anesthesia and postoperative analgesia for elderly hip replacement patients.

  15. Exercício imediato versus tardio na regeneração do nervo isquiático de ratos após axoniotmese: análise histomorfométrica e funcional Immediate versus later exercises for rat sciatic nerve regeneration after axonotmesis: histomorphometric and functional analyses

    Directory of Open Access Journals (Sweden)

    LL Sobral

    2008-08-01

    Full Text Available OBJETIVO: Devido à controvérsia sobre o melhor momento para iniciar o exercício físico, bem como sua influência sobre a regeneração nervosa periférica, este estudo realizou uma análise histomorfométrica e funcional para avaliar a influência do exercício físico em esteira, aplicado nas fases imediata e tardia da regeneração do nervo isquiático de ratos, após axoniotmese. MÉTODOS: Vinte ratos Wistar machos (229,05±18,02g foram divididos nos grupos: controle (CON; desnervado (D; desnervado+exercício+gaiola (DEG e desnervado+ gaiola+exercício (DGE. Após 24 horas da axoniotmese, o grupo DEG iniciou o exercício, enquanto o grupo DGE iniciou no 14º dia, com o seguinte protocolo: velocidade=8m/min, inclinação=0%, 30min/dia, durante 14 dias. Em seguida, a porção distal do nervo isquiático foi retirada para análise histomorfométrica. Realizou-se o registro da marcha (pré-operatório e 7º, 14º, 21º, 28º dias pós-operatório (PO, através do índice funcional do ciático (IFC. RESULTADOS: O número de axônios regenerados nos grupos D foi maior que no CON (pOBJECTIVE: Considering the controversies regarding the best period to begin physical exercise in relation to peripheral nerve regeneration, along with its influence on regeneration, this study accomplished a histomorphometric and functional analysis to evaluate the influence of physical exercise on a treadmill, applied to the immediate and late stages of sciatic nerve regeneration in rats following crushing injury. METHODS: Twenty male Wistar rats (229.05±18.02g were divided into the following groups: control (CON; denervated (D; denervated+exercise+cage (DEC and denervated+cage+exercise (DCE. The DEC group started the exercise 24 hours after the nerve injury, while the DCE group started on the 14th day after the injury, with the following protocol: speed=8m/min, inclination=0%, 30min/day, for 14 days. The distal segment of the sciatic nerve was then removed for

  16. Effects of sciatic-conditioned medium on neonatal rat retinal cells in vitro

    Directory of Open Access Journals (Sweden)

    Torres P.M.M.

    1998-01-01

    Full Text Available Schwann cells produce and release trophic factors that induce the regeneration and survival of neurons following lesions in the peripheral nerves. In the present study we examined the in vitro ability of developing rat retinal cells to respond to factors released from fragments of sciatic nerve. Treatment of neonatal rat retinal cells with sciatic-conditioned medium (SCM for 48 h induced an increase of 92.5 ± 8.8% (N = 7 for each group in the amount of total protein. SCM increased cell adhesion, neuronal survival and glial cell proliferation as evaluated by morphological criteria. This effect was completely blocked by 2.5 µM chelerythrine chloride, an inhibitor of protein kinase C (PKC. These data indicate that PKC activation is involved in the effect of SCM on retinal cells and demonstrate that fragments of sciatic nerve release trophic factors having a remarkable effect on neonatal rat retinal cells in culture.

  17. Continuous adductor canal blocks are superior to continuous femoral nerve blocks in promoting early ambulation after TKA.

    Science.gov (United States)

    Mudumbai, Seshadri C; Kim, T Edward; Howard, Steven K; Workman, J Justin; Giori, Nicholas; Woolson, Steven; Ganaway, Toni; King, Robert; Mariano, Edward R

    2014-05-01

    Femoral continuous peripheral nerve blocks (CPNBs) provide effective analgesia after TKA but have been associated with quadriceps weakness and delayed ambulation. A promising alternative is adductor canal CPNB that delivers a primarily sensory blockade; however, the differential effects of these two techniques on functional outcomes after TKA are not well established. We determined whether, after TKA, patients with adductor canal CPNB versus patients with femoral CPNB demonstrated (1) greater total ambulation distance on Postoperative Day (POD) 1 and 2 and (2) decreased daily opioid consumption, pain scores, and hospital length of stay. Between October 2011 and October 2012, 180 patients underwent primary TKA at our practice site, of whom 93% (n = 168) had CPNBs. In this sequential series, the first 102 patients had femoral CPNBs, and the next 66 had adductor canal CPNBs. The change resulted from a modification to our clinical pathway, which involved only a change to the block. An evaluator not involved in the patients' care reviewed their medical records to record the parameters noted above. Ambulation distances were higher in the adductor canal group than in the femoral group on POD 1 (median [10(th)-90(th) percentiles]: 37 m [0-90 m] versus 6 m [0-51 m]; p randomized studies are needed to validate our major findings. Level III, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.

  18. Low cost continuous femoral nerve block for relief of acute severe cancer related pain due to pathological fracture femur

    Directory of Open Access Journals (Sweden)

    Rachel Cherian Koshy

    2010-01-01

    Full Text Available Pathological fractures in cancer patient cause severe pain that is difficult to control pharmacologically. Even with good pain relief at rest, breakthrough and incident pain can be unmanageable. Continuous regional nerve blocks have a definite role in controlling such intractable pain. We describe two such cases where severe pain was adequately relieved in the acute phase. Continuous femoral nerve block was used as an efficient, cheap and safe method of pain relief for two of our patients with pathological fracture femur. This method was proved to be quite efficient in decreasing the fracture-related pain and improving the level of well being.

  19. Bone marrow-derived mesenchymal stem cells versus adipose-derived mesenchymal stem cells for peripheral nerve regeneration

    Directory of Open Access Journals (Sweden)

    Marcela Fernandes

    2018-01-01

    Full Text Available Studies have confirmed that bone marrow-derived mesenchymal stem cells (MSCs can be used for treatment of several nervous system diseases. However, isolation of bone marrow-derived MSCs (BMSCs is an invasive and painful process and the yield is very low. Therefore, there is a need to search for other alterative stem cell sources. Adipose-derived MSCs (ADSCs have phenotypic and gene expression profiles similar to those of BMSCs. The production of ADSCs is greater than that of BMSCs, and ADSCs proliferate faster than BMSCs. To compare the effects of venous grafts containing BMSCs or ADSCs on sciatic nerve injury, in this study, rats were randomly divided into four groups: sham (only sciatic nerve exposed, Matrigel (MG; sciatic nerve injury + intravenous transplantation of MG vehicle, ADSCs (sciatic nerve injury + intravenous MG containing ADSCs, and BMSCs (sciatic nerve injury + intravenous MG containing BMSCs groups. Sciatic functional index was calculated to evaluate the function of injured sciatic nerve. Morphologic characteristics of nerves distal to the lesion were observed by toluidine blue staining. Spinal motor neurons labeled with Fluoro-Gold were quantitatively assessed. Compared with sham-operated rats, sciatic functional index was lower, the density of small-diameter fibers was significantly increased, and the number of motor neurons significantly decreased in rats with sciatic nerve injury. Neither ADSCs nor BMSCs significantly improved the sciatic nerve function of rats with sciatic nerve injury, increased fiber density, fiber diameters, axonal diameters, myelin sheath thickness, and G ratios (axonal diameter/fiber diameter ratios in the sciatic nerve distal to the lesion site. There was no significant difference in the number of spinal motor neurons among ADSCs, BMSCs and MG groups. These results suggest that neither BMSCs nor ADSCs provide satisfactory results for peripheral nerve repair when using MG as the conductor for

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

    OpenAIRE

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

    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...

  1. High-voltage electrical stimulation improves nerve regeneration after sciatic crush injury Estimulação elétrica de alta voltagem favorece a regeneração nervosa após compressão do nervo isquiático

    Directory of Open Access Journals (Sweden)

    Rosana M. Teodori

    2011-08-01

    Full Text Available BACKGROUND: Peripheral nerve injury causes prolonged functional limitation being a clinical challenge to identify resources that accelerates its recovery. OBJECTIVES: To investigate the effect of high-voltage electrical stimulation (HVES on the morphometric and functional characteristics of the regenerated nerve after crush injury in rats. METHODS: Twenty Wistar rats were randomly allocated into 4 groups: Control (CON - without injury and without HVES; Denervated (D - sciatic nerve crush only; Denervated + HVES - sciatic nerve crush and HVES; SHAM - without injury but HVES. The HVES and SHAM groups were stimulated (100 Hz; minimum voltage of 100 V, 20 μs, 100 μs interpulse interval for 30 min/day, 5 days/week. The sciatic functional index (SFI was evaluated before the injury and at the 7th, 14th and 21st postoperatory (PO days. Neural components and the area density of connective tissue, blood vessels and macrophages were analyzed. RESULTS: Axonal diameter was higher on the HVES than on D group, reaching almost 80% above the control values after 21 days (pCONTEXTUALIZAÇÃO: Lesões nervosas periféricas provocam limitação funcional prolongada, sendo um desafio para a clínica identificar recursos que acelerem sua recuperação. OBJETIVOS: Investigar a influência da estimulação elétrica de alta voltagem (EEAV sobre a morfologia e a função do nervo regenerado após esmagamento em ratos. MÉTODOS: Vinte ratos Wistar foram divididos nos grupos: controle (CON - sem lesão e sem EEAV; desnervado (D - esmagamento do nervo isquiático; desnervado + EEAV (EEAV - esmagamento do nervo e EEAV; SHAM - sem lesão, porém submetido à EEAV. Os grupos EEAV e SHAM foram estimulados (100 Hz, tensão mínima de 100 V; 20 μs e 100 μs interpulso 30 min/dia, 5 dias/semana. O índice funcional do ciático (IFC foi avaliado antes da lesão, nos 7º, 14º e 21º dias pós-operatório (PO. Componentes neurais, densidade de área de tecido conjuntivo, de

  2. 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.

  3. 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

    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

  4. 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.

    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

  5. Let-7 microRNAs Regenerate Peripheral Nerve Regeneration by Targeting Nerve Growth Factor

    OpenAIRE

    Li, Shiying; Wang, Xinghui; Gu, Yun; Chen, Chu; Wang, Yaxian; Liu, Jie; Hu, Wen; Yu, Bin; Wang, Yongjun; Ding, Fei; Liu, Yan; Gu, Xiaosong

    2015-01-01

    Peripheral nerve injury is a common clinical problem. Nerve growth factor (NGF) promotes peripheral nerve regeneration, but its clinical applications are limited by several constraints. In this study, we found that the time-dependent expression profiles of eight let-7 family members in the injured nerve after sciatic nerve injury were roughly similar to each other. Let-7 microRNAs (miRNAs) significantly reduced cell proliferation and migration of primary Schwann cells (SCs) by directly target...

  6. A Rare Presentation of Sciatic Palsy Due to Hematoma After Use of the Kocher-Langenbeck Approach to the Acetabulum.

    Science.gov (United States)

    Rog, Dominik; Basmajian, Hrayr G

    2015-03-25

    A delayed sciatic palsy caused by compression due to hematoma formation is a rare complication of total hip arthroplasty. We report the case of a twenty-seven-year-old man who underwent open reduction and internal fixation of transverse and posterior wall acetabular fractures with posterior hip dislocation and had development of a delayed sciatic palsy due to the formation of a hematoma five days after the procedure. A patient who presents with a delayed-onset sciatic palsy with signs and symptoms of a hematoma after an acetabular surgery represents a surgical emergency. Early recognition and urgent decompression offers the best chance of nerve recovery.

  7. Efficacy of arthroscopically placed pain catheter adjacent to the suprascapular nerve (continuous arthroscopically assisted suprascapular nerve block following arthroscopic rotator-cuff repair

    Directory of Open Access Journals (Sweden)

    Yamakado K

    2014-05-01

    Full Text Available Kotaro YamakadoDepartment of Orthopaedics, Fukui General Hospital, Fukui, JapanBackground: Rotator-cuff surgery is well recognized to be a painful procedure.Objectives: The purpose of this study was to examine the effectiveness of an arthroscopically placed perineural catheter at the scapular notch to provide a continuous block of the suprascapular nerve (continuous arthroscopically assisted suprascapular nerve block [ca-SSNB] following arthroscopic rotator-cuff repair (ARCR.Materials and methods: This level II, prospective, randomized, controlled trial without postoperative blinding included 40 patients, who had a 48-hour pain pump, with 0.2% ropivacaine infusion and a continuous rate of 3 mL/hour, placed via an arthroscopically placed catheter following ARCR with arthroscopic release of the superior transverse ligament: 21 patients had a ca-SSNB, and 19 patients had a continuous subacromial bursal block (SAB. The visual analog scale (at 6 hours and on the first, second, and third postoperative days and the total number of additional pain-reduction attempts during the 3 postoperative days were calculated.Results: The respective visual analog scale scores (mm obtained from the ca-SSNB and SAB groups were 62.4 and 67.6 (P=0.73 before surgery, 9.1 and 19.4 (P=0.12 at 6 hours after surgery, 24.4 and 44.6 (P=0.019 on the first postoperative day, 19.4 and 40.4 (P=0.0060 on the second postoperative day, and 18.5 and 27.8 (P=0.21 on the third postoperative day. Total additional pain-reduction attempts recorded for the ca-SSNB and SAB groups during the 3 postoperative days were 0.3 times and 1.2 times (P=0.0020, respectively.Conclusion: ca-SSNB was highly effective in controlling postoperative pain after ARCR.Keywords: shoulder, rotator cuff tear, postoperative pain control, continuous suprascapular nerve block, arthroscopic rotator cuff repair

  8. Controle da dor pós-operatória da artroplastia total do joelho: é necessário associar o bloqueio do nervo isquiático ao bloqueio do nervo femoral? Control del dolor postoperatorio de la artroplastia total de la rodilla: ¿es necesario asociar el bloqueo del nervio isquiático al bloqueo del nervio femoral? Control of postoperative pain following total knee arthroplasty: is it necessary to associate sciatic nerve block to femoral nerve block?

    Directory of Open Access Journals (Sweden)

    Affonso H. Zugliani

    2007-10-01

    ón del bloqueo de los nervios isquiático y femoral. MÉTODO: Fueron estudiados 17 pacientes sometidos a ATR bajo raquianestesia, divididos en dos grupos: A y B. En el Grupo A (n = 9 fue realizado bloqueo del nervio femoral y en el Grupo B (n = 8 bloqueo de los nervios femoral e isquiático. Los bloqueos fueron realizados en el postoperatorio inmediato utilizando 20 mL de ropivacaína a 0,5% en cada uno. El dolor se comprobó en las primeras 24 horas a través de la Escala Analógica Visual y escala verbal. Fue observado el tiempo transcurrido entre los bloqueos y el primer quejido de dolor (M1. RESULTADOS: La mediana del tiempo de analgesia (M1 en el Grupo A fue de 110 min y en el Grupo B de 1.285 min (p = 0,0001. No fueron observadas complicaciones atribuibles a las técnicas utilizadas. CONCLUSIONES: El bloqueo del nervio isquiático, cuando se asocia al bloqueo del nervio femoral, e las condiciones de este estudio, mejoró de manera significativa la calidad de la analgesia en postoperatorio de la ATR.BACKGROUND AND OBJECTIVES: Total knee arthroplasty (TKA causes severe tissue trauma, leading to severe postoperative pain. Good postoperative analgesia is fundamental and one should consider that early mobilization of the joint is an important aspect to obtain good results. There is a controversy in the literature on the efficacy of isolated femoral nerve block. The objective of this study was to evaluate postoperative analgesia with the association of sciatic and femoral nerve block. METHODS: Seventeen patients undergoing TKA under spinal anesthesia were divided in two groups: A and B. In Group A (n = 9, femoral nerve block was performed, while in Group B (n = 8, femoral and sciatic nerve block were done. The blockades were done in the immediate postoperative period with 20 mL of 0.5% of ropivacaine. Pain was evaluated in the first 24 hours using the Visual Analog Scale and the verbal scale. The length of time between the nerve block and the first complaint of pain (M1

  9. Rhabdomyolysis and truncular sciatic pain. MRI study of 2 cases; Rhabdomyolyse et sciatique tronculaire. Deux cas etudies en IRM

    Energy Technology Data Exchange (ETDEWEB)

    Le Friant, G.; Brinquin, L.; Soulie, D.; Sarrazin, J.L.; Cosnard, G.; Cordoliani, Y.S. [Hopital des Armees du Val-de-Grace, 75 - Paris (France)

    1995-02-01

    We report two cases of acute rhabdomyolysis in pelvic girdle muscles with sciatic palsy secondary to compression of the sciatic nerve trunk, with clinical and MRI correlation. The diagnosis of rhabdomyolysis is based on clinical and biological data, but diagnosis of compression complications secondary to swelling of the muscles, especially the compression of nerve trunk, is done by imaging. T2 weighted images give a definite anatomical evaluation. They show enlarged high signal intensity muscles and anatomic relationship with the sciatic nerve from its emergence out of pelvis, giving a good correlation between rhabdomyolysis and the compressed nervous trunk. It helps for planning a possible surgical fasciotomy. However, MRI provides only morphological informations, but not differentiates edema from necrosis in involved muscles. (authors). 7 refs., 2 figs.

  10. Ultrasound-guided continuous suprascapular nerve block for adhesive capsulitis: one case and a short topical review

    DEFF Research Database (Denmark)

    Neimann, Jens Dupont Børglum; Bartholdy, Anne; Hautopp, H

    2011-01-01

    We present a case with an ultrasound-guided (USG) placement of a perineural catheter beneath the transverse scapular ligament in the scapular notch to provide a continuous block of the suprascapular nerve (SSN). The patient suffered from a severe and very painful adhesive capsulitis of the left s...... in the immediate post-operative period following capsular release of the shoulder. Findings in other painful shoulder conditions and suggestions for future studies are discussed in the text....... shoulder secondary to an operation in the same shoulder conducted 20 weeks previously for impingement syndrome and a superior labral anterior-posterior tear. Following a new operation with capsular release, the placement of a continuous nerve block catheter subsequently allowed for nearly pain-free low...... impact passive and guided active mobilization by the performing physiotherapist for three consecutive weeks. This case and a short topical review on the use of SSN block in painful shoulder conditions highlight the possibility of a USG continuous nerve block of the SSN as sufficient pain management...

  11. A novel concept for continuous peripheral nerve blocks. Presentation of a new ultrasound-guided device

    DEFF Research Database (Denmark)

    Rothe, C; Steen-Hansen, C; Madsen, M H

    2015-01-01

    concept and prototype for ultrasound-guided in-plane positioning and readjustment of peripheral nerve catheters (patent pending). The integrated catheter-needle prototype comprises three parts: a curved needle, a catheter with clear echogenic markings attached to the needle tail and a detachable hub...

  12. 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.

  13. Anomalous common peroneal nerve supplying the gluteus maximus ...

    African Journals Online (AJOL)

    On dissection of a 60-year-old adult male cadaver, a high division of the sciatic nerve was observed on the right side along with an accessory slip of the piriformis. In this case, the common peroneal nerve pierced through and the tibial nerve passed below the accessory slip of the piriformis. Additionally, there was an ...

  14. Nerve identification and prevention of intraneural injection in regional anesthesia

    NARCIS (Netherlands)

    Moayeri, N.|info:eu-repo/dai/nl/313998264

    2010-01-01

    This thesis deals with techniques to more reliably identify nervous structures and subsequently prevent intraneural injection in the practice of regional anesthesia. To identify nerves of the brachial plexus and sciatic nerve, both conventional techniques such as nerve stimulation, as well as

  15. Experimental study of vascularized nerve graft: evaluation of nerve regeneration using choline acetyltransferase activity.

    Science.gov (United States)

    Iwai, M; Tamai, S; Yajima, H; Kawanishi, K

    2001-01-01

    A comparative study of nerve regeneration was performed on vascularized nerve graft (VNG) and free nerve graft (FNG) in Fischer strain rats. A segment of the sciatic nerve with vascular pedicle of the femoral artery and vein was harvested from syngeneic donor rat for the VNG group and the sciatic nerve in the same length without vascular pedicle was harvested for the FNG group. They were transplanted to a nerve defect in the sciatic nerve of syngeneic recipient rats. At 2, 4, 6, 8, 12, 16, and 24 weeks after operation, the sciatic nerves were biopsied and processed for evaluation of choline acetyltransferase (CAT) activity, histological studies, and measurement of wet weight of the muscle innervated by the sciatic nerve. Electrophysiological evaluation of the grafted nerve was also performed before sacrifice. The average CAT activity in the distal to the distal suture site was 383 cpm in VNG and 361 cpm in FNG at 2 weeks; 6,189 cpm in VNG and 2,264 cpm in FNG at 4 weeks; and 11,299 cpm in VNG and 9,424 cpm in FNG at 6 weeks postoperatively. The value of the VNG group was statistically higher than that of the FNG group at 4 weeks postoperatively. Electrophysiological and histological findings also suggested that nerve regeneration in the VNG group was superior to that in the FNG group during the same period. However, there was no significant difference between the two groups after 6 weeks postoperatively in any of the evaluations. The CAT measurement was useful in the experiments, because it was highly sensitive and reproducible. Copyright 2001 Wiley-Liss, Inc.

  16. Use of the cumulative sum method (CUSUM) to assess the learning curves of ultrasound-guided continuous femoral nerve block.

    Science.gov (United States)

    Kollmann-Camaiora, A; Brogly, N; Alsina, E; Gilsanz, F

    2017-10-01

    Although ultrasound is a basic competence for anaesthesia residents (AR) there is few data available on the learning process. This prospective observational study aims to assess the learning process of ultrasound-guided continuous femoral nerve block and to determine the number of procedures that a resident would need to perform in order to reach proficiency using the cumulative sum (CUSUM) method. We recruited 19 AR without previous experience. Learning curves were constructed using the CUSUM method for ultrasound-guided continuous femoral nerve block considering 2 success criteria: a decrease of pain score>2 in a [0-10] scale after 15minutes, and time required to perform it. We analyse data from 17 AR for a total of 237 ultrasound-guided continuous femoral nerve blocks. 8/17 AR became proficient for pain relief, however all the AR who did more than 12 blocks (8/8) became proficient. As for time of performance 5/17 of AR achieved the objective of 12minutes, however all the AR who did more than 20 blocks (4/4) achieved it. The number of procedures needed to achieve proficiency seems to be 12, however it takes more procedures to reduce performance time. The CUSUM methodology could be useful in training programs to allow early interventions in case of repeated failures, and develop competence-based curriculum. Copyright © 2017 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. Insulin and IGF-II, but not IGF-I, stimulate the in vitro regeneration of adult frog sciatic sensory axons

    DEFF Research Database (Denmark)

    Edbladh, M; Svenningsen, Åsa Fex; Ekström, P A

    1994-01-01

    We used the in vitro regenerating frog sciatic nerve to look for effects of insulin and insulin-like growth factors I and II (IGF-I, IGF-II) on regeneration of sensory axons and on injury induced support cell proliferation in the outgrowth region. In nerves cultured for 11 days, a physiological...

  18. 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.

  19. Multiple Variations of the Nerves of Gluteal Region and their Clinical Implications

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    Prasad AM

    2016-01-01

    Full Text Available Knowledge of variations of nerves of gluteal region is important for clinicians administering intramuscular injections, for orthopedic surgeons dealing with the hip surgeries and possibly for physiotherapists managing the painful conditions and paralysis of this region. We report multiple variations of the nerves of gluteal region through this article. In the current case, the sciatic nerve was absent. The common peroneal and tibial nerves arose from sacral plexus and reached the gluteal region through greater sciatic foramen above and below piriformis respectively. The common peroneal nerve gave a muscular branch to the gluteus maximus. The inferior gluteal nerve and posterior cutaneous nerve of the thigh arose from a common trunk. The common trunk was formed by three roots. Upper and middle roots arose from sacral plexus and entered gluteal region through greater sciatic foramen respectively above and below piriformis. The lower root arose from the pudendal nerve and joined the common trunk. We discuss the clinical implications of the variations.

  20. Nerve entrapment after hamstring injury.

    Science.gov (United States)

    Lohrer, Heinz; Nauck, Tanja; Konerding, Moritz A

    2012-09-01

    Hamstring muscle injuries are a frequent cause of athletic sequelae, and the frequency of reinjuries is high. Frequently, disability in sport is the consequence and performance is limited. A case report of a soccer player who was unable to play his sport after a minor hamstring muscle injury is presented. We introduce a previously undescribed lesion featured by a scar compromising a motor branch of the sciatic nerve to the long head of the biceps femoris muscle. Resection of the involved branch of the nerve resulted in complete pain relief and full sport capacity. This case report demonstrates that in very rare cases, a scar tissue-induced intramuscular entrapment of a branch of the sciatic nerve must be considered as a reason for athletic incapacity after minor hamstring injury. Both the degree of a muscular injury and its specific location within the injured muscle may therefore influence the functional outcome.

  1. Arthroscopic medial meniscus trimming or repair under nerve blocks: Which nerves should be blocked?

    Science.gov (United States)

    Taha, AM; Abd-Elmaksoud, AM

    2016-01-01

    Background: This study aimed to determine the role of the sciatic and obturator nerve blocks (in addition to femoral block) in providing painless arthroscopic medial meniscus trimming/repair. Materials and Methods: One hundred and twenty patients with medial meniscus tear, who had been scheduled to knee arthroscopy, were planned to be included in this controlled prospective double-blind study. The patients were randomly allocated into three equal groups; FSO, FS, and FO. The femoral, sciatic, and obturator nerves were blocked in FSO groups. The femoral and sciatic nerves were blocked in FS group, while the femoral and obturator nerves were blocked in FO group. Intraoperative pain and its causative surgical maneuver were recorded. Results: All the patients (n = 7, 100%) in FO group had intraoperative pain. The research was terminated in this group but completed in FS and FSO groups (40 patients each). During valgus positioning of the knee for surgical management of the medial meniscus tear, the patients in FS group experienced pain more frequently than those in FSO group (P = 0.005). Conclusion: Adding a sciatic nerve block to the femoral nerve block is important for painless knee arthroscopy. Further adding of an obturator nerve block may be needed when a valgus knee position is required to manage the medial meniscus tear. PMID:27375382

  2. Significance of sciatic scoliotic list in operated patients with lumbar disc herniation.

    Science.gov (United States)

    Matsui, H; Ohmori, K; Kanamori, M; Ishihara, H; Tsuji, H

    1998-02-01

    The authors retrospectively reviewed the relation between the location of disc herniation and pre- and postoperative changes in sciatic scoliotic list in 40 patients with surgically confirmed lumbar disc herniation who had sciatic scoliotic list with postoperative recovery. Clinical factors associated with scoliosis also were included. To evaluate the significance and pathomechanism of sciatic scoliotic list. The proposed causes of lumbar sciatic scoliosis mainly imply an alleviation of nerve root irritation in relation to the anatomic location of disc herniation relative to the nerve root. The pre- and postoperative serial Cobb angle between L1 and L5 in anteroposterior lumbar radiographs in the standing position were measured. The relation between the convex side of scoliosis and clinical parameters in terms of the side of symptoms, age, gender, duration of low back pain or leg pain, the angle of a positive straight leg raising test, and the time required for recovery of sciatic scoliosis were investigated. In addition, magnetic resonance imaging also was performed in five recent cases from 40 patients. The average Cobb angle decreased from 10.7 degrees to 2.7 degrees within an average of 7.5 months after surgery. The preoperative Cobb angle of patients with disc herniation medial to the nerve root was significantly higher than that just beneath or lateral to the nerve root. Thirty-two of 40 patients (80.0%) had a lumbar disc herniation at the convex side of scoliosis, irrespective of the transverse location of the herniation. The time required for scoliosis disappearance in disc herniation located lateral to the nerve root tended to be longer than that for other types of disc herniation. Magnetic resonance imaging through the paramedian planes showed enlargement of the intervertebral foramen at the convex side of scoliosis, compared with that at the concave side in five recent cases from the current study. These results suggest that sciatic scoliotic list is not

  3. Salvianolic Acid A Protects the Peripheral Nerve Function in Diabetic Rats through Regulation of the AMPK-PGC1α-Sirt3 Axis

    Directory of Open Access Journals (Sweden)

    Guanhua Du

    2012-09-01

    Full Text Available Salvianolic acid A (SalA is one of the main efficacious, water-soluble constituents of Salvia miltiorrhiza Bunge. This study investigated the protective effects of SalA on peripheral nerve in diabetic rats. Administration of SalA (0.3, 1 and 3 mg/kg, ig was started from the 5th week after strepotozotocin (STZ60 mg/kg intraperitoneal injection and continued for 8 weeks. Paw withdrawal mechanical threshold (PWMT and motor nerve conduction velocity (MNCV were used to assess peripheral nerve function. The western blot methods were employed to test the expression levels of serine-threonine liver kinase B1 (LKB1, AMP-activated protein kinase (AMPK, peroxisome proliferator-activated receptor-gamma coactivator-1alpha (PGC-1α, silent information regulator protein3 (sirtuin 3/Sirt3 and neuronal nitric oxide synthase (nNOS in sciatic nerve. Results showed that SalA administration could increase PWMT and MNCV in diabetic rats; reduce the deterioration of sciatic nerve pathology; increase AMPK phosphorylation level, up-regulate PGC-1α, Sirt3 and nNOS expression, but had no influence on LKB1. These results suggest that SalA has protective effects against diabetic neuropathy. The beneficial effects of SalA on peripheral nerve function in diabetic rats might be attributed to improvements in glucose metabolism through regulation of the AMPK-PGC1α-Sirt3 axis.

  4. Differential astroglial responses in the spinal cord of rats submitted to a sciatic nerve double crush treated with local injection of cultured Schwann cell suspension or lesioned spinal cord extract: implications on cell therapy for nerve repair Respostas astrocitárias na medula espinal do rato submetido ao esmagamento duplo do nervo ciático e tratado com injeção local de suspensão de células de Schwann cultivadas ou de extrato de medula espinal lesada: implicações na terapia celular para o reparo do nervo

    Directory of Open Access Journals (Sweden)

    João Gabriel Martins Dallo

    2007-12-01

    Full Text Available PURPOSE: Reactive astrocytes are implicated in several mechanisms after central or peripheral nervous system lesion, including neuroprotection, neuronal sprouting, neurotransmission and neuropathic pain. Schwann cells (SC, a peripheral glia, also react after nerve lesion favoring wound/repair, fiber outgrowth and neuronal regeneration. We investigated herein whether cell therapy for repair of lesioned sciatic nerve may change the pattern of astroglial activation in the spinal cord ventral or dorsal horn of the rat. METHODS: Injections of a cultured SC suspension or a lesioned spinal cord homogenized extract were made in a reservoir promoted by a contiguous double crush of the rat sciatic nerve. Local injection of phosphate buffered saline (PBS served as control. One week later, rats were euthanized and spinal cord astrocytes were labeled by immunohistochemistry and quantified by means of quantitative image analysis. RESULTS: In the ipsilateral ventral horn, slight astroglial activations were seen after PBS or SC injections, however, a substantial activation was achieved after cord extract injection in the sciatic nerve reservoir. Moreover, SC suspension and cord extract injections were able to promote astroglial reaction in the spinal cord dorsal horn bilaterally. Conclusion: Spinal cord astrocytes react according to repair processes of axotomized nerve, which may influence the functional outcome. The event should be considered during the neurosurgery strategies.OBJETIVO: Astrócitos reativos participam de vários mecanismos após lesões do sistema nervoso central e periférico, os quais incluem neuroproteção, brotamento neuronal, neurotransmissão e dor neuropática. As células de Schwann (CS, um tipo de glia periférica, também reagem com a lesão do nervo, podendo interferir com o reparo e cicatrização, crescimento de fibras e regeneração neuronais. Investigamos aqui a possibilidade da terapia celular para o reparo do nervo ci

  5. Continuous sacral nerve root block in the management of neuropathic cancer pain

    NARCIS (Netherlands)

    Vranken, Jan H.; van der Vegt, Marinus H.; Ubags, Leon H.; Pijl, Aarnout J.; Dzoljic, Misa

    2002-01-01

    IMPLICATIONS: Neuropathic cancer pain caused by tumor infiltration in the sacral plexus is primarily treated by nonsteroidal antiinflammatory drugs, antidepressants, anticonvulsants, and opioids. In one patient with severe pain despite pharmacotherapy, a catheter for the continuous administration of

  6. Electronmicroscopical evaluation of short-term nerve regeneration through a thin-walled biodegradable poly(DLLA-epsilon-CL) nerve guide filled with modified denatured muscle tissue

    NARCIS (Netherlands)

    Meek, MF; Robinson, PH; Stokroos, [No Value; Blaauw, EH; Kors, G; den Dunnen, WFA

    The aim of this study was to evaluate short-term peripheral nerve regeneration across a 15-mm gap in the sciatic nerve of the rat, using a thin-walled biodegradable poly(DL-lactide-epsilon -caprolactone) nerve guide filled with modified denatured muscle tissue (MDMT). The evaluation was performed

  7. Prostaglandin E1 Protects the Peripheral Nerve in Diabetics through Preventing Vascular Permeability Changes.

    Science.gov (United States)

    Mo, Feifei; Hu, Guotao; Liu, Wei; He, Li; Wang, Hailan

    2018-02-01

    The aims of this study were to investigate the effects of the vasodilator prostaglandin E1 on microvascular permeability, the expression of vascular endothelial growth factor (VEGF), as well as the structural and functional changes of the peripheral nerve in diabetic rats. Streptozotocin-induced diabetes mellitus were randomly divided into two groups and intraperitoneally received, once daily, an injection of prostaglandin E1 at 1.6 μg/kg in normal saline or the same volume of normal saline (diabetic control), respectively. Six rats were randomly selected as normal controls. Diabetic controls exhibited a significant increase in the tail flick threshold temperature, water content of the sciatic nerve, serum VEGF level, and VEGF level in the sciatic nerve; in addition, a decrease in the sciatic nerve conduction velocity (NCV) was observed, compared with normal rats (Pprostaglandin E1 resulted in similar changes but at a slower rate than in those without treatment. Diabetic control rats also showed histological and ultrastructural abnormalities of the sciatic nerve, whereas prostaglandin E1-treated rats exhibited similar but less severe injury. The serum VEGF level was negatively correlated with the sciatic NCV (r=-0.932, PProstaglandin E1 could protect the peripheral nerve by improving sciatic nerve function, reducing the VEGF level, and decreasing the vascular permeability. This study provides an experimental proof that prostaglandin E1 has potential benefits in improving DPN in early stage. © Georg Thieme Verlag KG Stuttgart · New York.

  8. Suprazygomatic Access for Continuous Bilateral Mandibular Nerve Block for Pain and Trismus Relief in the Tetraplegic Patient.

    Science.gov (United States)

    Dziadzko, Mikhail A; Heritier, Fabrice

    2016-10-01

    Extraoral mandibular nerve block (MNB) is used in oropharyngeal surgery for analgesia and anesthesia. Repeated or continuous MNB has been used successfully as treatment for uncontrollable pain, masseter spasticity, and airway assessment. The usual technique involves transcutaneous infrazygomatic access. However, in some specific settings, this approach is not always feasible. A continuous bilateral MNB with a suprazygomatic approach to the pterygomandibular space was used to resolve a case of refractory and painful trismus in a patient with tetraplegia. Analgesia was achieved and maintained by bilateral catheter placement to the pterygomandibular space and repeated injection of local anesthetic for 48 hours. The right-side catheter was accidentally withdrawn; the left-side catheter was maintained up to 72 hours. The efficiency of analgesia was not affected. This block provided effective analgesia within the first few hours after local anesthetic injection, helped to improve mouth opening, and resolved acute pain. Because kinesitherapy could be introduced, the patient was left on nonopioid analgesics. Continuous bilateral MNB through the suprazygomatic approach was used safely and efficiently. The suggested approach is quite unique, as is the clinical circumstance, and might be considered when the usual technique is challenging. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  9. Treating Intractable Post-Amputation Phantom Limb Pain with Ambulatory Continuous Peripheral Nerve Blocks

    Science.gov (United States)

    2016-01-01

    AD_________________ Award Number: W81XWH-13-2-0009 TITLE: Treating Intractable Post-Amputation Phantom Limb Pain with Ambulatory Continuous...Annual 3. DATES COVERED 26 Dec 2014- 25 Dec 2015 4. TITLE AND SUBTITLE Treating Intractable Post-Amputation Phantom Limb Pain with Ambulatory...effective treatment for intractable phantom limb pain following a traumatic limb amputation. There is currently no reliable treatment for phantom limb pain

  10. Efeito da terapia com laser de arsenieto de gálio e alumínio (660Nm sobre a recuperação do nervo ciático de ratos após lesão por neurotmese seguida de anastomose epineural: análise funcional Effect of gallium-aluminum-arsenide laser therapy (660Nm on recovery of the sciatic nerve in rats following neurotmesis lesion and epineural anastomosis: functional analysis

    Directory of Open Access Journals (Sweden)

    FA Reis

    2008-06-01

    Full Text Available CONTEXTUALIZAÇÃO: As lesões nervosas periféricas podem comprometer atividades diárias de um indivíduo e resultam em perda da sensibilidade e motricidade do território inervado. OBJETIVO: Com o intuito de acelerar os processos regenerativos, objetivou-se analisar a influência da aplicação do laser de arsenieto de gálio e alumínio (AsGaAl, 660Nm sobre a recuperação funcional do nervo ciático de ratos. MATERIAIS E MÉTODOS: O nervo ciático de 12 ratos Wistar foi submetido à lesão por neurotmese e anastomose epineural e divididos em dois grupos: controle e laserterapia. Após a lesão, utilizou-se o laser de GaAlAs, 660Nm, 4J/cm², 26,3mW, feixe de 0,63cm², em três pontos eqüidistantes sobre a lesão, por 20 dias. As impressões das pegadas dos animais foram obtidas antes e após (sete, 14 e 21 dias pós-operatórios o procedimento cirúrgico e calculou-se o índice funcional do ciático (IFC. RESULTADOS: A comparação do IFC não resultou em diferença significante (p>0,05 entre os grupos. CONCLUSÕES: Conclui-se que os parâmetros e métodos empregados na laserterapia demonstram resultados nulos sobre o IFC no período avaliado.CONTEXT: Peripheral nerve injuries result in sensory and motor losses in the innervated area and can hinder individuals’ daily activities. Objective: The objective was to analyze the influence of applying gallium-aluminum-arsenide (GaAlAs laser (660Nm on the functional recovery of the sciatic nerve in rats. METHODS: The sciatic nerve of 12 Wistar rats was subjected to injury consisting of neurotmesis and epineural anastomosis. The rats were divided into two groups: control and laser therapy. After the injury, a GaAlAs laser was used (660Nm, 4J/cm², 26.3mW and 0.63cm² beam at three equidistant points on the injury, for 20 days. Footprint impressions were obtained from the animals before and seven, 14 and 21 days after the surgical procedure and the sciatic functional index (SFI was calculated

  11. Botulinum Toxin B Affects Neuropathic Pain but Not Functional Recovery after Peripheral Nerve Injury in a Mouse Model

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    Alba Finocchiaro

    2018-03-01

    Full Text Available Clinical use of neurotoxins from Clostridium botulinum is well established and is continuously expanding, including in treatment of pain conditions. Background: The serotype A (BoNT/A has been widely investigated, and current data demonstrate that it induces analgesia and modulates nociceptive processing initiated by inflammation or nerve injury. Given that data concerning the serotype B (BoNT/B are limited, the aim of the present study was to verify if also BoNT/B is able not only to counteract neuropathic pain, but also to interfere with inflammatory and regenerative processes associated with the nerve injury. Methods: As model of neuropathic pain, chronic constriction injury (CCI of the sciatic nerve was performed in CD1 male mice. Mice were intraplantarly injected with saline (control or BoNT/B (5 or 7.5 pg/mouse into the injured hindpaw. For comparison, another mouse group was injected with BoNT/A (15 pg/mouse. Mechanical allodynia and functional recovery of the injured paw was followed for 101 days. Spinal cords and sciatic nerves were collected at day 7 for immunohistochemistry. Results and Conclusions: The results of this study show that BoNT/B is a powerful biological molecule that, similarly to BoNT/A, can reduce neuropathic pain over a long period of time. However, the analgesic effects are not associated with an improvement in functional recovery, clearly highlighting an important difference between the two serotypes for the treatment of this chronic pain state.

  12. Botulinum Toxin B Affects Neuropathic Pain but Not Functional Recovery after Peripheral Nerve Injury in a Mouse Model

    Science.gov (United States)

    Finocchiaro, Alba; Marinelli, Sara; De Angelis, Federica; Vacca, Valentina; Pavone, Flaminia

    2018-01-01

    Clinical use of neurotoxins from Clostridium botulinum is well established and is continuously expanding, including in treatment of pain conditions. Background: The serotype A (BoNT/A) has been widely investigated, and current data demonstrate that it induces analgesia and modulates nociceptive processing initiated by inflammation or nerve injury. Given that data concerning the serotype B (BoNT/B) are limited, the aim of the present study was to verify if also BoNT/B is able not only to counteract neuropathic pain, but also to interfere with inflammatory and regenerative processes associated with the nerve injury. Methods: As model of neuropathic pain, chronic constriction injury (CCI) of the sciatic nerve was performed in CD1 male mice. Mice were intraplantarly injected with saline (control) or BoNT/B (5 or 7.5 pg/mouse) into the injured hindpaw. For comparison, another mouse group was injected with BoNT/A (15 pg/mouse). Mechanical allodynia and functional recovery of the injured paw was followed for 101 days. Spinal cords and sciatic nerves were collected at day 7 for immunohistochemistry. Results and Conclusions: The results of this study show that BoNT/B is a powerful biological molecule that, similarly to BoNT/A, can reduce neuropathic pain over a long period of time. However, the analgesic effects are not associated with an improvement in functional recovery, clearly highlighting an important difference between the two serotypes for the treatment of this chronic pain state. PMID:29562640

  13. The Impact of Motor Axon Misdirection and Attrition on Behavioral Deficit Following Experimental Nerve Injuries

    Science.gov (United States)

    Alant, Jacob Daniel de Villiers; Senjaya, Ferry; Ivanovic, Aleksandra; Forden, Joanne; Shakhbazau, Antos; Midha, Rajiv

    2013-01-01

    Peripheral nerve transection and neuroma-in-continuity injuries are associated with permanent functional deficits, often despite successful end-organ reinnervation. Axonal misdirection with non-specific reinnervation, frustrated regeneration and axonal attrition are believed to be among the anatomical substrates that underlie the poor functional recovery associated with these devastating injuries. Yet, functional deficits associated with axonal misdirection in experimental neuroma-in-continuity injuries have not yet been studied. We hypothesized that experimental neuroma-in-continuity injuries would result in motor axon misdirection and attrition with proportional persistent functional deficits. The femoral nerve misdirection model was exploited to assess major motor pathway misdirection and axonal attrition over a spectrum of experimental nerve injuries, with neuroma-in-continuity injuries simulated by the combination of compression and traction forces in 42 male rats. Sciatic nerve injuries were employed in an additional 42 rats, to evaluate the contribution of axonal misdirection to locomotor deficits by a ladder rung task up to 12 weeks. Retrograde motor neuron labeling techniques were utilized to determine the degree of axonal misdirection and attrition. Characteristic histological neuroma-in-continuity features were demonstrated in the neuroma-in-continuity groups and poor functional recovery was seen despite successful nerve regeneration and muscle reinnervation. Good positive and negative correlations were observed respectively between axonal misdirection (pinjuries of mixed motor nerves that contribute to the long-term functional deficits. Although widely accepted in theory, to our knowledge, this is the first experimental evidence to convincingly demonstrate these correlations with data inclusive of the neuroma-in-continuity spectrum. This work emphasizes the need to focus on strategies that promote both robust and accurate nerve regeneration to optimize

  14. Intraexaminer and interexaminer reliability of manual palpation and pressure algometry of the lower limb nerves in asymptomatic subjects.

    LENUS (Irish Health Repository)

    Fingleton, Caitriona P

    2014-02-01

    Nerve palpation is a method of clinically identifying mechanosensitivity of neural tissue by means of pressure algometry and manual palpation. There are few investigations of the reliability of lower limb nerve palpation, and femoral nerve palpation has never been previously reported. The aim of this study was to investigate the reliability of nerve palpation of the femoral, sciatic, tibial, and common peroneal nerves and to report normative values for the femoral nerve.

  15. 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.

  16. Analgesic efficacy of continuous femoral nerve block commenced prior to operative fixation of fractured neck of femur

    LENUS (Irish Health Repository)

    Szucs, Szilard

    2012-06-27

    AbstractBackgroundPeripheral nerve blocks are effective in treating acute pain, thereby minimizing the requirement for opiate analgesics. Fractured neck of femur (FNF) is a common, painful injury. The provision of effective analgesia to this cohort is challenging but an important determinant of their functional outcome. We investigated the analgesic efficacy of continuous femoral nerve block (CFNB) in patients with FNF.MethodsFollowing institutional ethical approval and with informed consent, patients awaiting FNF surgery were randomly allocated to receive either standard opiate-based analgesia (Group 1) or a femoral perineural catheter (Group 2). Patients in Group 1 received parenteral morphine as required. Those in Group 2 received a CFNB comprising a bolus of local anaesthetic followed by a continuous infusion of 0.25% bupivacaine. For both Groups, rescue analgesia consisted of intramuscular morphine as required and all patients received paracetamol regularly. Pain was assessed using a visual analogue scale at rest and during passive movement (dynamic pain score) at 30 min following first analgesic intervention and six hourly thereafter for 72 hours. Patient satisfaction with the analgesic regimen received was recorded using verbal rating scores (0-10). The primary outcome measured was dynamic pain score from initial analgesic intervention to 72 hours later.ResultsOf 27 recruited, 24 patients successfully completed the study protocol and underwent per protocol analysis. The intervals from recruitment to the study until surgery were similar in both groups [31.4(17.7) vs 27.5(14.2) h, P = 0.57]. The groups were similar in terms of baseline clinical characteristics. For patients in Group 2, pain scores at rest were less than those reported by patients in Group 1 [9.5(9.4) vs 31(28), P = 0.031]. Dynamic pain scores reported by patients in Group 2 were less at each time point from 30 min up to 54 hours [e.g at 6 h 30.7(23.4) vs 67.0(32.0), P = 0

  17. Brain injury in combination with tacrolimus promotes the regeneration of injured peripheral nerves

    Directory of Open Access Journals (Sweden)

    Xin-ze He

    2017-01-01

    Full Text Available Both brain injury and tacrolimus have been reported to promote the regeneration of injured peripheral nerves. In this study, before transection of rat sciatic nerve, moderate brain contusion was (or was not induced. After sciatic nerve injury, tacrolimus, an immunosuppressant, was (or was not intraperitoneally administered. At 4, 8 and 12 weeks after surgery, Masson's trichrome, hematoxylin-eosin, and toluidine blue staining results revealed that brain injury or tacrolimus alone or their combination alleviated gastrocnemius muscle atrophy and sciatic nerve fiber impairment on the experimental side, simultaneously improved sciatic nerve function, and increased gastrocnemius muscle wet weight on the experimental side. At 8 and 12 weeks after surgery, brain injury induction and/or tacrolimus treatment increased action potential amplitude in the sciatic nerve trunk. Horseradish peroxidase retrograde tracing revealed that the number of horseradish peroxidase-positive neurons in the anterior horn of the spinal cord was greatly increased. Brain injury in combination with tacrolimus exhibited better effects on repair of injured peripheral nerves than brain injury or tacrolimus alone. This result suggests that brain injury in combination with tacrolimus promotes repair of peripheral nerve injury.

  18. Injection-induced Sciatic Nerve Injury Among Children Managed in ...

    African Journals Online (AJOL)

    African Journal of Physiotherapy and Rehabilitation Sciences. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 3, No 1 (2011) >. Log in or Register to get access to full text downloads.

  19. Combination Therapy with Continuous Three-in-One Femoral Nerve Block and Periarticular Multimodal Drug Infiltration after Total Hip Arthroplasty

    Directory of Open Access Journals (Sweden)

    Tomonori Tetsunaga

    2016-01-01

    Full Text Available Background. Various postoperative pain relief modalities, including continuous femoral nerve block (CFNB, local infiltration analgesia (LIA, and combination therapy, have been reported for total knee arthroplasty. However, no studies have compared CFNB with LIA for total hip arthroplasty (THA. The aim of this study was to compare the efficacy of CFNB versus LIA after THA. Methods. We retrospectively reviewed the postoperative outcomes of 93 THA patients (20 men, 73 women; mean age 69.2 years. Patients were divided into three groups according to postoperative analgesic technique: CFNB, LIA, or combined CFNB+LIA. We measured the following postoperative outcome parameters: visual analog scale (VAS for pain at rest, supplemental analgesia, side effects, mobilization, length of hospital stay, and Harris Hip Score (HHS. Results. The CFNB+LIA group had significantly lower VAS pain scores than the CFNB and LIA groups on postoperative day 1. There were no significant differences among the three groups in use of supplemental analgesia, side effects, mobilization, length of hospital stay, or HHS at 3 months after THA. Conclusions. Although there were no clinically significant differences in outcomes among the three groups, combination therapy with CFNB and LIA provided better pain relief after THA than CFNB or LIA alone, with few side effects.

  20. Continuous Femoral Nerve Block versus Intravenous Patient Controlled Analgesia for Knee Mobility and Long-Term Pain in Patients Receiving Total Knee Replacement: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Lihua Peng

    2014-01-01

    Full Text Available Objectives. To evaluate the comparative analgesia effectiveness and safety of postoperative continuous femoral nerve block (CFNB with patient controlled intravenous analgesia (PCIA and their impact on knee function and chronic postoperative pain. Methods. Participants were randomly allocated to receive postoperative continuous femoral nerve block (group CFNB or intravenous patient controlled analgesia (group PCIA. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC scores for knee and incidence of chronic postoperative pain at 3, 6, and 12 months postoperatively were compared. postoperative pain and salvage medication at rest or during mobilization 24 hours, 48 hours, and 7 days postoperatively were also recorded. Results. After discharge from the hospital and rehabilitation of joint function, patients in group CFNB reported significantly improved knee flexion and less incidence of chronic postoperative pain at 3 months and 6 months postoperatively (P<0.05. Analgesic rescue medications were significantly reduced in patients receiving CFNB (P<0.001 and P=0.031, resp.. Conclusion. With standardized rehabilitation therapy, continuous femoral nerve block analgesia reduced the incidence of chronic postoperative pain, improved motility of replaced joints, and reduced the dosages of rescue analgesic medications, suggesting a recovery-enhancing effect of peripheral nerve block analgesia.

  1. Contribution of α-adrenoceptors to depolarization and contraction evoked by continuous asynchronous sympathetic nerve activity in rat tail artery

    Science.gov (United States)

    Brock, J A; McLachlan, E M; Rayner, S E

    1997-01-01

    The effects of continuous but asynchronous nerve activity induced by ciguatoxin (CTX-1) on the membrane potential and contraction of smooth muscle cells have been investigated in rat proximal tail arteries isolated in vitro. These effects have been compared with those produced by the continuous application of phenylephrine (PE).CTX-1 (0.4 nM) and PE (10 μM) produced a maintained depolarization of the arterial smooth muscle that was almost completely blocked by α-adrenoceptor blockade. In both cases, the depolarization was more sensitive to the selective α2-adrenoceptor antagonist, idazoxan (0.1 μM), than to the selective α1-adrenoceptor antagonist, prazosin (0.01 μM).In contrast, the maintained contraction of the tail artery induced by CTX-1 (0.2 nM) and PE (2 and 10 μM) was more sensitive to prazosin (0.01) μM, than to idazoxan (0.01 μM). In combination, these antagonists almost completely inhibited contraction to both agents.Application of the calcium channel antagonist, nifedipine (1 μM), had no effect on the depolarization induced by either CTX-1 or PE but maximally reduced the force of the maintained contraction to both agents by about 50%.We conclude that the constriction of the tail artery induced by CTX-1, which mimics the natural discharge of postganglionic perivascular axons, is due almost entirely to α-adrenoceptor activation. The results indicate that neuronally released noradrenaline activates more than one α-adrenoceptor subtype. The depolarization is dependent primarily on α2-adrenoceptor activation whereas the contraction is dependent primarily on α1-adrenoceptor activation. The links between α-adrenoceptor activation and the voltage-dependent and voltage-independent mechanisms that deliver Ca2+ to the contractile apparatus appear to be complex. PMID:9113373

  2. 0.5% levobupivacaine versus 0.5% ropivacaine: Are they different in ultrasound-guided sciatic block?

    Directory of Open Access Journals (Sweden)

    Pham Dang Charles

    2015-01-01

    Full Text Available Context and Aims: Little is known about onset and duration of sciatic block after 0.5% levobupivacaine (Levo versus 0.5% ropivacaine (Ropi for ultrasound-guided technique. We assessed these parameters in the ultrasound-guided block, to know for the practice. Setting and Design: A comparative randomized double-blind study was conducted in the University Hospital. Materials and Methods: Were included 35 adults of ASA I-II, scheduled for foot surgery, presenting clear imaging of their sciatic nerve at mid-thigh. A volume of 20 mL of either 0.5% Levo or 0.5% Ropi were injected around the sciatic nerve at mid-thigh using ultrasound guidance (out of the plane followed by placement of a catheter to use, if necessary, for perioperative analgesia. A femoral single shot block was systematically performed to block the saphenous nerve. The onset times until complete foot block (primary outcome and the sensory and motor block duration (secondary outcome were assessed using Wilcoxon test. Values were expressed as medians (1 st -3 rd quartile. Results: Except for two delayed sciatic blocks in each group, the onset time otherwise was 35 min (20-60 in Ropi versus 40 min (30-60 in Levo, P = 0.5. Sensory block lasted longer in Levo, 17 h (14-27 compared with 15 h (10-17 in Ropi, P = 0.04. No significant between-group difference was found with motor block durations, 15 h (12-18 in Levo and 15 h (12-16 in Ropi, P = 0.3. Conclusion: No difference of onset times was found in ultrasound-guided sciatic block whether using Levo or Ropi. Levo induced a longer-lasting sensory block.

  3. Vascular entrapment of the sciatic plexus causing catamenial sciatica and urinary symptoms.

    Science.gov (United States)

    Lemos, Nucelio; Marques, Renato Moretti; Kamergorodsky, Gil; Ploger, Christine; Schor, Eduardo; Girão, Manoel J B C

    2016-02-01

    Pelvic congestion syndrome is a well-known cause of cyclic pelvic pain (Ganeshan et al., Cardiovasc Intervent Radiol 30(6):1105-11, 2007). What is much less well known is that dilated or malformed branches of the internal or external iliac vessels can entrap the nerves of the sacral plexus against the pelvic sidewalls, producing symptoms that are not commonly seen in gynecological practice, such as sciatica, or refractory urinary and anorectal dysfunction (Possover et al., Fertil Steril 95(2):756-8. 2011). The objective of this video is to explain and describe the symptoms suggestive of vascular entrapment of the sacral plexus, as well as the technique for the laparoscopic decompression of these nerves. Two anecdotal cases of intrapelvic vascular entrapment are used to review the anatomy of the lumbosacral plexus and demonstrate the laparoscopic surgical technique for decompression at two different sites, one on the sciatic nerve and one on the sacral nerve roots. After surgery, the patient with the sciatic entrapment showed full recovery of the sciatica and partial recovery of the myofascial pain. The patient with sacral nerve root entrapment showed full recovery with resolution of symptoms. The symptoms suggestive of intrapelvic nerve entrapment are: perineal pain or pain irradiating to the lower limbs in the absence of a spinal disorder, and lower urinary tract symptoms in the absence of prolapse of a bladder lesion. In the presence of such symptoms, the radiologist should provide specific MRI sequences of the intrapelvic portion of the sacral plexus and a team and equipment to expose and decompress the sacral nerves should be prepared.

  4. Local administration of prostaglandin E1 combined with silicone chamber improves peripheral nerve regeneration.

    Science.gov (United States)

    Najafpour, Alireza; Mohammadi, Rahim; Faraji, Darab; Amini, Keyvan

    2013-01-01

    The aim of this study was to assess the effect of locally administered prostaglandin E1 on peripheral nerve regeneration and functional recovery. Sixty male healthy white Wistar rats were divided into four experimental groups (n = 15), randomly: In transected group (TC), left sciatic nerve was transected and stumps were fixed in the adjacent muscle. In treatment group defect was bridged using silicone graft (SIL/PE) filled with 10 μL prostaglandin E1. In silicone graft group (SIL), the graft was filled with phosphate-buffered saline alone. In sham-operated group (SHAM), sciatic nerve was exposed and manipulated. Each group was subdivided into three subgroups of five animals each and regenerated nerve fibers were studied 4, 8 and 12 weeks after surgery. Behavioral testing, sciatic nerve functional study, gastrocnemius muscle mass and morphometric indices confirmed faster recovery of regenerated axons in SIL/PE than SIL group (p prostaglandin E1 improved functional recovery and morphometric indices of sciatic nerve. Local application of prostaglandin E1 improved functional recovery and morphometric indices of sciatic nerve. Copyright © 2013 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  5. Vascularized nerve grafts: an experimental study.

    Science.gov (United States)

    Donzelli, Renato; Capone, Crescenzo; Sgulò, Francesco Giovanni; Mariniello, Giuseppe; Maiuri, Francesco

    2016-08-01

    The aim of this study is to define an experimental model in order to promote the functional recovery of the nerves using grafts with vascular support (Vascular Nerve Grafts - VNG). The aim of this study is to define, on an experimental model in normal recipient bed, whether the functional recovery with VNG is superior to that obtained non-vascularized graft (NNG). Twenty male rabbits, which underwent dissection of sciatic nerve, were later treated by reinnervation through an autograft. In 10 animals the reconstruction of sciatic nerve was realized with VNG; in 10 control animals the reconstruction of sciatic nerve was realized with NNG. The VNG group showed a better axonal organization and a significantly higher number of regenerated axons in the early phases (after 30 days) than the NNG group, whereas the difference in the axonal number at day 90 was less significant; besides, the axon diameter and the myelin thickness were not significantly improved by VNG group. Our data suggests that the use of VNG leads to a faster regeneration process and a better functional recovery, although the final results are comparable to those of the NNG. VNG improve the quality of the axonal regeneration (axonal diameter and Schwann cells), although the increase in the axonal number is not significant and does not improve the long-term functional outcome.

  6. Long-term evaluation of functional nerve recovery after reconstruction with a thin-walled biodegradable poly (DL-lactide-epsilon-caprolactone) nerve guide, using walking track analysis and electrostimulation tests

    NARCIS (Netherlands)

    Meek, MF; Den Dunnen, WFA; Schakenraad, JM; Robinson, PH

    1999-01-01

    This study was performed to evaluate the long-term functional nerve recovery after reconstruction of a IO-mm gap in the sciatic nerve of the rat, with a thin-walled nerve guide, composed of a biodegradable copolymer of DL-lactide and epsilon-caprolactone [p(DLLA-epsilon-CL)]. To evaluate both motor

  7. Reasonable classical concepts in human lower limb anatomy from the viewpoint of the primitive persistent sciatic artery and twisting human lower limb.

    Science.gov (United States)

    Kawashima, Tomokazu; Sasaki, Hiroshi

    2010-11-01

    The main aim of this review is (1) to introduce the two previous studies we published human lower limb anatomy based on the conventional macroscopic anatomical [corrected] criteria with hazardous recognition of this description, (2) to activate the discussion whether the limb homology exists, and (3) to contribute to future study filling the gap between the gross anatomy and embryology. One of the topics we discussed was the human persistent sciatic artery. To date, numerous human cases of persistent sciatic artery have been reported in which the anomalous artery was present in the posterior compartment of the thigh alongside the sciatic nerve. As one of the important criteria for assessing the human primitive sciatic artery, its ventral arterial position with respect to the sciatic nerve is reasonable based on the initial positional relationship between ventral arterial and dorsal nervous systems and comparative anatomical findings. We also discuss ways of considering the topography of muscles of the lower limb and their innervations compared to those of the upper limb. We propose a schema of the complex anatomical characteristics of the lower limb based on the vertebrate body plan. According to this reasonable schema, the twisted anatomy of the lower limb can be understood more easily. These two main ideas discussed in this paper will be useful for further understanding of the anatomy of the lower limb and as a first step for future. We hope that the future study in lower limb will be further developed by both viewpoints of the classical gross anatomy and recent embryology.

  8. Comparison of Continuous Femoral Nerve Block versus Local Infiltration Analgesia as a Postoperative Analgesia in Unilateral Total Knee Arthroplasty.

    Science.gov (United States)

    Chaubey, Deepika; Mahajan, Hari Krishan; Chauhan, Parshu Ram; Govind, Preeti S; Singh, Pushpinder; Dhanevar, Ravinder; Gupta, Abhinav

    2017-07-01

    Local infiltration of knee joint in arthroplasty, provide postoperative analgesia and preserves motor power of quadriceps, which helps in early mobilisation, as compared to femoral nerve block which paralyses vastus medialis. To compare the quality of postoperative analgesia provided by femoral nerve block and local infiltration in unilateral Total Knee Arthroplasty (TKA). A prospective study was conducted on 60 patients (25-65 years) of ASA I and II, which were randomly(using random number table) divided into two groups - Group 1-femoral nerve block (FNB) and Group 2-Local Infiltration Analgesia (LIA). Patients with chronic pain and on opioids were excluded. Numeric rating scale (primary objective), sedation score, nausea vomiting score and motor power were analysed. The results were analysed by parametric and nonparametric tests using SPSS software version 22. ppower grading (<0.001). FNB has better pain relief than LIA Group but range of motion was reduced in FNB Group grossly, effect on mobilisation remained comparable in both group.

  9. Effects of 660-nm gallium-aluminum-arsenide low-energy laser on nerve regeneration after acellular nerve allograft in rats.

    Science.gov (United States)

    Zhang, Li-Xin; Tong, Xiao-Jie; Yuan, Xiu-Hua; Sun, Xiao-Hong; Jia, Hua

    2010-02-01

    The purpose of this study was to explore and discuss the effects of 660-nm gallium-aluminum-arsenide low-energy laser (GaAlAs LEL) irradiation on neural regeneration after acellular nerve allograft repair of the sciatic nerve gap in rats. Eight male and female Sprague-Dawley rats were used as nerve donors, and 32 healthy Wistar rats were randomly divided into four groups: normal control group, acellular rat sciatic nerve (ARSN) group, laser group, and autograft group. Twelve weeks after surgery, nerve conduction velocity, restoration rate of tibialis anterior wet muscle weight, myelinated nerve number, and calcitonin gene-related peptide (CGRP) protein and mRNA expression of the spinal cord and muscle at the injury site were quantified and statistically analyzed. Compared with the ARSN group, laser therapy significantly increased nerve conduction velocity, restoration rate of tibialis anterior wet muscle weight, myelinated nerve number, and CGRP protein and mRNA expression of the L(4) spinal cord at the injury site. These findings demonstrate that 660-nm GaAlAs LEL therapy upregulates CGRP protein and mRNA expression of the L(4) spinal cord at the injury site and increases the rate of regeneration and target reinnervation after acellular nerve allograft repair of the sciatic nerve gap in rats. Low-energy laser irradiation may be a useful, noninvasive adjunct for promoting nerve regeneration in surgically induced defects repaired with ARSN.

  10. Efeito analgésico de longa duração da dipirona sobre a hiperalgesia persistente induzida pela constrição do nervo ciático em ratos: participação do óxido nítrico Long term analgesic effect of dipyrone on the persistent hyperalgesia induced by chronic constriction injury of sciatic nerve in rats: involviment of nitric oxide

    Directory of Open Access Journals (Sweden)

    Fábio José Reis

    2006-12-01

    Full Text Available O efeito analgésico de longa duração da dipirona foi avaliado em um modelo de dor neuropática assim como a participação da via óxido nítrico-GMPc neste mecanismo analgésico. Uma única administração intraplantar de dipirona (80 µg, no 14º dia após a instalação da hiperalgesia neuropática induzida pela constrição do nervo ciático exerceu um efeito analgésico, significativo e de longa duração. A inibição da óxido nítrico sintetase com L-NAME (50 ou 100 µg/pata, ou do óxido nítrico (NO endógeno com hemoglobina (10 ou 30 µg/pata, bloquearam o desenvolvimento do efeito analgésico da dipirona. A L-arginina (500 µg/pata reverteu o efeito do L-NAME. Cloreto de metiltionínio (azul de metileno (500 µg/pata, ODQ (50 µg/pata (bloqueadores da guanilil ciclase ou glibenclamida (100, 200 ou 300 µg/pata (bloqueador de canais de K+ sensíveis ao ATP inibiram o efeito analgésico da dipirona. O nitroprussiato de sódio administrado no 14º dia após a instalação da hiperalgesia neuropática também exerceu efeito analgésico de longa duração, semelhante ao observado com a dipirona. Sugerimos que a ação analgésica periférica e de longa duração da dipirona, neste modelo experimental, ocorra devido a provável dessensibilização dos nociceptores, envolvendo a via óxido nítrico - GMPc e canais de K+ sensíveis ao ATP.The long term analgesic effect of dipyrone was evaluated on a model of neuropathic pain and the role of nitric oxide/GMPc pathway in this antinociceptive mechanism. One intraplantar dipyrone administration (80 mg, at 14th day after the chronic constriction injury of the sciatic nerve, induced a significant and long term analgesic effect. The inhibition of nitric oxide synthase (NOS with L-NAME (50 or 100 mg/paw or scavenging of the endogenous NO with hemoglobin (10 or 30 mg/paw inhibited the development of the dipyrone analgesia. L-arginine (500 mg/paw could reverted the effect of L-NAME. Metylene blue

  11. 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.

  12. Calcium regulation in frog peripheral nerve by the blood-nerve barrier

    International Nuclear Information System (INIS)

    Wadhwani, K.C.

    1986-01-01

    The objectives of this research were: (a) to investigate the characteristics of calcium transport across the perineurium and the endoneurial capillaries, and (b) to gain a better understanding of the extent of calcium homeostasis in the endoneurial space. To study the nature of calcium transport across the perineurium, the flux of radiotracer 45 Ca was measured through the perineurial cylinder, isolated from the frog sciatic nerve, and through the perineurium into the nerve in situ. To study the nature of calcium transport across the endoneurial capillaries, the permeability-surface area product (PA) of 45 Ca was determined as a function of the calcium concentration in the blood. To study calcium homeostasis, the calcium content of the frog sciatic nerve was determined as a function of chronic changes in plasma [Ca

  13. Beta secretase activity in peripheral nerve regeneration

    Directory of Open Access Journals (Sweden)

    Carolyn Tallon

    2017-01-01

    Full Text Available While the peripheral nervous system has the capacity to regenerate following a nerve injury, it is often at a slow rate and results in unsatisfactory recovery, leaving patients with reduced function. Many regeneration associated genes have been identified over the years, which may shed some insight into how we can manipulate this intrinsic regenerative ability to enhance repair following peripheral nerve injuries. Our lab has identified the membrane bound protease beta-site amyloid precursor protein-cleaving enzyme 1 (BACE1, or beta secretase, as a potential negative regulator of peripheral nerve regeneration. When beta secretase activity levels are abolished via a null mutation in mice, peripheral regeneration is enhanced following a sciatic nerve crush injury. Conversely, when activity levels are greatly increased by overexpressing beta secretase in mice, nerve regeneration and functional recovery are impaired after a sciatic nerve crush injury. In addition to our work, many substrates of beta secretase have been found to be involved in regulating neurite outgrowth and some have even been identified as regeneration associated genes. In this review, we set out to discuss BACE1 and its substrates with respect to axonal regeneration and speculate on the possibility of utilizing BACE1 inhibitors to enhance regeneration following acute nerve injury and potential uses in peripheral neuropathies.

  14. Therapeutic electrical stimulation of injured peripheral nerve tissue using implantable thin-film wireless nerve stimulators.

    Science.gov (United States)

    MacEwan, Matthew R; Gamble, Paul; Stephen, Manu; Ray, Wilson Z

    2018-02-09

    OBJECTIVE Electrical stimulation of peripheral nerve tissue has been shown to accelerate axonal regeneration. Yet existing methods of applying electrical stimulation to injured peripheral nerves have presented significant barriers to clinical translation. In this study, the authors examined the use of a novel implantable wireless nerve stimulator capable of simultaneously delivering therapeutic electrical stimulation of injured peripheral nerve tissue and providing postoperative serial assessment of functional recovery. METHODS Flexible wireless stimulators were fabricated and implanted into Lewis rats. Thin-film implants were used to deliver brief electrical stimulation (1 hour, 20 Hz) to sciatic nerves after nerve crush or nerve transection-and-repair injuries. RESULTS Electrical stimulation of injured nerves via implanted wireless stimulators significantly improved functional recovery. Brief electrical stimulation was observed to increase the rate of functional recovery after both nerve crush and nerve transection-and-repair injuries. Wireless stimulators successfully facilitated therapeutic stimulation of peripheral nerve tissue and serial assessment of nerve recovery. CONCLUSIONS Implantable wireless stimulators can deliver therapeutic electrical stimulation to injured peripheral nerve tissue. Implantable wireless nerve stimulators might represent a novel means of facilitating therapeutic electrical stimulation in both intraoperative and postoperative settings.

  15. Post-scurfy sciatic neuralgia: case report

    Directory of Open Access Journals (Sweden)

    Evaristo Febles Piñar

    2012-05-01

    Full Text Available Introduction: Post scurfy neuralgia is a frequent cause of chronic intractable pain and constitutes the most feared complication of Herpetic Neuralgia. It can last for many years leading the patient to despair, depression, social isolation, and suicidal ideas. Ojectives: To present the clinical course of an elderly patient with post herpetic sciatic neuralgia treated at the Pain Clinic of Ameijeiras Brothers Hospital in January of 2011. Conclusions: Success in treating post scurfy neuralgia is related to early detection and intervention.

  16. Nestin-Expressing Stem Cells Promote Nerve Growth in Long-Term 3-Dimensional Gelfoam®-Supported Histoculture.

    Directory of Open Access Journals (Sweden)

    Sumiyuki Mii

    Full Text Available We have previously reported that hair follicles contain multipotent stem cells which express nestin. The nestin-expressing cells form the hair follicle sensory nerve. In vitro, the nestin-expressing hair follicle cells can differentiate into neurons, Schwann cells, and other cell types. In the present study, the sciatic nerve was excised from transgenic mice in which the nestin promoter drives green fluorescent protein (ND-GFP mice. The ND-GFP cells of the sciatic nerve were also found to be multipotent as the ND-GFP cells in the hair follicle. When the ND-GFP cells in the mouse sciatic nerve cultured on Gelfoam® and were imaged by confocal microscopy, they were observed forming fibers extending the nerve. The fibers consisted of ND-GFP-expressing spindle cells, which co-expressed the neuron marker β-III tubulin, the immature Schwann-cell marker p75(NTR and TrkB which is associated with neurons. The fibers also contain nestin-negative spherical cells expressing GFAP, a Schwann-cell marker. The β-III tubulin-positive fibers had growth cones on their tips expressing F-actin, indicating they are growing axons. When the sciatic nerve from mice ubiquitously expressing red fluorescent protein (RFP was co-cultured on Gelfoam® with the sciatic nerve from ND-GFP transgenic mice, the interaction of nerves was observed. Proliferating nestin-expressing cells in the injured sciatic nerve were also observed in vivo. Nestin-expressing cells were also observed in posterior nerves but not in the spinal cord itself, when placed in 3-D Gelfoam® culture. The results of the present report suggest a critical function of nestin-expressing cells in peripheral nerve growth and regeneration.

  17. Complement inhibition accelerates regeneration in a model of peripheral nerve injury

    NARCIS (Netherlands)

    Ramaglia, Valeria; Tannemaat, Martijn Rudolf; de Kok, Maryla; Wolterman, Ruud; Vigar, Miriam Ann; King, Rosalind Helen Mary; Morgan, Bryan Paul; Baas, Frank

    2009-01-01

    Complement (C) activation is a crucial event in peripheral nerve degeneration but its effect on the subsequent regeneration is unknown. Here we show that genetic deficiency of the sixth C component, C6, accelerates axonal regeneration and recovery in a rat model of sciatic nerve injury. Foot-flick

  18. A novel suture method to place and adjust peripheral nerve catheters

    DEFF Research Database (Denmark)

    Rothe, C.; Steen-Hansen, C.; Madsen, M. H.

    2015-01-01

    We have developed a peripheral nerve catheter, attached to a needle, which works like an adjustable suture. We used in-plane ultrasound guidance to place 45 catheters close to the femoral, saphenous, sciatic and distal tibial nerves in cadaver legs. We displaced catheters after their initial...

  19. Regeneration of unmyelinated and myelinated sensory nerve fibres studied by a retrograde tracer method

    DEFF Research Database (Denmark)

    Lozeron, Pierre; Krarup, Christian; Schmalbruch, Henning

    2004-01-01

    Regeneration of myelinated and unmyelinated sensory nerve fibres after a crush lesion of the rat sciatic nerve was investigated by means of retrograde labelling. The advantage of this method is that the degree of regeneration is estimated on the basis of sensory somata rather than the number...

  20. Uma nova pinça regulável para a produção de lesões por esmagamento do nervo ciático do rato A new adjustable pinch designed for producing crush nerve injuries in the sciatic nerve of rats

    Directory of Open Access Journals (Sweden)

    Vanessa Vilela Monte-Raso

    2009-01-01

    Full Text Available OBJETIVO: Foi nosso objetivo, desenvolver uma pinça regulável que permite produzir uma lesão com carga conhecida, num segmento de 5 mm de comprimento do nervo isquiático de ratos. MÉTODOS: O material escolhido para confecção da pinça foi o aço inoxidável, pela sua maior durabilidade e possibilidade de esterilização com soluções anti-sépticas, quase sempre corrosivas. A carga de esmagamento da pinça é regulável, pelo aumento ou diminuição da tensão da mola que a aciona, por meio de um parafuso de regulagem de calibração, feita com uma célula de carga. RESULTADO: A pinça foi utilizada em investigações experimentais e mostrou-se tão eficiente quanto as máquinas de ensaio e de peso morto anteriormente utilizadas. CONCLUSÃO: A pinça desenvolvida apresenta vantagens de ser portátil, de fácil manuseio, baixo custo e permite padronização da carga aplicada.OBJECTIVE: A new adjustable pinch has been developed for producing a crush injury, with a previously known load of 5 kg, on a 5 mm-long segment of the nerve. METHODS: Stainless steel was the material selected for building the pinch due its durability and possibility of sterilization with anti-septic substances, which are often corrosive. The crushing load of the pinch is adjustable by increasing or decreasing the tension of the spring by means of a screw used for calibration, which is performed by a load cell. RESULT: This pinch has been used in a few experimental investigations and was shown to be as efficient as both the universal testing machine and the dead weight machine, previously used. CONCLUSION: The developed pinch has the advantages of being portable and user-friendly. In addition, the pinch is cheap and allows for the standardization of the applied load.

  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

    Aim: Glucagon-like peptide-1 (GLP-1) is an incretin hormone that induces glucose-dependent insulin secretion and may have neurotrophic properties. Our aim was to identify the presence and activity of GLP-1 receptors (GLP-1Rs) in peripheral nerve and to assess the impact of GLP-1R agonists on diab...... that the peripheral nerve of diabetic rodents exhibits functional GLP-1R and suggest that GLP-1R-mediated ERK-signalling in sciatic nerve of diabetic rodents may protect large motor fibre function and small C fibre structure by a mechanism independent of glycaemic control....

  2. The role of dexamethasone in peripheral and neuraxial nerve blocks ...

    African Journals Online (AJOL)

    axillary, lumbar plexus, femoral, 3 in 1, sciatic, popliteal, ankle block, caudal, epidural or nerve block. The 'and' function was used to combine these terms with dexamethasone, corticosteroid, or steroid with the definition exploded. The initial search terms with the keywords with the definition exploded were utilised. We.

  3. Electrophysiological characterization of spino-sciatic and cortico-sciatic associative plasticity: modulation by trans-spinal direct current and effects on recovery after spinal cord injury in mice.

    Science.gov (United States)

    Ahmed, Zaghloul

    2013-03-13

    Associative stimulation causes enduring changes in the nervous system based on the Hebbian concept of spike-timing-dependent plasticity. The present study aimed to characterize the immediate and long-term electrophysiological effects of associative stimulation at the level of spinal cord and to test how trans-spinal direct current stimulation (tsDC) modulates associative plasticity. The effect of combined associative stimulation and tsDC on locomotor recovery was tested in a unilateral model of spinal cord injury (SCI). Two associative protocols were tested: (1) spino-sciatic associative (SSA) protocol, in which the first stimulus originated from the sciatic nerve and the second from the spinal cord; and (2) cortico-sciatic associative (CSA) protocol, in which the first stimulus originated from the sciatic nerve and the second from the motor cortex. In addition, those two protocols were repeated in combination with cathodal tsDC application. SSA and CSA stimulation produced immediate enhancement of spinal and cortical outputs, respectively, depending on the duration of the interstimulus interval. Repetitive SSA or CSA stimulation produced long-term potentiation of spinal and cortical outputs, respectively. Applying tsDC during SSA or CSA stimulation markedly enhanced their immediate and long-term effects. In behaving mice with unilateral SCI, four consecutive 20 min sessions of CSA + tsDC markedly reduced error rate in a horizontal ladder-walking test. Thus, this form of artificially enhanced associative connection can be translated into a form of motor relearning that does not depend on practice or experience.

  4. Treadmill Training Enhances Axon Regeneration In Injured Mouse Peripheral Nerves Without Increased Loss of Topographic Specificity

    Science.gov (United States)

    English, Arthur W.; Cucoranu, Delia; Mulligan, Amanda; Sabatier, Manning

    2009-01-01

    We investigated the extent of misdirection of regenerating axons when that regeneration was enhanced using treadmill training. Retrograde fluorescent tracers were applied to the cut proximal stumps of the tibial and common fibular nerves two or four weeks after transection and surgical repair of the mouse sciatic nerve. The spatial locations of retrogradely labeled motoneurons were studied in untreated control mice and in mice receiving two weeks of treadmill training, either according to a continuous protocol (10 m/min, one hour/day, five day/week) or an interval protocol (20 m/min for two minutes, followed by a five minute rest, repeated 4 times, five days/week). More retrogradely labeled motoneurons were found in both treadmill trained groups. The magnitude of this increase was as great as or greater than that found after using other enhancement strategies. In both treadmill trained groups, the proportions of motoneurons labeled from tracer applied to the common fibular nerve that were found in spinal cord locations reserved for tibial motoneurons in intact mice was no greater than in untreated control mice and significantly less than found after electrical stimulation or chondroitinase treatment. Treadmill training in the first two weeks following peripheral nerve injury produces a marked enhancement of motor axon regeneration without increasing the propensity of those axons to choose pathways leading to functionally inappropriate targets. PMID:19731339

  5. Effects of short-term continuous positive airway pressure on myocardial sympathetic nerve function and energetics in patients with heart failure and obstructive sleep apnea: a randomized study.

    Science.gov (United States)

    Hall, Allison B; Ziadi, Maria C; Leech, Judith A; Chen, Shin-Yee; Burwash, Ian G; Renaud, Jennifer; deKemp, Robert A; Haddad, Haissam; Mielniczuk, Lisa M; Yoshinaga, Keiichiro; Guo, Ann; Chen, Li; Walter, Olga; Garrard, Linda; DaSilva, Jean N; Floras, John S; Beanlands, Rob S B

    2014-09-09

    Heart failure with reduced ejection fraction and obstructive sleep apnea (OSA), 2 states of increased metabolic demand and sympathetic nervous system activation, often coexist. Continuous positive airway pressure (CPAP), which alleviates OSA, can improve ventricular function. It is unknown whether this is due to altered oxidative metabolism or presynaptic sympathetic nerve function. We hypothesized that short-term (6-8 weeks) CPAP in patients with OSA and heart failure with reduced ejection fraction would improve myocardial sympathetic nerve function and energetics. Forty-five patients with OSA and heart failure with reduced ejection fraction (left ventricular ejection fraction 35.8±9.7% [mean±SD]) were evaluated with the use of echocardiography and 11C-acetate and 11C-hydroxyephedrine positron emission tomography before and ≈6 to 8 weeks after randomization to receive short-term CPAP (n=22) or no CPAP (n=23). Work metabolic index, an estimate of myocardial efficiency, was calculated as follows: (stroke volume index×heart rate×systolic blood pressure÷Kmono), where Kmono is the monoexponential function fit to the myocardial 11C-acetate time-activity data, reflecting oxidative metabolism. Presynaptic sympathetic nerve function was measured with the use of the 11C-hydroxyephedrine retention index. CPAP significantly increased hydroxyephedrine retention versus no CPAP (Δretention: +0.012 [0.002, 0.021] versus -0.006 [-0.013, 0.005] min(-1); P=0.003). There was no significant change in work metabolic index between groups. However, in those with more severe OSA (apnea-hypopnea index>20 events per hour), CPAP significantly increased both work metabolic index and systolic blood pressure (Penergetics. In those with more severe OSA, CPAP may improve cardiac efficiency. Further outcome-based investigation of the consequences of CPAP is warranted. http://www.clinicaltrials.gov. Unique identifier: NCT00756366. © 2014 American Heart Association, Inc.

  6. Phase Difference in the Induction of Tyrosine Hydroxylase in Cell Body and Nerve Terminals of Sympathetic Neurones

    Science.gov (United States)

    Thoenen, Hans; Mueller, Robert A.; Axelrod, Julius

    1970-01-01

    The induction of tyrosine hydroxylase in the nerve terminals of the rat heart by reserpine lags behind that in the stellate ganglion by two to three days. Cycloheximide given three days after reserpine blocks the further rise of the enzyme in the nerve terminals. The increase in tyrosine hydroxylase activity of the lumbar ganglion is as marked as that in the stellate ganglion. The increase of enzyme activity in the sciatic nerve after reserpine administration resembles that found in the heart nerve terminals. Determination of enzyme activity in segments of sciatic nerves indicates a two-day lag and then a proximal-distal transport of enzyme, but the apparent rate is not sufficient to account for the increase in enzyme in the nerve terminals. These findings are compatible with the local synthesis of induced tyrosine hydroxylase in the nerve terminals rather than the peripheral movement of the completed enzyme. PMID:4189989

  7. Continuous intraoperative neuromonitoring (CIONM of the recurrent laryngeal nerve is sufficient as the only neuromonitoring technique in thyroidectomy performed because of benign goitre

    Directory of Open Access Journals (Sweden)

    Zbigniew Adamczewski

    2015-09-01

    Full Text Available [b][/b]Introduction. Recently, intraoperative neurophysiological neuromonitoring (IONM of recurrent laryngeal nerves (RLN has been evolving quickly. This evolution touched many aspects of the technique, leading to continuous stimulation of the RLN with real time analysis of the electrical signal. Objective. The aim of the study was to estimate the value of continuous intraoperative neuromonitoring (CIONM as the only technique for intraoperative neuromonitoring in thyroidectomy performed because of benign goitre. Material and methods. The study comprised 80 women qualified for thyroidectomy due to nodular goitre. The patients were divided into 4 groups depending on the technique used for RLN integrity verification: group 1 – thyroidectomy with CIONM; group 2 – thyroidectomy with direct, intermittent stimulation of RLN and vagus nerve (NX; group 3 – both CIONM and intermittent stimulation of RLN and NX; group 4 – thyroidectomy without any IONM. Results. Mean operation time did not differ significantly among the groups with IONM, but was significantly longer in comparison to group 4, as well as the operation’s cost. In the analysed groups there was no significant difference in complication ratio. Conclusion. CIONM with RLN visualization in thyroidectomy performed because of benign goitre is as safe as other methods of IONM and gives a continuous confirmation of the electrical integrity of the loop NX-RLN-vocal folds during almost the entire procedure. There is a clinical need for the development of external stimulation of NX (transdermal or trancranial, particularly for minimally invasive techniques in which access to NX is limited (i.e. transoral thyroidectomy.

  8. Vascular mechanism of axonal degeneration in peripheral nerves in hemiplegic sides after cerebral hemorrhage: An experimental study

    Directory of Open Access Journals (Sweden)

    Bayram Ednan

    2008-04-01

    Full Text Available Abstract Background Though retrograde neuronal death and vascular insufficiency have been well established in plegics following intracerebral hemorrhage, the effects of plegia on arterial nervorums of peripheral nerves have not been reported. In this study, the histopathological effects of the intracerebral hemorrhage on the dorsal root ganglions and sciatic nerves via affecting the arterial nervorums were investigated. Methods This study was conducted on 13 male hybrid rabbits. Three animals were taken as control group and did not undergo surgery. The remaining 10 subjects were anesthetized and were injected with 0.50 ml of autologous blood into their right sensory-motor region. All rabbits were followed-up for two months and then sacrificed. Endothelial cell numbers and volume values were estimated a three dimensionally created standardized arterial nervorums model of lumbar 3. Neuron numbers of dorsal root ganglions, and axon numbers in the lumbar 3 nerve root and volume values of arterial nervorums were examined histopathologically. The results were analyzed by using a Mann-Whitney-U test. Results Left hemiplegia developed in 8 animals. On the hemiplegic side, degenerative vascular changes and volume reduction in the arterial nervorums of the sciatic nerves, neuronal injury in the dorsal root ganglions, and axonal injury in the lumbar 3 were detected. Statistical analyses showed a significant correlation between the normal or nonplegic sides and plegic sides in terms of the neurodegeneration in the dorsal root ganglions (p Conclusion Intracerebral hemorrhage resulted in neurodegeneration in the dorsal root ganglion and axonolysis in the sciatic nerves, endothelial injury, and volume reduction of the arterial nervorums in the sciatic nerves. The interruption of the neural network connection in the walls of the arterial nervorums in the sciatic nerves may be responsible for circulation disorders of the arterial nervorums, and arterial

  9. An implantable wireless optogenetic stimulation system for peripheral nerve control.

    Science.gov (United States)

    Kang-Il Song; Park, Sunghee E; Myoung-Soo Kim; Chulmin Joo; Yong-Jun Kim; Suh, Jun-Kyo F; Dosik Hwang; Inchan Youn

    2015-08-01

    An implantable wireless optogenetic stimulation system with an LED-based optical stimulation cuff electrode was developed for peripheral nerve control. The proposed system consisted of a battery-powered optical cuff electrode, optical stimulation controller, and wireless communication system. The optical cuff electrode had a polydimethylsiloxane (PDMS) structure was designed to illuminate the entire sciatic nerve. The wireless communication system was designed to comply with medical implant communication service (MICS) regulations. To evaluate the proposed system, optogenetic stimulation was performed in optogenetic transgenic mice (Thy1::ChR2). The optical cuff electrode was implanted on the sciatic nerve, and movement was elicited during optical stimulation. The experimental results show that ankle movement can be generated wirelessly using optical stimulation pulse parameters.

  10. Effect of a combined continuous and intermittent transcutaneous electrical nerve stimulation on pain perception of burn patients evaluated by visual analog scale: a pilot study

    Directory of Open Access Journals (Sweden)

    Pérez-Ruvalcaba I

    2015-12-01

    Full Text Available Irma Pérez-Ruvalcaba,1 Viridiana Sánchez-Hernández,1 Arieh R Mercado-Sesma2,3 1Burn Unit, Hospital de Especialidades, Centro Médico Nacional de Occidente, Mexican Institute of Social Security, 2Health Sciences Department, Centro Universitario de Tonalá, University of Guadalajara, Guadalajara, Mexico; 3Diabetes sin Complicaciones, Zapopan, Mexico Aim: The aim of this study was to assess the effect of continuous and intermittent electrical transcutaneous nerve stimulation on the perception of pain in patients with burns of different types. Materials and methods: A pilot study was conducted in 14 patients (age 30.9±7.5 years with second- and third-degree burns of different types. The burn types included electrical, fire/flame, and chemical. All patients received continuous and intermittent electrical transcutaneous nerve stimulation sessions three times per week for 4 weeks. Each session had a duration of 30 minutes. A pair of electrodes were placed around the burn. The primary efficacy endpoint was the perception of pain assessed by a visual analog scale at baseline and at the 30th day. Results: A significant reduction of pain perception was reported (8.0±1.7 vs 1.0±0.5; P=0.027 by all patients after electrical stimulation therapy. There were no reports of adverse events during the intervention period. Conclusion: Electrical stimulation could be a potential nonpharmacological therapeutic option for pain management in burn patients. Keywords: TENS, burn pain, pain management, electrotherapy

  11. Functional and Molecular Characterization of a Novel Traumatic Peripheral Nerve-Muscle Injury Model.

    Science.gov (United States)

    Wanner, Renate; Gey, Manuel; Abaei, Alireza; Warnecke, Daniela; de Roy, Luisa; Dürselen, Lutz; Rasche, Volker; Knöll, Bernd

    2017-09-01

    Traumatic injuries to human peripheral nerves are frequently associated with damage to nerve surrounding tissues including muscles and blood vessels. Currently, most rodent models of peripheral nerve injuries (e.g., facial or sciatic nerve) employ surgical nerve transection with scissors or scalpels. However, such an isolated surgical nerve injury only mildly damages neighboring tissues and weakly activates an immune response. In order to provide a rodent nerve injury model accounting for such nerve-associated tissue damage and immune cell activation, we developed a drop tower-based facial nerve trauma model in mice. We compare nerve regeneration in this novel peripheral nerve trauma model with the established surgical nerve injury along several parameters. These include gene expression, histological and functional facial motoneuron (FMN) regeneration, facial nerve degeneration, immune cell activation and muscle damage. Regeneration-associated genes (RAGs; e.g., Atf3) were strongly induced in FMNs subjected to traumatic and surgical injury. Regeneration of FMNs and functional recovery of whisker movement were faster in traumatic versus complete surgical injury, thus cutting down experimentation time. Wallerian degeneration of distal nerve stumps was readily observed in this novel trauma injury model. Importantly, drop tower-inflicted facial nerve injury resulted in muscle damage, activation of muscle satellite cell markers (PAX7) and pronounced infiltration of immune cells to the injury site only in this model but not upon surgical nerve transection. Thus, we provide a novel rodent PNS trauma model that can be easily adopted to other PNS nerves such as the sciatic nerve. Since this nerve trauma model replicates multiple tissue damage frequently encountered in clinical routine, it will be well suited to identify molecular and cellular mechanisms of PNS nerve repair in wild-type and genetically modified rodents.

  12. Optical Biopsy of Peripheral Nerve Using Confocal Laser Endomicroscopy: A New Tool for Nerve Surgeons?

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    Christopher S Crowe

    2015-09-01

    Full Text Available Peripheral nerve injuries remain a challenge for reconstructive surgeons with many patients obtaining suboptimal results. Understanding the level of injury is imperative for successful repair. Current methods for distinguishing healthy from damaged nerve are time consuming and possess limited efficacy. Confocal laser endomicroscopy (CLE is an emerging optical biopsy technology that enables dynamic, high resolution, sub-surface imaging of live tissue. Porcine sciatic nerve was either left undamaged or briefly clamped to simulate injury. Diluted fluorescein was applied topically to the nerve. CLE imaging was performed by direct contact of the probe with nerve tissue. Images representative of both damaged and undamaged nerve fibers were collected and compared to routine H&E histology. Optical biopsy of undamaged nerve revealed bands of longitudinal nerve fibers, distinct from surrounding adipose and connective tissue. When damaged, these bands appear truncated and terminate in blebs of opacity. H&E staining revealed similar features in damaged nerve fibers. These results prompt development of a protocol for imaging peripheral nerves intraoperatively. To this end, improving surgeons' ability to understand the level of injury through real-time imaging will allow for faster and more informed operative decisions than the current standard permits.

  13. STUDY OF ULTRASOUND-GUIDED CONTINUOUS FEMORAL NERVE BLOCKADE WITH EPIDURAL ANALGESIA FOR PAIN RELIEF AFTER TOTAL KNEE REPLACEMENT

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    Srinivas Rapolu

    2016-11-01

    Full Text Available BACKGROUND Total knee replacement causes moderate-to-severe pain requiring effective analgesia. With use of ultrasound guidance, we may prove a more suitable approach compared with the epidural technique. Aim of this study is the comparison between Continuous Epidural Analgesia (CEA and Continuous Femoral Block (CFB techniques in Total Knee Replacement surgeries. MATERIALS AND METHODS This study was conducted on 60 adult male and female patients undergoing total knee replacement surgery for a period of 2 years. Patients were divided into 2 groups. Group - 1: Continuous epidural analgesia patients, Group - 2: Continuous femoral blockage patients. All patients were assessed clinically preoperatively and investigated to rule out any systemic disease. RESULTS The mean age of patient in Group - 1 was 66.54 ± 4.98 and in Group - 2 was 66.98 ± 5.02 years. P value was > 0.05, which was not significant. No significant differences in gender is observed between the groups. VAS scores were significantly high (P < 0.05 in the femoral group at 6 h, after which there was a declining trend and scores were essentially similar from 24 h. The use of rescue analgesic was also higher in the femoral group. Analysis of side-effects showed that all the five common sideeffects were twice as common in the epidural group than in the femoral study group. Only one patient in the femoral group had urinary retention when compared with four in the epidural group. The differences were not statistically significant. Muscle power at 48 h, time getting out of the bed and time stay in hospital (days are significant in comparison in 2 groups, range of movement is insignificant in groups. Patient satisfaction score was measured on a scale of 1 - 10. Patients in the Femoral group were slightly more satisfied with a mean ± SD score of 8.1 ± 1.2 when compared with the epidural group 7.3 ± 1.01. CONCLUSION Continuous femoral blockade using US guidance provides equivalent analgesia

  14. Expression patterns and role of PTEN in rat peripheral nerve development and injury.

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    Chen, Hui; Xiang, Jianping; Wu, Junxia; He, Bo; Lin, Tao; Zhu, Qingtang; Liu, Xiaolin; Zheng, Canbin

    2018-04-09

    Studies have suggested that phosphatase and tensin homolog (PTEN) plays an important role in neuroprotection and neuronal regeneration. To better understand the potential role of PTEN with respect to peripheral nerve development and injury, we investigated the expression pattern of PTEN at different stages of rat peripheral nerve development and injury and subsequently assessed the effect of pharmacological inhibition of PTEN using bpV(pic) on axonal regeneration in a rat sciatic nerve crush injury model. During the early stages of development, PTEN exhibits low expression in neuronal cell bodies and axons. From embryonic day (E) 18.5 and postnatal day (P)5 to adult, PTEN protein becomes more detectable, with high expression in the dorsal root ganglia (DRG) and axons. PTEN expression is inhibited in peripheral nerves, preceding myelination during neuronal development and remyelination after acute nerve injury. Low PTEN expression after nerve injury promotes Akt/mammalian target of rapamycin (mTOR) signaling pathway activity. In vivo pharmacological inhibition of PTEN using bpV(pic) promoted axonal regrowth, increased the number of myelinated nerve fibers, improved locomotive recovery and enhanced the amplitude response and nerve conduction velocity following stimulation in a rat sciatic nerve crush injury model. Thus, we suggest that PTEN may play potential roles in peripheral nerve development and regeneration and that inhibition of PTEN expression is beneficial for nerve regeneration and functional recovery after peripheral nerve injury. Copyright © 2018. Published by Elsevier B.V.

  15. Novel drug delivering conduit for peripheral nerve regeneration

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    Labroo, Pratima; Shea, Jill; Edwards, Kyle; Ho, Scott; Davis, Brett; Sant, Himanshu; Goodwin, Isak; Gale, Bruce; Agarwal, Jay

    2017-12-01

    Objective. This paper describes the design of a novel drug delivery apparatus integrated with a poly lactic-co-glycolic acid (PLGA) based nerve guide conduit for controlled local delivery of nerve growth factor (NGF) and application in peripheral nerve gap injury. Approach. An NGF dosage curve was acquired to determine the minimum in vitro concentration for optimal neurite outgrowth of dorsal root ganglion (DRG) cells; PLGA based drug delivery devices were then designed and tested in vitro and in vivo across 15 mm rat sciatic nerve gap injury model. Main results. The drug delivery nerve guide was able to release NGF for 28 d at concentrations (0.1–10 ng ml‑1) that were shown to enhance DRG neurite growth. Furthermore, the released NGF was bioactive and able to enhance DRG neurite growth. Following these tests, optimized NGF-releasing nerve conduits were implanted across 15 mm sciatic nerve gaps in a rat model, where they demonstrated significant myelination and muscle innervation in vivo as compared to empty nerve conduits (p  nerve guide can release NGF for extended periods of time and enhance axon growth in vitro and in vivo and has the potential to improve nerve regeneration following a peripheral nerve injury. Significance. This integrated drug delivering nerve guide simplifies the design process and provides increased versatility for releasing a variety of different growth factors. This innovative device has the potential for broad applicability and allows for easier customization to change the type of drugs and dosage of individual drugs without devising a completely new biomaterial–drug conjugate each time.

  16. Dual-Component Gelatinous Peptide/Reactive Oligomer Formulations as Conduit Material and Luminal Filler for Peripheral Nerve Regeneration.

    Science.gov (United States)

    Kohn-Polster, Caroline; Bhatnagar, Divya; Woloszyn, Derek J; Richtmyer, Matthew; Starke, Annett; Springwald, Alexandra H; Franz, Sandra; Schulz-Siegmund, Michaela; Kaplan, Hilton M; Kohn, Joachim; Hacker, Michael C

    2017-05-21

    Toward the next generation of nerve guidance conduits (NGCs), novel biomaterials and functionalization concepts are required to address clinical demands in peripheral nerve regeneration (PNR). As a biological polymer with bioactive motifs, gelatinous peptides are promising building blocks. In combination with an anhydride-containing oligomer, a dual-component hydrogel system (cGEL) was established. First, hollow cGEL tubes were fabricated by a continuous dosing and templating process. Conduits were characterized concerning their mechanical strength, in vitro and in vivo degradation and biocompatibility. Second, cGEL was reformulated as injectable shear thinning filler for established NGCs, here tyrosine-derived polycarbonate-based braided conduits. Thereby, the formulation contained the small molecule LM11A-31. The biofunctionalized cGEL filler was assessed regarding building block integration, mechanical properties, in vitro cytotoxicity, and growth permissive effects on human adipose tissue-derived stem cells. A positive in vitro evaluation motivated further application of the filler material in a sciatic nerve defect. Compared to the empty conduit and pristine cGEL, the functionalization performed superior, though the autologous nerve graft remains the gold standard. In conclusion, LM11A-31 functionalized cGEL filler with extracellular matrix (ECM)-like characteristics and specific biochemical cues holds great potential to support PNR.

  17. Are human peripheral nerves sensitive to X-ray imaging?

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    Jonas Francisco Scopel

    Full Text Available Diagnostic imaging techniques play an important role in assessing the exact location, cause, and extent of a nerve lesion, thus allowing clinicians to diagnose and manage more effectively a variety of pathological conditions, such as entrapment syndromes, traumatic injuries, and space-occupying lesions. Ultrasound and nuclear magnetic resonance imaging are becoming useful methods for this purpose, but they still lack spatial resolution. In this regard, recent phase contrast x-ray imaging experiments of peripheral nerve allowed the visualization of each nerve fiber surrounded by its myelin sheath as clearly as optical microscopy. In the present study, we attempted to produce high-resolution x-ray phase contrast images of a human sciatic nerve by using synchrotron radiation propagation-based imaging. The images showed high contrast and high spatial resolution, allowing clear identification of each fascicle structure and surrounding connective tissue. The outstanding result is the detection of such structures by phase contrast x-ray tomography of a thick human sciatic nerve section. This may further enable the identification of diverse pathological patterns, such as Wallerian degeneration, hypertrophic neuropathy, inflammatory infiltration, leprosy neuropathy and amyloid deposits. To the best of our knowledge, this is the first successful phase contrast x-ray imaging experiment of a human peripheral nerve sample. Our long-term goal is to develop peripheral nerve imaging methods that could supersede biopsy procedures.

  18. Peripheral nerve injury causes transient expression of MHC class I antigens in rat motor neurons and skeletal muscles

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    Maehlen, J; Nennesmo, I; Olsson, A B

    1989-01-01

    After a peripheral nerve lesion (rat facial and sciatic) an induction of major histocompatibility complex (MHC) antigens class I was detected immunohistochemically in skeletal muscle fibers and motor neurons. This MHC expression was transient after a nerve crush, when regeneration occurred......, but persisted after a nerve cut, when regeneration was prevented. Since the time course of MHC class I expression correlates to that of regeneration a role for this cell surface molecule in regeneration may be considered....

  19. Neural stem cells promote nerve regeneration through IL12-induced Schwann cell differentiation.

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    Lee, Don-Ching; Chen, Jong-Hang; Hsu, Tai-Yu; Chang, Li-Hsun; Chang, Hsu; Chi, Ya-Hui; Chiu, Ing-Ming

    2017-03-01

    Regeneration of injured peripheral nerves is a slow, complicated process that could be improved by implantation of neural stem cells (NSCs) or nerve conduit. Implantation of NSCs along with conduits promotes the regeneration of damaged nerve, likely because (i) conduit supports and guides axonal growth from one nerve stump to the other, while preventing fibrous tissue ingrowth and retaining neurotrophic factors; and (ii) implanted NSCs differentiate into Schwann cells and maintain a growth factor enriched microenvironment, which promotes nerve regeneration. In this study, we identified IL12p80 (homodimer of IL12p40) in the cell extracts of implanted nerve conduit combined with NSCs by using protein antibody array and Western blotting. Levels of IL12p80 in these conduits are 1.6-fold higher than those in conduits without NSCs. In the sciatic nerve injury mouse model, implantation of NSCs combined with nerve conduit and IL12p80 improves motor recovery and increases the diameter up to 4.5-fold, at the medial site of the regenerated nerve. In vitro study further revealed that IL12p80 stimulates the Schwann cell differentiation of mouse NSCs through the phosphorylation of signal transducer and activator of transcription 3 (Stat3). These results suggest that IL12p80 can trigger Schwann cell differentiation of mouse NSCs through Stat3 phosphorylation and enhance the functional recovery and the diameter of regenerated nerves in a mouse sciatic nerve injury model. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Local effect of celecoxib on peripheral nerve repair combined with silicone tubulization in rat

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    Mohammadi Rahim

    2013-10-01

    Full Text Available 【Abstract】Objective: To assess local effect of celecoxib on nerve regeneration in a rat sciatic nerve transection model. Methods: Forty-five male healthy white Wistar rats were randomly divided into three experimental groups (n=15 for each: sham-oper ation (SHAM, control (SIL and celecoxib treated (SIL/CLX groups. In SHAM group after anesthesia left sciatic nerve was exposed and after homeostasis muscle was sutured. In SIL group the left sciatic nerve was exposed in the same way and transected proximal to tibioperoneal bifurcation leaving a 10 mm gap. Proximal and distal stumps were each inserted into a silicone tube and filled with 10 µl phosphate buffered solution. In SIL/CLX group defect was bridged using a silicone tube filled with 10 µl celecoxib (0.1 g/L. Results: Functional study and gastrocnemius muscle mass confirmed faster and better recovery of regenerated axons in SIL/CLX than in SIL group(P<0.05. Morphometric indices of regenerated fibers showed number and diameter of the my elinated fibers in SIL/CLX were significantly greater than those in control group. In immunohistochemistry, location of reactions to S-100 in SIL/CLX was clearly more positive than that in SIL group. Conclusion: Response to local treatment of celecoxib demonstrates that it influences and improves functional recovery of peripheral nerve regeneration. Key words: Peripheral nerve; Sciaticnerve; Celecoxib; Nerve regeneration

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

    Science.gov (United States)

    Luo, Lihua; Gan, Li; Liu, Yongming; Tian, Weiqun; Tong, Zan; Wang, Xiong; Huselstein, Celine; Chen, Yun

    2015-02-20

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

  2. Long-nerve grafts and nerve transfers demonstrate comparable outcomes for axillary nerve injuries.

    Science.gov (United States)

    Wolfe, Scott W; Johnsen, Parker H; Lee, Steve K; Feinberg, Joseph H

    2014-07-01

    To compare the functional and EMG outcomes of long-nerve grafts to nerve transfers for complete axillary nerve palsy. Over a 10-year period at a single institution, 14 patients with axillary nerve palsy were treated with long-nerve grafts and 24 patients were treated with triceps-to-axillary nerve transfers by the same surgeon (S.W.W.). Data were collected prospectively at regular intervals, beginning before surgery and continuing up to 11 years after surgery. Prior to intervention, all patients demonstrated EMG evidence of complete denervation of the deltoid. Deltoid recovery (Medical Research Council [MRC] grade), shoulder abduction (°), improvement in shoulder abduction (°), and EMG evidence of deltoid reinnervation were compared between cohorts. There were no significant differences between the long-nerve graft cohort and the nerve transfer cohort with respect to postoperative range of motion, deltoid recovery, improvement in shoulder abduction, or EMG evidence of deltoid reinnervation. These data demonstrate that outcomes of long-nerve grafts for axillary nerve palsy are comparable with those of modern nerve transfers and question a widely held belief that long-nerve grafts do poorly. When healthy donor roots or trunks are available, long-nerve grafts should not be overlooked as an effective intervention for the treatment of axillary nerve injuries in adults with brachial plexus injuries. Therapeutic III. Copyright © 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  3. Intracorporeal knotting of a femoral nerve catheter

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    Ghanem, Mohamed

    2015-01-01

    Full Text Available Peripheral nerve catheters are effective and well-established tools to provide postoperative analgesia to patients undergoing orthopedic surgery. The performance of these techniques is usually considered safe. However, placement of nerve catheters may be associated with a considerable number of side effects and major complications have repeatedly been published. In this work, we report on a patient who underwent total knee replacement with spinal anesthesia and preoperative insertion of femoral and sciatic nerve catheters for postoperative analgesia. During insertion of the femoral catheter, significant resistance was encountered upon retracting the catheter. This occurred due to knotting of the catheter. The catheter had to be removed by operative intervention which has to be considered a major complication. The postoperative course was uneventful. The principles for removal of entrapped peripheral catheters are not well established, may differ from those for neuroaxial catheters, and range from cautious manipulation up to surgical intervention.

  4. Prefabrication of a vascularized nerve graft by vessel implantation: preliminary report of an experimental model.

    Science.gov (United States)

    Cavadas, P C; Vera-Sempere, F J

    1994-01-01

    Regeneration through vascularized nerve grafts (VNG) seems to be better than nonvascularized nerve grafts (NVNG), especially in hostile beds. We report on an experimental technique of prefabrication of VNG by direct vessel implantation. An arteriovenous fistula was created in the groin region with autologous vein grafts in the Wistar rat model, and implanted into the sciatic nerve. Five weeks later the sciatic VNG was elevated on the prefabricated pedicle. The flap was free-transferred orthotopically over a silicone sheet to impede plasmatic imbibition. Flap viability at 3 days was complete. India ink injection of the AV fistula resulted in capillary ink filling within the nerve and surrounding tissues. Histologic sections of the flap were examined, revealing its neovascularity. In an ongoing study, the regeneration through this prefabricated VNG is being compared to native VNG.

  5. Amniotic mesenchymal stem cells display neurovascular tropism and aid in the recovery of injured peripheral nerves.

    Science.gov (United States)

    Li, YongNan; Guo, Longzhe; Ahn, Hyun Sook; Kim, Moo Hyun; Kim, Sung-Whan

    2014-06-01

    Recently, we reported that human amniotic membrane-derived mesenchymal stem cells (AMMs) possess great angiogenic potential. In this study, we determined whether local injection of AMMs ameliorates peripheral neuropathy. AMMs were transplanted into injured sciatic nerves. AMM injection promoted significant recovery of motor nerve conduction velocity and voltage amplitude compared to human adipose-derived mesenchymal stem cells. AMM implantation also augmented blood perfusion and increased intraneural vascularity. Whole-mount fluorescent imaging analysis demonstrated that AMMs exhibited higher engraftment and endothelial incorporation abilities in the sciatic nerve. In addition, the higher expression of pro-angiogenic factors was detected in AMMs injected into the peripheral nerve. Therefore, these data provide novel therapeutic and mechanistic insights into stem cell biology, and AMM transplantation may represent an alternative therapeutic option for treating peripheral neuropathy. © 2014 The Authors. Journal of Cellular and Molecular Medicine published by John Wiley & Sons Ltd and Foundation for Cellular and Molecular Medicine.

  6. Soluble complement receptor 1 protects the peripheral nerve from early axon loss after injury

    NARCIS (Netherlands)

    Ramaglia, Valeria; Wolterman, Ruud; de Kok, Maryla; Vigar, Miriam Ann; Wagenaar-Bos, Ineke; King, Rosalind Helen Mary; Morgan, Brian Paul; Baas, Fra