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Sample records for protrusion nerve root

  1. Unique Asymmetric Protrusion of Nerve Cord in the Amphioxus, Branchiostoma belcheri

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    Nozaki, Masumi; Terakado, Kiyoshi; Kubokawa, Kaoru

    The amphioxus is the only surviving prevertebrate segmented chordate. In this animal Hatschek's pit has long been regarded as a putative homologue of the adenohypophysis because of the presence of secretory granules and immunoreactive cells to vertebrate gonadotrophic hormone in this organ. We found that the nerve cord extends a protrusion to the pit along the right side of the notochord. Furthermore, secretory granules were found not only in the pit but also in the protrusion of the nerve cord. These results suggest that Hatschek's pit and the nerve protrusion are homologous to the adenohypophysis and neurohypophysis, respectively. We believe that this is an evidence for the presence of the neuroendocrine link between the central nervous system and Hatschek's pit in the amphioxus.

  2. How should we grade lumbar disc herniation and nerve root compression? A systematic review.

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    Li, Yiping; Fredrickson, Vance; Resnick, Daniel K

    2015-06-01

    MRI is the gold standard for evaluating the relationship of disc material to soft tissue and neural structures. However, terminologies used to describe lumbar disc herniation and nerve root compression have always been a source of confusion. A clear understanding of lumbar disc terminology among clinicians, radiologists, and researchers is vital for patient care and future research. Through a systematic review of the literature, the purpose of this article is to describe lumbar disc terminology and comment on the reliability of various nomenclature systems and their application to clinical practice. PubMed was used for our literature search using the following MeSH headings: "Magnetic Resonance Imaging and Intervertebral Disc Displacement" and "Lumbar Vertebrae" and terms "nomenclature" or "grading" or "classification". Ten papers evaluating lumbar disc herniation/nerve root compression using different grading criteria and providing information regarding intraobserver and interobserver agreement were identified. To date, the Combined Task Force (CTF) and van Rijn classification systems are the most reliable methods for describing lumbar disc herniation and nerve root compression, respectively. van Rijn dichotomized nerve roots from "definitely no root compression, possibly no root compression, indeterminate root compression, possible root compression, and definite root compression" into no root compression (first three categories) and root compression (last two categories). The CTF classification defines lumbar discs as normal, focal protrusion, broad-based protrusion, or extrusion. The CTF classification system excludes "disc bulges," which is a source of confusion and disagreement among many practitioners. This potentially accounts for its improved reliability compared with other proposed nomenclature systems. The main issue in the management of patients with lumbar disc disease and nerve root compression is correlation of imaging findings with clinical

  3. Conjoined lumbosacral nerve roots

    International Nuclear Information System (INIS)

    Kyoshima, Kazumitsu; Nishiura, Iwao; Koyama, Tsunemaro

    1986-01-01

    Several kinds of the lumbosacral nerve root anomalies have already been recognized, and the conjoined nerve roots is the most common among them. It does not make symptoms by itself, but if there is a causation of neural entrapment, for example, disc herniation, lateral recessus stenosis, spondylolisthesis, etc., so called ''biradicular syndrome'' should occur. Anomalies of the lumbosacral nerve roots, if not properly recognized, may lead to injury of these nerves during operation of the lumbar spine. Recently, the chance of finding these anomalous roots has been increased more and more with the use of metrizamide myelography and metrizamide CT, because of the improvement of the opacification of nerve roots. We describe the findings of the anomalous roots as revealed by these two methods. They demonstrate two nerve roots running parallel and the asymmetrical wide root sleeve. Under such circumstances, it is important to distinguish the anomalous roots from the normal ventral and dorsal roots. (author)

  4. Tractography of lumbar nerve roots: initial results

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

    2011-06-15

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

  5. Tractography of lumbar nerve roots: initial results

    International Nuclear Information System (INIS)

    Balbi, Vincent; Budzik, Jean-Francois; Thuc, Vianney le; Cotten, Anne; Duhamel, Alain; Bera-Louville, Anne

    2011-01-01

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

  6. Anatomic investigation of the lumbosacral nerve roots and dorsal root ganglia by MRI

    International Nuclear Information System (INIS)

    Hasegawa, Toru; Fuse, Kenzo; Mikawa, Yoshihiro; Watanabe, Ryo

    1995-01-01

    The morphology of the lumbosacral nerve roots and dorsal root ganglia (DRG) was examined by using magnetic resonance imaging (MRI) in 11 healthy male volunteers aged 20-40 years. One hundred and twenty-three nerve roots (15 at the L1 level, 22 each at the L2-L5 levels, and 20 at the S1 level) were examined in terms of the position and angle of the bifurcation of the nerve roots, length of the nerve root, and the position and width of DRG. The nerve roots at the lower levels showed more cephalad position and smaller angle of bifurcation on MRI. The distance from the bifurcation of nerve roots to the cephalad edge of DRG was significantly longer in the upper root levels and was significantly shorter in the L5 roots than the S1 roots. The positions of DRG at the S1 level tended to become cephalad. DRG that was positioned toward more caudal direction was larger and more elliptic. MRI provided useful information concerning morphology and anatomical position of nerve roots and DRG, thereby allowing accurate diagnosis and the determination of surgical indications. (N.K.)

  7. Long term outcomes from CT-guided indirect cervical nerve root blocks and their relationship to the MRI findings. A prospective study

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    Bensler, Susanne; Sutter, Reto; Pfirrmann, Christian W.A.; Peterson, Cynthia K. [Orthopedic University Hospital Balgrist, Department of Radiology, Zurich (Switzerland); University of Zurich, Faculty of Medicine, Zurich (Switzerland)

    2015-11-15

    To investigate long-term pain reduction and 'improvement' in patients with indirect cervical nerve-root-blocks in comparison to MRI findings. One hundred and twelve patients with MRI confirmed cervical radiculopathy and an indirect cervical nerve-root-block were included. Two radiologists independently evaluated the MRI examinations. 12 different MRI abnormalities at the level and side of infiltration were compared to pain relief and 'improvement' at 1-month, 3-months and 1-year post injection. The proportion of patients reporting clinically relevant 'improvement' was 36.7 % at 1-month, 53.9 % at 3-months and 68.1 % at 1-year. At 1-month post injection, a statistically significantly lower percentage of patients eventually requiring surgery reported improvement and lower NRS change scores compared to those who did not undergo surgery (p = 0.001). Patients with extrusion of the disc were around 4-times more likely to have surgery. At 1-year post-injection the presence of nerve-root compromise was significantly linked to treatment outcome (p = 0.011). Patients with nerve root compression were more likely to report improvement at 1 year. Patients with disc extrusions have less pain relief and are 4 times more likely to go to surgery than patients with disc protrusions. (orig.)

  8. Long term outcomes from CT-guided indirect cervical nerve root blocks and their relationship to the MRI findings. A prospective study

    International Nuclear Information System (INIS)

    Bensler, Susanne; Sutter, Reto; Pfirrmann, Christian W.A.; Peterson, Cynthia K.

    2015-01-01

    To investigate long-term pain reduction and 'improvement' in patients with indirect cervical nerve-root-blocks in comparison to MRI findings. One hundred and twelve patients with MRI confirmed cervical radiculopathy and an indirect cervical nerve-root-block were included. Two radiologists independently evaluated the MRI examinations. 12 different MRI abnormalities at the level and side of infiltration were compared to pain relief and 'improvement' at 1-month, 3-months and 1-year post injection. The proportion of patients reporting clinically relevant 'improvement' was 36.7 % at 1-month, 53.9 % at 3-months and 68.1 % at 1-year. At 1-month post injection, a statistically significantly lower percentage of patients eventually requiring surgery reported improvement and lower NRS change scores compared to those who did not undergo surgery (p = 0.001). Patients with extrusion of the disc were around 4-times more likely to have surgery. At 1-year post-injection the presence of nerve-root compromise was significantly linked to treatment outcome (p = 0.011). Patients with nerve root compression were more likely to report improvement at 1 year. Patients with disc extrusions have less pain relief and are 4 times more likely to go to surgery than patients with disc protrusions. (orig.)

  9. Five Roots Pattern of Median Nerve Formation

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    Konstantinos Natsis

    2016-04-01

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

  10. Myelography for nerve root avulsion in birth palsy

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    Hashimoto, Tsutomu; Mitomo, Masanori; Hirabuki, Norio; Miura, Takashi; Kawai, Ryuji; Imakita, Satoshi; Harada, Koshi; Nakamura, Hironobu; Kozuka, Takahiro (Osaka Univ. (Japan). Faculty of Medicine)

    1990-04-01

    Myelography and CT myelography (CMT) were reviewed in 18 cases of birth palsy with clinically suspected avulsion injury. Root-somatosensory evoked potential (root-SEP) was also reviewed for myelographic evaluation of the nerve root avolusion in birth palsy. Root-SEP is not induced in case of avulsed nerve roots, but is induced in case of both normal and incompletely avulsed roots. Myelography demonstrated 58 abnormal nerve roots in 18 cases (19 limbs); 45 (78%) complete and 13 (22%) incomplete nerve root avulsions. Each of complete and incomplete avulsions was defined as total absence and partial presence of rootlets on myelography, respectively. Traumatic meningoceles were detected at 46 roots (79%) on myelography and/or CTM; 35 roots on myelography and 45 roots on CTM. CTM could not detect only a very small meningocele at one root. At 11 roots CTM was superior to myelography in delineating a meningocele because CTM is sensitive to a poorly enhanced meningocele. CTM, however, could not diagnose nerve root avulsions so accurately as myelography, since myelography detected 12 (7 completely and 5 incompletely) avulsed roots without meningocele, whereas CTM could not delineate the nerve roots clearly. Thus, myelography is indispensable to evaluate nerve root avulsions without meningocele. Root-SEP was examined in 9 patients who underwent branchial plexus exploration. SEP was negative at 22/25 roots with complete avulsion and was positive at 7/7 roots with myelographically incomplete avulsion, regardless of presence or absence of any traumatic meningocele. Myelography and root-SEP correlated well at 29 (92%) out of 32 roots in evaluating complete and incomplete avulsion injuries. Myelography and root-SEP were not considered in 3 roots. Though myelography demonstrated complete avulsions with traumatic meningocele, SEP was positive in these three roots, which were interpreted as partially avulsed roots. (J.P.N.).

  11. Myelography for nerve root avulsion in birth palsy

    International Nuclear Information System (INIS)

    Hashimoto, Tsutomu; Mitomo, Masanori; Hirabuki, Norio; Miura, Takashi; Kawai, Ryuji; Imakita, Satoshi; Harada, Koshi; Nakamura, Hironobu; Kozuka, Takahiro

    1990-01-01

    Myelography and CT myelography (CMT) were reviewed in 18 cases of birth palsy with clinically suspected avulsion injury. Root-somatosensory evoked potential (root-SEP) was also reviewed for myelographic evaluation of the nerve root avolusion in birth palsy. Root-SEP is not induced in case of avulsed nerve roots, but is induced in case of both normal and incompletely avulsed roots. Myelography demonstrated 58 abnormal nerve roots in 18 cases (19 limbs); 45 (78%) complete and 13 (22%) incomplete nerve root avulsions. Each of complete and incomplete avulsions was defined as total absence and partial presence of rootlets on myelography, respectively. Traumatic meningoceles were detected at 46 roots (79%) on myelography and/or CTM; 35 roots on myelography and 45 roots on CTM. CTM could not detect only a very small meningocele at one root. At 11 roots CTM was superior to myelography in delineating a meningocele because CTM is sensitive to a poorly enhanced meningocele. CTM, however, could not diagnose nerve root avulsions so accurately as myelography, since myelography detected 12 (7 completely and 5 incompletely) avulsed roots without meningocele, whereas CTM could not delineate the nerve roots clearly. Thus, myelography is indispensable to evaluate nerve root avulsions without meningocele. Root-SEP was examined in 9 patients who underwent branchial plexus exploration. SEP was negative at 22/25 roots with complete avulsion and was positive at 7/7 roots with myelographically incomplete avulsion, regardless of presence or absence of any traumatic meningocele. Myelography and root-SEP correlated well at 29 (92%) out of 32 roots in evaluating complete and incomplete avulsion injuries. Myelography and root-SEP were not considered in 3 roots. Though myelography demonstrated complete avulsions with traumatic meningocele, SEP was positive in these three roots, which were interpreted as partially avulsed roots. (J.P.N.)

  12. Retinal Nerve Fiber Layer Protrusion Associated with Tilted Optic Discs.

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    Chiang, Jaclyn; Yapp, Michael; Ly, Angelica; Hennessy, Michael P; Kalloniatis, Michael; Zangerl, Barbara

    2018-03-01

    This study resulted in the identification of an optic nerve head (ONH) feature associated with tilted optic discs, which might potentially contribute to ONH pathologies. Knowledge of such findings will enhance clinical insights and drive future opportunities to understand disease processes related to tilted optic discs. The aim of this study was to identify novel retinal nerve fiber layer (RNFL) anomalies by evaluating tilted optic discs using optical coherence tomography. An observed retinal nerve fiber protrusion was further investigated for association with other morphological or functional parameters. A retrospective review of 400 randomly selected adult patients with ONH examinations was conducted in a referral-only, diagnostic imaging center. After excluding other ONH pathologies, 215 patients were enrolled and evaluated for optic disc tilt and/or torsion. Gross anatomical ONH features, including size and rim or parapapillary region elevation, were assessed with stereoscopic fundus photography. Optical coherence tomography provided detailed morphological information of individual retinal layers. Statistical analysis was applied to identify significant changes between individual patient cohorts. A dome-shaped hyperreflective RNFL bulge, protruding into the neurosensory retina at the optic disc margins, was identified in 17 eyes with tilted optic discs. Available follow-up data were inconclusive regarding natural changes with this ONH feature. This RNFL herniation was significantly correlated with smaller than average optic disc size (P = .005), congenital disc tilt (P optic discs, which has not previously been assessed as an independent ONH structure. The feature is predominantly related to congenital crowded, small optic discs and variable between patients. This study is an important first step to elucidate diagnostic capabilities of tilted disc morphological changes and understanding associated functional deficits.

  13. CT diagnosis of lumbosacral conjoined nerve roots

    International Nuclear Information System (INIS)

    Torricelli, P.; Martinelli, C.; Spina, V.

    1987-01-01

    The authors report the observations derived from CT evaluation of 19 cases of lumbosacral conjoined nerve roots; 11 of these have been confirmed by lumbar myelography and/or at surgery. They conclude that CT without intrathecal metrizamide allows the recognition in most cases the presence of conjoined nerve roots and to differentiate them from a herniated disk fragment; this is especially usefull avoid surgical damage of anomalous roots. (orig.)

  14. Ultrastructural changes of compressed lumbar ventral nerve roots following decompression

    International Nuclear Information System (INIS)

    El-Barrany, Wagih G.; Hamdy, Raid M.; Al-Hayani, Abdulmonem A.; Jalalah, Sawsan M.; Al-Sayyad, Mohammad J.

    2006-01-01

    To study whether there will be permanent lumbar nerve rot scanning or degeneration secondary to continuous compression followed by decompression on the nerve roots, which can account for postlaminectomy leg weakness or back pain. The study was performed at the Department of Anatomy, Faulty of Medicine, king Abdulaziz University, Jeddah, Kingdom of Saudi Arabia during 2003-2005. Twenty-six adult male New Zealand rabbits were used in the present study. The ventral roots of the left fourth lumbar nerve were clamped for 2 weeks then decompression was allowed by removal of the clips. The left ventral roots of the fourth lumbar nerve were excised for electron microscopic study. One week after nerve root decompression, the ventral root peripheral to the site of compression showed signs of Wallerian degeneration together with signs of regeneration. Schwann cells and myelinated nerve fibers showed severe degenerative changes. Two weeks after decompression, the endoneurium of the ventral root showed extensive edema with an increase in the regenerating myelinated and unmyentilated nerve fibers, and fibroblasts proliferation. Three weeks after decompression, the endoneurium showed an increase in the regenerating myelinated and unmyelinated nerve fibers with diminution of the endoneurial edema, and number of macrophages and an increase in collagen fibrils. Five and 6 weeks after decompression, the endoneurium showed marked diminution of the edema, macrophages, mast cells and fibroblasts. The enoneurium was filed of myelinated and unmyelinated nerve fibers and collagen fibrils. Decompression of the compressed roots of a spinal nerve is followed by regeneration of the nerve fibers and nerve and nerve recovery without endoneurial scarring. (author)

  15. Lumbar Nerve Root Occupancy in the Foramen in Achondroplasia

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    Modi, Hitesh N.; Song, Hae-Ryong; Yang, Jae Hyuk

    2008-01-01

    Lumbar stenosis is common in patients with achondroplasia because of narrowing of the neural canal. However, it is unclear what causes stenosis, narrowing of the central canal or foramina. We performed a morphometric analysis of the lumbar nerve roots and intervertebral foramen in 17 patients (170 nerve roots and foramina) with achondroplasia (eight symptomatic, nine asymptomatic) and compared the data with that from 20 (200 nerve roots and foramina) asymptomatic patients without achondroplasia presenting with low back pain without neurologic symptoms. The measurements were made on left and right parasagittal MRI scans of the lumbar spine. The foramen area and root area were reduced at all levels from L1 to L5 between the patients with achondroplasia (Groups I and II) and the nonachondroplasia group (Group III). The percentage of nerve root occupancy in the foramen between Group I and Group II as compared with the patients without achondroplasia was similar or lower. This implied the lumbar nerve root size in patients with achondroplasia was smaller than that of the normal population and thus there is no effective nerve root compression. Symptoms of lumbar stenosis in achondroplasia may be arising from the central canal secondary to degenerative disc disease rather than a true foraminal stenosis. Level of Evidence: Level I, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence. PMID:18259829

  16. A novel rat model of brachial plexus injury with nerve root stumps.

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    Fang, Jintao; Yang, Jiantao; Yang, Yi; Li, Liang; Qin, Bengang; He, Wenting; Yan, Liwei; Chen, Gang; Tu, Zhehui; Liu, Xiaolin; Gu, Liqiang

    2018-02-01

    The C5-C6 nerve roots are usually spared from avulsion after brachial plexus injury (BPI) and thus can be used as donors for nerve grafting. To date, there are no appropriate animal models to evaluate spared nerve root stumps. Hence, the aim of this study was to establish and evaluate a rat model with spared nerve root stumps in BPI. In rupture group, the proximal parts of C5-T1 nerve roots were held with the surrounding muscles and the distal parts were pulled by a sudden force after the brachial plexus was fully exposed, and the results were compared with those of sham group. To validate the model, the lengths of C5-T1 spared nerve root stumps were measured and the histologies of the shortest one and the corresponding spinal cord were evaluated. C5 nerve root stump was found to be the shortest. Histology findings demonstrated that the nerve fibers became more irregular and the continuity decreased; numbers and diameters of myelinated axons and thickness of myelin sheaths significantly decreased over time. The survival of motoneurons was reduced, and the death of motoneurons may be related to the apoptotic process. Our model could successfully create BPI model with nerve root stumps by traction, which could simulate injury mechanisms. While other models involve root avulsion or rupturing by distal nerve transection. This model would be suitable for evaluating nerve root stumps and testing new therapeutic strategies for neuroprotection through nerve root stumps in the future. Copyright © 2017. Published by Elsevier B.V.

  17. Redundant nerve roots of the cauda equina : MR findings

    International Nuclear Information System (INIS)

    Oh, Kyu Hyen; Lee, Jung Man; Jung, Hak Young; Lee, Young Hwan; Sung, Nak Kwan; Chung, Duck Soo; Kim, Ok Dong; Lee, Sang Kwon; Suh, Kyung Jin

    1997-01-01

    To evaluate MR findings of redundant nerve roots (RNR) of the cauda equina. 17 patients with RNR were studied; eight were men and nine were women, and their ages ranged from 46 to 82 (mean 63) years. Diagroses were established on the basis of T2-weighted sagittal and coronal MRI, which showed a tortuous or coiled configuration of the nerve roots of the cauda equina. MR findings were reviewed for location, magnitude, and signal intensity of redundant nerve roots, and the relationship between magnitude of redundancy and severity of lumbar spinal canal stenosis (LSCS) was evaluated. In all 17 patients, MR showed moderate or severe LSCS caused by herniation or bulging of an intervertebral disc, osteophyte from the vertebral body or facet joint, thickening of the ligamentum flavum, degenerative spondylolisthesis, or a combination of these. T2-weighted sagittal and coronal MR images well clearly showed the location of RNR of the cauda equina;in 16 patients(94%), these were seen above the level of constriction of the spinal canal, and in one case, they were observed below the level of constriction. T2-weighted axial images showed the thecal sac filled with numerous nerve roots. The magnitude of RNR was mild in six cases (35%), moderate in five cases (30%), and severe in six cases (35%). Compared with normal nerve roots, the RNR signal on T2-weighted images was iso-intense. All patients with severe redundancy showed severe LSCS, but not all cases with severe LSCS showed severe redundancy. Redundant nerve roots of cauda equina were seen in relatively older patients with moderate or severe LSCS and T2-weighted MR images were accurate in identifying redundancy of nerve roots and evaluating their magnitude and location

  18. Is it necessary to use the entire root as a donor when transferring contralateral C7 nerve to repair median nerve?

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    Gao, Kai-Ming; Lao, Jie; Guan, Wen-Jie; Hu, Jing-Jing

    2018-01-01

    If a partial contralateral C 7 nerve is transferred to a recipient injured nerve, results are not satisfactory. However, if an entire contralateral C 7 nerve is used to repair two nerves, both recipient nerves show good recovery. These findings seem contradictory, as the above two methods use the same donor nerve, only the cutting method of the contralateral C 7 nerve is different. To verify whether this can actually result in different repair effects, we divided rats with right total brachial plexus injury into three groups. In the entire root group, the entire contralateral C 7 root was transected and transferred to the median nerve of the affected limb. In the posterior division group, only the posterior division of the contralateral C 7 root was transected and transferred to the median nerve. In the entire root + posterior division group, the entire contralateral C 7 root was transected but only the posterior division was transferred to the median nerve. After neurectomy, the median nerve was repaired on the affected side in the three groups. At 8, 12, and 16 weeks postoperatively, electrophysiological examination showed that maximum amplitude, latency, muscle tetanic contraction force, and muscle fiber cross-sectional area of the flexor digitorum superficialis muscle were significantly better in the entire root and entire root + posterior division groups than in the posterior division group. No significant difference was found between the entire root and entire root + posterior division groups. Counts of myelinated axons in the median nerve were greater in the entire root group than in the entire root + posterior division group, which were greater than the posterior division group. We conclude that for the same recipient nerve, harvesting of the entire contralateral C 7 root achieved significantly better recovery than partial harvesting, even if only part of the entire root was used for transfer. This result indicates that the entire root should be used as a

  19. MR imaging of nerve root impingement in the lumbar spine

    International Nuclear Information System (INIS)

    Teresi, L.M.; Bradley, W.G. Jr.; Bloze, A.E.; Davis, S.J.; Amster, J.; Berger, P.E.

    1990-01-01

    This paper determines the relationship between MR imaging findings of nerve root impingement, presenting symptoms, and physical examination findings, and physiologic data (DSEP and EMG) in a population of patients presented with classic radicular symptoms. Fifty-eight patients presenting with classic radicular pain were studied with MR imaging, DSER, and EMG, MR imaging was performed with a GE Signa imaging system with use of T1- and T2-weighted sequences and 5-mm-thick sections. Nerve root impingement in the subarticular recess (the root exiting the next lowest level) was distinguished from nerve root impingement in the superior intervertebral foramen (the root exiting the same level)

  20. Optimal imaging parameters to visualize lumbar spinal nerve roots in MRI

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    Yamato, Hidetada; Takahashi, Toshiyuki; Funata, Tomonari; Nitta, Masaru; Nakazawa, Yasuo [Showa Univ., Tokyo (Japan). Hospital

    2001-05-01

    Radiculopathy due to lumber spine disorders is diagnosed mainly by radiculography. Recent advances in MRI have enabled non-invasive visualization of the lumbar nerve roots. Fifty normal volunteers were evaluated for optimal imaging angle to visualize the lumbar nerve roots and optimal imaging sequences. Results showed that in the coronal oblique plane, angles that visualized the nerve roots best were L4 17, L5 29.6, and S1 36.8. In the left sagittal oblique plane, the angles were L4 17.9, L5 21.4, and S1 12.6, and in the right sagittal oblique plane, L4 16.3, L5 19.4 and S1 12.6. SPGR showed the best results both in CNR values and visually. In summary, the optimal angle by which to visualize the lumbar spinal nerve roots increased as the roots became more caudal, except for S1 of the sagittal oblique plane, where individual variations were pronounced. SPGR was the best sequence for visualizing the nerve roots. (author)

  1. Detection of the symptomatic nerve root

    International Nuclear Information System (INIS)

    Toyone, Tomoaki; Takahashi, Kazuhisa; Yamagata, Masayasu

    1993-01-01

    Twenty-five patients with lumbar disc herniation with a chief complaint of unilateral leg pain underwent gadolinium-DTPA enhanced MRI, particularly to examine the nerve root in the distal area of hernia. MRI appearance fell into three grades: 0 - no visualization (n=7), 1 - heterogeneous visualization (n=7), and 2 - homogeneous visualization (n=10). In the quantitative evaluation of the severity of sciatica using SLR and JOA scores, it was found to be associated with the degree of visualization. All patients of grade 2 were required to receive surgery because pain relief was not attained in spite of 3 months or more conservative treatment. These findings indicatd the usefulness of MRI in predicting prognosis, as well as in diagnosing the responsible level. Since blood-nerve barrier damage and intraneural edema are considered to be involved in the visualization of the nerve root on MRI, MRI will help in diagnosing radicular sciatica and elucidating the pathophysiology of the disease. (N.K.)

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

    Science.gov (United States)

    Shi, Yin; Zong, Min; Xu, Xiaoquan; Zou, Yuefen; Feng, Yang; Liu, Wei; Wang, Chuanbing; Wang, Dehang

    2015-04-01

    To quantitatively evaluate nerve roots by measuring fractional anisotropy (FA) values in healthy volunteers and sciatica patients, visualize nerve roots by tractography, and compare the diagnostic efficacy between conventional magnetic resonance imaging (MRI) and DTI. Seventy-five sciatica patients and thirty-six healthy volunteers underwent MR imaging using DTI. FA values for L5-S1 lumbar nerve roots were calculated at three levels from DTI images. Tractography was performed on L3-S1 nerve roots. ROC analysis was performed for FA values. The lumbar nerve roots were visualized and FA values were calculated in all subjects. FA values decreased in compressed nerve roots and declined from proximal to distal along the compressed nerve tracts. Mean FA values were more sensitive and specific than MR imaging for differentiating compressed nerve roots, especially in the far lateral zone at distal nerves. DTI can quantitatively evaluate compressed nerve roots, and DTT enables visualization of abnormal nerve tracts, providing vivid anatomic information and localization of probable nerve compression. DTI has great potential utility for evaluating lumbar nerve compression in sciatica. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  3. Computed tomography of cystic nerve root sleeve dilatation.

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    Neave, V C; Wycoff, R R

    1983-10-01

    A case of cystic nerve root sleeve dilatation in the lumbar area associated with a chronic back pain syndrome is presented. Prominent computed tomography (CT) findings include: (a) rounded masses in the region of the foramina isodense with cerebrospinal fluid in the subarachnoid space; (b) associated asymmetry of epidural fat distribution; (c) enlargement of the neural foramina in axial sections with scalloped erosion of the adjacent posteriolateral vertebral body, pedicle, and pedicular-laminar junction with preservation of cortex and without bony sclerosis or infiltrative appearance; (d) prominent or ectatic dural sac with lack of usual epidural landmarks between the sac and vertebral body; and (e) multilevel abnormalities throughout the entire lumbar region. Myelographic and CT correlations are demonstrated with a review of the literature. A discussion of the various cystic abnormalities involving nerve root sheaths is undertaken in an attempt to clarify the confusing nomenclature applied to nerve root sleeve pathology.

  4. Diffusion-weighted magnetic resonance imaging of symptomatic nerve root of patients with lumbar disk herniation

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    Eguchi, Yawara; Ohtori, Seiji; Yamashita, Masaomi; Yamauchi, Kazuyo; Suzuki, Munetaka; Orita, Sumihisa; Kamoda, Hiroto; Arai, Gen; Ishikawa, Tetsuhiro; Miyagi, Masayuki; Ochiai, Nobuyasu; Kishida, Shunji; Inoue, Gen; Takahashi, Kazuhisa [Chiba University, Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba (Japan); Masuda, Yoshitada; Ochi, Shigehiro; Kikawa, Takashi [Chiba University Hospital, Department of Radiology, Chiba (Japan); Toyone, Tomoaki [Teikyo University Chiba Medical Center, Department of Orthopaedic Surgery, Chiba (Japan); Takaso, Masashi [Kitasato University, Department of Orthopaedic Surgery, School of Medicine, Sagamihara City, Kanagawa (Japan); Aoki, Yasuchika [Chiba Rosai Hospital, Department of Orthopedic Surgery, Ichihara, Chiba (Japan)

    2011-09-15

    Diffusion-weighted imaging (DWI) can provide valuable structural information that may be useful for evaluating pathological changes of the lumbar nerve root. Diffusion-weighted magnetic resonance (MR) neurography has recently been introduced as an alternative way to visualize nerves, but to date, quantitative DWI and MR neurography have not been applied to evaluate the pathology of lumbar nerve roots. Our purpose was to visualize lumbar nerve roots and to analyze their morphology by MR neurography, and to measure the apparent diffusion coefficient (ADC) of lumbar nerve roots compressed by herniated disks using 1.5-T MR imaging. Ten consecutive patients (median age, 48.0 and range, 20-72 years) with monoradicular symptoms caused by a lumbar herniated disk and 14 healthy volunteers were studied. Regions of interests were placed on the lumbar roots at dorsal root ganglia (DRG) and distal spinal nerves on DWI to quantify mean ADC values. The spinal nerve roots were also visualized by MR neurography. In the patients, mean ADC values were significantly greater in the compressed DRG and distal spinal nerves than in intact nerves. MR neurography also showed abnormalities such as nerve swelling at and below the compression in the symptomatic nerve root. Increased ADC values were considered to be because of edema and Wallerian degeneration of compressed nerve roots. DWI is a potential tool for analysis of the pathophysiology of lumbar nerve roots compressed by herniated disks. (orig.)

  5. Diffusion-weighted magnetic resonance imaging of symptomatic nerve root of patients with lumbar disk herniation

    International Nuclear Information System (INIS)

    Eguchi, Yawara; Ohtori, Seiji; Yamashita, Masaomi; Yamauchi, Kazuyo; Suzuki, Munetaka; Orita, Sumihisa; Kamoda, Hiroto; Arai, Gen; Ishikawa, Tetsuhiro; Miyagi, Masayuki; Ochiai, Nobuyasu; Kishida, Shunji; Inoue, Gen; Takahashi, Kazuhisa; Masuda, Yoshitada; Ochi, Shigehiro; Kikawa, Takashi; Toyone, Tomoaki; Takaso, Masashi; Aoki, Yasuchika

    2011-01-01

    Diffusion-weighted imaging (DWI) can provide valuable structural information that may be useful for evaluating pathological changes of the lumbar nerve root. Diffusion-weighted magnetic resonance (MR) neurography has recently been introduced as an alternative way to visualize nerves, but to date, quantitative DWI and MR neurography have not been applied to evaluate the pathology of lumbar nerve roots. Our purpose was to visualize lumbar nerve roots and to analyze their morphology by MR neurography, and to measure the apparent diffusion coefficient (ADC) of lumbar nerve roots compressed by herniated disks using 1.5-T MR imaging. Ten consecutive patients (median age, 48.0 and range, 20-72 years) with monoradicular symptoms caused by a lumbar herniated disk and 14 healthy volunteers were studied. Regions of interests were placed on the lumbar roots at dorsal root ganglia (DRG) and distal spinal nerves on DWI to quantify mean ADC values. The spinal nerve roots were also visualized by MR neurography. In the patients, mean ADC values were significantly greater in the compressed DRG and distal spinal nerves than in intact nerves. MR neurography also showed abnormalities such as nerve swelling at and below the compression in the symptomatic nerve root. Increased ADC values were considered to be because of edema and Wallerian degeneration of compressed nerve roots. DWI is a potential tool for analysis of the pathophysiology of lumbar nerve roots compressed by herniated disks. (orig.)

  6. Changes in lumbosacral spinal nerve roots on diffusion tensor imaging in spinal stenosis

    Directory of Open Access Journals (Sweden)

    Zhong-jun Hou

    2015-01-01

    Full Text Available Lumbosacral degenerative disc disease is a common cause of lower back and leg pain. Conventional T1-weighted imaging (T1WI and T2-weighted imaging (T2WI scans are commonly used to image spinal cord degeneration. However, these modalities are unable to image the entire lumbosacral spinal nerve roots. Thus, in the present study, we assessed the potential of diffusion tensor imaging (DTI for quantitative assessment of compressed lumbosacral spinal nerve roots. Subjects were 20 young healthy volunteers and 31 patients with lumbosacral stenosis. T2WI showed that the residual dural sac area was less than two-thirds that of the corresponding normal area in patients from L 3 to S 1 stenosis. On T1WI and T2WI, 74 lumbosacral spinal nerve roots from 31 patients showed compression changes. DTI showed thinning and distortion in 36 lumbosacral spinal nerve roots (49% and abruption in 17 lumbosacral spinal nerve roots (23%. Moreover, fractional anisotropy values were reduced in the lumbosacral spinal nerve roots of patients with lumbosacral stenosis. These findings suggest that DTI can objectively and quantitatively evaluate the severity of lumbosacral spinal nerve root compression.

  7. Changes in lumbosacral spinal nerve roots on diffusion tensor imaging in spinal stenosis.

    Science.gov (United States)

    Hou, Zhong-Jun; Huang, Yong; Fan, Zi-Wen; Li, Xin-Chun; Cao, Bing-Yi

    2015-11-01

    Lumbosacral degenerative disc disease is a common cause of lower back and leg pain. Conventional T1-weighted imaging (T1WI) and T2-weighted imaging (T2WI) scans are commonly used to image spinal cord degeneration. However, these modalities are unable to image the entire lumbosacral spinal nerve roots. Thus, in the present study, we assessed the potential of diffusion tensor imaging (DTI) for quantitative assessment of compressed lumbosacral spinal nerve roots. Subjects were 20 young healthy volunteers and 31 patients with lumbosacral stenosis. T2WI showed that the residual dural sac area was less than two-thirds that of the corresponding normal area in patients from L3 to S1 stenosis. On T1WI and T2WI, 74 lumbosacral spinal nerve roots from 31 patients showed compression changes. DTI showed thinning and distortion in 36 lumbosacral spinal nerve roots (49%) and abruption in 17 lumbosacral spinal nerve roots (23%). Moreover, fractional anisotropy values were reduced in the lumbosacral spinal nerve roots of patients with lumbosacral stenosis. These findings suggest that DTI can objectively and quantitatively evaluate the severity of lumbosacral spinal nerve root compression.

  8. Clinical significance of nerve root enhancement in contrast-enhanced MR imaging of the postoperative lumbar spine

    International Nuclear Information System (INIS)

    Lee, Yeon Soo; Lee, Eun Ja; Kang, Si Won; Choi, Eun Seok; Song, Chang June; Kim, Jong Chul

    2001-01-01

    To determine the significance of nerve root contrast enhancement in patients with residual or recurrent symptomatic postoperative lumbar spine. Eighty-eight patients with 116 postoperative lumbar disc lesions causing radiating back pain underwent enhanced MR imaging. Intradural nerve root enhancement was quantified by pixel measurement, and affected nerve roots were compared before and after contrast administration. Extradural nerve root enhancement was assessed visually, and nerve root enhancement and clinical symptoms were correlated. Associated lesions such as recurrent disc herniation, scar tissue, nerve root thickening and nerve root displacement were also evaluated. Of 26 cases (22.4%) involving intradural nerve root enhancement, 22 (84.6%) showed significant clinical symptoms (p=0.002). and of 59 (50.9%) demonstrating extradural enhancement, clinical symptoms showed significant correlation in 47 (79.7%) (p=0.001). Nerve root enhancement, including eleven cases where this was both intra-and extradural, showed highly significant association with clinical symptoms in 74 of the 116 cases (63.8%) (p=0.000). Among 33 cases (28.4%) of recurrent disc herniation, nerve root enhancement was observed in 28 (84.8%) and in 24 of these 28 (85.7%), significant correlation with clinical symptoms was observed (p=0.000). Where epidural fibrosis was present, correlation between nerve root enhancement and clinical symptoms was not significant (p>0.05). Nerve root thickening and displaced nerve root were, however, significantly associated with symptoms (87.2% and 88.6%, respectively). In patients with postoperative lumbar spine, the association between nerve root enhancement revealed by MRI and clinical symptoms was highly significant

  9. MRI of enlarged dorsal ganglia, lumbar nerve roots, and cranial nerves in polyradiculoneuropathies

    International Nuclear Information System (INIS)

    Castillo, M.; Mukherji, S.K.

    1996-01-01

    This paper describes the MRI findings in four patients with a clinical diagnosis of hypertrophic polyradiculoneuropathies. In two examination of the lumbar spine showed enlarged nerve roots and dorsal ganglia, and similar findings were present in the cervical spine in a third. The cisternal portions of the cranial nerves were enlarged in another patient. MRI allows identification of enlarged nerves in hypertrophic polyradiculopathies. (orig.)

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

    International Nuclear Information System (INIS)

    Shi, Yin; Zong, Min; Xu, Xiaoquan; Zou, Yuefen; Feng, Yang; Liu, Wei; Wang, Chuanbing; Wang, Dehang

    2015-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-04-15

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

  12. Gadolinium-DTPA enhancement of symptomatic nerve roots in MRI of the lumbar spine

    Energy Technology Data Exchange (ETDEWEB)

    Tyrrell, P.N.M.; Cassar-Pullicino, V.N.; McCall, I.W. [Department of Diagnostic Imaging, The Institute of Orthopaedics, The Robert Jones and Agnes Hunt Orthopaedic and District Hospital NHS Trust, Oswestry, Shropshire SY10 7AG (United Kingdom)

    1998-02-01

    Disc prolapse presenting with sciatica may be associated with enhancement of the symptomatic nerve root following magnetic resonance imaging (MRI) with intravenous gadolinium (Gd)-DTPA. Previous studies have shown, however, that this does not occur in all cases. The aim of this study was to assess the incidence of nerve root enhancement in patients with sciatica and disc prolapse and to try to identify any specific features that might be associated with the phenomenon. A total of 227 patients presenting with low back pain and/or sciatica underwent a MRI study of the lumbar spine with intravenous contrast enhancement. Nineteen of 81 (23.5 %) patients with disc prolapse demonstrated nerve root enhancement. Nerve root enhancement had a highly significant association with sequestrated disc lesions (13/19, 68 %; P < 0.0005), and was primarily seen in the symptomatic ipsilateral nerve root (16/19, 84 %). The sensitivity of nerve root enhancement associated with disc prolapse was 23.5 % with a specificity of 95.9 %, a positive predictive value of 76 % and a negative predictive value of 69.3 %. Nerve root enhancement may be indicative of the symptomatic level but its poor sensitivity negates the routine use of Gd-DTPA in MRI for sciatica. (orig.) With 4 figs., 1 tab., 37 refs.

  13. Gadolinium-DTPA enhancement of symptomatic nerve roots in MRI of the lumbar spine

    International Nuclear Information System (INIS)

    Tyrrell, P.N.M.; Cassar-Pullicino, V.N.; McCall, I.W.

    1998-01-01

    Disc prolapse presenting with sciatica may be associated with enhancement of the symptomatic nerve root following magnetic resonance imaging (MRI) with intravenous gadolinium (Gd)-DTPA. Previous studies have shown, however, that this does not occur in all cases. The aim of this study was to assess the incidence of nerve root enhancement in patients with sciatica and disc prolapse and to try to identify any specific features that might be associated with the phenomenon. A total of 227 patients presenting with low back pain and/or sciatica underwent a MRI study of the lumbar spine with intravenous contrast enhancement. Nineteen of 81 (23.5 %) patients with disc prolapse demonstrated nerve root enhancement. Nerve root enhancement had a highly significant association with sequestrated disc lesions (13/19, 68 %; P < 0.0005), and was primarily seen in the symptomatic ipsilateral nerve root (16/19, 84 %). The sensitivity of nerve root enhancement associated with disc prolapse was 23.5 % with a specificity of 95.9 %, a positive predictive value of 76 % and a negative predictive value of 69.3 %. Nerve root enhancement may be indicative of the symptomatic level but its poor sensitivity negates the routine use of Gd-DTPA in MRI for sciatica. (orig.)

  14. MR imaging of the lumber spine; Visualization capability of the nerve root

    Energy Technology Data Exchange (ETDEWEB)

    Ishibashi, Kazumasa; Hieda, Hiroshi; Goto, Takeshi; Goto, Hiroshi; Koga, Hiromichi; Hiraoka, Kouji (Moji Rousai Hospital, Fukuoka (Japan))

    1991-01-01

    We studied visualization capability of the nerve root in mainly coronary section pattern using magnetic resonance imaging (MRI). MRI was carried out in 91 patients with lumbago and sciatica. Coronary section was additionally photographed in 58 cases of these patients (32 with intervertebral hernia, 20 with spinal canal stenosis, 2 with spondylolytic spondylolisthesis, 2 with compression fracture and the other 2 patients). The visualization capability of the nerve root was studied with photographing 2 pulse systems of the coronary section by using spin echo and field echo methods. The high signal area of the cerebrospinal fluid and nerve root in the normal lumbar vertebra was noted by field echo method, and pattern that is visualized by myelogram was obtained. The coincidence of the main foci (disturbed lesions of the nerve root) in the intervertebral hernia and coronary section pattern was noted in 21 of 32 cases (64.5%) with considerably high ratio. The condition of the nerve root in the blocked lesion was visualized in the spinal canal stenosis. (author).

  15. Characterization of a chondroitin sulfate hydrogel for nerve root regeneration

    Science.gov (United States)

    Conovaloff, Aaron; Panitch, Alyssa

    2011-10-01

    Brachial plexus injury is a serious medical problem that affects many patients annually, with most cases involving damage to the nerve roots. Therefore, a chondroitin sulfate hydrogel was designed to both serve as a scaffold for regenerating root neurons and deliver neurotrophic signals. Capillary electrophoresis showed that chondroitin sulfate has a dissociation constant in the micromolar range with several common neurotrophins, and this was determined to be approximately tenfold stronger than with heparin. It was also revealed that nerve growth factor exhibits a slightly stronger affinity for hyaluronic acid than for chondroitin sulfate. However, E8 chick dorsal root ganglia cultured in the presence of nerve growth factor revealed that ganglia cultured in chondroitin sulfate scaffolds showed more robust growth than those cultured in control gels of hyaluronic acid. It is hypothesized that, despite the stronger affinity of nerve growth factor for hyaluronic acid, chondroitin sulfate serves as a better scaffold for neurite outgrowth, possibly due to inhibition of growth by hyaluronic acid chains.

  16. Clinical and imaging characteristics of foraminal nerve root disorders of the lumbar spine

    International Nuclear Information System (INIS)

    Nishi, Tomio; Tani, Takayuki; Suzuki, Norio; Aonuma, Hiroshi

    2009-01-01

    We analyzed cases of lumbar nerve root compression at intervertebral foramina, by comparing 19 cases of foraminal stenosis (FS), and 38 cases of foraminal hernia (FH) with 21 cases of lumbar canal stenosis (LCS). Japan Orthopedic Association (JOA) scores, intervertebral disc degeneration, anatomical measurements of the nerve root foramina and the MRI findings were reviewed. The scores for pain in the lower extremities, and walking ability were both lowest in the FS group. The scores for low back pain, lower extremities, and sensory disturbances were lowest in the FH group. Anterior-posterior diameters of the nerve root foramina were smaller in the FS group and FH group than in the LCS group. More degenerated discs and short length of upper part of the nerve root foramina were seen in FS group than in the other groups. The MRI images of so-called black out nerve root foramina were positive in 63.6% of FS cases, 75% of FH cases. (author)

  17. Diagnostic value of MRI for nerve root compression due to lumbar canal stenosis. Clinical and anatomic study

    International Nuclear Information System (INIS)

    Seki, Michihiro; Kikuchi, Shinichi; Kageyama, Kazuhiro; Katakura, Toshihiko; Suzuki, Kenji

    1995-01-01

    Magnetic resonance imaging (MRI) was undertaken in 26 patients with surgically proven nerve root compression due to lumbar canal stenosis. The findings on coronary images were compared with those of selective radiculography to assess the diagnostic ability of MRI to determine the site of nerve root compression. Intermission and partial defect, which reflect nerve root compression, were seen in only 5 (19.2%) of 26 nerve roots on MRI, as compared with 20 (76.9%) on radiculography. Thus MRI alone was difficult to diagnose nerve root compression due to lumbar canal stenosis. Furthermore, the optimum angle of coronary views was determined in 13 cadavers. Para-sagittal views were found to be optimal for the observation of the whole running of the nerve root. Three-dimensional MRI was found to have a potential to diagnose nerve root compression in the intervertebral foramen and the distal part of the intervertebral foramen. (N.K.)

  18. Intrathecal ligaments and nerve root tension: possible sources of lumbar pain during spaceflight.

    Science.gov (United States)

    Kershner, David; Binhammer, Robert

    2004-04-01

    Lumbar intrathecal ligaments have recently been demonstrated to randomly bind dorsal nerve roots to the dura within the lumbar vertebral column. Lengthening of the vertebral column and associated lumbar back pain experienced by astronauts is common in microgravity. This study was designed to investigate the relationship of lumbar intrathecal ligaments in spinal lengthening as a possible mechanism for back pain. A two-part study was designed using 36 vertebral columns from embalmed cadavers. There were 12 vertebral columns studied in mid-sagittal section to demonstrate the possible movement of the spinal cord during lengthening of the vertebral column. The remainder were assessed for the amount of tension placed on a dorsal nerve root by the lumbar intrathecal ligament during lengthening of the vertebral column. The spinal cord moves in a cephalic direction approximately 2.8 mm with 4 cm lengthening of the vertebral column. During lengthening, a loss of thoracic and lordotic curvature was noted with an increase in disk height. Tension was significantly increased on the dorsal nerve roots being tethered by the lumbar intrathecal ligaments in comparison to non-tethered nerve roots during lengthening of the vertebral column. A significant amount of tension is placed on dorsal nerve roots tethered by intrathecal ligaments within the lumbar spine during spinal lengthening. These ligaments randomly bind dorsal nerve roots in the lumbar spine and may be involved in the back pain experienced by astronauts in microgravity.

  19. Reduction in nerve root compression by the nucleus pulposus after Feng's Spinal Manipulation☆

    Science.gov (United States)

    Feng, Yu; Gao, Yan; Yang, Wendong; Feng, Tianyou

    2013-01-01

    Ninety-four patients with lumbar intervertebral disc herniation were enrolled in this study. Of these, 48 were treated with Feng's Spinal Manipulation, hot fomentation, and bed rest (treatment group). The remaining 46 patients were treated with hot fomentation and bed rest only (control group). After 3 weeks of treatment, clinical parameters including the angle of straight-leg raising, visual analogue scale pain score, and Japanese Orthopaedic Association score for low back pain were improved. The treatment group had significantly better improvement in scores than the control group. Magnetic resonance myelography three-dimensional reconstruction imaging of the vertebral canal demonstrated that filling of the compressed nerve root sleeve with cerebrospinal fluid increased significantly in the treatment group. The diameter of the nerve root sleeve was significantly larger in the treatment group than in the control group. However, the sagittal diameter index of the herniated nucleus pulposus and the angle between the nerve root sleeve and the thecal sac did not change significantly in either the treatment or control groups. The effectiveness of Feng's Spinal Manipulation for the treatment of symptoms associated with lumbar intervertebral disc herniation may be attributable to the relief of nerve root compression, without affecting the herniated nucleus pulposus or changing the morphology or position of the nerve root. PMID:25206408

  20. The usefulness of MR myelography for evaluation of nerve root avulsion in brachial plexus injury

    International Nuclear Information System (INIS)

    Nishiura, Yasumasa; Ochiai, Naoyuki; Miyauchi, Yukio; Niitsu, Mamoru

    2002-01-01

    Myelography has been the most popular and reliable method for evaluation of nerve root avulsion in brachial plexus injury. However, it is invasive because it requires the use of contrast medium, dural puncture and exposure to radiation. In addition, it has a fault. When a nerve rootlet is not filled with contrast medium, it is impossible to evaluate it. It has sometimes been a problem in the injury to upper roots. Recently, MRI also has been used for diagnosis of brachial plexus injury. But it was not until recently that it has had a high resolution to detect affected nerve rootlets. We have used MR myelography with high resolution for diagnosis of brachial plexus injury. The purpose of this study is to investigate the usefulness of it. MR myelography was preoperatively performed in 14 cases, consisting of 13 traumatic brachial plexus injuries and an obstetrical palsy. In them, 12 cases had root avulsion injuries and 2 cases had infraclavicular injuries. A 1.5 Tesla MR system (Philips) and a cervical coil were used. Coronal sections with 2 mm-overcontiguous thickness were obtained by heavily T2-weighted sequence fast spin echo (TR/TE=3000/450). The fat signal was suppressed by a presaturation inversion-pulse. The scanning time was about five minutes. The three-dimensional image was reconstructed by using maximum intensity projection (MIP) method. MIP images and individual coronal images were used for evaluation for root avulsion. In evaluation the shape of a nerve sleeve and nerve rootlets was compared on both sides. The abnormal shape of a nerve sleeve or the defect of nerve rootlets was diagnosed as root avulsion. The brachial plexus lesions were exposed operatively and examined with electrophysiologic methods (SEP and/or ESCP) in all cases. Operative findings were compared with MR myelography. Twenty-four roots had been diagnosed as normal and 46 roots had been diagnosed as root avulsion with MR myelography preoperatively. In the former only one root was

  1. Prevalence of extraforaminal nerve root compression below lumbosacral transitional vertebrae.

    Science.gov (United States)

    Porter, Neil A; Lalam, Radhesh K; Tins, Bernhard J; Tyrrell, Prudencia N M; Singh, Jaspreet; Cassar-Pullicino, Victor N

    2014-01-01

    Although pathology at the first mobile segment above a lumbosacral transitional vertebra (LSTV) is a known source of spinal symptoms, nerve root compression below an LSTV, has only sporadically been reported. Our objective was to assess the prevalence of nerve root entrapment below an LSTV, review the causes of entrapment, and correlate with presenting symptoms. A retrospective review of MR and CT examinations of the lumbar spine was performed over a 5.5-year period in which the words "transitional vertebra" were mentioned in the report. Nerve root compression below an LSTV was assessed as well as the subtype of transitional vertebra. Correlation with clinical symptoms at referral was made. MR and CT examinations were also reviewed to exclude any other cause of symptoms above the LSTV. One hundred seventy-four patients were included in the study. Neural compression by new bone formation below an LSTV was demonstrated in 23 patients (13%). In all of these patients, there was a pseudarthrosis present on the side of compression due to partial sacralization with incomplete fusion. In three of these patients (13%), there was symptomatic correlation with no other cause of radiculopathy demonstrated. A further 13 patients (57%) had correlating symptoms that may in part be attributable to compression below an LSTV. Nerve root compression below an LSTV occurs with a prevalence of 13% and can be symptomatic in up to 70% of these patients. This region should therefore be carefully assessed in all symptomatic patients with an LSTV.

  2. Optimising the image of the intradural nerve root: the value of MR radiculography

    Energy Technology Data Exchange (ETDEWEB)

    Hofman, P.A.M. [Department of Diagnostic Radiology, University Hospital Maastricht (Netherlands); Wilmink, J.T. [Department of Diagnostic Radiology, University Hospital Maastricht (Netherlands)

    1996-10-01

    We evaluated the additional value of MR radiculography for increasing the sensitivity and specificity of MRI with regard to nerve root compression in patients with sciatica. The single slices of a heavily T 2-weighted oblique coronal image set were reformatted with a maximum intensity projection protocol. This image resembles a classical contrast radiculogram and shows the intradural nerve root and its sleeve. In 43 patients studied with a standard MRI examination there was a need for further assessment of nerve root compression in 19 (44 %). In 13 (68 %) of these, MR radiculography made a definite verdict possible. (orig.). With 4 figs., 2 tabs.

  3. Optimising the image of the intradural nerve root: the value of MR radiculography

    International Nuclear Information System (INIS)

    Hofman, P.A.M.; Wilmink, J.T.

    1996-01-01

    We evaluated the additional value of MR radiculography for increasing the sensitivity and specificity of MRI with regard to nerve root compression in patients with sciatica. The single slices of a heavily T 2-weighted oblique coronal image set were reformatted with a maximum intensity projection protocol. This image resembles a classical contrast radiculogram and shows the intradural nerve root and its sleeve. In 43 patients studied with a standard MRI examination there was a need for further assessment of nerve root compression in 19 (44 %). In 13 (68 %) of these, MR radiculography made a definite verdict possible. (orig.). With 4 figs., 2 tabs

  4. MR imaging of spondylolytic spondylolisthesis: changes of intervertebral foramen and nerve root compression

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ji Hyung [Ajou Univ. College of Medicine, Seoul (Korea, Republic of); Chung, Tae Sub; Kim, Young Soo [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

    1999-08-01

    To evaluate the factors affecting intervertebral foramen stenosis and nerve root compression in spondylolytic spondylolisthesis. We investigated 120 intervertebral foramina of 60 patients with spondylolytic spondylolisthesis who had undergone lumbar MRI. A retrospective review of their MR images revealed the degree of intervertebral foramen stenosis and causes of nerve root compression. The relationship between disk height diminution following spondylolysis and degree of intervertebral foramen stenosis was also evaluated. Forty eight of 60 patients showed a similar degree of intervertebral foramen stenosis, and in 12 patients the degree of stenosis was different. In 110 intervertebral foramina, stenosis of both the superior and inferior compartments of intervertebral foramina was demonstrated. In 37 of 120 cases (30.8%), stenosis was mild ; in 44 of 120 (36.7%) it was modcrate, and in 29 of 120 (24.2%) it was severe. Stenosis of the inferior compartment was demonstrated in ten of 120 intervertebral foramina (8.3%). Nerve root compression was caused by posterior bulging of the intervertebral disk (65/120), descent of the pedicle (51/120), an isthmic bony segment above the site of spondylolytic (44/120), a bony spur formed at a spondylolytic site (11/120), and fibrocartilaginous callus at a spondylolytic site (5/48). In all cases there was degenerative change of the intervertebral disk at the affected level. There was no relationship between degree of disk height diminution and degree of intervertebral foramen stenosis (p > 0.05). The degree of intervertebral foramen stenosis and causes of nerve root compression in spondylolytic spondylolisthesis are variable, and MRI demonstrates them precisely. There was no positive relationship between degree of nerve root compression at an intervertebral foramen and degree of spondylolysis and degeneration of an intervertebral foramen. The degree of nerve root compression is believed to be another criterion for describing

  5. MR imaging of spondylolytic spondylolisthesis: changes of intervertebral foramen and nerve root compression

    International Nuclear Information System (INIS)

    Kim, Ji Hyung; Chung, Tae Sub; Kim, Young Soo

    1999-01-01

    To evaluate the factors affecting intervertebral foramen stenosis and nerve root compression in spondylolytic spondylolisthesis. We investigated 120 intervertebral foramina of 60 patients with spondylolytic spondylolisthesis who had undergone lumbar MRI. A retrospective review of their MR images revealed the degree of intervertebral foramen stenosis and causes of nerve root compression. The relationship between disk height diminution following spondylolysis and degree of intervertebral foramen stenosis was also evaluated. Forty eight of 60 patients showed a similar degree of intervertebral foramen stenosis, and in 12 patients the degree of stenosis was different. In 110 intervertebral foramina, stenosis of both the superior and inferior compartments of intervertebral foramina was demonstrated. In 37 of 120 cases (30.8%), stenosis was mild ; in 44 of 120 (36.7%) it was modcrate, and in 29 of 120 (24.2%) it was severe. Stenosis of the inferior compartment was demonstrated in ten of 120 intervertebral foramina (8.3%). Nerve root compression was caused by posterior bulging of the intervertebral disk (65/120), descent of the pedicle (51/120), an isthmic bony segment above the site of spondylolytic (44/120), a bony spur formed at a spondylolytic site (11/120), and fibrocartilaginous callus at a spondylolytic site (5/48). In all cases there was degenerative change of the intervertebral disk at the affected level. There was no relationship between degree of disk height diminution and degree of intervertebral foramen stenosis (p > 0.05). The degree of intervertebral foramen stenosis and causes of nerve root compression in spondylolytic spondylolisthesis are variable, and MRI demonstrates them precisely. There was no positive relationship between degree of nerve root compression at an intervertebral foramen and degree of spondylolysis and degeneration of an intervertebral foramen. The degree of nerve root compression is believed to be another criterion for describing

  6. Imaging features suggestive of a conjoined nerve root on routine axial MRI

    Energy Technology Data Exchange (ETDEWEB)

    Song, Su Jin; Lee, Joon Woo; Kang, Heung Sik [Seoul National University Bundang Hospital, Department of Radiology, Gyeongi-do (Korea); Choi, Ja-Young; Hong, Sung Hwan; Kim, Na Ra [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea); Kim, Ki-Jeong; Chung, Sang-Ki; Kim, Hyun-Jib [Seoul National University Bundang Hospital, Department of Neurosurgery, Gyeongi-Do (Korea)

    2008-02-15

    The purpose of our study is to evaluate imaging features suggestive of a conjoined nerve root on routine axial MRI. Two radiologists and two surgeons retrospectively reviewed the MRI of three cases in which a conjoined nerve root was discovered during operation and found three suggestive signs on routine axial MR images: ''corner'' (asymmetric morphology of the anterolateral corner of the dural sac), ''fat crescent'' (intervening extradural fat between the asymmetric dura and the nerve root), and ''parallel'' signs (visualization of the entire parallel course of the nerve root at the disc level). Two radiologists prospectively found these signs during routine MRI interpretation sessions over a period of 6 months. If one or a combination of signs were noted on axial MR images, contiguous axial scans were additionally obtained. Three cases that were previously found during operations were also included. Prevalence and confidence scores for each sign were assessed on axial T1- and T2-weighted images. Twelve patients showed one or a combination of the three signs, 9 had contiguous axial MR scans. Five cases were confirmed by operation. The prevalence of the corner, fat crescent, and parallel signs were 12 out of 12 (100%), 6 out of 12 (50%), and 8 out of 12 (67.7%) on axial T1-weighted images. The overall diagnostic confidence was higher on T1- than on T2-weighted images (P < 0.05). On routine axial L-spine MRI, corner, fat crescent, and parallel signs are suggestive of and assist in the recognition of a conjoined nerve root. (orig.)

  7. Radiofrequency thermocoagulation for the treatment of lumbar intervertebral disc protrusion: a clinical observation of 30 cases

    International Nuclear Information System (INIS)

    Gong Weidong; Li Yazhou; Cao Wei; Yang Wei; Zhang Peng; Wang Zhimin; Wu Zhiqun

    2010-01-01

    Objective: To observe the clinical effects and safety of radiofrequency thermocoagulation in treating the lumbar intervertebral disc protrusion. Methods: Thirty patients with lumbar intervertebral disc protrusion, whose diagnoses were confirmed by clinical manifestations and CT findings, were involved in this study. The needle was punctured to the target point of the diseased intervertebral space under C-arm fluoroscopic guidance. After the testing of sensory nerve, motor nerve and temperature was made, the target needles were heated until the nerve radiofrequency temperature meter reached the point of 92 degree C. This point of temperature was held for 100 seconds and the procedure was repeated for four cycles. Results: Six months after the treatment, all patients showed an obvious improvement in VAS, which decreased from 7.83 ± 0.33 before operation to 2.37 ± 0.48 after treatment (P < 0.05). According to the modified Macnab therapeutic evaluation criteria, excellent result was seen in 9, good result in 12, fair result in 5 and poor result in 4 cases, with a total effective rate of 86.7%. No serious complications occurred in all patients. Conclusion: Radiofrequency thermocoagulation is an effective and safe method for the treatment of lumbar intervertebral disc protrusion. (authors)

  8. Incremental benefit of three-dimensional transesophageal echocardiography in the assessment of left main coronary artery stent protrusion.

    Science.gov (United States)

    Arisha, Mohammed J; Hsiung, Ming C; Ahmad, Amier; Nanda, Navin C; Elkaryoni, Ahmed; Mohamed, Ahmed H; Yin, Wei-Hsian

    2017-06-01

    Ostial lesions represent a challenging clinical scenario and percutaneous intervention (PCI) of left main coronary artery ostial lesions has been associated with postintervention complications, including protrusion of deployed stents into a sinus of Valsalva or aortic root. We report a case of stent protrusion into the aortic root following aorto-ostial left main coronary artery PCI, in which three-dimensional transesophageal echocardiography (3DTEE) provided incremental benefit over standard two-dimensional images. Specifically, 3DTEE confirmed the presence of stent protrusion by allowing clear visualization of the stent scaffold, in addition to characterizing the relationship between the stent and surrounding structures. © 2017, Wiley Periodicals, Inc.

  9. The brain plasticity in patients with brachial plexus root avulsion after contralateral C7 nerve-root transfer: a FDG-PET study

    International Nuclear Information System (INIS)

    Zuo, C.T.; Guan, Y.H.; Xu, W.D.; Zhao, J.; Sun, G.X.; Lin, X.T.

    2002-01-01

    Objectives: To study FDG-PET for imaging the brain plasticity in patients with brachial plexus root avulsion after contralateral C7 nerve-root transfer. Methods: One male patient with left brachial plexus root avulsion underwent a two-stage procedure (first phase: C7 root → ulnar nerve; second phase: ulnar nerve → recipient nerve) 4 years ago; Another with right brachial plexus root avulsion also underwent a two-stage procedure 3 years ago. First two patients underwent basic FDG-PET imaging, the next day FDG-PET scans were performed after initiative or passive limb movement. Using ROI and MPI tools to evaluate the images. The ratios of sensorimotor frontal cingulated Thalami to white matter were used as the semiquantitive index. Results: Whether brain plasticity had occurred was determined by whether the affected limb can perform initiative movement. The increases in glucose metabolism of left sensorimotor frontal cingulated Thalami in patient with left brachial plexus root avulsion were 40.1%, 37.9%, 48.3%, 31.9% after initiative movement, the right corresponding brain regions were 39.4%, 34.3%, 48.5%,35.4% respectively. However, the increases in glucose metabolism of left sensorimotor frontal cingulated Thalami in patient with right brachial plexus root avulsion were increased by 12.6%, 9.6%, 10.7%, 5.3% after passive movement, the right corresponding brain regions were respectively 17.9%, 12.9%, 15.4%, 10.1%. It was founded that the metabolism of bilateral sensorimotor frontal cingulated Thalami increased after initiative movement, while the metabolism of right sensorimotor frontal cingulated Thalami increased more obviously than that of the left brain regions when using MPI tool to substract the images before and after the affected limb movement. Conclusions: Sensorimotor frontal cingulated Thalami were necessary to the initiative movement. After being activated by movement, the metabolisms of plasticised brain regions increased obviously. However, the

  10. Lumbar nerve root avulsions with secondary ipsilateral hip dysplasia in a child

    Energy Technology Data Exchange (ETDEWEB)

    Polyzoidis, Konstandinos; Vranos, Georgios [Department of Neurosurgery, Medical School, University of Ioannina, 45110, Ioannina (Greece); Petropoulou, Calliope; Argyropoulou, Paraskevi I.; Argyropoulou, Maria I. [Department of Radiology, Medical School, University of Ioannina, 45110, Ioannina (Greece); Sarmas, Ioannis [Department of Neurology, Medical School, University of Ioannina, 45110, Ioannina (Greece)

    2002-09-01

    We report on an 8-year-old child with avulsions of the left L3, L4 and L5 nerve roots and traumatic meningoceles that were not associated with lumbar spine or pelvic girdle fractures. The patient had a history of a road traffic accident. Plain radiographs of the pelvis revealed left hip dysplasia. The magnetic resonance imaging findings of the lumbar spine are illustrated. The pathogenesis of lumbar nerve root avulsions and their association with ipsilateral hip dysplasia are discussed. (orig.)

  11. Lumbar nerve root avulsions with secondary ipsilateral hip dysplasia in a child

    International Nuclear Information System (INIS)

    Polyzoidis, Konstandinos; Vranos, Georgios; Petropoulou, Calliope; Argyropoulou, Paraskevi I.; Argyropoulou, Maria I.; Sarmas, Ioannis

    2002-01-01

    We report on an 8-year-old child with avulsions of the left L3, L4 and L5 nerve roots and traumatic meningoceles that were not associated with lumbar spine or pelvic girdle fractures. The patient had a history of a road traffic accident. Plain radiographs of the pelvis revealed left hip dysplasia. The magnetic resonance imaging findings of the lumbar spine are illustrated. The pathogenesis of lumbar nerve root avulsions and their association with ipsilateral hip dysplasia are discussed. (orig.)

  12. Ultrasound Guided Nerve Root Injection in Patients with Cervical Spondylytic Radicular Pain

    Directory of Open Access Journals (Sweden)

    LT Choong

    2009-05-01

    Full Text Available Selective cervical nerve root injection using a mixture of corticosteroid and lignocaine is a treatment option for managing cervical radiculopathic pain. The procedure is usually performed under image guided fluoroscopy or Computerized Tomograhy. Ultrasound-guided cervical nerve root block does not expose the patients and personnel to radiation. During injection, the fluid is mostly visualized in a real-time fashion. This retrospective study reviewed the effectiveness of ultrasound in guiding cervical peri-radicular injection for pain relief in patients with recalcitrant cervical radiculopathy. There were no complications reported in this series.

  13. MRI-guided and CT-guided cervical nerve root infiltration therapy. A cost comparison

    Energy Technology Data Exchange (ETDEWEB)

    Maurer, M.H.; Froeling, V.; Roettgen, R.; Bucourt, M. de; Hamm, B.; Streitparth, F. [Charite University Medicine Berlin (Germany). Dept. of Diagnostic and Interventional Radiology; Bretschneider, T. [Magdeburg Univ. (Germany). Dept. of Radiology and Nuclear Medicine; Hartwig, T.; Disch, A.C. [Charite University Medicine Berlin (Germany). Center for Musculoskeletal Surgery

    2014-06-15

    Purpose: To evaluate and compare the costs of MRI-guided and CT-guided cervical nerve root infiltration for the minimally invasive treatment of radicular neck pain. Materials and Methods: Between September 2009 and April 2012, 22 patients (9 men, 13 women; mean age: 48.2 years) underwent MRI-guided (1.0 Tesla, Panorama HFO, Philips) single-site periradicular cervical nerve root infiltration with 40 mg triamcinolone acetonide. A further 64 patients (34 men, 30 women; mean age: 50.3 years) were treated under CT fluoroscopic guidance (Somatom Definition 64, Siemens). The mean overall costs were calculated as the sum of the prorated costs of equipment use (purchase, depreciation, maintenance, and energy costs), personnel costs and expenditure for disposables that were identified for MRI- and CT-guided procedures. Additionally, the cost of ultrasound guidance was calculated. Results: The mean intervention time was 24.9 min. (range: 12-36 min.) for MRI-guided infiltration and 19.7 min. (range: 5-54 min.) for CT-guided infiltration. The average total costs per patient were EUR 240 for MRI-guided interventions and EUR 124 for CT-guided interventions. These were (MRI/CT guidance) EUR 150/60 for equipment use, EUR 46/40 for personnel, and EUR 44/25 for disposables. The mean overall cost of ultrasound guidance was EUR 76. Conclusion: Cervical nerve root infiltration using MRI guidance is still about twice as expensive as infiltration using CT guidance. However, since it does not involve radiation exposure for patients and personnel, MRI-guided nerve root infiltration may become a promising alternative to the CT-guided procedure, especially since a further price decrease is expected for MRI devices and MR-compatible disposables. In contrast, ultrasound remains the less expensive method for nerve root infiltration guidance. (orig.)

  14. MRI-guided and CT-guided cervical nerve root infiltration therapy. A cost comparison

    International Nuclear Information System (INIS)

    Maurer, M.H.; Froeling, V.; Roettgen, R.; Bucourt, M. de; Hamm, B.; Streitparth, F.; Bretschneider, T.; Hartwig, T.; Disch, A.C.

    2014-01-01

    Purpose: To evaluate and compare the costs of MRI-guided and CT-guided cervical nerve root infiltration for the minimally invasive treatment of radicular neck pain. Materials and Methods: Between September 2009 and April 2012, 22 patients (9 men, 13 women; mean age: 48.2 years) underwent MRI-guided (1.0 Tesla, Panorama HFO, Philips) single-site periradicular cervical nerve root infiltration with 40 mg triamcinolone acetonide. A further 64 patients (34 men, 30 women; mean age: 50.3 years) were treated under CT fluoroscopic guidance (Somatom Definition 64, Siemens). The mean overall costs were calculated as the sum of the prorated costs of equipment use (purchase, depreciation, maintenance, and energy costs), personnel costs and expenditure for disposables that were identified for MRI- and CT-guided procedures. Additionally, the cost of ultrasound guidance was calculated. Results: The mean intervention time was 24.9 min. (range: 12-36 min.) for MRI-guided infiltration and 19.7 min. (range: 5-54 min.) for CT-guided infiltration. The average total costs per patient were EUR 240 for MRI-guided interventions and EUR 124 for CT-guided interventions. These were (MRI/CT guidance) EUR 150/60 for equipment use, EUR 46/40 for personnel, and EUR 44/25 for disposables. The mean overall cost of ultrasound guidance was EUR 76. Conclusion: Cervical nerve root infiltration using MRI guidance is still about twice as expensive as infiltration using CT guidance. However, since it does not involve radiation exposure for patients and personnel, MRI-guided nerve root infiltration may become a promising alternative to the CT-guided procedure, especially since a further price decrease is expected for MRI devices and MR-compatible disposables. In contrast, ultrasound remains the less expensive method for nerve root infiltration guidance. (orig.)

  15. Role of motor-evoked potential monitoring in conjunction with temporary clipping of spinal nerve roots in posterior thoracic spine tumor surgery.

    Science.gov (United States)

    Eleraky, Mohammed A; Setzer, Matthias; Papanastassiou, Ioannis D; Baaj, Ali A; Tran, Nam D; Katsares, Kiesha M; Vrionis, Frank D

    2010-05-01

    The vascular supply of the thoracic spinal cord depends on the thoracolumbar segmental arteries. Because of the small size and ventral course of these arteries in relation to the dorsal root ganglion and ventral root, they cannot be reliably identified during surgery by anatomic or morphologic criteria. Sacrificing them will most likely result in paraplegia. The goal of this study was to evaluate a novel method of intraoperative testing of a nerve root's contribution to the blood supply of the thoracic spinal cord. This is a clinical retrospective study of 49 patients diagnosed with thoracic spine tumors. Temporary nerve root clipping combined with motor-evoked potential (MEP) and somatosensory-evoked potential (SSEP) monitoring was performed; additionally, postoperative clinical evaluation was done and reported in all cases. All cases were monitored by SSEP and MEPs. The nerve root to be sacrificed was temporarily clipped using standard aneurysm clips, and SSEP/MEP were assessed before and after clipping. Four nerve roots were sacrificed in four cases, three nerve roots in eight cases, and two nerve roots in 22 cases. Nerve roots were sacrificed bilaterally in 12 cases. Most patients (47/49) had no changes in MEP/SSEP and had no neurological deficit postoperatively. One case of a spinal sarcoma demonstrated changes in MEP after temporary clipping of the left T11 nerve root. The nerve was not sacrificed, and the patient was neurologically intact after surgery. In another case of a sarcoma, MEPs changed in the lower limbs after ligation of left T9 nerve root. It was felt that it was a global event because of anesthesia. Postoperatively, the patient had complete paraplegia but recovered almost completely after 6 months. Temporary nerve root clipping combined with MEP and SSEP monitoring may enhance the impact of neuromonitoring in the intraoperative management of patients with thoracic spine tumors and favorably influence neurological outcome. Copyright 2010 Elsevier

  16. Changes in lumbosacral spinal nerve roots on diffusion tensor imaging in spinal stenosis

    OpenAIRE

    Zhong-jun Hou; Yong Huang; Zi-wen Fan; Xin-chun Li; Bing-yi Cao

    2015-01-01

    Lumbosacral degenerative disc disease is a common cause of lower back and leg pain. Conventional T1-weighted imaging (T1WI) and T2-weighted imaging (T2WI) scans are commonly used to image spinal cord degeneration. However, these modalities are unable to image the entire lumbosacral spinal nerve roots. Thus, in the present study, we assessed the potential of diffusion tensor imaging (DTI) for quantitative assessment of compressed lumbosacral spinal nerve roots. Subjects were 20 young healthy v...

  17. Co-occurrence of lumbar spondylolysis and lumbar disc herniation with lumbosacral nerve root anomaly

    Science.gov (United States)

    Yılmaz, Tevfik; Turan, Yahya; Gülşen, İsmail; Dalbayrak, Sedat

    2014-01-01

    Lumbosacral nerve root anomalies are the leading cause of lumbar surgery failures. Although co-occurrence of lumbar spondylolysis and disc herniation is common, it is very rare to observe that a nerve root anomaly accompanies these lesions. A 49-year-old male patient presented with sudden-onset right leg pain. Examinations revealed L5/S1 lumbar spondylolysis and disc herniation. At preoperative period, he was also diagnosed with lumbosacral root anomaly. Following discectomy and root decompression, stabilization was performed. The complaints of the patient diagnosed with lumbosacral root anomaly at intraoperative period were improved at postoperative period. It should be remembered that in patients with lumbar disc herniation and spondylolysis, lumbar root anomalies may coexist when clinical and neurological picture is severe. Preoperative and perioperative assessments should be made meticulously to prevent neurological injury. PMID:25210343

  18. Co-occurrence of lumbar spondylolysis and lumbar disc herniation with lumbosacral nerve root anomaly

    Directory of Open Access Journals (Sweden)

    Tevfik Yilmaz

    2014-01-01

    Full Text Available Lumbosacral nerve root anomalies are the leading cause of lumbar surgery failures. Although co-occurrence of lumbar spondylolysis and disc herniation is common, it is very rare to observe that a nerve root anomaly accompanies these lesions. A 49-year-old male patient presented with sudden-onset right leg pain. Examinations revealed L5/S1 lumbar spondylolysis and disc herniation. At preoperative period, he was also diagnosed with lumbosacral root anomaly. Following discectomy and root decompression, stabilization was performed. The complaints of the patient diagnosed with lumbosacral root anomaly at intraoperative period were improved at postoperative period. It should be remembered that in patients with lumbar disc herniation and spondylolysis, lumbar root anomalies may coexist when clinical and neurological picture is severe. Preoperative and perioperative assessments should be made meticulously to prevent neurological injury.

  19. Detection of the symptomatic nerve root; A contrast-enhanced MR study

    Energy Technology Data Exchange (ETDEWEB)

    Toyone, Tomoaki; Takahashi, Kazuhisa; Yamagata, Masayasu (Chiba Univ. (Japan). School of Medicine) (and others)

    1993-04-01

    Twenty-five patients with lumbar disc herniation with a chief complaint of unilateral leg pain underwent gadolinium-DTPA enhanced MRI, particularly to examine the nerve root in the distal area of hernia. MRI appearance fell into three grades: 0 - no visualization (n=7), 1 - heterogeneous visualization (n=7), and 2 - homogeneous visualization (n=10). In the quantitative evaluation of the severity of sciatica using SLR and JOA scores, it was found to be associated with the degree of visualization. All patients of grade 2 were required to receive surgery because pain relief was not attained in spite of 3 months or more conservative treatment. These findings indicatd the usefulness of MRI in predicting prognosis, as well as in diagnosing the responsible level. Since blood-nerve barrier damage and intraneural edema are considered to be involved in the visualization of the nerve root on MRI, MRI will help in diagnosing radicular sciatica and elucidating the pathophysiology of the disease. (N.K.).

  20. Peripheral Nerve Stimulation of Brachial Plexus Nerve Roots and Supra-Scapular Nerve for Chronic Refractory Neuropathic Pain of the Upper Limb.

    Science.gov (United States)

    Bouche, Bénédicte; Manfiotto, Marie; Rigoard, Philippe; Lemarie, Jean; Dix-Neuf, Véronique; Lanteri-Minet, Michel; Fontaine, Denys

    2017-10-01

    We report the outcome of a consecutive series of 26 patients suffering from chronic medically-refractory neuropathic pain of the upper limb (including 16 patients with complex regional pain syndrome), topographically limited, treated by brachial plexus (BP) nerve roots or supra-scapular nerve (SSN) peripheral nerve stimulation (PNS). The technique consisted in ultrasound-guided percutaneous implantation of a cylindrical lead (Pisces-Quad, Medtronic) close to the SSN or the cervical nerve roots within the BP, depending on the pain topography. All the patients underwent a positive trial stimulation before lead connection to a subcutaneous stimulator. Chronic bipolar stimulation mean parameters were: frequency 55.5 Hertz, voltage 1.17 Volts. The voltage was set below the threshold inducing muscle contractions or paresthesias. Two patients were lost immediately after surgery. At last follow-up (mean 27.5 months), the 20 patients still using the stimulation experienced a mean pain relief of 67.1%. Seventeen patients were improved ≥50%, including 12 improved ≥70%. In 11 patients with a follow-up >2 years, the mean pain relief was 68%. At last follow-up, respectively, six out of the nine (67%) patients treated by SSN stimulation and 10 out of 17 patients (59%) treated by BP stimulation were improved ≥50%. At last follow-up, 12 out of 20 patients still using the stimulation were very satisfied, six were satisfied, and two were poorly satisfied. Complications were: stimulation intolerance due to shock-like sensations (three cases), superficial infection (1), lead fractures (2), and migration (1). In this pilot study, SSN or BP roots PNS provided a relatively safe, durable and effective option to control upper limb neuropathic pain. © 2017 International Neuromodulation Society.

  1. MRI-guided periradicular nerve root infiltration therapy in low-field (0.23-T) MRI system using optical instrument tracking

    International Nuclear Information System (INIS)

    Sequeiros, Roberto Blanco; Ojala, Risto O.; Klemola, Rauli; Jyrkinen, Lasse; Tervonen, Osmo A.; Vaara, Teuvo J.

    2002-01-01

    The purpose of this study was to evaluate the feasibility of the MRI-guided periradicular nerve root infiltration therapy. Sixty-seven nerve root infiltrations under MRI guidance were done for 61 patients suffering from lumbosacral radicular pain. Informed consent was acquired from all patients. A 0.23-T open-MRI scanner with interventional tools (Outlook Proview, Philips Medical Systems, MR Technologies, Finland) was used. A surface coil was used in all cases. Nerve root infiltration was performed with MRI-compatible 20-G needle (Chiba type MReye, Cook, Bloomington, Ind.; or Manan type, MD Tech, Florida). The evaluation of clinical outcome was achieved with 6 months of clinical follow-up and questionnaire. The effect of nerve root infiltration to the radicular pain was graded: 1=good to excellent, i.e., no pain or not disturbing pain allowing normal physical activity at 3 months from the procedure; 2=temporary, i.e., temporary relief of pain; 3=no relief of pain; and 4=worsening of pain. As an adjunct to MRI-guided positioning of the needle the correct needle localization by the nerve root was confirmed with saline injection to nerve root channel and single-shot fast spin echo (SSFSE) imaging. The MRI guidance allowed adequate needle positioning in all but 1 case (98.5%). This failure was caused by degeneration-induced changes in anatomy. Of patients, 51.5% had good to excellent effect with regard to radicular pain from the procedure, 22.7% had temporary relief, 21.2% had no effect, and in 4.5% the pain worsened. Our results show that MRI guidance is accurate and safe in performing nerve root infiltration at lumbosacral area. The results of radicular pain relief from nerve root infiltration are comparable to CT or fluoroscopy studies on the subject. (orig.)

  2. Pleural malignant mesothelioma causing cord infiltration through the nerve root. Case report.

    Science.gov (United States)

    Okura, Hidehiro; Suga, Yasuo; Akiyama, Osamu; Kudo, Kentaro; Tsutsumi, Satoshi; Abe, Yusuke; Yasumoto, Yukimasa; Ito, Masanori; Izumi, Hiroshi; Shiomi, Kazu

    2009-04-01

    A 61-year-old man presented with a rare pleural malignant mesothelioma of the spine manifesting as progressive weakness of the bilateral lower extremities, numbness in the body and both legs, and dysfunction of the bladder and bowel. He had previous occupational exposure to asbestos while working at a car repair shop and had undergone right panpleuropneumonectomy under a diagnosis of sarcomatous type mesothelioma in the right pleural space. Magnetic resonance imaging of the spine with gadolinium showed an enhanced intramedullary tumor at the T4 level. Operative findings disclosed the clouded and swollen right posterior nerve root, and the pial surface was covered by clouded arachnoid-like membrane. The removed part of the T4 posterior nerve root and intramedullary tumor revealed malignant mesothelioma with invasion spreading along the posterior nerve root. He died of respiratory failure 3 months after the diagnosis. This case shows that spinal metastasis must be considered if a patient with pleural malignant mesothelioma shows neurological worsening and neuroimaging shows an abnormal lesion in the thoracic spinal cord. However, the patient's neurological condition is very difficult to improve in the presence of spinal cord infiltration.

  3. The anatomical relationship between the roots of mandibular second molars and the inferior alveolar nerve.

    Science.gov (United States)

    Chong, B S; Quinn, A; Pawar, R R; Makdissi, J; Sidhu, S K

    2015-06-01

    To evaluate the anatomical relationship between the roots of mandibular second molars and the inferior alveolar nerve (IAN) in relation to the risk of potential nerve injury during root canal treatment. Cone-beam computed tomography (CBCT) images from the patient record database at a dental hospital were selected. The anonymized CBCT images were reconstructed and examined in three planes (coronal, axial and sagittal) using 3D viewing software. The relationship between each root apex of mandibular second molars and the IAN was evaluated by measuring the horizontal and vertical distances from coronal CBCT sections, and the actual distance was then calculated mathematically using Pythagoras' theorem. In 55% of the 272 mandibular second molar roots evaluated, from a total of 134 scans, the distance between the anatomical root apex and the IAN was ≤3 mm. In over 50% of the cases evaluated, there was an intimate relationship between the roots of mandibular second molars and the inferior alveolar nerve (IAN). Therefore, root canal treatment of mandibular second molars may pose a more significant potential risk of IAN injury; necessary precautions should be exercised, and the prudent use of CBCT should be considered if an intimate relationship is suspected. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

  4. Delayed radiation necrosis of a spinal nerve root presenting as an intra-spinal mass

    International Nuclear Information System (INIS)

    Mikhael, M.A.

    1979-01-01

    Details are given of the case history of a 16 year old male with a six week history of progressive weakness of the arms and legs seven years after his last course of radiotherapy for Hodgkin's disease. Histopathological examination of an excised hard fibrotic mass revealed delayed radiation necrosis of a spinal root nerve with no evidence of Hodgkin's disease. The mass recurred seven months later and was removed by wide excision. The spinal cord had probably received less than 2000 rad during one course of radiotherapy. The 15 MeV electron beam of the second course of radiotherapy would not have penetrated the spinal cord itself, but the nerve roots would have received a much higher dose. Nerve roots should therefore be shielded whenever possible during radiotherapy, and the possibility of radiation necrosis considered in the differential diagnosis of intraspinal masses in the field of earlier radiation therapy. (UK)

  5. The anatomy of the first sacral nerve root sheath shown by computed tomography.

    Science.gov (United States)

    Moore, N R; Dixon, A K; Freer, C E

    1989-08-01

    Analysis of 25 patients with normal computed tomographic appearances at the lumbosacral junction revealed wide variation in the anatomical level at which the first sacral nerve root sheaths were seen emerging from the theca. In nine patients (36%), the S1 nerve root sheaths were first recognized at the level of the lumbosacral disc. In 14 patients (56%), the sheaths emerged cranial to the disc; it is possible that these patients may be more prone to neurological complications related to disc or facet joint disease, especially if the sheath is laterally sited within the lateral recess. Conversely, that minority of patients (two, 8%) in whom the root sheaths emerge caudal to the disc level may be relatively protected from neurological complications.

  6. Microstructural Changes in Compressed Nerve Roots Are Consistent With Clinical Symptoms and Symptom Duration in Patients With Lumbar Disc Herniation.

    Science.gov (United States)

    Wu, Weifei; Liang, Jie; Ru, Neng; Zhou, Caisheng; Chen, Jianfeng; Wu, Yongde; Yang, Zong

    2016-06-01

    A prospective study. To investigate the association between microstructural nerve roots changes on diffusion tensor imaging (DTI) and clinical symptoms and their duration in patients with lumbar disc herniation. The ability to identify microstructural properties of the nervous system with DTI has been demonstrated in many studies. However, there are no data regarding the association between microstructural changes evaluated using DTI and symptoms assessed with the Oswestry Disability Index (ODI) and their duration. Forty consecutive patients with foraminal disc herniation affecting unilateral sacral 1 (S1) nerve roots were enrolled in this study. DTI with tractography was performed on the S1 nerve roots. Clinical symptoms were evaluated using an ODI questionnaire for each patient, and the duration of clinical symptoms was noted based on the earliest instance of leg pain and numbness. Mean fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were calculated from tractography images. The mean FA value of the compressed lumbar nerve roots was significantly lower than the FA of the contralateral nerve roots (P leg pain, indicating that the microstructure of the nerve root has been damaged. 3.

  7. Effect of the gamma knife treatment on the trigeminal nerve root in Chinese patients with primary trigeminal neuralgia.

    Science.gov (United States)

    Song, Zhi-Xiu; Qian, Wei; Wu, Yu-Quan; Sun, Fang-Jie; Fei, Jun; Huang, Run-Sheng; Fang, Jing-Yu; Wu, Cai-Zhen; An, You-Ming; Wang, Daxin; Yang, Jun

    2014-01-01

    To understand the mechanism of the gamma knife treating the trigeminal neuralgia. Using the MASEP-SRRS type gamma knife treatment system, 140 Chinese patients with trigeminal neuralgia (NT) were treated in our hospital from 2002 to 2010, in which the pain relief rate reached 95% and recurrence rate was 3% only. We investigated the effect of the gamma knife treatment on the trigeminal nerve root in 20 Chinese patients with primary trigeminal neuralgia by the magnetic resonance imager (MRI) observation. 1) The cross-sectional area of trigeminal nerve root became smaller and MRI signals were lower in the treatment side than those in the non-treatment side after the gamma knife treatment of primary trigeminal neuralgia; 2) in the treatment side, the cross-sectional area of the trigeminal nerve root decreased significantly after the gamma knife treatment; 3) there was good correlation between the clinical improvement and the MRI findings; and 4) the straight distance between the trigeminal nerve root and the brainstem did not change after the gamma knife treatment. The pain relief induced the gamma knife radiosurgery might be related with the atrophy of the trigeminal nerve root in Chinese patients with primary trigeminal neuralgia.

  8. Effects of ischemic phrenic nerve root ganglion injury on respiratory disturbances in subarachnoid hemorrhage: an experimental study.

    Science.gov (United States)

    Ulvi, Hızır; Demir, Recep; Aygül, Recep; Kotan, Dilcan; Calik, Muhammet; Aydin, Mehmet Dumlu

    2013-12-30

    Phrenic nerves have important roles on the management of respiration rhythm. Diaphragm paralysis is possible in phrenic nerve roots ischemia in subarachnoid hemorrhage (SAH). We examined whether there is a relationship between phrenic nerve root ischemia and respiratory disturbances in SAH. This study was conducted on 5 healthy control and 14 rabbits with experimentally induced SAH by injecting autologous blood into their cisterna magna. Animals were followed up via monitors for detecting the heart and respiration rhythms for 20 days and then decapitaed by humanely. Normal and degenerated neuron densities of phrenic nerve root at the level of C4 dorsal root ganglia (C4DRG) were estimated by Stereological methods. Between the mean numerical density of degenerated neurons of C4DRG and respiratory rate/minute of groups were compared statistically. Phrenic nerve roots, artery and diaphragm muscles degeneration was detected in respiratory arrest developed animals. The mean neuronal density of C4DRG was 13272 ±1201/mm3 with a mean respiration rate of 23 ±4/min in the control group. The mean degenerated neuron density was 2.240 ±450/mm(3) and respiration rhythm was 31 ±6/min in survivors. But, the mean degenerated neuron density was 5850 ±650/mm(3) and mean respiration rhythm was 34 ±7/min in respiratory arrest developed animals (n = 7). A linear relationship was noticed between the degenerated neuron density of C4DRG and respiraton rate (r = -0.758; p Phrenic nerve root ischemia may be an important factor in respiration rhythms deteriorations in SAH which has not been mentioned in the literature.

  9. CT-guided cervical nerve root injections: comparing the immediate post-injection anesthetic-related effects of the transforaminal injection with a new indirect technique

    International Nuclear Information System (INIS)

    Sutter, Reto; Pfirrmann, Christian W.A.; Peterson, Cynthia K.; Zanetti, Marco; Hodler, Juerg

    2011-01-01

    To describe an ''indirect'' cervical nerve root injection technique with a dorsal approach that should carry less inherent risk than the ''direct'' cervical transforaminal injection approach, and to compare the immediate post-injection results of the two procedures. The indirect and direct cervical nerve root injection procedures are described in detail. Fifty-three consecutive patients receiving the indirect nerve root injections during 2009-2010 were age- and gender-matched to 53 patients who underwent direct transforaminal nerve root injections performed in 2006. Pain level data were collected immediately before and 20-30 min after each procedure. The percentages of pain change in the two groups were compared using the unpaired Student's t test. Fifty-two men (mean age 49) and 54 women (mean age 55) were included. The mean percentage of pain reduction for patients receiving indirect nerve root injections was 38.4% and for those undergoing the direct nerve root injections approach it was 43.2%. This was not significantly different (P = 0.455). No immediate or late adverse effects were reported after either injection procedure. The indirect cervical nerve root injection procedure is a potentially safer alternative to direct cervical transforaminal nerve root injections. The short-term pain reduction is similar using the two injection methods. (orig.)

  10. Trigeminal Nerve Root Demyelination Not Seen in Six Horses Diagnosed with Trigeminal-Mediated Headshaking

    Directory of Open Access Journals (Sweden)

    Veronica L. Roberts

    2017-05-01

    Full Text Available Trigeminal-mediated headshaking is an idiopathic neuropathic facial pain syndrome in horses. There are clinical similarities to trigeminal neuralgia, a neuropathic facial pain syndrome in man, which is usually caused by demyelination of trigeminal sensory fibers within either the nerve root or, less commonly, the brainstem. Our hypothesis was that the neuropathological substrate of headshaking in horses is similar to that of trigeminal neuralgia in man. Trigeminal nerves, nerve roots, ganglia, infraorbital, and caudal nasal nerves from horse abattoir specimens and from horses euthanized due to trigeminal-mediated headshaking were removed, fixed, and processed for histological assessment by a veterinary pathologist and a neuropathologist with particular experience of trigeminal neuralgia histology. No histological differences were detected between samples from horses with headshaking and those from normal horses. These results suggest that trigeminal-mediated headshaking may have a different pathological substrate from trigeminal neuralgia in man.

  11. Clinical potential and limitation of MRI for degenerative lumbar spinal diseases. Comparison of MRI, myelography, CT and selective nerve root infiltration

    Energy Technology Data Exchange (ETDEWEB)

    Seki, Michihiro; Kikuchi, Shinichi [Fukushima Medical Coll. (Japan)

    1994-12-01

    To assess the clinical potential and limitations of magnetic resonance imaging (MRI) in degenerative lumbar spinal diseases, the findings of MR imaging were compared with those of myelography and CT. The subjects were 80 patients with intervertebral disc herniation (46), spondylosis (28), degenerative spondylolisthesis (5), and spondylolysis (one). There was a good correlation between sagittal MRI (T1-weighted images) and myelography in measuring the anteroposterior diameter and the compression rate of the injured dural canal in all disease categories. However, MRI was inferior, irrespective of sagittal and coronal images, to myelography in detecting blocking of the dural canal and intradural findings such as redundant nerve roots. MRI was inferior to selective nerve root infiltration in visualizing the compression of the nerve root, irrespective of diseases; however, there was no difference in abnormal findings of the running of nerve root between the two modalities. Transverse MRI was superior to CT in visualizing the nerve root. Thus, MRI alone is insufficient for the diagnosis of degenerative lumbar spinal diseases, and the other modalities should be supplementary for pathophysiological understanding of these diseases. (N.K.).

  12. Clinical potential and limitation of MRI for degenerative lumbar spinal diseases. Comparison of MRI, myelography, CT and selective nerve root infiltration

    International Nuclear Information System (INIS)

    Seki, Michihiro; Kikuchi, Shinichi

    1994-01-01

    To assess the clinical potential and limitations of magnetic resonance imaging (MRI) in degenerative lumbar spinal diseases, the findings of MR imaging were compared with those of myelography and CT. The subjects were 80 patients with intervertebral disc herniation (46), spondylosis (28), degenerative spondylolisthesis (5), and spondylolysis (one). There was a good correlation between sagittal MRI (T1-weighted images) and myelography in measuring the anteroposterior diameter and the compression rate of the injured dural canal in all disease categories. However, MRI was inferior, irrespective of sagittal and coronal images, to myelography in detecting blocking of the dural canal and intradural findings such as redundant nerve roots. MRI was inferior to selective nerve root infiltration in visualizing the compression of the nerve root, irrespective of diseases; however, there was no difference in abnormal findings of the running of nerve root between the two modalities. Transverse MRI was superior to CT in visualizing the nerve root. Thus, MRI alone is insufficient for the diagnosis of degenerative lumbar spinal diseases, and the other modalities should be supplementary for pathophysiological understanding of these diseases. (N.K.)

  13. Coronal MR imaging of the normal 3rd, 4th, and 5th lumbar and 1st sacral nerve roots

    International Nuclear Information System (INIS)

    Hald, J.K.; Nakstad, P.H.; Hauglum, B.E.

    1991-01-01

    Seven healthy volunteers underwent coronal MR imaging at 1.5 tesla of the normal 3rd, 4th, and 5th lumbar, and 1st sacral nerve roots. Coronal slices, 3-mm-thick with a 0.3-mm gap between the slices were obtained (TR/TE 600/22) through the lumbar spinal canal. All the nerve roots were visible on at least one image. One can routinely expect to demonstrate the 3rd, 4th, and 5th lumbar, and 1st sacral nerve roots on T1-weighted, 3-mm-thick coronal MR scans. We found no correlation between the degree of lumbar lordosis and the lengths of the visible nerve roots. Five patients with one of the following spinal problems: anomaly, tumor, disk herniation, and failed back surgery syndrome were examined according to our protocol. In all these cases coronal MR imaging gave the correct diagnosis. (orig.)

  14. Coronal MR imaging of the normal 3rd, 4th, and 5th lumbar and 1st sacral nerve roots

    Energy Technology Data Exchange (ETDEWEB)

    Hald, J K; Nakstad, P H; Hauglum, B E [National Hospital, Oslo (Norway). Dept. of Radiology

    1991-05-01

    Seven healthy volunteers underwent coronal MR imaging at 1.5 tesla of the normal 3rd, 4th, and 5th lumbar, and 1st sacral nerve roots. Coronal slices, 3-mm-thick with a 0.3-mm gap between the slices were obtained (TR/TE 600/22) through the lumbar spinal canal. All the nerve roots were visible on at least one image. One can routinely expect to demonstrate the 3rd, 4th, and 5th lumbar, and 1st sacral nerve roots on T1-weighted, 3-mm-thick coronal MR scans. We found no correlation between the degree of lumbar lordosis and the lengths of the visible nerve roots. Five patients with one of the following spinal problems: anomaly, tumor, disk herniation, and failed back surgery syndrome were examined according to our protocol. In all these cases coronal MR imaging gave the correct diagnosis. (orig.).

  15. Influence of needle position on lumbar segmental nerve root block selectivity.

    Science.gov (United States)

    Wolff, André P; Groen, Gerbrand J; Wilder-Smith, Oliver H

    2006-01-01

    In patients with chronic low back pain radiating to the leg, segmental nerve root blocks (SNRBs) are performed to predict surgical outcome and identify the putative symptomatic spinal nerve. Epidural spread may lead to false interpretation, affecting clinical decision making. Systematic fluoroscopic analysis of epidural local anesthetic spread and its relationship to needle tip location has not been published to date. Study aims include assessment of epidural local anesthetic spread and its relationship to needle position during fluoroscopy-assisted blocks. Patients scheduled for L4, L5, and S1 blocks were included in this prospective observational study. Under fluoroscopy and electrostimulation, they received 0.5 mL of a mixture containing lidocaine 5 mg and iohexol 75 mg. X-rays with needle tip and contrast were scored for no epidural spread (grade 0), local spread epidurally (grade 1), or to adjacent nerve roots (grade 2). Sixty-five patients were analyzed for epidural spread, 62 for needle position. Grade 1 epidural spread occurred in 47% of L4 and 28% of L5 blocks and grade 2 spread in 3 blocks (5%; L5 n = 1, S1 n = 2). For lumbar blocks, the needle was most frequently found in the lateral upper half of the intervertebral foramen. Epidural spread occurred more frequently with medial needle positions (P = .06). The findings suggest (P = .06) that the risk of grade 1 and 2 lumbar epidural spread, which results in decreased SNRB selectivity, is greater with medial needle positions in the intervertebral foramen. The variability in anatomic position of the dorsal root ganglion necessitates electrostimulation to guide SNRB in addition to fluoroscopy.

  16. Conjoined lumbosacral nerve roots compromised by disk herniation: sagittal shoulder sign for the preoperative diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Chang Ho [University of Ulsan College of Medicine, Asan Medical Center, Department of Radiology and Research Institute of Radiology, Seoul (Korea); Korea University College of Medicine, Department of Radiology, Anam Hospital, Seoul (Korea); Shin, Myung Jin; Kim, Sung Moon; Lee, Sang Hoon; Kim, Hee Kyung; Ryu, Jeong Ah [University of Ulsan College of Medicine, Asan Medical Center, Department of Radiology and Research Institute of Radiology, Seoul (Korea); Lee, Choon-Sung [University of Ulsan College of Medicine, Asan Medical Center, Department of Orthopedic Surgery, Seoul (Korea); Kim, Sam Soo [Kangwon National University College of Medicine, Department of Radiology, Kangwon (Korea)

    2008-03-15

    The objective was to determine the importance of the ''sagittal shoulder sign'' on magnetic resonance (MR) images for the diagnosis of conjoined lumbosacral nerve roots (CLNR) that are compromised by herniated disks. Magnetic resonance images of 11 patients (6 men and 5 women; age range, 25-71 years; average age, 48.7 years) with surgically proven CLNR, which was compromised by herniated disks, were retrospectively evaluated by two musculoskeletal radiologists. MR images were evaluated for the presence or absence of the sagittal shoulder sign - a vertical structure connecting two consecutive nerve roots and overlying disk on the sagittal MR images. The radiologists noted the type of accompanying disk herniation and bony spinal canal changes, as well as other characteristic MR features of CLNR, the common passage of two consecutive nerve roots through the neural foramen on axial MR images. The sagittal shoulder sign was identified with a mean frequency of 90.9% by the two observers (in 10 of 11 patients). The common passage of two consecutive nerve roots through the neural foramen on axial MR images was identified with a mean frequency of 59.1% (in 7 and 6 out of 11 patients, by observers 1 and 2, respectively). Good interobserver agreement for the sagittal shoulder sign was present (k = 0.621, p < 0.05). Observation of the sagittal shoulder sign may prove helpful for diagnosing CLNR in patients with disk herniation. In particular, this sign appears to be useful when there is no evidence of CLNR on axial MR images. (orig.)

  17. The short- and medium-term effectiveness of CT-guided selective cervical nerve root injection for pain and disability

    Energy Technology Data Exchange (ETDEWEB)

    Desai, Amidevi; Saha, Shouvik; Sharma, Naveen; Huckerby, Lauren; Houghton, Russell [Guy' s and St. Thomas' Hospitals, Department of Radiology, London (United Kingdom)

    2014-07-15

    CT-guided cervical nerve root injection with corticosteroid and/or local anesthetic is a recognized technique in the evaluation and treatment of cervical radiculopathy. There are few prospective studies on the efficacy of the various techniques employed in cervical nerve root injection. We present our results from a 1-year prospective series using a CT-guided anterolateral transforaminal approach for cervical nerve root injection of bupivacaine and dexamethasone. Pain using a numeric rating scale was assessed at pre-injection, 15 min post-injection, 1 month, and 3 months. Disability was assessed using the Oswestry Neck Disability Index (NDI) questionnaire at pre-injection, 1 month post-injection, and 3 months. In total, 50 patients were followed for 3 months. The mean reductions in pain were: 15 min (77 %), 1 month (39 %), and 3 months (33 %). The mean reductions in NDI were: 1 month (26 %) and 3 months (also 26 %). Results were statistically significant. CT-guided selective cervical nerve root injection in the treatment of cervical radicular pain and related disability produces statistically significant reductions in pain and disability to at least 3 months post-procedure. (orig.)

  18. The short- and medium-term effectiveness of CT-guided selective cervical nerve root injection for pain and disability

    International Nuclear Information System (INIS)

    Desai, Amidevi; Saha, Shouvik; Sharma, Naveen; Huckerby, Lauren; Houghton, Russell

    2014-01-01

    CT-guided cervical nerve root injection with corticosteroid and/or local anesthetic is a recognized technique in the evaluation and treatment of cervical radiculopathy. There are few prospective studies on the efficacy of the various techniques employed in cervical nerve root injection. We present our results from a 1-year prospective series using a CT-guided anterolateral transforaminal approach for cervical nerve root injection of bupivacaine and dexamethasone. Pain using a numeric rating scale was assessed at pre-injection, 15 min post-injection, 1 month, and 3 months. Disability was assessed using the Oswestry Neck Disability Index (NDI) questionnaire at pre-injection, 1 month post-injection, and 3 months. In total, 50 patients were followed for 3 months. The mean reductions in pain were: 15 min (77 %), 1 month (39 %), and 3 months (33 %). The mean reductions in NDI were: 1 month (26 %) and 3 months (also 26 %). Results were statistically significant. CT-guided selective cervical nerve root injection in the treatment of cervical radicular pain and related disability produces statistically significant reductions in pain and disability to at least 3 months post-procedure. (orig.)

  19. The role of Gd-enhanced three-dimensional MRI fast low-angle shot (FLASH) in the evaluation of symptomatic lumbosacral nerve roots

    Energy Technology Data Exchange (ETDEWEB)

    Kikkawa, Ichiro; Sugimoto, Hideharu; Saita, Kazuo; Ookami, Hitoshi; Nakama, Sueo; Hoshino, Yuichi [Jichi Medical School, Minamikawachi, Tochigi (Japan)

    2001-07-01

    In the field of lumbar spine disorders, three-dimensional (3-D) magnetic resonance imaging (MRI) can clearly depict a lumbar nerve root from the distal region to the dorsal root ganglion. In this study, we used a gadoliniumdiethylenetriaminepentaacetic acid (Gd-DTPA) enhanced-three-dimensional (3-D) fast low-angle shot (FLASH) sequence when examining lumbosacral disorders. The subjects were 33 patients (14 men and 19 women) in whom lumbosacral neural compression had been diagnosed clinically. Twenty-one patients had lumbar disc herniation, 11 had lumbar spinal stenosis, and 1 had lumbar radiculopathy caused by rheumatoid arthritis. Five subjects with low back pain were also studied as a control group. In all patients and in all 5 of the controls, the dorsal root ganglion of every root was enhanced clearly. There was no root enhancement in the 5 controls. Enhancement of the symptomatic nerve roots, caused by compression, was found in 11 of the 33 patients. All 11 patients had rediculopathy, and muscle weakness was more frequent in patients with enhanced nerve roots than in those without enhancement. There was no enhancement of the cauda equina, even in the patients with cauda syndrome. The enhancement effect may reflect some pathological condition of the compressed nerve root and needs to be studied further. (author)

  20. The role of Gd-enhanced three-dimensional MRI fast low-angle shot (FLASH) in the evaluation of symptomatic lumbosacral nerve roots

    International Nuclear Information System (INIS)

    Kikkawa, Ichiro; Sugimoto, Hideharu; Saita, Kazuo; Ookami, Hitoshi; Nakama, Sueo; Hoshino, Yuichi

    2001-01-01

    In the field of lumbar spine disorders, three-dimensional (3-D) magnetic resonance imaging (MRI) can clearly depict a lumbar nerve root from the distal region to the dorsal root ganglion. In this study, we used a gadoliniumdiethylenetriaminepentaacetic acid (Gd-DTPA) enhanced-three-dimensional (3-D) fast low-angle shot (FLASH) sequence when examining lumbosacral disorders. The subjects were 33 patients (14 men and 19 women) in whom lumbosacral neural compression had been diagnosed clinically. Twenty-one patients had lumbar disc herniation, 11 had lumbar spinal stenosis, and 1 had lumbar radiculopathy caused by rheumatoid arthritis. Five subjects with low back pain were also studied as a control group. In all patients and in all 5 of the controls, the dorsal root ganglion of every root was enhanced clearly. There was no root enhancement in the 5 controls. Enhancement of the symptomatic nerve roots, caused by compression, was found in 11 of the 33 patients. All 11 patients had rediculopathy, and muscle weakness was more frequent in patients with enhanced nerve roots than in those without enhancement. There was no enhancement of the cauda equina, even in the patients with cauda syndrome. The enhancement effect may reflect some pathological condition of the compressed nerve root and needs to be studied further. (author)

  1. Electrophysiologic evaluation of lumbosacral single nerve roots using compound muscle action potentials.

    Science.gov (United States)

    Ogura, Taku; Shikata, Hideto; Hase, Hitoshi; Mori, Masaki; Hayashida, Taturo; Osawa, Toru; Mikami, Yasuo; Kubo, Toshikazu

    2003-10-01

    Transcutaneous electrical stimulation applied to the vertebral column produces compound muscle action potentials (CMAPs) from the leg muscles. Using this method, we evaluated the efferent pathways of the lumbosacral nerve roots. The subjects were 26 healthy volunteers and 31 patients with lumbar disc herniation (LDH). CMAP recordings were obtained from the bilateral vastus medialis, tibialis anterior, extensor digitorum brevis, and abductor hallucis muscles using low-output-impedance stimulation. In normal subjects, the CMAP latency increased linearly with the distance between the stimulating electrode and the recording electrode, with little difference in latency between the left and the right sides in each subject. The CMAP amplitude was significantly lower in the patients with LDH, and the latency was also prolonged when the stimulating electrode was placed above the lesion. This technique may thus be a useful noninvasive method for assessing lumbosacral nerve root function in patients with LDH.

  2. The Relationship amongst Intervertebral Disc Vertical Diameter, Lateral Foramen Diameter and Nerve Root Impingement in Lumbar Vertebra

    Directory of Open Access Journals (Sweden)

    Yusof MI

    2018-03-01

    Full Text Available Introduction: The vertical diameter of the foramen is dependent upon the vertical diameter of the corresponding intervertebral disc. A decrease in disc vertical diameter has direct anatomic consequences to the foraminal diameter and area available for the nerve root passing through it. This study is to establish the relationship amongst the intervertebral disc vertical diameter, lateral foramen diameters and nerve root compression in the lumbar vertebra. Materials and Methods: Measurements of the study parameters were performed using sagittal MRI images. The parameters studied were: intervertebral disc vertical diameter (DVD, foraminal vertical diameter (FVD, foraminal transverse diameter (FTD and nerve root diameter (NRD of both sides. The relationship between the measured parameters were then analyzed. Results: A total of 62 MRI images were available for this study. Statistical analysis showed moderate to strong correlation between DVD and FVD at all the lumbar levels except at left L23 and L5S1 and right L3L4 and L4L5. Correlation between DVD and FTD were not significant at all lumbar levels. Regression analysis showed that a decrease of 1mm of DVD was associated with 1.3, 1.7, 3.3, 3.3 and 1.3mm reduction of FVD at L1L2, L2L3, L3L4, L4L5 and L5S1 respectively. Conclusion: Reduction of DVD was associated with reduction of FVD. However, FVD was relatively wide for the nerve root even with complete loss of DVD. FTD was much narrower than the FVD making it more likely to cause nerve root compression at the exit foramina. These anatomical details should be given consideration in treating patients with lateral canal stenosis.

  3. Sacral nerve root neuromodulation: an effective treatment for refractory urge incontinence.

    Science.gov (United States)

    Shaker, H S; Hassouna, M

    1998-05-01

    Sacral foramina implants have been recognized recently as a method for treatment of refractory urinary urge incontinence. We study the outcome of the procedure with in-depth analysis of the results of 18 implanted cases. Patients with urinary urge incontinence were subjected to percutaneous nerve evaluation of the S3 roots as a temporary screening test to determine response to neuromodulation. Satisfactory responders were implanted with permanent sacral root neuroprosthesis. The study design included comprehensive voiding diaries for 4 consecutive days twice as a baseline, 1 with percutaneous nerve evaluation screening, 1 after the percutaneous nerve evaluation, 1 at the 1, 3 and 6 post-implantation visits, and every 6 months thereafter. Uroflowmetry and quality of life questionnaires were performed at the same intervals. Urodynamic study was done as a baseline and 6 months after implantation of the neuroprosthesis. All 18 patients (16 women and 2 men) with refractory urge incontinence received a sacral foramina neuroprosthesis after demonstrating a good response to the percutaneous nerve evaluation. Average patient age at presentation was 42.3+/-3.3 years (range 22 to 67) and duration of urinary symptoms was 6.6+/-1.3 years (range 1.2 to 18.8). Average followup was 18.8 months (range 3 to 83). Neuromodulation in these patients showed a marked reduction in leakage episodes from 6.49 to 1.98 times per 24 hours and in the leakage severity score. Eight patients became completely dry and 4 had average leakage episodes of 1 or less daily. Patients showed as well a decrease in urinary frequency with an increase in functional bladder capacity. Associated pelvic pain improved substantially. Cystometrograms demonstrated increased volume at first sensation by 50% and increased cystometric capacity by 15% with the disappearance of uninhibited contractions in 1 of the 4 patients who presented with it preoperatively. There was also noticeable improvement in the quality of life

  4. Agreement between computed tomography, magnetic resonance imaging, and surgical findings in dogs with degenerative lumbosacral stenosis.

    Science.gov (United States)

    Suwankong, Niyada; Voorhout, George; Hazewinkel, Herman A W; Meij, Björn P

    2006-12-15

    To assess the extent of agreement between computed tomography (CT), magnetic resonance imaging (MRI), and surgical findings in dogs with degenerative lumbosacral stenosis. Observational study. 35 dogs with degenerative lumbosacral stenosis. Results of preoperative CT and MRI were compared with surgical findings with respect to degree and location of disk protrusion, position of the dural sac, amount of epidural fat, and swelling of spinal nerve roots. A lumbosacral step was seen on radiographic images from 22 of 32 (69%) dogs, on CT images from 23 of 35 (66%) dogs, and on MR images from 21 of 35 (60%) dogs. Most dogs had slight or moderate disk protrusion that was centrally located. There was substantial or near perfect agreement between CT and MRI findings in regard to degree of disk protrusion (kappa, 0.88), location of disk protrusion (0.63), position of the dural sac (0.89), amount of epidural fat (0.72), and swelling of spinal nerve roots (0.60). The degree of agreement between CT and surgical findings and between MRI and surgical findings was moderate in regard to degree and location of disk protrusion (kappa, 0.44 to 0.56) and swelling of spinal nerve roots (0.40 and 0.50). Results indicate that there is a high degree of agreement between CT and MRI findings in dogs with degenerative lumbosacral stenosis but that the degree of agreement between diagnostic imaging findings and surgical findings is lower.

  5. Accuracy of Clinical Tests in Detecting Disk Herniation and Nerve Root Compression in Subjects With Lumbar Radicular Symptoms.

    Science.gov (United States)

    Ekedahl, Harald; Jönsson, Bo; Annertz, Mårten; Frobell, Richard B

    2018-04-01

    To investigate the accuracy of 3 commonly used neurodynamic tests (slump test, straight-leg raise [SLR] test, femoral neurodynamic test) and 2 clinical assessments to determine radiculopathy (radiculopathy I, 1 neurologic sign; radiculopathy II, 2 neurologic signs corresponding to 1 specific nerve root) in detecting magnetic resonance imaging (MRI) findings (extrusion, subarticular nerve root compression, and foraminal nerve root compression). Validity study. Secondary care. We included subjects (N=99; mean age, 58y; 54% women) referred for epidural steroid injection because of lumbar radicular symptoms who had positive clinical and MRI findings. Positive clinical findings included the slump test (n=67), SLR test (n=50), femoral neurodynamic test (n=7), radiculopathy I (n=70), and radiculopathy II (n=33). Positive MRI findings included extrusion (n=27), subarticular nerve compression (n=14), and foraminal nerve compression (n=25). Not applicable. Accuracy of clinical tests in detecting MRI findings was evaluated using sensitivity, specificity, and receiver operating characteristics analysis with area under the curve (AUC). The slump test had the highest sensitivity in detecting extrusion (.78) and subarticular nerve compression (1.00), but the respective specificity was low (.36 and .38). Radiculopathy I was most sensitive in detecting foraminal nerve compression (.80) but with low specificity (.34). Only 1 assessment had a concurrent high sensitivity and specificity (ie, radiculopathy II) in detecting subarticular nerve compression (.71 and .73, respectively). The AUC for all tests in detecting extrusion, subarticular nerve compression, and foraminal nerve compression showed ranges of .48 to .60, .63 to .82, and .33 to .57, respectively. In general, the investigated neurodynamic tests or assessments for radiculopathy lacked diagnostic accuracy. The slump test was the most sensitive test, while radiculopathy II was the most specific test. Most interestingly, no

  6. Selective detrusor activation by electrical sacral nerve root stimulation in spinal cord injury

    NARCIS (Netherlands)

    Rijkhoff, N. J.; Wijkstra, H.; van Kerrebroeck, P. E.; Debruyne, F. M.

    1997-01-01

    Electrical sacral nerve root stimulation can be used in spinal cord injury patients to induce urinary bladder contraction. However, existing stimulation methods activate simultaneously both the detrusor muscle and the urethral sphincter. Urine evacuation is therefore only possible using poststimulus

  7. Proximally evoked soleus H-reflex to S1 nerve root stimulation in sensory neuronopathies (ganglionopathies).

    Science.gov (United States)

    Zhu, Dong-Qing; Zhu, Yu; Qiao, Kai; Zheng, Chao-Jun; Bradley, Scott; Weber, Robert; Chen, Xiang-Jun

    2013-11-01

    Sensory neuronopathy (SNN) mimics distal sensory axonopathy. The conventional H-reflex elicited by tibial nerve stimulation (tibial H-reflex) is usually abnormal in both conditions. We evaluated the proximally evoked soleus H-reflex in response to S1 nerve root stimulation (S1 foramen H-reflex) in SNN. Eleven patients with SNN and 6 with distal sensory axonopathy were studied. Tibial and S1 foramen H-reflexes were performed bilaterally in each patient. Tibial and S1 foramen H-reflexes were absent bilaterally in all patients with SNN. In the patients with distal sensory axonopathy, tibial H-reflexes were absent in 4 and demonstrated prolonged latencies in 2, but S1 foramen H-reflexes were normal. Characteristic absence of the H-reflex after both proximal and distal stimulation reflects primary loss of dorsal root ganglion (DRG) neurons and the distinct non-length-dependent impairment of sensory nerve fibers in SNN. Copyright © 2013 Wiley Periodicals, Inc.

  8. Relationships between the integrity and function of lumbar nerve roots as assessed by diffusion tensor imaging and neurophysiology

    Energy Technology Data Exchange (ETDEWEB)

    Chiou, S.Y.; Strutton, P.H. [Imperial College London, The Nick Davey Laboratory, Division of Surgery, Human Performance Group, Department of Surgery and Cancer, Faculty of Medicine, London (United Kingdom); Hellyer, P.J. [Imperial College London, Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, London (United Kingdom); Imperial College London, Department of Bioengineering, London (United Kingdom); Sharp, D.J. [Imperial College London, Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, London (United Kingdom); Newbould, R.D. [Imanova, Ltd, London (United Kingdom); Patel, M.C. [Charing Cross Hospital, Imaging Department, Imperial College Healthcare NHS Trust, London (United Kingdom)

    2017-09-15

    Diffusion tensor imaging (DTI) has shown promise in the measurement of peripheral nerve integrity, although the optimal way to apply the technique for the study of lumbar spinal nerves is unclear. The aims of this study are to use an improved DTI acquisition to investigate lumbar nerve root integrity and correlate this with functional measures using neurophysiology. Twenty healthy volunteers underwent 3 T DTI of the L5/S1 area. Regions of interest were applied to L5 and S1 nerve roots, and DTI metrics (fractional anisotropy, mean, axial and radial diffusivity) were derived. Neurophysiological measures were obtained from muscles innervated by L5/S1 nerves; these included the slope of motor-evoked potential input-output curves, F-wave latency, maximal motor response, and central and peripheral motor conduction times. DTI metrics were similar between the left and right sides and between vertebral levels. Conversely, significant differences in DTI measures were seen along the course of the nerves. Regression analyses revealed that DTI metrics of the L5 nerve correlated with neurophysiological measures from the muscle innervated by it. The current findings suggest that DTI has the potential to be used for assessing lumbar spinal nerve integrity and that parameters derived from DTI provide quantitative information which reflects their function. (orig.)

  9. Cerebellar and brainstem infarction as a complication of CT-guided transforaminal cervical nerve root block

    Energy Technology Data Exchange (ETDEWEB)

    Suresh, S. [The Royal National Orthopaedic Hospital NHS Trust, London (United Kingdom); Berman, J. [The Royal National Orthopaedic Hospital NHS Trust, Anaesthetic Department, London (United Kingdom); Connell, David A. [The Royal National Orthopaedic Hospital NHS Trust, Department of Radiology, London (United Kingdom)

    2007-05-15

    A 60-year-old man with a 4-year history of intractable neck pain and radicular pain in the C5 nerve root distribution presented to our department for a CT-guided transforaminal left C5 nerve root block. He had had a similar procedure on the right 2 months previously, and had significant improvement of his symptoms with considerable pain relief. On this occasion he was again accepted for the procedure after the risks and potential complications had been explained. Under CT guidance, a 25G spinal needle was introduced and after confirmation of the position of the needle, steroid was injected. Immediately the patient became unresponsive, and later developed a MR-proven infarct affecting the left vertebral artery (VA) territory. This is the first report of a major complication of a cervical root injection under CT guidance reported in the literature. We present this case report and the literature review of the potential complications of this procedure. (orig.)

  10. Cerebellar and brainstem infarction as a complication of CT-guided transforaminal cervical nerve root block

    International Nuclear Information System (INIS)

    Suresh, S.; Berman, J.; Connell, David A.

    2007-01-01

    A 60-year-old man with a 4-year history of intractable neck pain and radicular pain in the C5 nerve root distribution presented to our department for a CT-guided transforaminal left C5 nerve root block. He had had a similar procedure on the right 2 months previously, and had significant improvement of his symptoms with considerable pain relief. On this occasion he was again accepted for the procedure after the risks and potential complications had been explained. Under CT guidance, a 25G spinal needle was introduced and after confirmation of the position of the needle, steroid was injected. Immediately the patient became unresponsive, and later developed a MR-proven infarct affecting the left vertebral artery (VA) territory. This is the first report of a major complication of a cervical root injection under CT guidance reported in the literature. We present this case report and the literature review of the potential complications of this procedure. (orig.)

  11. Radiation-induced nerve root degeneration and hypertrophic neuropathy in the lumbosacral spinal cord of rats: The relation with changes in aging rats

    International Nuclear Information System (INIS)

    Kogel, A.J. van der

    1977-01-01

    Three-month-old WAG Rij rats were irradiated with 300 kV X-rays on the lumbar region of the spinal column with doses below the level for causing paralysis due to radiation radiculomyelopathy. 8-9 months after irradiation. degeneration of predominantly the ventral nerve roots of the cauda equina was observed. Three stages were distinguishable: I) Demyelination and proliferation of Schwann cells: II) Local swelling of ventral nerve roots, with concentric layers of Schwann cells resembling hypertrophic neuropathy: III) Malignant Schwannoma, invading roots and spinal cord. It is concluded that the degenerative and proliferative lesions represent a continuous series of stages of slowly progressive lesions. The ventral nerve root degeneration (Ist stage) is similar to that observed in aging, unirradiated rats, normally developing at the age of 18-20 months. (orig.) [de

  12. RESULTS OF TREATMENT OF ACUTE LUMBAR DISC HERNIATION WITH TRANSFORAMINAL NERVE ROOT BLOCK

    Directory of Open Access Journals (Sweden)

    EMILIANO NEVES VIALLE

    Full Text Available ABSTRACT Objective: To determine the efficacy of anesthetic transforaminal nerve root block in patients with sciatica secondary to lumbar disc herniation through a prospective observational study. Methods: The study included 176 patients from a private clinic undergoing transforaminal injection performed by a single spinal surgeon. The patients were assessed after two weeks, three months and six months regarding to the improvement of the pain radiating to the lower limbs. In case of persistent symptoms, patients could choose to perform a new nerve root block and maintenance of physical therapy or be submitted to conventional microdiscectomy. Results: By the end of six-month follow-up of the 176 patients, 116 had a favorable outcome (95 after one block and 21 after two blocks, and only 43 required surgery. Conclusion: The results of our study suggest a positive effect of transforaminal block for the treatment of sciatica in patients with lumbar disc herniation.

  13. Magnetic resonance imaging of nerve root inflammation in the Guillain-Barre syndrome

    International Nuclear Information System (INIS)

    Perry, J.R.; Fung, A.; Poon, P.; Bayer, N.

    1994-01-01

    We report gadolinium-enhancing nerve root lesions in a 52-year-old man with typical Guillain-Barre syndrome (GBS). This enhancement correlates well with the perineurial inflammatory and demyelinating processes known to characterize GBS and other inflammatory neuropathies. MRI should enable further exploration of patterns of disease in GBS and, with further study, perhaps assist in evaluating therapy. (orig.)

  14. Magnetic resonance imaging of nerve root inflammation in the Guillain-Barre syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Perry, J.R. [St. Michael`s Hospital, Toronto, ON (Canada). Div. of Neurology; Fung, A. [St. Michael`s Hospital, Toronto, ON (Canada). Div. of Radiology; Poon, P. [St. Michael`s Hospital, Toronto, ON (Canada). Div. of Radiology; Bayer, N. [St. Michael`s Hospital, Toronto, ON (Canada). Div. of Neurology

    1994-02-01

    We report gadolinium-enhancing nerve root lesions in a 52-year-old man with typical Guillain-Barre syndrome (GBS). This enhancement correlates well with the perineurial inflammatory and demyelinating processes known to characterize GBS and other inflammatory neuropathies. MRI should enable further exploration of patterns of disease in GBS and, with further study, perhaps assist in evaluating therapy. (orig.)

  15. Peripheral nerve stimulation (PNS) in the trapezius muscle region alleviate chronic neuropathic pain after lower brachial plexus root avulsion lesion: A case report

    DEFF Research Database (Denmark)

    Sørensen, Jens Christian Hedemann; Meier, Kaare; Perinpam, Larshan

    Peripheral nerve stimulation (PNS) in the trapezius muscle region alleviate chronic neuropathic pain after lower brachial plexus root avulsion lesion: A case report......Peripheral nerve stimulation (PNS) in the trapezius muscle region alleviate chronic neuropathic pain after lower brachial plexus root avulsion lesion: A case report...

  16. Neural-Dural Transition at the Thoracic and Lumbar Spinal Nerve Roots: A Histological Study of Human Late-Stage Fetuses

    Directory of Open Access Journals (Sweden)

    Kwang Ho Cho

    2016-01-01

    Full Text Available Epidural blocks have been used extensively in infants. However, little histological information is available on the immature neural-dural transition. The neural-dural transition was histologically investigated in 12 late-stage (28–30 weeks fetuses. The dural sheath of the spinal cord was observed to always continue along the nerve roots with varying thicknesses between specimens and segments, while the dorsal root ganglion sheath was usually very thin or unclear. Immature neural-dural transitions were associated with effective anesthesia. The posterior radicular artery was near the dorsal root ganglion and/or embedded in the nerve root, whereas the anterior radicular artery was separated from the nearest nerve root. The anterior radicular artery was not associated with the dural sheath but with thin mesenchymal tissue. The numbers of radicular arteries tended to become smaller in larger specimens. Likewise, larger specimens of the upper thoracic and lower lumbar segments did not show the artery. Therefore, elimination of the radicular arteries to form a single artery of Adamkiewicz was occurring in late-stage fetuses. The epidural space was filled with veins, and the loose tissue space extended ventrolaterally to the subpleural tissue between the ribs. Consequently, epidural blocks in infants require special attention although immature neural-dural transitions seemed to increase the effect.

  17. Subdural spread of injected local anesthetic in a selective transforaminal cervical nerve root block: a case report

    Directory of Open Access Journals (Sweden)

    Tofuku Katsuhiro

    2012-06-01

    Full Text Available Abstract Introduction Although uncommon, selective cervical nerve root blocks can have serious complications. The most serious complications that have been reported include cerebral infarction, spinal cord infarction, transient quadriplegia and death. Case presentation A 40-year-old Japanese woman with a history of severe right-sided cervical radicular pain was scheduled to undergo a right-sided C6 selective cervical nerve root block using a transforaminal approach under fluoroscopic guidance. An anterior oblique view of the C5-C6 intervertebral foramen was obtained, and a 23-gauge spinal needle, connected to the normal extension tube with a syringe filled with contrast medium, was introduced into the posterior-caudal aspect of the C5-C6 intervertebral foramen on the right side. In the anteroposterior view, the placement of the needle was considered satisfactory when it was placed no more medial than halfway across the width of the articular pillar. Although the spread of the contrast medium along the C6 nerve root was observed with right-sided C6 radiculography, the subdural flow of the contrast medium was not observed with real-time fluoroscopy. The extension tube used for the radiculography was removed from the spinal needle and a normal extension tube with a syringe filled with lidocaine connected in its place. We performed a negative aspiration test and then injected 1.5 mL of 1.0% lidocaine slowly around the C6 nerve root. Immediately after the injection of the local anesthetic, our patient developed acute flaccid paralysis, complained of breathing difficulties and became unresponsive; her respiratory pattern was uncoordinated. After 20 minutes, she regained consciousness and became alert, and her muscle strength in all four limbs returned to normal without any sensory deficits after receiving emergent cardiorespiratory support. Conclusions We believe that confirming maintenance of the appropriate needle position in the anteroposterior

  18. Selective stimulation of sacral nerve roots for bladder control: a study by computer modeling

    NARCIS (Netherlands)

    Rijkhoff, N. J.; Holsheimer, J.; Koldewijn, E. L.; Struijk, J. J.; van Kerrebroeck, P. E.; Debruyne, F. M.; Wijkstra, H.

    1994-01-01

    The aim of this study was to investigate theoretically the conditions for the activation of the detrusor muscle without activation of the urethral sphincter and afferent fibers, when stimulating the related sacral roots. Therefore, the sensitivity of excitation and blocking thresholds of nerve

  19. Diagnostic utility of selective nerve root blocks in the diagnosis of lumbosacral radicular pain: systematic review and update of current evidence.

    Science.gov (United States)

    Datta, Sukdeb; Manchikanti, Laxmaiah; Falco, Frank J E; Calodney, Aaron K; Atluri, Sairam; Benyamin, Ramsin M; Buenaventura, Ricardo M; Cohen, Steven P

    2013-04-01

      Lumbosacral selective nerve root blocks and/ or transforaminal epidural injections are used for diagnosis and treatment of different disorders causing low back and lower extremity pain. A clear consensus on the use of selective nerve root injections as a diagnostic tool does not currently exist. Additionally, the validity of this procedure as a diagnostic tool is not clear. To evaluate and update the accuracy of selective nerve root injections in diagnosing lumbar spinal disorders. A systematic review of selective nerve root blocks for the diagnosis of low back and lower extremity pain. Methodological quality assessment of included studies was performed using the Quality Appraisal of Reliability Studies (QAREL) checklist. Only diagnostic accuracy studies meeting at least 50% of the designated inclusion criteria were utilized for analysis. Studies scoring less than 50% are presented descriptively and analyzed critically. The level of evidence was classified as good, fair, or limited or poor based on the quality of evidence grading scale developed by the United States Preventive Services Task Force (USPSTF). Data sources included relevant literature identified through searches of PubMed and EMBASE from 1966 to September 2012, and manual searches of the bibliographies of known primary and review articles. In this review, we evaluated studies in which controlled local anesthetic blocks were performed using at least 50% pain relief as the reference standard. There is limited evidence for the accuracy of selective nerve root injections as a diagnostic tool for lumbosacral disorders. There is limited evidence for their use in the preoperative evaluation of patients with negative or inconclusive imaging studies. The limitations of this systematic review include a paucity of literature, variations in technique, and variable criterion standards for the diagnosis of lumbar radicular pain. There is limited evidence for selective nerve root injections as a diagnostic tool in

  20. Intrathecal Spread of Injectate Following an Ultrasound-Guided Selective C5 Nerve Root Injection in a Human Cadaver Model.

    Science.gov (United States)

    Falyar, Christian R; Abercrombie, Caroline; Becker, Robert; Biddle, Chuck

    2016-04-01

    Ultrasound-guided selective C5 nerve root blocks have been described in several case reports as a safe and effective means to anesthetize the distal clavicle while maintaining innervation of the upper extremity and preserving diaphragmatic function. In this study, cadavers were injected with 5 mL of 0.5% methylene blue dye under ultrasound guidance to investigate possible proximal and distal spread of injectate along the brachial plexus, if any. Following the injections, the specimens were dissected and examined to determine the distribution of dye and the structures affected. One injection revealed dye extended proximally into the epidural space, which penetrated the dura mater and was present on the spinal cord and brainstem. Dye was noted distally to the divisions in 3 injections. The anterior scalene muscle and phrenic nerve were stained in all 4 injections. It appears unlikely that local anesthetic spread is limited to the nerve root following an ultrasound-guided selective C5 nerve root injection. Under certain conditions, intrathecal spread also appears possible, which has major patient safety implications. Additional safety measures, such as injection pressure monitoring, should be incorporated into this block, or approaches that are more distal should be considered for the acute pain management of distal clavicle fractures.

  1. The analysis of the effective of preserving sacral nerve root during surgical treatment of chordoma

    International Nuclear Information System (INIS)

    Ji Yiming; Chen Kangwu; Yang Huilin; Zhu Lifan

    2010-01-01

    Objective: To analyze the effective of preserving sacral nerve root during surgical treatment of sacral chordoma. Methods: This retrospective study included 30 cases of sacral chordomas. All the cases were operated with posterior approach. The blood loss and blood transfusion during operation, the drainged blood after operation were reviewed. The sphincter muscle function of bladder and bowl were observed. Results: Tremendous reduction of blood loss during surgery was found in all cases, the blood loss was 1280 ml in average, the blood transfusion was 1080 ml in average, the drainged blood after ope-ration was 650 ml. Nine patients whose sacral nerve roots had been reserved bilaterally at and above S 3 level, the sphincter muscle function of bladder and bowl was good, whereas the function of sphincter muscle impaired in the other 21 patients and in one case colostomy and ureterocutaneostomy were used. Conclusion: Preoperative arterial embolization is effective method and can lead to excellent results. Even if the tumor is relatively huge and the upper resection margin is as high as at S 1 or S 2 level, the tumor can be removed successfully by posterior approach. Sacral nerve should be preserved as possible. (authors)

  2. Does pain relief by CT-guided indirect cervical nerve root injection with local anesthetics and steroids predict pain relief after decompression surgery for cervical nerve root compression?

    Science.gov (United States)

    Antoniadis, Alexander; Dietrich, Tobias J; Farshad, Mazda

    2016-10-01

    The relationship of pain relief from a recently presented CT-guided indirect cervical nerve root injection with local anesthetics and steroids to surgical decompression as a treatment for single-level cervical radiculopathy is not clear. This retrospective study aimed to compare the immediate and 6-week post-injection effects to the short- and long-term outcomes after surgical decompression, specifically in regard to pain relief. Patients (n = 39, age 47 ± 10 years) who had undergone CT-guided indirect injection with local anesthetics and steroids as an initial treatment for single cervical nerve root radiculopathy and who subsequently needed surgical decompression were included retrospectively. Pain levels (VAS scores) were monitored before, immediately after, and 6 weeks after injection (n = 34), as well as 6 weeks (n = 38) and a mean of 25 months (SD ± 12) after surgical decompression (n = 36). Correlation analysis was performed to find potential associations of pain relief after injection and after surgery to investigate the predictive value of post-injection pain relief. There was no correlation between immediate pain relief after injection (-32 ± 27 %) and 6 weeks later (-7 ± 19 %), (r = -0.023, p = 0.900). There was an association by tendency between immediate pain relief after injection and post-surgical pain relief at 6 weeks (-82 ± 27 %), (r = 0.28, p = 0.08). Pain relief at follow-up remained high at -70 ± 21 % and was correlated with the immediate pain amelioration effect of the injection (r = 0.37, p = 0.032). Five out of seven patients who reported no pain relief from injection had a pain relief from surgery in excess of 50 %. The amount of immediate radiculopathic pain relief after indirect cervical nerve root injection is associated with the amount of pain relief achieved at long-term follow-up after surgical decompression of single-level cervical radiculopathy

  3. New technique targeting the C5 nerve root proximal to the traditional interscalene sonoanatomical approach is analgesic for outpatient arthroscopic shoulder surgery.

    Science.gov (United States)

    Dobie, Katherine H; Shi, Yaping; Shotwell, Matthew S; Sandberg, Warren S

    2016-11-01

    Regional anesthesia and analgesia for shoulder surgery is most commonly performed via interscalene nerve block. We developed an ultrasound-guided technique that specifically targets the C5 nerve root proximal to the traditional interscalene block and assessed its efficacy for shoulder analgesia. Prospective case series. Vanderbilt Bone and Joint Surgery Center. Patients undergoing shoulder arthroscopy at an ambulatory surgery center. Thirty-five outpatient shoulder arthroscopy patients underwent an analgesic nerve block using a new technique where ultrasound visualization of the C5 nerve root served as the primary target at a level proximal to the traditional interscalene approach. The block was performed with 15mL of 0.5% plain ropivicaine. Post anesthesia care unit pain scores, opioid consumption, hand strength, and duration of block were recorded. Cadaver dissection after injection with methylene blue confirmed that the primary target under ultrasound visualization was the C5 nerve root. Pain scores revealed 97% patients had 0/10 pain at arrival to PACU, with 91% having a pain score of 3/10 or less at discharge from PACU. Medical Research Council (MRC) hand strength mean (SD) score was 4.17 (0.92) on a scale of 1-5. The mean (SD) duration of the block was 13.9 (3.5) hours. A new technique for ultrasound-guided blockade at the level of the C5 nerve root proximal to the level of the traditional interscalene block is efficacious for shoulder post-operative pain control. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Cone-beam computed tomography-based diagnosis and treatment simulation for a patient with a protrusive profile and a gummy smile

    Science.gov (United States)

    Imamura, Toshihiro; Kokai, Satoshi; Ono, Takashi

    2018-01-01

    For patients with bimaxillary protrusion, significant retraction and intrusion of the anterior teeth are sometimes essential to improve the facial profile. However, severe root resorption of the maxillary incisors occasionally occurs after treatment because of various factors. For instance, it has been reported that approximation or invasion of the incisive canal by the anterior tooth roots during retraction may cause apical root damage. Thus, determination of the position of the maxillary incisors is key for orthodontic diagnosis and treatment planning in such cases. Cone-beam computed tomography (CBCT) may be useful for simulating the post-treatment position of the maxillary incisors and surrounding structures in order to ensure safe teeth movement. Here, we present a case of Class II malocclusion with bimaxillary protrusion, wherein apical root damage due to treatment was minimized by pretreatment evaluation of the anatomical structures and simulation of the maxillary central incisor movement using CBCT. Considerable retraction and intrusion of the maxillary incisors, which resulted in a significant improvement in the facial profile and smile, were achieved without severe root resorption. Our findings suggest that CBCT-based diagnosis and treatment simulation may facilitate safe and dynamic orthodontic tooth movement, particularly in patients requiring maximum anterior tooth retraction. PMID:29732305

  5. A review on the molecular mechanism of plants rooting modulated ...

    African Journals Online (AJOL)

    Adventitious root formation is a key step in vegetative propagation of woody or horticul-tural species, and it is a complex process known to be affected by multiple factors. The process of roots development could be divided into three stages: root induction, root initiation, and root protrusion. Phytohormones, especially auxin ...

  6. Thoracic Nerve Root Entrapment by Intrathecal Catheter Coiling: Case Report and Review of the Literature.

    Science.gov (United States)

    Han, Jing L; Loriaux, Daniel B; Tybout, Caroline; Kinon, Merritt D; Rahimpour, Shervin; Runyon, Scott L; Hopkins, Thomas J; Boortz-Marx, Richard L; Lad, Shivanand P

    2016-03-01

    Intrathecal catheter placement has long-term therapeutic benefits in the management of chronic, intractable pain. Despite the diverse clinical applicability and rising prevalence of implantable drug delivery systems in pain medicine, the spectrum of complications associated with intrathecal catheterization remains largely understudied and underreported in the literature. To report a case of thoracic nerve root entrapment resulting from intrathecal catheter migration. Case report. Inpatient hospital service. A 60-year-old man status post implanted intrathecal (IT) catheter for intractable low back pain secondary to failed back surgery syndrome returned to the operating room for removal of IT pump trial catheter after experiencing relapse of preoperative pain and pump occlusion. Initial attempt at ambulatory removal of the catheter was aborted after the patient reported acute onset of lower extremity radiculopathic pain during the extraction. Noncontrast computed tomography (CT) subsequently revealed that the catheter had ascended and coiled around the T10 nerve root. The patient was taken back to the operating room for removal of the catheter under fluoroscopic guidance, with possible laminectomy for direct visualization. Removal was ultimately achieved with slow continuous tension, with complete resolution of the patient's new radicular symptoms. This report describes a single case report. This case demonstrates that any existing loops in the intrathecal catheter during initial implantation should be immediately re-addressed, as they can precipitate nerve root entrapment and irritation. Reduction of the loop or extrication of the catheter should be attempted under continuous fluoroscopic guidance to prevent further neurosurgical morbidity.

  7. MR imaging of the lumbar disk herniation : relationship between the direction of herniated disc and pressure effect on nerve root and dural sac

    International Nuclear Information System (INIS)

    Cha, B. H.; Shon, M. Y.; Kim, K. W.; Lim, M. A.; Kwon, K. R; Kim, S. S.

    1996-01-01

    To evaluate the relationship between the direction of herniated disc and pressure effect on nerve root and dural sac, as seen on MRI. We retrospectively reviewed lumbar spine MR images of 122 cases of lumbar disk herniation 75 patients MRI findings were analyzed with regard to the relationship between the direction of the herniated disc and pressure effect on nerve root and dural sac. Pressure effect on nerve root and dural sac was arbitrarily divided into three types. Type I was defined as zero or minimal compression of nerve roots or thecal sac by the herniated disc ; type II was defined as mild to moderate compression, while III was defined as severe compression or displacement of nerve roots and/or thecal sac. Of the 122 cases seen in these 75 patients, 97(80%) were observed at L4-5 and L5-S1. The central type(71cases ; 58%) was more frequently observed than the posterolateral type(48cases ; 40%) or lateral type(3cases ; 2%). The totals of types I, II, and III were 44(36%), 43(35%) and 35 cases(29%), respectively. Seventy-seven %(34/44) of type I and 65%(28/43) of type II were of the central type but for type III, the corresponding figure was only 26%(9/35). On MR imaging, most of lumbar disk herniations were observed at L4-5 and L5-S1, with a predominance of the central type rather than the posterolateral one. Most of the central types were either type I or type II

  8. CFD simulations to study the effects of wall protrusions on microfluidic mixing

    Science.gov (United States)

    Sarkar, Sourav; Singh, K. K.; Shankar, V.; Shenoy, K. T.

    2015-08-01

    In this study the effects of different types of wall protrusions on microfluidic mixing are studied using computational fluid dynamics (CFD) simulations. Two new protrusions, single first bracket protrusions and double opposite first bracket protrusions (DOFBPs), are conceptualized, evaluated through CFD simulations and compared to protrusions having standard geometrical shapes, e.g. rectangular protrusions, triangular protrusions and semicircular protrusions. In the range of Reynolds numbers covered in this study, the microchannel having an opposed T-junction and DOFBPs is found to provide good mixing. A hybrid approach relying on the modification of microfluidic junctions as well as wall protrusions for enhancing microfluidic mixing is also evaluated. The microchannel based on the hybrid approach of an OA 10°-20°-165° WY-junction and DOFBPs is also found to provide very good mixing for a wide range of Reynolds numbers.

  9. Functional reorganization of human motor cortex after unaffected side C7 nerve root transposition

    International Nuclear Information System (INIS)

    Gao Gejun; Feng Xiaoyuan; Xu Wendong; Gu Yudong; Tang Weijun; Sun Guixin; Li Ke; Li Yuan; Geng Daoying

    2006-01-01

    Objective: To assess the characteristics of neuronal activity in human motor cortex after the seventh cervical nerve root transposition of the unaffected side by using functional MRI (fMRI). Methods: Thirteen patients who accepted the seventh cervical nerve root transposition of the unaffected side, due to total brachial plexus traction injury diagnosed by manifestation and operation, were examined retrospectively by using fMRI. 10 patients were injured on the left side and 3 on the right side. According to functional recovery of the affected hand, all subjects can be divided into 2 groups. The patients of the first group could not move the affected hand voluntarily. The patients of the second group could move the affected hand self-determined. 12 healthy volunteer's were also involved in this study as control. The fMRI examinations were performed by using echo-planer BOLD sequence. Then the SPM 99 software was used for post-processing. Results: The neuronal activation induced by the movement of both unaffected and affected upper' limb was seen in the contralateral PMC in all patients; Neuronal activation in the ipsilateral PMC evoked by movement of the unaffected extremity was seen in 10 cases, and induced by movement of the affected limb was seen in 7 cases. In the first group, the sharp of clusters in the contralateral PMC resulted by movement of the unaffected extremity showed normal in 9 eases, the average size of clusters resulted by the unaffected hand was 3159 (voxel), and resulted by the unaffected shoulder was 1746(voxel). The sharp of clusters in the contralateral PMC resulted by the affected shoulder or hand were revealed enlargement in 6 cases of each. In the second group, 1 case showed neuronal activation induced by movement of the affected limb in the PMC in both sides of motor cortex, and 2 cases showed neuronal activation in the contralateral PMC. Conclusions: Peripheral nerve injury was able to cause changes of motor cortex in human brain

  10. Distortion-free diffusion tensor imaging for evaluation of lumbar nerve roots: Utility of direct coronal single-shot turbo spin-echo diffusion sequence.

    Science.gov (United States)

    Sakai, Takayuki; Doi, Kunio; Yoneyama, Masami; Watanabe, Atsuya; Miyati, Tosiaki; Yanagawa, Noriyuki

    2018-06-01

    Diffusion tensor imaging (DTI) based on a single-shot echo planer imaging (EPI-DTI) is an established method that has been used for evaluation of lumbar nerve disorders in previous studies, but EPI-DTI has problems such as a long acquisition time, due to a lot of axial slices, and geometric distortion. To solve these problems, we attempted to apply DTI based on a single-shot turbo spin echo (TSE-DTI) with direct coronal acquisition. Our purpose in this study was to investigate whether TSE-DTI may be more useful for evaluation of lumbar nerve disorders than EPI-DTI. First, lumbar nerve roots of five healthy volunteers were evaluated for optimization of imaging parameters with TSE-DTI including b-values and the number of motion proving gradient (MPG) directions. Subsequently, optimized TSE-DTI was quantitatively compared with conventional EPI-DTI by using fractional anisotropy (FA) values and visual scores in subjective visual evaluation of tractography. Lumbar nerve roots of six patients, who had unilateral neurologic symptoms in one leg, were evaluated by the optimized TSE-DTI. TSE-DTI with b-value of 400 s/mm 2 and 32 diffusion-directions could reduce the image distortion compared with EPI-DTI, and showed that the average FA values on the symptomatic side for six patients were significantly lower than those on the non-symptomatic side (P DTI might show damaged areas of lumbar nerve roots without severe image distortion. TSE-DTI might improve the reproducibility in measurements of FA values for quantification of a nerve disorder, and would become a useful tool for diagnosis of low back pain. Copyright © 2018 Elsevier Inc. All rights reserved.

  11. S3 Dorsal Root Ganglion/Nerve Root Stimulation for Refractory Postsurgical Perineal Pain: Technical Aspects of Anchorless Sacral Transforaminal Lead Placement

    Directory of Open Access Journals (Sweden)

    X. Zuidema

    2016-01-01

    Full Text Available Chronic perineal pain limits patients in physical and sexual activities, leading to social and psychological distress. In most cases, this pain develops after surgery in the urogenital area or as a consequence of trauma. Neuromodulation is one of the options in chronic postsurgical perineal pain treatment. We present a case of refractory perineal pain after right sided surgical resection of a Bartholin’s cyst which was treated with third sacral nerve root/dorsal root ganglion stimulation using the transforaminal approach. We describe a new anchorless lead placement technique using a unique curved lead delivery sheath. We postulate that this new posterior foraminal technique of lead placement is simple, safe, and reversible and may lower the occurrence of lead related complications.

  12. The effect of collagenase on nerve conduction velocity of dorsal root ganglion in rats

    International Nuclear Information System (INIS)

    Zhuang Wenquan; Li Heping; Yang Jianyong; Chen Wei; Huang Yonghui; Guo Wenbo

    2006-01-01

    Objective: To study the functional effects of collagenase on dorsal root ganglion (DRG) in rats by evoked potential conduction velocity measurement. Methods: A total of 57 male healthy Sprague-Dawley rats were randomized into 7 groups: normal group, acute collagenase group, subacute collagenase group, chronic collagenase group, acute pseudo-operation group, subacute pseudo-operation group, chronic pseudo-operation group. 1200 units of collagenase was reconstituted in 4 ml isotonic saline prior for the experimental application. The left fifth lumbar DRG was exposed in each rat and followed by 1 ml collagenase solution (300 units) dropping on the exposed DRG in collagenase groups; and similarly 1 ml isotonic saline was applied to each of the exposed DRG in pseudo-operation groups. the effects of collagenase on nerve conduction velocity (NCV) were analyzed 1 hour, 1 week or 1 month after the procedure. The statistical analysis was carried out by software SPSS11.0. Results: The differences of NCV measured by evoked potential method between all groups including the normal group, collagenase groups, and pseudo-operation groups were not significant (P>0.05). Conclusion: The Neuroelectricity physiologic function of dorsal root ganglion and nerve would not be damaged by collagenase used in therapeutic concentration. (authors)

  13. Transanal protrusion of intussusceptions in children

    Directory of Open Access Journals (Sweden)

    Ezomike Uchechukwu Obiora

    2014-01-01

    Full Text Available Background: The aim of the following study is to report our management experience and outcome of transanal protrusion of intussusceptions. Patients and Methods: Retrospective analysis of all cases of intussusceptions protruding through the anal opening from January 2008 to June 2013. Results: Of 62 cases of intussusceptions, transanal protrusion occurred in 10 patients (16% anal protrusion rate with a male:female ratio of 2:3. They were aged 4-96 months (mean 22.6 ± 30.7, median 7.5 months. Six were infants while four were above 1 year. Duration of symptoms ranged from 2 to 14 days (mean 5.9 days ± 3.4 with only two patients presenting within 48 h. Clinical features included vomiting (100%, abdominal pains (100%, bloody mucoid stool (100%, abdominal distension (90%, and palpable left iliac fossa mass (70%. Three patients had preceding diarrhoea (30% and two had preceding upper respiratory tract infection (20%. Duration of hospital stay ranged from 5 to 23 days (mean 12 days ± 5.6. Findings at surgery included seven ileocolic and two colocolic intussusceptions (one patient died before surgery. Operative procedures were right hemicolectomy (5, operative manual reduction (3, left hemicolectomy (1 giving a 67% bowel resection rate. One patient died giving a 10% mortality rate. Conclusion: Transanal protrusion occurred more in females and is associated with late presentation, older age, high bowel resection rate, and high mortality.

  14. Nerve Root Compression Increases Spinal Astrocytic Vimentin in Parallel With Sustained Pain and Endothelial Vimentin in Association With Spinal Vascular Reestablishment.

    Science.gov (United States)

    Smith, Jenell R; Lee, Jasmine; Winkelstein, Beth A

    2017-10-01

    Temporal immunohistochemistry analysis of spinal cord tissue from a rat model of cervical radiculopathy. The goal was to measure spinal endothelial and astrocytic vimentin expression after a painful nerve root compression to define spinal cellular expression of vimentin in the context of pain. The intermediate filament, vimentin, is expressed in a variety of cell types in the spinal cord and is modulated in response to neural pathologies. Early after nerve root compression spinal astrocytes become activated and blood-spinal cord barrier (BSCB) breakdown occurs in parallel with development of pain-related behaviors; these spinal responses remain activated as does the presence of pain. In addition to vimentin, glial fibrillary acidic protein (GFAP) expression is a hallmark of astrocyte activation. In contrast, vascular endothelial cells down-regulate vimentin expression in parallel with vascular breakdown. It is not known whether spinal astrocytes and endothelial cells modulate their expression of vimentin in response to a painful neural injury. Mechanical hyperalgesia was measured and spinal cord tissue was harvested at days 1 and 7 after a unilateral nerve root compression in rats. Vimentin was coimmunolabeled with GFAP to label astrocytes and von Willebrand factor (VWF) for endothelial cells in the spinal cord on the side of injury. Spinal astrocytic vimentin increases by day 7 after nerve root compression, corresponding to when mechanical hyperalgesia is maintained. Spinal endothelial vimentin increases as early as day 1 after a painful compression and is even more robust at day 7. The delayed elevation in spinal astrocytic vimentin corresponding to sustained mechanical hyperalgesia supports its having a relationship with pain maintenance. Further, since BSCB integrity has been shown to be reestablished by day 7 after a painful compression, endothelial expressed vimentin may help to fortify spinal vasculature contributing to BSCB stability. N/A.

  15. Neuronal calcium-binding proteins 1/2 localize to dorsal root ganglia and excitatory spinal neurons and are regulated by nerve injury

    DEFF Research Database (Denmark)

    Zhang, Ming Dong; Tortoriello, Giuseppe; Hsueh, Brian

    2014-01-01

    , and nerve injury-induced regulation of NECAB1/NECAB2 in mouse dorsal root ganglia (DRGs) and spinal cord. In DRGs, NECAB1/2 are expressed in around 70% of mainly small- and medium-sized neurons. Many colocalize with calcitonin gene-related peptide and isolectin B4, and thus represent nociceptors. NECAB1....../2 neurons are much more abundant in DRGs than the Ca2+-binding proteins (parvalbumin, calbindin, calretinin, and secretagogin) studied to date. In the spinal cord, the NECAB1/2 distribution is mainly complementary. NECAB1 labels interneurons and a plexus of processes in superficial layers of the dorsal horn....... In the dorsal horn, most NECAB1/2 neurons are glutamatergic. Both NECAB1/2 are transported into dorsal roots and peripheral nerves. Peripheral nerve injury reduces NECAB2, but not NECAB1, expression in DRG neurons. Our study identifies NECAB1/2 as abundant Ca2+-binding proteins in pain-related DRG neurons...

  16. Device for cutting protrusions

    Science.gov (United States)

    Bzorgi, Fariborz M [Knoxville, TN

    2011-07-05

    An apparatus for clipping a protrusion of material is provided. The protrusion may, for example, be a bolt head, a nut, a rivet, a weld bead, or a temporary assembly alignment tab protruding from a substrate surface of assembled components. The apparatus typically includes a cleaver having a cleaving edge and a cutting blade having a cutting edge. Generally, a mounting structure configured to confine the cleaver and the cutting blade and permit a range of relative movement between the cleaving edge and the cutting edge is provided. Also typically included is a power device coupled to the cutting blade. The power device is configured to move the cutting edge toward the cleaving edge. In some embodiments the power device is activated by a momentary switch. A retraction device is also generally provided, where the retraction device is configured to move the cutting edge away from the cleaving edge.

  17. Ultrasound-guided approach for axillary brachial plexus, femoral nerve, and sciatic nerve blocks in dogs.

    Science.gov (United States)

    Campoy, Luis; Bezuidenhout, Abraham J; Gleed, Robin D; Martin-Flores, Manuel; Raw, Robert M; Santare, Carrie L; Jay, Ariane R; Wang, Annie L

    2010-03-01

    To describe an ultrasound-guided technique and the anatomical basis for three clinically useful nerve blocks in dogs. Prospective experimental trial. Four hound-cross dogs aged 2 +/- 0 years (mean +/- SD) weighing 30 +/- 5 kg and four Beagles aged 2 +/- 0 years and weighing 8.5 +/- 0.5 kg. Axillary brachial plexus, femoral, and sciatic combined ultrasound/electrolocation-guided nerve blocks were performed sequentially and bilaterally using a lidocaine solution mixed with methylene blue. Sciatic nerve blocks were not performed in the hounds. After the blocks, the dogs were euthanatized and each relevant site dissected. Axillary brachial plexus block Landmark blood vessels and the roots of the brachial plexus were identified by ultrasound in all eight dogs. Anatomical examination confirmed the relationship between the four ventral nerve roots (C6, C7, C8, and T1) and the axillary vessels. Three roots (C7, C8, and T1) were adequately stained bilaterally in all dogs. Femoral nerve block Landmark blood vessels (femoral artery and femoral vein), the femoral and saphenous nerves and the medial portion of the rectus femoris muscle were identified by ultrasound in all dogs. Anatomical examination confirmed the relationship between the femoral vessels, femoral nerve, and the rectus femoris muscle. The femoral nerves were adequately stained bilaterally in all dogs. Sciatic nerve block. Ultrasound landmarks (semimembranosus muscle, the fascia of the biceps femoris muscle and the sciatic nerve) could be identified in all of the dogs. In the four Beagles, anatomical examination confirmed the relationship between the biceps femoris muscle, the semimembranosus muscle, and the sciatic nerve. In the Beagles, all but one of the sciatic nerves were stained adequately. Ultrasound-guided needle insertion is an accurate method for depositing local anesthetic for axillary brachial plexus, femoral, and sciatic nerve blocks.

  18. F-18 FDG PET/CT findings of a case of sacral nerve root neurolymphomatosis that occurred during chemotherapy.

    Science.gov (United States)

    Suga, Kazuyoshi; Yasuhiko, Kawakami; Matsunaga, Naofumi; Yujiri, Toshiaki; Nakazora, Tatsuki; Ariyoshi, Kouichi

    2011-01-01

    Neurolymphomatosis (NL) is a rare, unique subtype of lymphomatous infiltration of peripheral nerves. Clinical/radiologic diagnosis of NL is challenging. We report F-18 FDG PET/CT findings of a case of breast diffuse large B-cell lymphoma, in which NL developed regardless of regression of systemic lesions during induction chemotherapy. FDG PET/CT showed characteristic findings of well-demarcated, linear abnormal FDG uptake along a sacral vertebral foramen, leading to diagnosis of NL, with the finding of thickened nerve roots on magnetic resonance imaging. Altered chemotherapeutic regimen resulted in disappearance of these abnormal FDG uptake, with recovery of neurologic symptoms. Peripheral nerve NL may occur during chemotherapy, and FDG PET/CT can be a useful imaging modality in diagnosis and monitoring of therapeutic response of this disease.

  19. CT findings of lumbar intervertebral disc: II. Disc herniation (HNP)

    International Nuclear Information System (INIS)

    Yang, W. J.; Lee, J. M.; Bahk, Y. W.

    1984-01-01

    In lumbar region the epidural fat pad is relatively abundant so that CT can provides sufficient information in diagnosis of lumbar HNP. Many authors have reported on the CT findings of HNP such as focal nodular protrusion of the posterior disc margin, obliteration of epidural fat pad, impingement of dural sac and nerve root, swelling of nerve root, soft tissue density in the spinal canal and calcification of disc. However there was so previous report describing incidence and reliability of the findings. It is the purpose of the present study to survey the frequency, reliability, and limitation of these CT findings. The clinical material was consisted of 30 operatively proven cases of HNP of the lumbar spine. Each lumbar CT scan was reviewed retrospectively and the findings were analysed by two radiologists independently. There were 20 males and 10 females and the mean age was 36.7 years. Involvement of L4-S5 level was 2.3 times more frequent than that of L5-S1 level. Of 30 cases, 22 were unilateral posterolateral types and 8 cases central or unilateral far lateral types. CT findings observed were nodular protrusion of the posterior margin of the disc, obliteration of epidural fat pad, impingement of dural sac or nerve root, soft tissue density in the spinal canal and calcification in the posterior portion of the protruded disc, in order of decreasing frequency. The conclusions are follows: 1. Nodular protrusion of the posterior disc margin accompanied by obliteration of epidural fat pad was observed in every case. The former findings was designated as direct sign and the latter indirect. 2. Obliteration of the epidural fat appears to be significant in lateral recesses especially when it occurs unilaterally. This was not true, however, in the centrally located fat pad. 3. Impingement of the dural sac and nerve root were observed in 90% and 67%, respectively, and were very helpful in establishing HNP diagnosis when the direct and indirect signs were equivocal

  20. Salvage of cervical motor radiculopathy using peripheral nerve transfer reconstruction.

    Science.gov (United States)

    Afshari, Fardad T; Hossain, Taushaba; Miller, Caroline; Power, Dominic M

    2018-05-10

    Motor nerve transfer surgery involves re-innervation of important distal muscles using either an expendable motor branch or a fascicle from an adjacent functioning nerve. This technique is established as part of the reconstructive algorithm for traumatic brachial plexus injuries. The reproducible outcomes of motor nerve transfer surgery have resulted in exploration of the application of this technique to other paralysing conditions. The objective of this study is to report feasibility and increase awareness about nerve transfer as a method of improving upper limb function in patients with cervical motor radiculopathy of different aetiology. In this case series we report 3 cases with different modes of injury to the spinal nerve roots with significant and residual motor radiculopathy that have been successfully treated with nerve transfer surgery with good functional outcomes. The cases involved iatrogenic nerve root injury, tumour related root compression and degenerative root compression. Nerve transfer surgery may offer reliable reconstruction for paralysis when there has been no recovery following a period of conservative management. However the optimum timing of nerve transfer intervention is not yet identified for patients with motor radiculopathy.

  1. A patient with protrusion and multiple missing teeth treated with autotransplantation and space closure.

    Science.gov (United States)

    Ko, Jeong-Min; Paik, Cheol-Ho; Choi, Simon; Baek, Seung-Hak

    2014-05-01

    To present a patient treated with submerging autotransplantation (SA) of an immature premolar and subsequent orthodontic space closure (OSC) and to report a 10-year follow-up result. A 10-year-old boy had multiple missing premolars with an asymmetric pattern (maxillary right first and second premolars, teeth 14 and 15; maxillary left second premolar, tooth 25; and mandibular right second premolar, tooth 45). After considering several treatment options, tooth 35 with immature root development underwent SA into the missing site of tooth 15 at a depth 5 mm below the occlusal plane and was stabilized with sutures to create a symmetric missing condition of the premolars in the four quadrants. Three months after autotransplantation, spontaneous eruption of the transplanted tooth was observed. Nine months after autotransplantation, presence of the lamina dura of the transplanted tooth was confirmed with a periapical radiograph. Active orthodontic treatment was initiated to reduce lip protrusion by closing the missing spaces of teeth 14, 25, 35, and 45 and to correct dental midline deviation. After 33 months of active orthodontic treatment, Class I canine and molar relationships were obtained. During the 10-year follow-up, the pulp vitality of the transplanted tooth was maintained without any pathologic findings, including root resorption or pulp canal obliteration. In a patient with lip protrusion and multiple congenitally missing premolars with an asymmetric pattern, SA of one premolar from the normal quadrant into the quadrant missing two premolars with subsequent OSC of the missing sites of the other premolars can be an effective treatment modality.

  2. Ventilator waveforms on anesthesia machine: a simple tool for intraoperative mapping of phrenic nerve and mid-cervical roots.

    Science.gov (United States)

    Georgoulis, George; Papagrigoriou, Eirini; Sindou, Marc

    2015-12-01

    A crucial aspect of surgery on the supraclavicular region, lateral neck, and mid-cervical vertebral region is the identification and sparing of the phrenic nerve and cervical (C4) root that are responsible for diaphragmatic innervation. Therefore intraoperative mapping of these nerve structures can be useful for difficult cases. Electrical stimulation with simultaneous observation of the ventilator waveforms of the anesthesia machine provides an effective method for the precise intraoperative mapping of these structures. In the literature, there is only one publication reporting the use of one of the waveforms (capnography) for this purpose. Capnography and pressure-time waveforms, two mandatory curves in anesthesiological monitoring, were studied under electrical stimulation of the phrenic nerve (one patient) and the C4 root (eight patients). The aim was to detect changes that would verify diaphragmatic contraction. No modifications in anesthesia or surgery and no additional maneuvers were required. In all patients, stimulation was followed by identifiable changes in the two waveforms, compatible with diaphragmatic contraction: acute reduction in amplitude on capnography and repetitive saw-like elevations on pressure-time curve. Frequency of patterns on pressure-time curve coincided with the frequency of stimulation; therefore the two recordings were complementary. This simple method proved effective in identifying the neural structures responsible for diaphragmatic function. We therefore suggest that it should be employed in the various types of surgery where these structures are at risk.

  3. Lateral Pectoral Nerve Injury Mimicking Cervical Radiculopathy.

    Science.gov (United States)

    Aktas, Ilknur; Palamar, Deniz; Akgun, Kenan

    2015-07-01

    The lateral pectoral nerve (LPN) is commonly injured along with the brachial plexus, but its isolated lesions are rare. Here, we present a case of an isolated LPN lesion confused with cervical radiculopathy. A 41-year-old man was admitted to our clinic because of weakness in his right arm. Previous magnetic resonance imaging (MRI) examination revealed right posterolateral protrusion at the C6-7 level. At the initial assessment, atrophy of the right pectoralis major muscle was evident, and mild weakness of the right shoulder adductor, internal rotator, and flexor muscles was observed. Therefore, electrodiagnostic evaluation was performed, and a diagnosis of isolated LPN injury was made. Nerve injury was thought to have been caused by weightlifting exercises and traction injury. Lateral pectoral nerve injury can mimic cervical radiculopathy, and MRI examination alone may lead to misdiagnosis. Repeated physical examinations during the evaluation and treatment phase will identify the muscle atrophy that occurs 1 or more months after the injury.

  4. Farris-Tang retractor in optic nerve sheath decompression surgery.

    Science.gov (United States)

    Spiegel, Jennifer A; Sokol, Jason A; Whittaker, Thomas J; Bernard, Benjamin; Farris, Bradley K

    2016-01-01

    Our purpose is to introduce the use of the Farris-Tang retractor in optic nerve sheath decompression surgery. The procedure of optic nerve sheath fenestration was reviewed at our tertiary care teaching hospital, including the use of the Farris-Tang retractor. Pseudotumor cerebri is a syndrome of increased intracranial pressure without a clear cause. Surgical treatment can be effective in cases in which medical therapy has failed and disc swelling with visual field loss progresses. Optic nerve sheath decompression surgery (ONDS) involves cutting slits or windows in the optic nerve sheath to allow cerebrospinal fluid to escape, reducing the pressure around the optic nerve. We introduce the Farris-Tang retractor, a retractor that allows for excellent visualization of the optic nerve sheath during this surgery, facilitating the fenestration of the sheath and visualization of the subsequent cerebrospinal fluid egress. Utilizing a medial conjunctival approach, the Farris-Tang retractor allows for easy retraction of the medial orbital tissue and reduces the incidence of orbital fat protrusion through Tenon's capsule. The Farris-Tang retractor allows safe, easy, and effective access to the optic nerve with good visualization in optic nerve sheath decompression surgery. This, in turn, allows for greater surgical efficiency and positive patient outcomes.

  5. Diagnosis of nerve root compromise of the lumbar spine: Evaluation of the performance of three-dimensional isotropic T2-weighted turbo spin-echo SPACE sequence at 3T

    Energy Technology Data Exchange (ETDEWEB)

    Sung, Jin Kyeong; Jee, Won Hee; Jung, Joon Yong; Jang, Jin Hee; Kim, Jin Sung; Kim, Young Hoon; Ha, Kee Yong [Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2017-01-15

    To explore the performance of three-dimensional (3D) isotropic T2-weighted turbo spin-echo (TSE) sampling perfection with application optimized contrasts using different flip angle evolution (SPACE) sequence on a 3T system, for the evaluation of nerve root compromise by disc herniation or stenosis from central to extraforaminal location of the lumbar spine, when used alone or in combination with conventional two-dimensional (2D) TSE sequence. Thirty-seven patients who had undergone 3T spine MRI including 2D and 3D sequences, and had subsequent spine surgery for nerve root compromise at a total of 39 nerve levels, were analyzed. A total of 78 nerve roots (48 symptomatic and 30 asymptomatic sites) were graded (0 to 3) using different MRI sets of 2D, 3D (axial plus sagittal), 3D (all planes), and combination of 2D and 3D sequences, with respect to the nerve root compromise caused by posterior disc herniations, lateral recess stenoses, neural foraminal stenoses, or extraforaminal disc herniations; grading was done independently by two readers. Diagnostic performance was compared between different imaging sets using the receiver operating characteristics (ROC) curve analysis. There were no statistically significant differences (p = 0.203 to > 0.999) in the ROC curve area between the imaging sets for both readers 1 and 2, except for combined 2D and 3D (0.843) vs. 2D (0.802) for reader 1 (p = 0.035), and combined 2D and 3D (0.820) vs. 3D including all planes (0.765) for reader 2 (p = 0.049). The performance of 3D isotropic T2-weighted TSE sequence of the lumbar spine, whether axial plus sagittal images, or all planes of images, was not significantly different from that of 2D TSE sequences, for the evaluation of nerve root compromise of the lumbar spine. Combining 2D and 3D might possibly improve the diagnostic accuracy compared with either one.

  6. End-to-side neurorrhaphy repairs peripheral nerve injury: sensory nerve induces motor nerve regeneration.

    Science.gov (United States)

    Yu, Qing; Zhang, She-Hong; Wang, Tao; Peng, Feng; Han, Dong; Gu, Yu-Dong

    2017-10-01

    End-to-side neurorrhaphy is an option in the treatment of the long segment defects of a nerve. It involves suturing the distal stump of the disconnected nerve (recipient nerve) to the side of the intimate adjacent nerve (donor nerve). However, the motor-sensory specificity after end-to-side neurorrhaphy remains unclear. This study sought to evaluate whether cutaneous sensory nerve regeneration induces motor nerves after end-to-side neurorrhaphy. Thirty rats were randomized into three groups: (1) end-to-side neurorrhaphy using the ulnar nerve (mixed sensory and motor) as the donor nerve and the cutaneous antebrachii medialis nerve as the recipient nerve; (2) the sham group: ulnar nerve and cutaneous antebrachii medialis nerve were just exposed; and (3) the transected nerve group: cutaneous antebrachii medialis nerve was transected and the stumps were turned over and tied. At 5 months, acetylcholinesterase staining results showed that 34% ± 16% of the myelinated axons were stained in the end-to-side group, and none of the myelinated axons were stained in either the sham or transected nerve groups. Retrograde fluorescent tracing of spinal motor neurons and dorsal root ganglion showed the proportion of motor neurons from the cutaneous antebrachii medialis nerve of the end-to-side group was 21% ± 5%. In contrast, no motor neurons from the cutaneous antebrachii medialis nerve of the sham group and transected nerve group were found in the spinal cord segment. These results confirmed that motor neuron regeneration occurred after cutaneous nerve end-to-side neurorrhaphy.

  7. Functional anatomy of the hypoglossal innervated muscles of the rat tongue: a model for elongation and protrusion of the mammalian tongue.

    Science.gov (United States)

    McClung, J R; Goldberg, S J

    2000-12-01

    This anatomical investigation in the rat was designed to illustrate the detailed organization of the tongue's muscles and their innervation in order to elucidate the actions of the muscles of the higher mammalian tongue and thereby clarify the protrusor subdivision of the hypoglossal-tongue complex. The hypoglossal innervated, extrinsic styloglossus, hyoglossus, and genioglossus and the intrinsic transversus, verticalis and longitudinalis linguae muscles were observed by microdissection and analysis of serial transverse-sections of the tongue. Sihler's staining technique was applied to whole rat tongues to demonstrate the hypoglossal nerve branching patterns. Dissections of the tongue demonstrate the angles at which the extrinsic muscles act on the base of the tongue. The Sihler stained hypoglossal nerves demonstrate branches to the styloglossus and hyoglossus emanating from its lateral division while branches to the genioglossus muscle exit from its medial division. The largest portions of both XIIth nerve divisions can be seen to enter the body of the tongue to innervate the intrinsic muscles. Transverse sections of the tongue demonstrate the organization of the intrinsic muscle fibers of the tongue. Longitudinal muscle fibers run along the entire circumference of the tongue. Alternating sheets of transverse lingual and vertical lingual muscles can be observed to insert into the circumference of the tongue. Most importantly in clarifying tongue protrusion, we demonstrate the transversus muscle fibers enveloping the most superior and inferior portions of the longitudinalis muscles. Longitudinal muscle fascicles are completely encircled and thus are likely to be compressed by transverse muscle fascicles resulting in elongation of the tongue. We discuss our findings in relation to biomechanical studies, that describe the tongue as a muscular hydrostat and thereby define the "elongation-protrusion apparatus" of the mammalian tongue. In so doing, we clarify the

  8. Haemangioblastoma of a cervical sensory nerve root in Von Hippel-Lindau syndrome.

    Science.gov (United States)

    McEvoy, A W; Benjamin, E; Powell, M P

    2000-10-01

    Spinal haemangioblastomas are rare, accounting for only about 7% of all central nervous system cases. The case of a 40-year-old woman with a haemangioblastoma arising solely from a cervical sensory nerve root is presented. At operation via a cervical laminectomy, it was possible to resect the tumour en masse with the sensory ramus, by extending the laminectomy through the exit foramen for C6. Haemangioblastomas are commonly intramedullary, and have only been reported in this location on one previous occasion. The patient has Von Hippel-Lindau syndrome and a history of multiple solid tumours. The possible role of the Von Hippel-Lindau tumour suppressor gene in the pathogenesis of these neoplasms is discussed.

  9. A posterior approach to cervical nerve root block and pulsed radiofrequency treatment for cervical radicular pain: a retrospective study.

    Science.gov (United States)

    Xiao, Lizu; Li, Jie; Li, Disen; Yan, Dong; Yang, Jun; Wang, Daniel; Cheng, Jianguo

    2015-09-01

    Catastrophic complications have been reported for selective cervical nerve root block (SCNRB) or pulsed radiofrequency (PRF) via an anterolateral transforaminal approach. A posterior approach to these procedures under computed tomography guidance has been reported. Here, we report the clinical outcomes of 42 patients with chronic cervical radicular pain (CCRP) treated with a combination of SCNRB and PRF through a posterior approach under fluoroscopy guidance. We retrospectively reviewed the clinical outcomes of 42 consecutive patients with CCRP who received a combination of SCNRB and PRF through a posterior approach under fluoroscopy guidance. The thresholds of electrical stimulation and imaging of the nerve roots after contrast injection were used to evaluate the accuracy of needle placement. The numeric rating scale was used to measure the pain and numbness levels as primary clinical outcomes, which were evaluate in scheduled follow-up visits of up to 3 months. A total of 53 procedures were performed on 42 patients at the levels of C5-C8. All patients reported concordant paresthesia in response to electrical stimulation. The average sensory and motor thresholds of stimulation were 0.28 ± 0.14 and 0.36 ± 0.14 V, respectively. Injection of nonionic contrast resulted in excellent spread along the target nerve root in large majority of the procedures. The numeric rating scale scores for both pain and numbness improved significantly at 1 day, 1 week, and 1 and 3 months after the treatment. No serious adverse effects were observed in any of the patients. The posterior approach to combined SCNRB and PRF under fluoroscopy guidance appears to be safe and efficacious in the management of CCRP. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Temporary unilateral hypoglossal nerve palsy secondary to infectious mononucleosis: A case report

    Directory of Open Access Journals (Sweden)

    Abbas Al Ramzi

    2016-06-01

    Full Text Available Tongue paralysis due to isolated palsy of XII cranial nerve is uncommon neurological finding. It is a multi-etiological condition, and may occur secondary to infectious mononucleosis. It is presented with characteristic signs e.g. reduced tongue movements with deviation to the affected side on protrusion. The diagnosis is challenging and based on thorough clinical examination and laboratory and imaging findings. A case of 31year old Kuwaiti male, presented to emergency room at Mubarak Alkabeer Hospital-Kuwait, with infectious mononucleosis complicated with temporary unilateral hypoglossal nerve palsy is reported, with an emphasis that paralysis of cranial nerve may be due to a less severe systemic condition, and not necessarily associate an underling malignancy. To the best of our knowledge, hypoglossal nerve palsy complicating infectious mononucleosis has never been previously reported in Kuwait.

  11. A Novel Collaborative Protocol for Successful Management of Penile Pain Mediated by Radiculitis of Sacral Spinal Nerve Roots From Tarlov Cysts

    Directory of Open Access Journals (Sweden)

    Irwin Goldstein, MD

    2017-09-01

    Goldstein I, Komisaruk BR, Rubin RS, et al. A Novel Collaborative Protocol for Successful Management of Penile Pain Mediated by Radiculitis of Sacral Spinal Nerve Roots From Tarlov Cysts. Sex Med 2017;5:e203–e211.

  12. POSITIONAL VARIATION OF OPTIC NERVE IN RELATION TO SPHENOID SINUSES AND ITS ASSOCIATION WITH PNEUMATISATION OF ANTERIOR CLINOID PROCESS : A RADIOLOGICAL STUDY

    Directory of Open Access Journals (Sweden)

    Santhana Lakshmi

    2015-08-01

    Full Text Available OBJECTIVE: The posterior most among the paranasal sinuses, the sphenoid sinuses exhibit high variability in their structure, pneumatisation and relation to surrounding neurovascular structures. The protrusion of optic nerve (ON into the superolateral wall of the sinus has been reported in literature wit h varied incidence. The pneumatisation of sphenoid sinus and its extension to anterior clinoid process (ACP is also been mentioned in few studies. The variability in the incidence and the inconsistency in the association between optic nerve protrusion and degree of pneumatisation seen in studies done in different ethnicity and with paucity of Indian studies necessitated this study on positional variation of optic nerve in relation to sphenoid sinuses and its association with pneumatisation of anterior clin oid process in South Indian ethnicity. THE METHODS: CT scan images in coronal section collected from 114 patients with sinusitis with in the age group of 16 - 64 years belonging to both sexes were studied. The CT images were evaluated for the position of ON with sphenoid sinuses, protrusion of it into the sinus walls, bony dehiscence, pneumatisation of ACP. The position of ON was classified into Delano’s four types and their incidence noted. RESULTS: Type 1 position of ON was observed predominantly in 65.8% s ides while Type 2, 3, 4 were seen in 29.8%, 1.8% and 2.6% sides respectively out of 228 sides studied. Associated bony dehiscence was noted in only 5 out of 228sides (2.1% studied. The pneumatisation of ACP was observed in 23.6% of the CT scans studied. T he association between ON protrusion and ACP pneumatisation was found to be statistically significant with P= 0.008 . CONCLUSION: The varying position of ON, its protrusion with or without dehiscence in to the sphenoid sinus wall with statistically signific ant association with ACP pneumatisation in south Indian ethnicity warrants a systematic CT evaluation pre operatively to ensure

  13. Heat transfer enhancement of free surface MHD-flow by a protrusion wall

    International Nuclear Information System (INIS)

    Hulin Huang; Bo Li

    2010-01-01

    Due to the magnetohydrodynamic (MHD) effect on the flow, which degrades heat transfer coefficients by pulsation suppression of external magnetic field on the flow, a hemispherical protrusion wall is applied to free surface MHD-flow system as a heat transfer enhancement, because the hemispherical protrusion wall has some excellent characteristics including high heat transfer coefficients, low friction factors and high overall thermal performances. So, the characteristics of the fluid flow and heat transfer of the free surface MHD-flow with hemispherical protrusion wall are simulated numerically and the influence of some parameters, such as protrusion height δ/D, and Hartmann number, are also discussed in this paper. It is found that, in the range of Hartmann number 30 ≤ Ha ≤ 70, the protrusion wall assemblies can achieve heat transfer enhancements (Nu/Nu 0 ) of about 1.3-2.3 relative to the smooth channel, while the friction loss (f/f 0 ) increases by about 1.34-1.45. Thus, the high Nusselt number can be obtained when the protrusion wall with a radically lower friction loss increase, which may help get much higher overall thermal performances.

  14. Carbon protrusions on PTFE surface prepared by ion irradiation and chemical defluorination

    Science.gov (United States)

    Kobayashi, T.; Iwaki, M.

    2006-01-01

    A surface of PTFE was covered with small protrusions by ion-beam irradiation. In this study, we converted PTFE protrusions into carbon protrusions by a defluorination (carbonization) process using sodium vapor. The morphology, composition and structure were analyzed by SEM-EDX, Raman spectroscopy and TEM. The irradiated PTFE sheets were packed in evacuated glass tubes with a sodium block and kept at 473 K for 2-48 h. The samples were then rinsed in HCl and distilled water to remove NaF precipitates. The EDX measurement showed that the NaF precipitates were completely removed by washing, and the percentage of carbon atoms was controlled from 60% to 99% by the treatment. Raman spectra showed that graphite structures grow during the defluorination process. TEM micrographs showed that the protrusions have a bubble structure and are covered with a thin wall. The carbonized protrusions were conductive and grew perpendicular to the substrate.

  15. Independently evolved upper jaw protrusion mechanisms show convergent hydrodynamic function in teleost fishes.

    Science.gov (United States)

    Staab, Katie Lynn; Holzman, Roi; Hernandez, L Patricia; Wainwright, Peter C

    2012-05-01

    A protrusible upper jaw has independently evolved multiple times within teleosts and has been implicated in the success of two groups in particular: Acanthomorpha and Cypriniformes. We use digital particle image velocimetry (DPIV) to compare suction feeding flow dynamics in a representative of each of these clades: goldfish and bluegill. Using DPIV, we contrast the spatial pattern of flow, the temporal relationship between flow and head kinematics, and the contribution of jaw protrusion to the forces exerted on prey. As expected, the spatial patterns of flow were similar in the two species. However, goldfish were slower to reach maximal kinematic excursions, and were more flexible in the relative timing of jaw protrusion, other jaw movements and suction flows. Goldfish were also able to sustain flow speeds for a prolonged period of time as compared with bluegill, in part because goldfish generate lower peak flow speeds. In both species, jaw protrusion increased the force exerted on the prey. However, slower jaw protrusion in goldfish resulted in less augmentation of suction forces. This difference in force exerted on prey corresponds with differences in trophic niches and feeding behavior of the two species. The bluegill uses powerful suction to capture insect larvae whereas the goldfish uses winnowing to sort through detritus and sediment. The kinethmoid of goldfish may permit jaw protrusion that is independent of lower jaw movement, which could explain the ability of goldfish to decouple suction flows (due to buccal expansion) from upper jaw protrusion. Nevertheless, our results show that jaw protrusion allows both species to augment the force exerted on prey, suggesting that this is a fundamental benefit of jaw protrusion to suction feeders.

  16. Obturator nerve schwannoma presenting as an adnexal mass: case report

    Energy Technology Data Exchange (ETDEWEB)

    Mehta, M.; Thurston, W.A.; Merchant, N. [The Toronto Hospital, Dept. of Medical Imaging, Toronto, Ontario (Canada); Murphy, K.J. [The Toronto Hospital, Dept. of Obstetrics and Gynecology, Toronto, Ontario (Canada)

    1999-02-01

    Schwannomas are relatively common, benign nerve-sheath tumours. They arise most commonly from either cranial nerves or the dorsal root of spinal nerves. Schwannomas have also been reported to occur in peripheral nerve-root trunks, although this location is much less common. We report a case of a 45-year-old woman with a large pelvic mass originally believed to be an ovarian tumour. Following surgical excision, the tumour was found to be a schwannoma of the obturator nerve. To our knowledge, there are no reported cases of an obturator nerve schwannoma. The imaging features of schwannomas are reviewed. (author)

  17. Inflammatory lesions of the spinal cord and the nerve roots in magnetic resonance imaging

    International Nuclear Information System (INIS)

    Sartoretti-Schefer, S.; Wichmann, W.; Valavanis, A.

    1996-01-01

    The MRI examinations of 52 patients with proven inflammatory lesions (39 patients) or tumorous/postactinic lesions of the spinal cord (6 patients) and vasuclar malformations of the spinal cord (7 patients) were retrospectively analyzed. All examinations were performed on a 1.5 T MR unit, using bi- or triplanar T1-w pre- and postcontrast as well as T2-w SE sequences. Clinical and radiological examinations allow a subdivision of inflammations of the spinal cord and the nerve roots into (mening-oradiculo) myelitis and meningoradiculo (myelitis). The MRI patterns of these two inflammatory subtypes vary: Meningoradiculitis presents with an enhancement of the nerve roots and the leptomeninges; myelitis itself is characterized by single or multiple, diffuse or multifocal, with or without nodular, patchy or diffusely enhancing intramedullary lessions, with or without thickening of the cord and leptomeningeal inflammation. The immunologically suppressed patient suffers from viral infections (especially herpes simplex, varicella-zoster virus, cytomegalovirus), bacterial infections (tuberculosis), but rarely viral infections, sarcoidosis and demyelinating diseases. Idiopathic myelitis is also common. Secondary ischemic and demyelinating processes result in a complex morphology of inflammatory lesions on MRI, and therefore the whole spectrum of demyelinating, ischemic and inflammatory lesions has to be included in the differential diagnosis. Even tumors may imitate inflammatory myelitis and radiculitis. Most commonly, meningoradiculitis can be separated from myelitis. A reliable diagnosis of a specific inflammatory lesion is difficult and is mostly achieved in patients with multiple sclerosis and in patients with HIV-associated cytomegalovirus infection. (orig.) [de

  18. 16 CFR 1511.4 - Protrusions.

    Science.gov (United States)

    2010-01-01

    ... Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION FEDERAL HAZARDOUS SUBSTANCES ACT REGULATIONS... orientation of the hinge axis shall be horizontal. A plane surface shall be applied to any protrusion from the... direction along the axis of the nipple. The normal of the plane surface shall be maintained parallel to the...

  19. Morphological change of self-organized protrusions of fluoropolymer surface by ion beam irradiation

    International Nuclear Information System (INIS)

    Kitamura, Akane; Kobayashi, Tomohiro; Satoh, Takahiro; Koka, Masashi; Kamiya, Tomihiro; Suzuki, Akihiro; Terai, Takayuki

    2013-01-01

    Polytetrafluoroethylene (PTFE) and fluorinated ethylene propylene (FEP) are typical fluoropolymers displaying several desirable technological properties such as electrical insulation and high chemical resistance. When their surfaces are irradiated with ion beams, dense micro-protrusions formed after the emergence and spread of micropores across the entire irradiated area, allowing culture cells to spread on the top of the protrusions. In this study, we investigate the morphological changes introduced in the fluoropolymer surfaces by ion beams as the energy of the beams is increased. When an FEP sample was irradiated with a nitrogen ion beam with an energy of less than 350 keV at 1.0 μA/cm 2 , protrusions were formed with a density between 2 × 10 7 /cm 2 and 2 × 10 8 /cm 2 . However, at energies higher than 350 keV, the protrusions became sparse, and the density dropped to 5 × 10 2 /cm 2 . Protrusions appeared sporadically during irradiation at high energies, and the top of the protrusions appeared as spots inside the sample, which were difficult to etch and became elongated as the erosion of the surface progressed. Erosion was caused by sputtering of FEP molecules and evaporation at notably elevated temperatures on the surface. Analysis based on attenuated total reflectance/Fourier transform infrared spectroscopy showed the presence of C=C bonds as well as –COOH, –C=O, and –OH bonds on all irradiated samples. Their concentration on the surface densely covered with micro-protrusions was higher than that on the surface with sparse protrusions after irradiation at energies exceeding 350 keV. Thus, we determined a suitable range for the ion energy for creating FEP surfaces densely covered with protrusions

  20. A diagnostic study in patients with sciatica establishing the importance of localization of worsening of pain during coughing, sneezing and straining to assess nerve root compression on MRI.

    Science.gov (United States)

    Verwoerd, Annemieke J H; Mens, Jan; El Barzouhi, Abdelilah; Peul, Wilco C; Koes, Bart W; Verhagen, Arianne P

    2016-05-01

    To test whether the localization of worsening of pain during coughing, sneezing and straining matters in the assessment of lumbosacral nerve root compression or disc herniation on MRI. Recently the diagnostic accuracy of history items to assess disc herniation or nerve root compression on magnetic resonance imaging (MRI) was investigated. A total of 395 adult patients with severe sciatica of 6-12 weeks duration were included in this study. The question regarding the influence of coughing, sneezing and straining on the intensity of pain could be answered on a 4 point scale: no worsening of pain, worsening of back pain, worsening of leg pain, worsening of back and leg pain. Diagnostic odds ratio's (DORs) were calculated for the various dichotomization options. The DOR changed into significant values when the answer option was more narrowed to worsening of leg pain. The highest DOR was observed for the answer option 'worsening of leg pain' with a DOR of 2.28 (95 % CI 1.28-4.04) for the presence of nerve root compression and a DOR of 2.50 (95 % CI 1.27-4.90) for the presence of a herniated disc on MRI. Worsening of leg pain during coughing, sneezing or straining has a significant diagnostic value for the presence of nerve root compression and disc herniation on MRI in patients with sciatica. This study also highlights the importance of the formulation of answer options in history taking.

  1. A Novel Collaborative Protocol for Successful Management of Penile Pain Mediated by Radiculitis of Sacral Spinal Nerve Roots From Tarlov Cysts.

    Science.gov (United States)

    Goldstein, Irwin; Komisaruk, Barry R; Rubin, Rachel S; Goldstein, Sue W; Elliott, Stacy; Kissee, Jennifer; Kim, Choll W

    2017-09-01

    Since 14 years of age, the patient had experienced extreme penile pain within seconds of initial sexual arousal through masturbation. Penile pain was so severe that he rarely proceeded to orgasm or ejaculation. After 7 years of undergoing multiple unsuccessful treatments, he was concerned for his long-term mental health and for his future ability to have relationships. To describe a novel collaboration among specialists in sexual medicine, neurophysiology, and spine surgery that led to successful management. Collaborating health care providers conferred with the referring physician, patient, and parents and included a review of all medical records. Elimination of postpubertal intense penile pain during sexual arousal. The patient presented to our sexual medicine facility at 21 years of age. The sexual medicine physician identifying the sexual health complaint noted a pelvic magnetic resonance imaging report of an incidental sacral Tarlov cyst. A subsequent sacral magnetic resonance image showed four sacral Tarlov cysts, with the largest measuring 18 mm. Neuro-genital testing result were abnormal. The neurophysiologist hypothesized the patient's pain at erection was produced by Tarlov cyst-induced neuropathic irritation of sensory fibers that course within the pelvic nerve. The spine surgeon directed a diagnostic injection of bupivacaine to the sacral nerve roots and subsequently morphine to the conus medullaris of the spinal cord. The bupivacaine produced general penile numbness; the morphine selectively decreased penile pain symptoms during sexual arousal without blocking penile skin sensation. The collaboration among specialties led to the conclusion that the Tarlov cysts were pathophysiologically mediating the penile pain symptoms during arousal. Long-term follow-up after surgical repair showed complete symptom elimination at 18 months after treatment. This case provides evidence that (i) Tarlov cysts can cause sacral spinal nerve root radiculitis through

  2. α-Synuclein pathology in the cranial and spinal nerves in Lewy body disease.

    Science.gov (United States)

    Nakamura, Keiko; Mori, Fumiaki; Tanji, Kunikazu; Miki, Yasuo; Toyoshima, Yasuko; Kakita, Akiyoshi; Takahashi, Hitoshi; Yamada, Masahito; Wakabayashi, Koichi

    2016-06-01

    Accumulation of phosphorylated α-synuclein in neurons and glial cells is a histological hallmark of Lewy body disease (LBD) and multiple system atrophy (MSA). Recently, filamentous aggregations of phosphorylated α-synuclein have been reported in the cytoplasm of Schwann cells, but not in axons, in the peripheral nervous system in MSA, mainly in the cranial and spinal nerve roots. Here we conducted an immunohistochemical investigation of the cranial and spinal nerves and dorsal root ganglia of patients with LBD. Lewy axons were found in the oculomotor, trigeminal and glossopharyngeal-vagus nerves, but not in the hypoglossal nerve. The glossopharyngeal-vagus nerves were most frequently affected, with involvement in all of 20 subjects. In the spinal nerve roots, Lewy axons were found in all of the cases examined. Lewy axons in the anterior nerves were more frequent and numerous in the thoracic and sacral segments than in the cervical and lumbar segments. On the other hand, axonal lesions in the posterior spinal nerve roots appeared to increase along a cervical-to-sacral gradient. Although Schwann cell cytoplasmic inclusions were found in the spinal nerves, they were only minimal. In the dorsal root ganglia, axonal lesions were seldom evident. These findings indicate that α-synuclein pathology in the peripheral nerves is axonal-predominant in LBD, whereas it is restricted to glial cells in MSA. © 2015 Japanese Society of Neuropathology.

  3. Microstructure Evolution and Protrusion of Electroplated Cu-Filled Through-Silicon Vias Subjected to Thermal Cyclic Loading

    Science.gov (United States)

    Chen, Si; An, Tong; Qin, Fei; Chen, Pei

    2017-10-01

    Through-silicon vias (TSVs) have become an important technology for three-dimensional integrated circuit (3D IC) packaging. Protrusion of electroplated Cu-filled vias is a critical reliability issue for TSV technology. In this work, thermal cycling tests were carried out to identify how the microstructure affects protrusion during thermal cycling. Cu protrusion occurs when the loading temperature is higher than 149°C. During the first five thermal cycles, the grain size of Cu plays a dominant role in the protrusion behavior. Larger Cu grain size before thermal cycling results in greater Cu protrusion. With increasing thermal cycle number, the effect of the Cu grain size reduces and the microstrain begins to dominate the Cu protrusion behavior. Higher magnitude of microstrain within Cu results in greater protrusion increment during subsequent thermal cycles. When the thermal cycle number reaches 25, the protrusion rate of Cu slows down due to strain hardening. After 30 thermal cycles, the Cu protrusion stabilizes within the range of 1.92 μm to 2.09 μm.

  4. Influence of bimaxillary protrusion on the perception of smile esthetics.

    Science.gov (United States)

    Almutairi, Terki K; Albarakati, Sahar F; Aldrees, Abdullah M

    2015-01-01

    To evaluate the impact of bimaxillary protrusion on smile esthetics as perceived by dental professionals and laypersons. One hundred and fifty evaluators, equally distributed into their respective panels (orthodontists, general dentists, and laypersons), participated in this cross-sectional study conducted in April to December 2012 in Riyadh, Saudi Arabia. The patient sample consisted of 14 female patients divided equally into 2 groups: bimaxillary protrusion patients, and patients who have had 4-premolar extraction treatment. Two standardized photographs (frontal and three-quarter close-up smile views), and a lateral cephalogram were taken for each patient. The evaluators were asked to rate the attractiveness of each photo according to a 100-mm visual analog scale. These esthetic ratings were correlated with the patients' cephalometric measurements. The bimaxillary protrusion group was rated significantly as less attractive than the treatment group by each evaluator panel. Panel comparison showed that laypeople were less receptive of bimaxillary protrusion than dental professionals. Frontal and three-quarter views of the same smiles were not similarly rated for esthetic perceptions. Correlational analysis revealed that the dentoalveolar measurement with the highest significant negative correlation to the smile esthetics was the upper incisors to palatal plane (U1-PP) angle. Patients with bimaxillary protrusion were found to be less attractive than patients who were treated for the condition. This was especially evident among the laypersons. An increase in the upper incisor inclination, as well as a decrease in the interincisal angle compounds the bimaxillary effect. 

  5. Measurements of the Curvature of Protrusions/Retrusions on Migrating Recrystallization Boundaries

    DEFF Research Database (Denmark)

    Zhang, Yubin; Godfrey, A.; Juul Jensen, Dorte

    2009-01-01

    Two methods to quantify protrusions/retrusions and to estimate local boundary curvature from sample plane sections are proposed. The methods are used to evaluate the driving force due to curvature of the protrusions/retrusions for partially recrystallized pure nickel cold rolled to 96% reduction...

  6. Mechanisms of leading edge protrusion in interstitial migration

    Science.gov (United States)

    Wilson, Kerry; Lewalle, Alexandre; Fritzsche, Marco; Thorogate, Richard; Duke, Tom; Charras, Guillaume

    2013-01-01

    While the molecular and biophysical mechanisms underlying cell protrusion on two-dimensional substrates are well understood, our knowledge of the actin structures driving protrusion in three-dimensional environments is poor, despite relevance to inflammation, development and cancer. Here we report that, during chemotactic migration through microchannels with 5 μm × 5 μm cross-sections, HL60 neutrophil-like cells assemble an actin-rich slab filling the whole channel cross-section at their front. This leading edge comprises two distinct F-actin networks: an adherent network that polymerizes perpendicular to cell-wall interfaces and a ‘free’ network that grows from the free membrane at the cell front. Each network is polymerized by a distinct nucleator and, due to their geometrical arrangement, the networks interact mechanically. On the basis of our experimental data, we propose that, during interstitial migration, medial growth of the adherent network compresses the free network preventing its retrograde movement and enabling new polymerization to be converted into forward protrusion. PMID:24305616

  7. The morphometric analysis of the intervertebral foramen and the spinal nerve root in the cervical spine

    International Nuclear Information System (INIS)

    Yoshida, Yasuo

    2008-01-01

    deg at C5 and C6, showing a significantly obtuse angle at C5 and C6 compared with at C3. The measurement at the merging section of the dorsal spinal nerve root showed that the width was about 7.0 to 7.5 mm at C3 through C6 and about 6.5 mm at C7 which was significantly low, while the cephalocaudal length was about 12.5 mm at C3, about 11.5 mm at C4, about 12 to 13 mm at C5, about 11.5 mm at C6, about 10.5 mm at C7, and about 10 mm at C8: there was a difference between the right and the left at C5, whereas no difference was observed between the right and the left at C3, C4, C6, C7, and C8. The incidence angle from the inlet of intervertebral foramen of the dorsal spinal nerve root toward the superior part of the spine indistinct a gradual obtuse angle at C3 through C5, whereas the angle gradually become an acute angle at C6 or below. The incidence angle in the inferior part was obtuse at C4 and C5, and acute at C6 or below, showing that the distance obliquely running within the dura mater tended to be short in the dorsal nerve rootlets at C4 and C5. Based on the above results, it was considered that the anatomy of the intervertebral foramen of the cervical spine and the difference by level at the origin of dorsal root have an influence on the onset of cervical myelopathy and cervical spondylotic radiculopathy as well as the occurrence of various types of disease states. (author)

  8. Asymmetry of the multifidus muscle in lumbar radicular nerve compression

    International Nuclear Information System (INIS)

    Farshad, Mazda; Gerber, Christian; Farshad-Amacker, Nadja A.; Dietrich, Tobias J.; Laufer-Molnar, Viviane; Min, Kan

    2014-01-01

    The multifidus muscle is the only paraspinal lumbar muscle that is innervated by a single nerve root. This study aimes to evaluate if the asymmetry of the multifidus muscle is related to the severity of compression of the nerve root or the duration of radiculopathy. MRI scans of 79 patients with symptomatic single level, unilateral, lumbar radiculopathy were reviewed for this retrospective case series with a nested case-control study. The cross-sectional area (CSA) of the multifidus muscle and the perpendicular distance of the multifidus to the lamina (MLD) were measured bilaterally by two radiologists and set into relation to the severity of nerve compression, duration of radiculopathy and probability of an indication for surgical decompression. In 67 recessal and 12 foraminal symptomatic nerve root compressions, neither the MLD ratio (severe 1.19 ± 0.55 vs less severe nerve compression: 1.12 ± 0.30, p = 0.664) nor the CSA ratio (severe 1 ± 0.16 vs less severe 0.98 ± 0.13, p = 0.577) nor the duration of symptoms significantly correlated with the degree of nerve compression. MR measurements of multifidus were not different in patients with (n = 20) and those without (n = 59) clinical muscle weakness in the extremity caused by nerve root compression. A MLD >1.5 was, however, associated with the probability of an indication for surgical decompression (OR 3, specificity 92 %, PPV 73 %). Asymmetry of the multifidus muscle correlates with neither the severity nor the duration of nerve root compression in the lumbar spine. Severe asymmetry with substantial multifidus atrophy seems associated with the probability of an indication of surgical decompression. (orig.)

  9. Asymmetry of the multifidus muscle in lumbar radicular nerve compression

    Energy Technology Data Exchange (ETDEWEB)

    Farshad, Mazda; Gerber, Christian; Farshad-Amacker, Nadja A.; Dietrich, Tobias J.; Laufer-Molnar, Viviane; Min, Kan [Balgrist University Hospital, University of Zuerich, Zuerich (Switzerland)

    2014-01-15

    The multifidus muscle is the only paraspinal lumbar muscle that is innervated by a single nerve root. This study aimes to evaluate if the asymmetry of the multifidus muscle is related to the severity of compression of the nerve root or the duration of radiculopathy. MRI scans of 79 patients with symptomatic single level, unilateral, lumbar radiculopathy were reviewed for this retrospective case series with a nested case-control study. The cross-sectional area (CSA) of the multifidus muscle and the perpendicular distance of the multifidus to the lamina (MLD) were measured bilaterally by two radiologists and set into relation to the severity of nerve compression, duration of radiculopathy and probability of an indication for surgical decompression. In 67 recessal and 12 foraminal symptomatic nerve root compressions, neither the MLD ratio (severe 1.19 ± 0.55 vs less severe nerve compression: 1.12 ± 0.30, p = 0.664) nor the CSA ratio (severe 1 ± 0.16 vs less severe 0.98 ± 0.13, p = 0.577) nor the duration of symptoms significantly correlated with the degree of nerve compression. MR measurements of multifidus were not different in patients with (n = 20) and those without (n = 59) clinical muscle weakness in the extremity caused by nerve root compression. A MLD >1.5 was, however, associated with the probability of an indication for surgical decompression (OR 3, specificity 92 %, PPV 73 %). Asymmetry of the multifidus muscle correlates with neither the severity nor the duration of nerve root compression in the lumbar spine. Severe asymmetry with substantial multifidus atrophy seems associated with the probability of an indication of surgical decompression. (orig.)

  10. A novel chondroitin sulfate hydrogel for nerve repair

    Science.gov (United States)

    Conovaloff, Aaron William

    Brachial plexus injuries affect numerous patients every year, with very debilitating results. The majority of these cases are very severe, and involve damage to the nerve roots. To date, repair strategies for these injuries address only gross tissue damage, but do not supply cells with adequate regeneration signals. As a result, functional recovery is often severely lacking. Therefore, a chondroitin sulfate hydrogel that delivers neurotrophic signals to damaged neurons is proposed as a scaffold to support nerve root regeneration. Capillary electrophoresis studies revealed that chondroitin sulfate can physically bind with a variety of neurotrophic factors, and cultures of chick dorsal root ganglia demonstrated robust neurite outgrowth in chondroitin sulfate hydrogels. Outgrowth in chondroitin sulfate gels was greater than that observed in control gels of hyaluronic acid. Furthermore, the chondroitin sulfate hydrogel's binding activity with nerve growth factor could be enhanced by incorporation of a synthetic bioactive peptide, as revealed by fluorescence recovery after photobleaching. This enhanced binding was observed only in chondroitin sulfate gels, and not in hyaluronic acid control gels. This enhanced binding activity resulted in enhanced dorsal root ganglion neurite outgrowth in chondroitin sulfate gels. Finally, the growth of regenerating dorsal root ganglia in these gels was imaged using label-free coherent anti-Stokes scattering microscopy. This technique generated detailed, high-quality images of live dorsal root ganglion neurites, which were comparable to fixed, F-actin-stained samples. Taken together, these results demonstrate the viability of this chondroitin sulfate hydrogel to serve as an effective implantable scaffold to aid in nerve root regeneration.

  11. Neurophysiological approach to disorders of peripheral nerve

    DEFF Research Database (Denmark)

    Crone, Clarissa; Krarup, Christian

    2013-01-01

    Disorders of the peripheral nerve system (PNS) are heterogeneous and may involve motor fibers, sensory fibers, small myelinated and unmyelinated fibers and autonomic nerve fibers, with variable anatomical distribution (single nerves, several different nerves, symmetrical affection of all nerves......, plexus, or root lesions). Furthermore pathological processes may result in either demyelination, axonal degeneration or both. In order to reach an exact diagnosis of any neuropathy electrophysiological studies are crucial to obtain information about these variables. Conventional electrophysiological...

  12. Inhibitory Activity of Yokukansankachimpihange against Nerve Growth Factor-Induced Neurite Growth in Cultured Rat Dorsal Root Ganglion Neurons

    Directory of Open Access Journals (Sweden)

    Chiaki Murayama

    2015-08-01

    Full Text Available Chronic pruritus is a major and distressing symptom of many cutaneous diseases, however, the treatment remains a challenge in the clinic. The traditional Chinese-Japanese medicine (Kampo medicine is a conservative and increasingly popular approach to treat chronic pruritus for both patients and medical providers. Yokukansankachimpihange (YKH, a Kampo formula has been demonstrated to be effective in the treatment of itching of atopic dermatitis in Japan although its pharmacological mechanism is unknown clearly. In an attempt to clarify its pharmacological actions, in this study, we focused on the inhibitory activity of YKH against neurite growth induced with nerve growth factor (NGF in cultured rat dorsal root ganglion (DRG neurons because epidermal hyperinnervation is deeply related to itch sensitization. YKH showed approximately 200-fold inhibitory activity against NGF-induced neurite growth than that of neurotropin (positive control, a drug used clinically for treatment of chronic pruritus. Moreover, it also found that Uncaria hook, Bupleurum root and their chemical constituents rhynchophylline, hirsutine, and saikosaponin a, d showed inhibitory activities against NGF-induced neurite growth, suggesting they should mainly contribute to the inhibitory activity of YKH. Further study on the effects of YKH against epidermal nerve density in “itch-scratch” animal models is under investigation.

  13. Quantitative evaluation of normal lumbosacral plexus nerve by using diffusion tensor imaging

    International Nuclear Information System (INIS)

    Shi Yin; Wang Chuanbing; Liu Wei; Zong Min; Sa Rina; Shi Haibin; Wang Dehang

    2014-01-01

    Objective: To observe the lumbosacral plexus nerves by diffusion tensor tractography (DTT) and quantitatively evaluate them by using diffusion tensor imaging (DTI) in healthy volunteers. Methods: A total of 60 healthy volunteers (30 males and 30 females) underwent DTI scanning. Mean FA values of the lumbosacral plexus nerves (both sides of lumbar roots L3 to S1, proximal and distal to the lumbar foraminal zone) were quantified. Differences among various segments of lumbar nerve roots were compared with ANOVA test and SNK test. Differences between two sides of the lumbar nerve roots at the same lumbar segment were compared with paired-samples t test. Differences between the proximal and the distal nerve to the the lumbar foraminal zone at the same lumbar segment were compared with paired-samples t test. The lumbosacral plexus nerve was visualized with tractography. Results: (1) The lumbosacral plexus nerve was clearly visualized with tractography. (2) Mean FA values of the lumbar nerve roots L3 to S1 were as followings: proximal to the left lumbar foraminal zone 0.202 ± 0.021, 0.201 ± 0.026, 0.201 ± 0.027, 0.191 ±0.016, distal to the left lumbar foraminal zone 0.222 ± 0.034, 0.250 ± 0.028, 0.203 ± 0.026, 0.183 ± 0.020, proximal to the right lumbar foraminal zone 0.200 ± 0.023, 0.202 ± 0.023, 0.205 ± 0.027, 0.191 ± 0.017, distal to the right lumbar foraminal zone 0.225 ± 0.032, 0.247 ± 0.027, 0.205 ± 0.033, 0.183 ± 0.021. Mean FA values were significantly different between the proximal nerve to the distal nerve in lumbar nerve roots L3, L4, S1 (t=-9.114-2.366, P<0.05), but not significantly different in L5 (P>0.05). Differences were not found between the right and left side nerves at the same lumbar segment (P>0.05). (3) The whole length of the lumbar roots nerve L3 to S1 can be visualized clearly by using DTT. Conclusions: Diffusion tensor imaging and tractography can show and provide quantitative information of human lumbosacral plexus nerves. DTI

  14. A methodological reappraisal of non invasive high voltage electrical stimulation of lumbosacral nerve roots.

    Science.gov (United States)

    Troni, Walter; Di Sapio, Alessia; Berra, Eliana; Duca, Sergio; Merola, Aristide; Sperli, Francesca; Bertolotto, Antonio

    2011-10-01

    To describe a neurophysiological method to locate the optimal stimulation site (OSS) over the vertebral column, customized to the individual subject, to achieve maximal activation of lumbosacral roots by means of non-invasive high voltage electrical stimulation (HVES). OSS was located in 30 volunteers by testing different stimulation points of a surface multi-electrode array placed over the dorso-lumbar junction of the vertebral column. The dorso-ventral stimulating montage was used (Troni et al., 1996). Motor responses to root stimulation (rCMAPs) were bilaterally recorded from Vastus Medialis (VM), Tibialis Anterior (TA), Soleus (SL) and Flexor Hallucis Brevis (FHB) muscles. The direct nature of rCMAPs was tested by delivering two maximal stimuli 50 ms apart. Except for a few subjects with large girth, maximal rCMAPs could be obtained from all muscles with a stimulating current intensity up to 550 V (1050 mA). Maximal double HVES excluded any reflex component in the recorded rCMAPs. The procedure was well tolerated and no side effects were observed. A single maximal electric shock delivered at the proper vertebral level by means of the dorso-ventral montage is able to safely achieve synchronous, bilateral maximal activation of several roots, from L3 to S1. Maximal activation of lumbosacral roots at their origin, unattainable with magnetic stimulation, is the essential requirement for direct detection of proximal nerve conduction slowing and block in lower limbs. Copyright © 2011 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  15. Vasodilative effects of prostaglandin E1 derivate on arteries of nerve roots in a canine model of a chronically compressed cauda equina

    Directory of Open Access Journals (Sweden)

    Konno Shin-ichi

    2008-04-01

    Full Text Available Abstract Background Reduction of blood flow is important in the induction of neurogenic intermittent claudication (NIC in lumbar spinal canal stenosis. PGE1 improves the mean walking distance in patients with NIC type cauda equina compression. PGE1 derivate might be effective in dilating blood vessels and improving blood flow in nerve roots with chronically compressed cauda equina. The aim of this study was to assess whether PGE1 derivate has vasodilatory effects on both arteries and veins in a canine model of chronic cauda equina compression. Methods Fourteen dogs were used in this study. A plastic balloon inflated to 10 mmHg was placed under the lamina of the 7th lumbar vertebra for 1 week. OP-1206-cyclodextrin clathrate (OP-1206-CD: prostaglandin E1 derivate was administered orally. The blood vessels of the second or third sacral nerve root were identified using a specially designed surgical microscope equipped with a video camera. The diameter of the blood vessels was measured on video-recordings every 15 minutes until 90 minutes after the administration of the PGE1 derivate. Results We observed seven arteries and seven veins. The diameter and blood flow of the arteries was significantly increased compared with the veins at both 60 and 75 minutes after administration of the PGE1 derivate (p Discussion The PGE1 derivate improved blood flow in the arteries but did not induce blood stasis in the veins. Our results suggest that the PGE1 derivate might be a potential therapeutic agent, as it improved blood flow in the nerve roots in a canine model of chronic cauda equina compression.

  16. Effect of Coriolis forces in a rotating channel with dimples and protrusions

    International Nuclear Information System (INIS)

    Elyyan, Mohammad A.; Tafti, Danesh K.

    2010-01-01

    Large-eddy simulations are used to investigate the effect of Coriolis forces and dimple depth on heat transfer and friction in a channel with dimples and protrusions on either side. Two geometries with two different dimple-protrusion depths, δ = 0.2 and 0.3 of channel height are investigated over a wide range of rotation numbers, Ro b = -0.77 to 1.10 based on mean velocity and channel height. It is found that the dimple side of the channel is much more sensitive to destabilizing rotational Coriolis forces than the protrusion side of the channel, although both dimples and protrusions react to the stabilizing effects of Coriolis forces on the leading side. The dimpled surface on the trailing side experiences a large increase in heat transfer coefficient from an augmentation ratio of 1.9 for stationary flow to 3.5 at Ro b = 0.77 for δ = 0.2, and from 2.3 to a maximum of 3.8 for δ = 0.3. Placing protrusion on the trailing side, however, only increases the augmentation ratio to between 3.25 and 3.7 from the stationary values of 3.0 and 3.4 for δ = 0.2 and 0.3, respectively. The dimpled leading side experiences a large drop in heat transfer to between augmentation ratios of 1.1 and 1.4 for the two dimple depths. The protrusion surface on the leading side also experiences a large drop in augmentation from 3.0 for a stationary channel to 1.3 at Ro b = 0.77 for δ = 0.2 and from 3.4 to 1.8 at Ro b = 1.1 for δ = 0.3. The results lead to the conclusion that for low rotation numbers |Ro b | b | > 0.2, dimples on the trailing side of the duct give better overall performance. Between the two depths, the deeper dimple/protrusion (δ = 0.3) gives higher heat transfer augmentation at the price of more frictional losses ranging from 6 to 10 versus 3 to 5 for depth δ = 0.2.

  17. Carotid artery protrusion and dehiscence in patients with acromegaly.

    Science.gov (United States)

    Sasagawa, Yasuo; Tachibana, Osamu; Doai, Mariko; Hayashi, Yasuhiko; Tonami, Hisao; Iizuka, Hideaki; Nakada, Mitsutoshi

    2016-10-01

    Acromegaly is a systemic disease which causes multiple bony alterations. Some authors reported that acromegalic patients have risk factors for an intraoperative vascular injury due to the specific anatomical features of their sphenoid sinus. The objective of our study was to analyze the anatomic characteristics of sphenoid sinus in acromegalic patients compared with controls, by evaluation of computed tomography (CT) findings. We examined 45 acromegalic (acromegaly group) and 45 non-acromegalic patients (control group) with pituitary adenomas who were matched for sex, age, height, tumor size, and cavernous sinus invasion (Knosp grade). Preoperative CT of the pituitary region including the sphenoid sinus was used to evaluate the following anatomic characteristics: type of sphenoid sinus (sellar or pre-sellar/conchal); intrasphenoid septa (non/single or multiple); carotid artery protrusion; carotid artery dehiscence; intercarotid distance. Sixteen acromegalic patients (35.5 %) and 6 controls (13.3 %) had carotid artery protrusion. Additionally, 10 acromegalic patients (22.2 %) and 3 controls (6.6 %) had carotid artery dehiscence. Carotid artery protrusion and dehiscence were more frequent in the acromegaly group than in control group (p = 0.013 and 0.035, respectively). Other anatomic characteristics (type of sphenoid sinus, intrasphenoid septa, and intracarotid distance) showed no significant differences between acromegaly and control groups. Our study suggests that carotid artery protrusion and dehiscence occur more frequently among acromegalic patients, compared with non-acromegalic patients. It is important for surgeons to be aware of these anatomic variations to avoid vital complications, such as carotid injuries, during surgery.

  18. Preferential control of basal dendritic protrusions by EphB2.

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    Matthew S Kayser

    2011-02-01

    Full Text Available The flow of information between neurons in many neural circuits is controlled by a highly specialized site of cell-cell contact known as a synapse. A number of molecules have been identified that are involved in central nervous system synapse development, but knowledge is limited regarding whether these cues direct organization of specific synapse types or on particular regions of individual neurons. Glutamate is the primary excitatory neurotransmitter in the brain, and the majority of glutamatergic synapses occur on mushroom-shaped protrusions called dendritic spines. Changes in the morphology of these structures are associated with long-lasting modulation of synaptic strength thought to underlie learning and memory, and can be abnormal in neuropsychiatric disease. Here, we use rat cortical slice cultures to examine how a previously-described synaptogenic molecule, the EphB2 receptor tyrosine kinase, regulates dendritic protrusion morphology in specific regions of the dendritic arbor in cortical pyramidal neurons. We find that alterations in EphB2 signaling can bidirectionally control protrusion length, and knockdown of EphB2 expression levels reduces the number of dendritic spines and filopodia. Expression of wild-type or dominant negative EphB2 reveals that EphB2 preferentially regulates dendritic protrusion structure in basal dendrites. Our findings suggest that EphB2 may act to specify synapse formation in a particular subcellular region of cortical pyramidal neurons.

  19. Patients with low back pain differ from those who also have leg pain or signs of nerve root involvement – a cross-sectional study

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    Kongsted Alice

    2012-11-01

    Full Text Available Abstract Background Leg pain associated with low back pain (LBP is recognized as a risk factor for a poor prognosis, and is included as a component in most LBP classification systems. The location of leg pain relative to the knee and the presence of a positive straight leg raise test have been suggested to have clinical implications. To understand differences between such leg pain subgroups, and whether differences include potentially modifiable characteristics, the purpose of this paper was to describe characteristics of patients classified into the Quebec Task Force (QTF subgroups of: 1 LBP only, 2 LBP and pain above the knee, 3 LBP and pain below the knee, and 4 LBP and signs of nerve root involvement. Methods Analysis of routine clinical data from an outpatient department. Based on patient reported data and clinical findings, patients were allocated to the QTF subgroups and described according to the domains of pain, activity limitation, work participation, psychology, general health and clinical examination findings. Results A total of 2,673 patients aged 18–95 years (median 47 who were referred for assessment of LBP were included. Increasing severity was consistently observed across the subgroups from LBP only to LBP with signs of nerve root involvement although subgroup differences were small. LBP patients with leg pain differed from those with LBP only on a wide variety of parameters, and patients with signs of nerve root involvement had a more severe profile on almost all measures compared with other patients with back-related leg pain. Conclusion LBP patients with pain referral to the legs were more severely affected than those with local LBP, and patients with signs of nerve root involvement were the ones most severily affected. These findings underpin the concurrent validity of the Quebec Task Force Classification. However, the small size of many between-subgroup differences amid the large variability in this sample of cross

  20. Transposition of branches of radial nerve innervating supinator to posterior interosseous nerve for functional reconstruction of finger and thumb extension in 4 patients with middle and lower trunk root avulsion injuries of brachial plexus.

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    Wu, Xia; Cong, Xiao-Bing; Huang, Qi-Shun; Ai, Fang-Xin; Liu, Yu-Tian; Lu, Xiao-Cheng; Li, Jin; Weng, Yu-Xiong; Chen, Zhen-Bing

    2017-12-01

    This study aimed to investigate the reconstruction of the thumb and finger extension function in patients with middle and lower trunk root avulsion injuries of the brachial plexus. From April 2010 to January 2015, we enrolled in this study 4 patients diagnosed with middle and lower trunk root avulsion injuries of the brachial plexus via imaging tests, electrophysiological examinations, and clinical confirmation. Muscular branches of the radial nerve, which innervate the supinator in the forearm, were transposed to the posterior interosseous nerve to reconstruct the thumb and finger extension function. Electrophysiological findings and muscle strength of the extensor pollicis longus and extensor digitorum communis, as well as the distance between the thumb tip and index finger tip, were monitored. All patients were followed up for 24 to 30 months, with an average of 27.5 months. Motor unit potentials (MUP) of the extensor digitorum communis appeared at an average of 3.8 months, while MUP of the extensor pollicis longus appeared at an average of 7 months. Compound muscle action potential (CMAP) appeared at an average of 9 months in the extensor digitorum communis, and 12 months in the extensor pollicis longus. Furthermore, the muscle strength of the extensor pollicis longus and extensor digitorum communis both reached grade III at 21 months. Lastly, the average distance between the thumb tip and index finger tip was 8.8 cm at 21 months. In conclusion, for patients with middle and lower trunk injuries of the brachial plexus, transposition of the muscular branches of the radial nerve innervating the supinator to the posterior interosseous nerve for the reconstruction of thumb and finger extension function is practicable and feasible.

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

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    Bhandari P

    2009-01-01

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

  2. Effective gene expression in the rat dorsal root ganglia with a non-viral vector delivered via spinal nerve injection

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    Chang, Ming-Fong; Hsieh, Jung-Hsien; Chiang, Hao; Kan, Hung-Wei; Huang, Cho-Min; Chellis, Luke; Lin, Bo-Shiou; Miaw, Shi-Chuen; Pan, Chun-Liang; Chao, Chi-Chao; Hsieh, Sung-Tsang

    2016-01-01

    Delivering gene constructs into the dorsal root ganglia (DRG) is a powerful but challenging therapeutic strategy for sensory disorders affecting the DRG and their peripheral processes. The current delivery methods of direct intra-DRG injection and intrathecal injection have several disadvantages, including potential injury to DRG neurons and low transfection efficiency, respectively. This study aimed to develop a spinal nerve injection strategy to deliver polyethylenimine mixed with plasmid (PEI/DNA polyplexes) containing green fluorescent protein (GFP). Using this spinal nerve injection approach, PEI/DNA polyplexes were delivered to DRG neurons without nerve injury. Within one week of the delivery, GFP expression was detected in 82.8% ± 1.70% of DRG neurons, comparable to the levels obtained by intra-DRG injection (81.3% ± 5.1%, p = 0.82) but much higher than those obtained by intrathecal injection. The degree of GFP expression by neurofilament(+) and peripherin(+) DRG neurons was similar. The safety of this approach was documented by the absence of injury marker expression, including activation transcription factor 3 and ionized calcium binding adaptor molecule 1 for neurons and glia, respectively, as well as the absence of behavioral changes. These results demonstrated the efficacy and safety of delivering PEI/DNA polyplexes to DRG neurons via spinal nerve injection. PMID:27748450

  3. 3D-MR myelography (3D-MRM) for the diagnosis of lumbal nerve root compression syndrome. A comparison with conventional myelography

    International Nuclear Information System (INIS)

    Eberhardt, K.E.W.; Hollenbach, H.P.; Huk, W.J.

    1994-01-01

    65 patients with nerve root compression syndrome were examined using a new type of MR-technique, which is comparable to the conventional X-ray myelography. The results of the prospective case study were compared with previous clinical experiences (1). For the examinations a 1.0 T whole body MR-system (Siemens Magnetom Impact) was used. A strong T 2 *-weighted 3D-FISP sequence (TR=73 ms, TE=21 ms, α=7 ) was applied in sagittal orientation using a circularly polarized oval spine coil. To obtain fat suppression a frequency selective 1-3-3-1 prepulse was applied prior to the imaging sequence. The acquired 3D-data set was evaluated using a Maximum Intensity Projection (MIP) program. Our results confirmed earlier experiences which showed that the diagnostic sensitivity of 3D-MR myelography (3D-MRM) is comparable to that of conventional X-ray myelography. In cases of severe spinal canal stenosis and spondylolisthesis, and in cases of postoperative scar tissue with nerve root compressions, the sensitivity of the 3D-MRM is higher as compared to that of conventional X-ray myelography. (orig.) [de

  4. T1-nerve root neuroma presenting with apical mass and Horner's syndrome

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    Podnar Simon

    2007-03-01

    Full Text Available Abstract Background The appearance of dumbbell neuroma of the first thoracic root is extremely rare. The extradural component of a T1-dumbbell neuroma may present as an apical mass. The diagnosis of hand weakness is complex and may be delayed in T1-neuroma because of absence of the palpable cervical mass. One-stage removal of a T1-root neuroma and its intrathoracic extension demanded an extended posterior midline approach in the sitting position. Case presentation A 51-year old man had suffered a traumatic partial tendon rupture of his wrist flexor muscles 6 years ago. Since the incident he occasionally felt fullness and tenderness in the affected forearm with some tingling in his fingers bilaterally. During the last two years the hand weakness was continuous and hypotrophy of the medial flexor and intrinsic hand muscles had become apparent. Electrophysiological studies revealed an ulnar neuropathy in addition to mild median and radial nerve dysfunction, including a mild contralateral carpal tunnel syndrome. The diagnostic work-up for multiple mononeuropathy in the upper extremity was negative. Repeated electrophysiological studies revealed fibrillations in the C7 paravertebral muscles on the affected side. Chest x-ray revealed a large round apical mass on the affected side. A Horner's syndrome was noted at this point of diagnostic work-up. MRI of the cervical and thoracic spine revealed a dumbbell T1 neuroma enlarging the intervertebral foramen at T1-2 and a 5 cm large extradural tumor with extension into the apex of the ipsilateral lung. The patient underwent surgery in sitting position using a left dorsal midline approach. Although the T1 root could not be preserved, the patient's neurological condition was unchanged after the surgery. Conclusion Extended posterior midline exposure described here using hemilaminectomy, unilateral facetectomy and costo-transversectomy is efficient and safe for one-stage removal of dumbbell tumors at the T1

  5. Management of low back pain with facet joint injections and nerve root blocks under computed tomography guidance. A prospective study

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    Fotiadou, Anastasia; Wojcik, Andrew; Shaju, Antony

    2012-01-01

    The aim of this work was to assess the performance of facet joint and nerve root infiltrations under computed tomography guidance for the management of low back pain and to investigate the complications and patient tolerance. The study was board-certified and informed consent was obtained from all patients. In 1 year, 86 consecutive patients (47 male, 39 female, age range 47-87 years, mean age 63) with low back pain for more than 2 years were included. All patients were clinically examined and had cross-sectional imaging performed before the procedure. Fifty-five facet joint infiltrations and 31 nerve blocks were performed under computed tomography guidance. All patients completed two valid pain questionnaires before and 3 months after the procedures. At the same time, they were clinically examined by the referring Orthopaedic Surgeon. The pain response was assessed by comparing the scores of the questionnaires. The improvement in clinical examination findings was assessed as well. In patients who underwent facet joint infiltrations, long-term pain improvement was achieved in 79% and in those with nerve blocks in 85%. Immediate pain relief was demonstrated in 83% of patients with nerve infiltrations. No complications were observed. All procedures were very well tolerated by patients. Facet joint and nerve infiltrations under computed tomography guidance constitute an accurate and safe method that could be used to relieve low back pain and minimize the risk of disability. (orig.)

  6. The Metalloprotease Mpl Supports Listeria monocytogenes Dissemination through Resolution of Membrane Protrusions into Vacuoles.

    Science.gov (United States)

    Alvarez, Diego E; Agaisse, Hervé

    2016-06-01

    Listeria monocytogenes is an intracellular pathogen that disseminates within the intestinal epithelium through acquisition of actin-based motility and formation of plasma membrane protrusions that project into adjacent cells. The resolution of membrane protrusions into vacuoles from which the pathogen escapes results in bacterial spread from cell to cell. This dissemination process relies on the mlp-actA-plcB operon, which encodes ActA, a bacterial nucleation-promoting factor that mediates actin-based motility, and PlcB, a phospholipase that mediates vacuole escape. Here we investigated the role of the metalloprotease Mpl in the dissemination process. In agreement with previous findings showing that Mpl is required for PlcB activation, infection of epithelial cells with the ΔplcB or Δmpl strains resulted in the formation of small infection foci. As expected, the ΔplcB strain displayed a strong defect in vacuole escape. However, the Δmpl strain showed an unexpected defect in the resolution of protrusions into vacuoles, in addition to the expected but mild defect in vacuole escape. The Δmpl strain displayed increased levels of ActA on the bacterial surface in protrusions. We mapped an Mpl-dependent processing site in ActA between amino acid residues 207 to 238. Similar to the Δmpl strain, the ΔactA207-238 strain displayed increased levels of ActA on the bacterial surface in protrusions. Although the ΔactA207-238 strain displayed wild-type actin-based motility, it formed small infection foci and failed to resolve protrusions into vacuoles. We propose that, in addition to its role in PlcB processing and vacuole escape, the metalloprotease Mpl is required for ActA processing and protrusion resolution. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  7. New Treatments for Spinal Nerve Root Avulsion Injury

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    Thomas Carlstedt

    2016-08-01

    Full Text Available Further progress in the treatment of the longitudinal spinal cord injury has been made. In an inverted translational study, it has been demonstrated that return of sensory function can be achieved by bypassing the avulsed dorsal root ganglion neurons. Dendritic growth from spinal cord sensory neurons could replace dorsal root ganglion axons and re-establish a reflex arch. Another research avenue has led to the development of adjuvant therapy for regeneration following dorsal root to spinal cord implantation in root avulsion injury. A small, lipophilic molecule that can be given orally acts on the retinoic acid receptor system as an agonist. Upregulation of dorsal root ganglion regenerative ability and organization of glia reaction to injury were demonstrated in treated animals. The dual effect of this substance may open new avenues for the treatment of root avulsion and spinal cord injuries.

  8. Role of TRPM8 in dorsal root ganglion in nerve injury-induced chronic pain

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    Su Lin

    2011-11-01

    Full Text Available Abstract Background Chronic neuropathic pain is an intractable pain with few effective treatments. Moderate cold stimulation can relieve pain, and this may be a novel train of thought for exploring new methods of analgesia. Transient receptor potential melastatin 8 (TRPM8 ion channel has been proposed to be an important molecular sensor for cold. Here we investigate the role of TRPM8 in the mechanism of chronic neuropathic pain using a rat model of chronic constriction injury (CCI to the sciatic nerve. Results Mechanical allodynia, cold and thermal hyperalgesia of CCI rats began on the 4th day following surgery and maintained at the peak during the period from the 10th to 14th day after operation. The level of TRPM8 protein in L5 dorsal root ganglion (DRG ipsilateral to nerve injury was significantly increased on the 4th day after CCI, and reached the peak on the 10th day, and remained elevated on the 14th day following CCI. This time course of the alteration of TRPM8 expression was consistent with that of CCI-induced hyperalgesic response of the operated hind paw. Besides, activation of cold receptor TRPM8 of CCI rats by intrathecal application of menthol resulted in the inhibition of mechanical allodynia and thermal hyperalgesia and the enhancement of cold hyperalgesia. In contrast, downregulation of TRPM8 protein in ipsilateral L5 DRG of CCI rats by intrathecal TRPM8 antisense oligonucleotide attenuated cold hyperalgesia, but it had no effect on CCI-induced mechanical allodynia and thermal hyperalgesia. Conclusions TRPM8 may play different roles in mechanical allodynia, cold and thermal hyperalgesia that develop after nerve injury, and it is a very promising research direction for the development of new therapies for chronic neuroapthic pain.

  9. Particulate versus non-particulate corticosteroids for transforaminal nerve root blocks. Comparison of outcomes in 494 patients with lumbar radiculopathy

    Energy Technology Data Exchange (ETDEWEB)

    Bensler, Susanne; Sutter, Reto; Pfirrmann, Christian W.A.; Peterson, Cynthia K. [Orthopaedic University Hospital Balgrist, Department of Radiology, Zurich (Switzerland); University of Zurich, Faculty of Medicine, Zurich (Switzerland)

    2018-03-15

    We set out to compare outcomes in CT-guided lumbar transforaminal nerve root block patients receiving either particulate or non-particulate corticosteroids. This was a retrospective comparative effectiveness outcomes study on two cohorts of lumbar radiculopathy patients. 321 received particulate and 173 non-particulate corticosteroids at CT-guided transforaminal lumbar nerve root injections. The particulate steroid was used from October 2009 until May 2014 and the non-particulate steroid was used from May 2014. Pain levels were collected at baseline using an 11-point numerical rating scale (NRS) and at 1 day, 1 week and 1 month. Overall 'improvement' was assessed using the Patients' Global Impression of Change (PGIC) at these same time points (primary outcome). The proportions of patients 'improved' were compared between the two groups using the Chi-square test. The NRS change scores were compared using the unpaired t-test. A significantly higher proportion of patients treated with particulate steroids were improved at 1 week (43.2 % vs. 27.7 %, p = 0.001) and at 1 month (44.3 % vs. 33.1 %, p = 0.019). Patients receiving particulate steroids also had significantly higher NRS change scores at 1 week (p = 0.02) and 1 month (p = 0.007). Particulate corticosteroids have significantly better outcomes than non-particulate corticosteroids. (orig.)

  10. Coordination of membrane and actin cytoskeleton dynamics during filopodia protrusion.

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    Changsong Yang

    2009-05-01

    Full Text Available Leading edge protrusion of migrating cells involves tightly coordinated changes in the plasma membrane and actin cytoskeleton. It remains unclear whether polymerizing actin filaments push and deform the membrane, or membrane deformation occurs independently and is subsequently stabilized by actin filaments. To address this question, we employed an ability of the membrane-binding I-BAR domain of IRSp53 to uncouple the membrane and actin dynamics and to induce filopodia in expressing cells. Using time-lapse imaging and electron microscopy of IRSp53-I-BAR-expressing B16F1 melanoma cells, we demonstrate that cells are not able to protrude or maintain durable long extensions without actin filaments in their interior, but I-BAR-dependent membrane deformation can create a small and transient space at filopodial tips that is subsequently filled with actin filaments. Moreover, the expressed I-BAR domain forms a submembranous coat that may structurally support these transient actin-free protrusions until they are further stabilized by the actin cytoskeleton. Actin filaments in the I-BAR-induced filopodia, in contrast to normal filopodia, do not have a uniform length, are less abundant, poorly bundled, and display erratic dynamics. Such unconventional structural organization and dynamics of actin in I-BAR-induced filopodia suggests that a typical bundle of parallel actin filaments is not necessary for generation and mechanical support of the highly asymmetric filopodial geometry. Together, our data suggest that actin filaments may not directly drive the protrusion, but only stabilize the space generated by the membrane deformation; yet, such stabilization is necessary for efficient protrusion.

  11. Effect of microscale protrusions on local fluid flow and mass transport in the presence of forced convection

    Energy Technology Data Exchange (ETDEWEB)

    Matzen, Gehard W. [Univ. of California, Berkeley, CA (United States)

    1997-01-01

    Three-dimensional creeping flow around single, axisymmetric protrusions is studied numerically using the boundary-integral technique. Emphasis is placed upon cylindrical protrusions on plane walls for various height-to-radius (h-to-a) aspect ratios, but cones and sections of spheres protruding from plane walls are also briefly examined. The presented items include shear-stress distributions, shear-stress contours, extents of the fluid-flow disturbance, total forces and torques on the cylinders, streamlines, and skin-friction lines. Also included is a discussion of flow topology around axisymmetric geometries. No flow reversal is observed for cylindrical protrusions with aspect ratios greater than 2.4 to 2.6. At higher aspect ratios, the fluid tends to be swept around cylindrical protrusions with little vertical motion. At lower aspect ratios, the strength of the recirculation increases, and the recirculation region becomes wider in the transverse direction and narrower in the flow direction. Also, the recirculation pattern begins to resemble the closed streamline patterns in two-dimensional flow over square ridges. However, unlike two-dimensional flow, closed streamline patterns are not observed. For arbitrary axisymmetric geometries, the extent of the fluid-flow disturbance can be estimated with the total force that is exerted on the protrusion. When the same force is exerted on protrusions with different aspect ratios, the protrusion with the higher aspect ratio tends to have a greater disturbance in the flow direction and a smaller disturbance in the transverse direction. The total force exerted on cylindrical protrusions with rounded corners is only slightly lower than the total force exerted on cylindrical protrusions with sharp corners.

  12. Assessment of Normal Eyeball Protrusion Using Computed Tomographic Imaging and Three-Dimensional Reconstruction in Korean Adults.

    Science.gov (United States)

    Shin, Kang-Jae; Gil, Young-Chun; Lee, Shin-Hyo; Kim, Jeong-Nam; Yoo, Ja-Young; Kim, Soon-Heum; Choi, Hyun-Gon; Shin, Hyun Jin; Koh, Ki-Seok; Song, Wu-Chul

    2017-01-01

    The aim of the present study was to assess normal eyeball protrusion from the orbital rim using two- and three-dimensional images and demonstrate the better suitability of CT images for assessment of exophthalmos. The facial computed tomographic (CT) images of Korean adults were acquired in sagittal and transverse views. The CT images were used in reconstructing three-dimensional volume of faces using computer software. The protrusion distances from orbital rims and the diameters of eyeballs were measured in the two views of the CT image and three-dimensional volume of the face. Relative exophthalmometry was calculated by the difference in protrusion distance between the right and left sides. The eyeball protrusion was 4.9 and 12.5 mm in sagittal and transverse views, respectively. The protrusion distances were 2.9 mm in the three-dimensional volume of face. There were no significant differences between right and left sides in the degree of protrusion, and the difference was within 2 mm in more than 90% of the subjects. The results of the present study will provide reliable criteria for precise diagnosis and postoperative monitoring using CT imaging of diseases such as thyroid-associated ophthalmopathy and orbital tumors.

  13. Signaling by Cellular Protrusions: Keeping the Conversation Private.

    Science.gov (United States)

    Buszczak, Michael; Inaba, Mayu; Yamashita, Yukiko M

    2016-07-01

    Information exchange between different cells makes multicellular life possible. Signaling between cells can occur over long distances, as in the case of hormone signaling, or it can take place over short distances between immediately juxtaposed neighbors, as in the case of stem cell-niche signaling. The ability of signal-sending and -receiving cells to communicate with one another in a specific manner is of paramount importance in the proper development and function of tissues. Growing evidence indicates that different cellular protrusions help to achieve specificity in signaling that occurs between distinct cell types. Here, we focus on new roles for cellular protrusions in cell-to-cell communication, drawing special attention to how stem cells use specialized extensions to promote reception of self-renewing signals emanating from the niche. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. Increased response to glutamate in small diameter dorsal root ganglion neurons after sciatic nerve injury.

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    Kerui Gong

    Full Text Available Glutamate in the peripheral nervous system is involved in neuropathic pain, yet we know little how nerve injury alters responses to this neurotransmitter in primary sensory neurons. We recorded neuronal responses from the ex-vivo preparations of the dorsal root ganglia (DRG one week following a chronic constriction injury (CCI of the sciatic nerve in adult rats. We found that small diameter DRG neurons (30 µm were unaffected. Puff application of either glutamate, or the selective ionotropic glutamate receptor agonists alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA and kainic acid (KA, or the group I metabotropic receptor (mGluR agonist (S-3,5-dihydroxyphenylglycine (DHPG, induced larger inward currents in CCI DRGs compared to those from uninjured rats. N-methyl-D-aspartate (NMDA-induced currents were unchanged. In addition to larger inward currents following CCI, a greater number of neurons responded to glutamate, AMPA, NMDA, and DHPG, but not to KA. Western blot analysis of the DRGs revealed that CCI resulted in a 35% increase in GluA1 and a 60% decrease in GluA2, the AMPA receptor subunits, compared to uninjured controls. mGluR1 receptor expression increased by 60% in the membrane fraction, whereas mGluR5 receptor subunit expression remained unchanged after CCI. These results show that following nerve injury, small diameter DRG neurons, many of which are nociceptive, have increased excitability and an increased response to glutamate that is associated with changes in receptor expression at the neuronal membrane. Our findings provide further evidence that glutamatergic transmission in the periphery plays a role in nociception.

  15. Upregulation of EMMPRIN (OX47 in Rat Dorsal Root Ganglion Contributes to the Development of Mechanical Allodynia after Nerve Injury

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    Qun Wang

    2015-01-01

    Full Text Available Matrix metalloproteinases (MMPs are widely implicated in inflammation and tissue remodeling associated with various neurodegenerative diseases and play an important role in nociception and allodynia. Extracellular Matrix Metalloproteinase Inducer (EMMPRIN plays a key regulatory role for MMP activities. However, the role of EMMPRIN in the development of neuropathic pain is not clear. Western blotting, real-time quantitative RT-PCR (qRT-PCR, and immunofluorescence were performed to determine the changes of messenger RNA and protein of EMMPRIN/OX47 and their cellular localization in the rat dorsal root ganglion (DRG after nerve injury. Paw withdrawal threshold test was examined to evaluate the pain behavior in spinal nerve ligation (SNL model. The lentivirus containing OX47 shRNA was injected into the DRG one day before SNL. The expression level of both mRNA and protein of OX47 was markedly upregulated in ipsilateral DRG after SNL. OX47 was mainly expressed in the extracellular matrix of DRG. Administration of shRNA targeted against OX47 in vivo remarkably attenuated mechanical allodynia induced by SNL. In conclusion, peripheral nerve injury induced upregulation of OX47 in the extracellular matrix of DRG. RNA interference against OX47 significantly suppressed the expression of OX47 mRNA and the development of mechanical allodynia. The altered expression of OX47 may contribute to the development of neuropathic pain after nerve injury.

  16. Nerve transfer to relieve pain in upper brachial plexus injuries: Does it work?

    Science.gov (United States)

    Emamhadi, Mohammadreza; Andalib, Sasan

    2017-12-01

    Patients with C5 and C6 nerve root avulsion may complain from pain. For these patients, end-to-side nerve transfer of the superficial radial nerve into the median nerve is suggested to relieve pain. Eleven patients (with a primary brachial plexus reconstruction) undergoing end-to-side nerve transfer of the superficial radial nerve into the ulnovolar part of the median nerve were assessed. Pain before surgery was compared to that at 6-month follow-up using visual analog scale (VAS) scores. A significant difference was seen between the mean VAS before (8.5) and after surgery (0.7) (P=0.0). After the six-month follow-up, 6 patients felt no pain according to VAS, notwithstanding 5 patients with a mild pain. The evidence from the present study suggests that end-to-side nerve transfer of the superficial radial nerve into the ulnovolar part of the median nerve is an effective technique in reducing pain in patients with C5 and C6 nerve root avulsion. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Do L5 and s1 nerve root compressions produce radicular pain in a dermatomal pattern?

    Science.gov (United States)

    Taylor, Christopher S; Coxon, Andrew J; Watson, Paul C; Greenough, Charles G

    2013-05-20

    Observational case series. To compare the pattern of distribution of radicular pain with published dermatome charts. Dermatomal charts vary and previous studies have demonstrated significant individual subject variation. Patients with radiologically and surgically proven nerve root compression (NRC) caused by prolapsed intervertebral disc completed computerized diagrams of the distribution of pain and pins and needles. Ninety-eight patients had L5 compressions and 83 had S1 compressions. The distribution of pain and pins and needles did not correspond well with dermatomal patterns. Of those patients with L5 NRC, only 22 (22.4%) recorded any hits on the L5 dermatome on the front, and only 60 (61.2%) on the back with only 13 (13.3%) on both. Only 1 (1.0%) patient placed more than 50% of their hits within the L5 dermatome. Of those patients with S1 NRC, only 3 (3.6%) recorded any hits on the S1 dermatome on the front, and only 64 (77.1%) on the back with only 15 (18.1%) on both. No patients placed more than 50% of their hits within the S1 dermatome. Regarding pins and needles, 27 (29.7%) patients with L5 NRC recorded hits on the front alone, 27 (29.7%) on the back alone, and 14 (15.4%) on both. Nineteen (20.9%) recorded more than 50% of hits within the L5 dermatome. Three (3.6%) patients with S1 NRC recorded hits on the front alone, 44 (53.0%) on the back alone, and 18 (21.7%) on both. Twelve (14.5%) recorded more than 50% of hits within the S1 dermatome. Patient report is an unreliable method of identifying the anatomical source of pain or paresthesia caused by nerve root compression. 4.

  18. Fluoroscopically Guided Extraforaminal Cervical Nerve Root Blocks: Analysis of Epidural Flow of the Injectate with Respect to Needle Tip Position

    Science.gov (United States)

    Shipley, Kyle; Riew, K. Daniel; Gilula, Louis A.

    2013-01-01

    Study Design Retrospective evaluation of consecutively performed fluoroscopically guided cervical nerve root blocks. Objective To describe the incidence of injectate central epidural flow with respect to needle tip position during fluoroscopically guided extraforaminal cervical nerve root blocks (ECNRBs). Methods Between February 19, 2003 and June 11, 2003, 132 consecutive fluoroscopically guided ECNRBs performed with contrast media in the final injected material (injectate) were reviewed on 95 patients with average of 1.3 injections per patient. Fluoroscopic spot images documenting the procedure were obtained as part of standard quality assurance. An independent observer not directly involved in the procedures retrospectively reviewed the images, and the data were placed into a database. Image review was performed to determine optimal needle tip positioning for injectate epidural flow. Results Central epidural injectate flow was obtained in only 28.9% of injections with the needle tip lateral to midline of the lateral mass (zone 2). 83.8% of injectate went into epidural space when the needle tip was medial to midline of the lateral mass (zone 3). 100% of injectate flowed epidurally when the needle tip was medial to or at the medial cortex of the lateral mass (zone 4). There was no statistically significant difference with regards to central epidural flow and the needle tip position on lateral view. Conclusion To ensure central epidural flow with ECNRBs one must be prepared to pass the needle tip medial to midplane of the lateral mass or to medial cortex of the lateral mass. Approximately 16% of ECNRBs with needle tip medial to midline of the lateral mass did not flow into epidural space. One cannot claim a nerve block is an epidural block unless epidural flow of injectate is observed. PMID:24494176

  19. Numerical investigation of thermal-hydraulic performance of channel with protrusions by turbulent cross flow jet

    Science.gov (United States)

    Sahu, M. K.; Pandey, K. M.; Chatterjee, S.

    2018-05-01

    In this two dimensional numerical investigation, small rectangular channel with right angled triangular protrusions in the bottom wall of test section is considered. A slot nozzle is placed at the middle of top wall of channel which impinges air normal to the protruded surface. A duct flow and nozzle flow combined to form cross flow which is investigated for heat transfer enhancement of protruded channel. The governing equations for continuity, momentum, energy along with SST k-ω turbulence model are solved with finite volume based Computational fluid dynamics code ANSYS FLUENT 14.0. The range of duct Reynolds number considered for this analysis is 8357 to 51760. The ratios of pitch of protrusion to height of duct considered are 0.5, 0.64 and 0.82. The ratios of height of protrusion to height of duct considered are 0.14, 0.23 and 0.29. The effect of duct Reynolds number, pitch and height of protrusion on thermal-hydraulic performance is studied under cross flow condition. It is found that heat transfer rate is more at relatively larger pitch and small pressure drop is found in case of low height of protrusion.

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

    Directory of Open Access Journals (Sweden)

    Ying Liu

    2015-01-01

    Full Text Available Phrenic nerve transfer is a major dynamic treatment used to repair brachial plexus root avulsion. We analyzed 72 relevant articles on phrenic nerve transfer to repair injured brachial plexus that were indexed by Science Citation Index. The keywords searched were brachial plexus injury, phrenic nerve, repair, surgery, protection, nerve transfer, and nerve graft. In addition, we performed neurophysiological analysis of the preoperative condition and prognosis of 10 patients undergoing ipsilateral phrenic nerve transfer to the musculocutaneous nerve in our hospital from 2008 to 201 3 and observed the electromyograms of the biceps brachii and motor conduction function of the musculocutaneous nerve. Clinically, approximately 28% of patients had brachial plexus injury combined with phrenic nerve injury, and injured phrenic nerve cannot be used as a nerve graft. After phrenic nerve transfer to the musculocutaneous nerve, the regenerated potentials first appeared at 3 months. Recovery of motor unit action potential occurred 6 months later and became more apparent at 12 months. The percent of patients recovering ′excellent′ and ′good′ muscle strength in the biceps brachii was 80% after 18 months. At 12 months after surgery, motor nerve conduction potential appeared in the musculocutaneous nerve in seven cases. These data suggest that preoperative evaluation of phrenic nerve function may help identify the most appropriate nerve graft in patients with an injured brachial plexus. The functional recovery of a transplanted nerve can be dynamically observed after the surgery.

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

    Science.gov (United States)

    Liu, Ying; Xu, Xun-Cheng; Zou, Yi; Li, Su-Rong; Zhang, Bin; Wang, Yue

    2015-02-01

    Phrenic nerve transfer is a major dynamic treatment used to repair brachial plexus root avulsion. We analyzed 72 relevant articles on phrenic nerve transfer to repair injured brachial plexus that were indexed by Science Citation Index. The keywords searched were brachial plexus injury, phrenic nerve, repair, surgery, protection, nerve transfer, and nerve graft. In addition, we performed neurophysiological analysis of the preoperative condition and prognosis of 10 patients undergoing ipsilateral phrenic nerve transfer to the musculocutaneous nerve in our hospital from 2008 to 201 3 and observed the electromyograms of the biceps brachii and motor conduction function of the musculocutaneous nerve. Clinically, approximately 28% of patients had brachial plexus injury combined with phrenic nerve injury, and injured phrenic nerve cannot be used as a nerve graft. After phrenic nerve transfer to the musculocutaneous nerve, the regenerated potentials first appeared at 3 months. Recovery of motor unit action potential occurred 6 months later and became more apparent at 12 months. The percent of patients recovering 'excellent' and 'good' muscle strength in the biceps brachii was 80% after 18 months. At 12 months after surgery, motor nerve conduction potential appeared in the musculocutaneous nerve in seven cases. These data suggest that preoperative evaluation of phrenic nerve function may help identify the most appropriate nerve graft in patients with an injured brachial plexus. The functional recovery of a transplanted nerve can be dynamically observed after the surgery.

  2. Membrane Protrusion Coarsening and Nanotubulation within Giant Unilamellar Vesicles

    KAUST Repository

    Węgrzyn, Ilona; Jeffries, Gavin D. M.; Nagel, Birgit; Katterle, Martin; Gerrard, Simon R.; Brown, Tom; Orwar, Owe; Jesorka, Aldo

    2011-01-01

    implementation of an IR laser via an optical fiber, enabling localized directed heating. Polymer-membrane interactions were monitored using confocal imaging techniques as subsequent membrane protrusions occurred and lipid nanotubes formed in response

  3. Neurofibroma Derived from the Deep Peroneal Nerve: A Case Report

    Directory of Open Access Journals (Sweden)

    Li-Ren Chang

    2006-06-01

    Full Text Available Neurofibromas may arise anywhere along a nerve from the dorsal root ganglion to the terminal nerve branches; however, peroneal nerve involvement is not common. Surgical resection of neurofibroma with total preservation of nerve function had been thought to be difficult. Here, we report a case of an intermuscular intraneural neurofibroma derived from the deep peroneal nerve in a patient with neurofibromatosis type 1. The diagnostic criteria, characteristics of imaging studies, and operative approach are described. The function of the deep peroneal nerve was preserved, with satisfactory results.

  4. Patterns of motor activity in the isolated nerve cord of the octopus arm.

    Science.gov (United States)

    Gutfreund, Yoram; Matzner, Henry; Flash, Tamar; Hochner, Binyamin

    2006-12-01

    The extremely flexible octopus arm provides a unique opportunity for studying movement control in a highly redundant motor system. We describe a novel preparation that allows analysis of the peripheral nervous system of the octopus arm and its interaction with the muscular and mechanosensory elements of the arm's intrinsic muscular system. First we examined the synaptic responses in muscle fibers to identify the motor pathways from the axial nerve cord of the arm to the surrounding musculature. We show that the motor axons project to the muscles via nerve roots originating laterally from the arm nerve cord. The motor field of each nerve is limited to the region where the nerve enters the arm musculature. The same roots also carry afferent mechanosensory information from the intrinsic muscle to the axial nerve cord. Next, we characterized the pattern of activity generated in the dorsal roots by electrically stimulating the axial nerve cord. The evoked activity, although far reaching and long lasting, cannot alone account for the arm extension movements generated by similar electrical stimulation. The mismatch between patterns of activity in the isolated cord and in an intact arm may stem from the involvement of mechanosensory feedback in natural arm extension.

  5. Successful treatment of Class II malocclusion with bidental protrusion using standard edgewise prescription

    Directory of Open Access Journals (Sweden)

    Mohd Ayaz

    2016-01-01

    Full Text Available This case report deals with the successful orthodontic treatment of a 14-year-old female patient having Class II malocclusion with bidental protrusion using standard edgewise prescription. She reported with forwardly placed upper front teeth and difficulty in closing lips. She had prognathic maxilla, retrognathic mandible, and full cusp Class II molar and canine relation bilaterally with overjet of 7 mm. She was in cervical vertebrae maturation indicator Stage IV. The case was treated by fixed extraction mechanotherapy. Interarch Class II mechanics was used to retract the upper incisor and to mesialize the lower molars. Simultaneously, Class I mechanics was used to upright lower incisors. Tip back bend, curve of Spee, and extra palatal root torque were incorporated in upper archwire to maintain molars in upright position and prevent extrusion and deepening of bite, respectively. There was satisfactory improvement in facial profile at the end of 24 months. After a follow-up of 6 months, occlusion was stable.

  6. An update-tissue engineered nerve grafts for the repair of peripheral nerve injuries.

    Science.gov (United States)

    Patel, Nitesh P; Lyon, Kristopher A; Huang, Jason H

    2018-05-01

    Peripheral nerve injuries (PNI) are caused by a range of etiologies and result in a broad spectrum of disability. While nerve autografts are the current gold standard for the reconstruction of extensive nerve damage, the limited supply of autologous nerve and complications associated with harvesting nerve from a second surgical site has driven groups from multiple disciplines, including biomedical engineering, neurosurgery, plastic surgery, and orthopedic surgery, to develop a suitable or superior alternative to autografting. Over the last couple of decades, various types of scaffolds, such as acellular nerve grafts (ANGs), nerve guidance conduits, and non-nervous tissues, have been filled with Schwann cells, stem cells, and/or neurotrophic factors to develop tissue engineered nerve grafts (TENGs). Although these have shown promising effects on peripheral nerve regeneration in experimental models, the autograft has remained the gold standard for large nerve gaps. This review provides a discussion of recent advances in the development of TENGs and their efficacy in experimental models. Specifically, TENGs have been enhanced via incorporation of genetically engineered cells, methods to improve stem cell survival and differentiation, optimized delivery of neurotrophic factors via drug delivery systems (DDS), co-administration of platelet-rich plasma (PRP), and pretreatment with chondroitinase ABC (Ch-ABC). Other notable advancements include conduits that have been bioengineered to mimic native nerve structure via cell-derived extracellular matrix (ECM) deposition, and the development of transplantable living nervous tissue constructs from rat and human dorsal root ganglia (DRG) neurons. Grafts composed of non-nervous tissues, such as vein, artery, and muscle, will be briefly discussed.

  7. DIC imaging for identification of motor and sensory nerves

    Directory of Open Access Journals (Sweden)

    Dayu Chen

    2016-09-01

    Full Text Available Identification of motor and sensory nerves is important in applications such as nerve injury repair. Conventional practice relies on time consuming staining methods for this purpose. Here, we use laser scanning infrared differential interference contrast (IR-DIC microscopy for label-free observation of the two types of nerve. Ventral and dorsal nerve roots of adult beagle dogs were collected and sections of different thicknesses were imaged with an IR-DIC microscope. Different texture patterns of the IR-DIC images of the motor and sensory nerve can be distinguished when the section thickness increases to 40μm. This suggests that nerve fibers in motor and sensory nerves have different distribution patterns. The result hints a potential new way for more rapid identification of nerve type in peripheral nerve repair surgery.

  8. [Treatment of adult bimaxillary arch protrusion with micro-implant anchorage].

    Science.gov (United States)

    Chen, Cheng; Zhang, Xiao-Rong

    2015-02-01

    In this study, micro-implants were used in 15 adult patients with mild and moderate bimaxillary arch protrusion or crowding. Cephalometric analysis was used to analyze hard and soft-tissues change before and after treatment, with the aim to investigate the effects of treatment on adult bimaxillary arch protrusion with micro-implant anchorage. Fifteen adult patients with mild and moderate bimaxillary arch protrusion were selected in this study. Micro-implants were inserted into the zygomaticoalveolar ridge of maxilla and the external oblique line of mandible. A NiTi coil spring was attached to the micro-implant to drag the whole upper and lower dentition for distal movement. Cephalometrics were taken before and after treatment, and the changes of soft and hard-tissue profile were studied. SPSS13.0 software package was used to analyze the data. (1)Sixty micro-implants remained stable.(2)SNA, SNB had no significant changes (P>0.05), and the relationship between the maxilla and the mandible did not change significantly. U1/NA, U1-NA, L1/NB, L1-NB and U1/L1 changes in hard tissue had significant difference in cephalometric measurement (PMicro-implant can provide not only excellent skeletal anchorage but also a novel way to distalize the whole dentition efficiently.

  9. 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

  10. Prominin-2 expression increases protrusions, decreases caveolae and inhibits Cdc42 dependent fluid phase endocytosis

    Energy Technology Data Exchange (ETDEWEB)

    Singh, Raman Deep, E-mail: Takhter.Ramandeep@mayo.edu; Schroeder, Andreas S.; Scheffer, Luana; Holicky, Eileen L.; Wheatley, Christine L.; Marks, David L., E-mail: Marks.david@mayo.edu; Pagano, Richard E.

    2013-05-10

    Highlights: •Prominin-2 expression induced protrusions that co-localized with lipid raft markers. •Prominin-2 expression decreased caveolae, caveolar endocytosis and increased pCav1. •Prominin-2 expression inhibited fluid phase endocytosis by inactivation of Cdc42. •These endocytic effects can be reversed by adding exogenous cholesterol. •Caveolin1 knockdown restored fluid phase endocytosis in Prominin2 expressing cells. -- Abstract: Background: Membrane protrusions play important roles in biological processes such as cell adhesion, wound healing, migration, and sensing of the external environment. Cell protrusions are a subtype of membrane microdomains composed of cholesterol and sphingolipids, and can be disrupted by cholesterol depletion. Prominins are pentaspan membrane proteins that bind cholesterol and localize to plasma membrane (PM) protrusions. Prominin-1 is of great interest as a marker for stem and cancer cells, while Prominin-2 (Prom2) is reportedly restricted to epithelial cells. Aim: To characterize the effects of Prom-2 expression on PM microdomain organization. Methods: Prom2-fluorescent protein was transfected in human skin fibroblasts (HSF) and Chinese hamster ovary (CHO) cells for PM raft and endocytic studies. Caveolae at PM were visualized using transmission electron microscopy. Cdc42 activation was measured and caveolin-1 knockdown was performed using siRNAs. Results: Prom2 expression in HSF and CHO cells caused extensive Prom2-positive protrusions that co-localized with lipid raft markers. Prom2 expression significantly decreased caveolae at the PM, reduced caveolar endocytosis and increased caveolin-1 phosphorylation. Prom2 expression also inhibited Cdc42-dependent fluid phase endocytosis via decreased Cdc42 activation. Effects on endocytosis were reversed by addition of cholesterol. Knockdown of caveolin-1 by siRNA restored Cdc42 dependent fluid phase endocytosis in Prom2-expressing cells. Conclusions: Prom2 protrusions primarily

  11. Imaging the trigeminal nerve

    International Nuclear Information System (INIS)

    Borges, Alexandra; Casselman, Jan

    2010-01-01

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

  12. Imaging the trigeminal nerve

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-05-15

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

  13. Regional Aggressive Root Resorption Caused by Neuronal Virus Infection

    Directory of Open Access Journals (Sweden)

    Inger Kjær

    2012-01-01

    Full Text Available During orthodontic treatment, root resorption can occur unexplainably. No clear distinction has been made between resorption located within specific regions and resorption occurring generally in the dentition. The purpose is to present cases with idiopathic (of unknown origin root resorption occurring regionally. Two cases of female patients, 26 and 28 years old, referred with aggressive root resorption were investigated clinically and radiographically. Anamnestic information revealed severe virus diseases during childhood, meningitis in one case and whooping cough in the other. One of the patients was treated with dental implants. Virus spreading along nerve paths is a possible explanation for the unexpected resorptions. In both cases, the resorptions began cervically. The extent of the resorption processes in the dentition followed the virus infected nerve paths and the resorption process stopped when reaching regions that were innervated differently and not infected by virus. In one case, histological examination revealed multinuclear dentinoclasts. The pattern of resorption in the two cases indicates that innervation is a factor, which under normal conditions may protect the root surface against resorption. Therefore, the normal nerve pattern is important for diagnostics and for predicting the course of severe unexpected root resorption.

  14. Nasal-Type Extranodal Natural Killer/T-cell Neurolymphomatosis Confined to the Lumbar Nerve Roots: A Case Report

    International Nuclear Information System (INIS)

    Park, Jong Chun; Mun, Sung Hee; Lee, Young Hwan

    2009-01-01

    Neurolymphomatosis refers to lymphoma that has infiltrated the peripheral nervous system and this is the least common clinical presentation of nervous system lymphoma. Most neurolymphomatosis is due to B-cell non-Hodgkin lymphoma, and most patients show lymphomatous infiltration in the meninges and brain parenchyma, in addition to peripheral nervous system involvement. We diagnosed a case of neurolymphomatosis that was confined to the right 4th and 5th lumbar nerve roots without involvement of the meninges or brain parenchyma in a patient with the nasal-type extranodal natural killer/T-cell lymphoma. We made this diagnosis based on the MRI and 18F-FDG PET-CT findings and the clinical manifestations

  15. Nasal-Type Extranodal Natural Killer/T-cell Neurolymphomatosis Confined to the Lumbar Nerve Roots: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jong Chun; Mun, Sung Hee; Lee, Young Hwan [Catholic University, Daegu (Korea, Republic of)

    2009-11-15

    Neurolymphomatosis refers to lymphoma that has infiltrated the peripheral nervous system and this is the least common clinical presentation of nervous system lymphoma. Most neurolymphomatosis is due to B-cell non-Hodgkin lymphoma, and most patients show lymphomatous infiltration in the meninges and brain parenchyma, in addition to peripheral nervous system involvement. We diagnosed a case of neurolymphomatosis that was confined to the right 4th and 5th lumbar nerve roots without involvement of the meninges or brain parenchyma in a patient with the nasal-type extranodal natural killer/T-cell lymphoma. We made this diagnosis based on the MRI and 18F-FDG PET-CT findings and the clinical manifestations.

  16. Enhancing Peripheral Nerve Regeneration with a Novel Drug-Delivering Nerve Conduit

    Science.gov (United States)

    2015-10-01

    our novel nerve conduit. 15. SUBJECT TERMS 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 19a. NAME OF RESPONSIBLE...growth in dorsal root ganglion ( DRG ) cell culture Tasks/Subtasks: 1. In Vitro NGF/GNDF release kinetics experiments.......................... (Gale...Axonal growth of DRGs ................................................................ (Terry, Shea) (11-18months) Progress: We have started these

  17. An evaluation of self-esteem and quality of life in orthodontic patients: effects of crowding and protrusion.

    Science.gov (United States)

    Jung, Min-Ho

    2015-09-01

    To evaluate the effect of dental crowding and lip protrusion on self-esteem and quality of life (QOL) in female orthodontic patients with Class I malocclusion. The study sample consisted of 201 patients (mean age 22.6 ± 3.0 years) who sought orthodontic treatment. All the patients were evaluated before treatment in terms of their degree of dental crowding and lip protrusion. Rosenberg's Self-Esteem Scale and the Orthognathic Quality of Life Questionnaire (OQLQ) were used to determine self-esteem and QOL and to evaluate whether these values were related to malocclusion severity. The results indicated that severe crowding and severe protrusion can result in lower self-esteem and poorer QOL (P self-esteem and QOL scores than severe crowding or protrusion patients.

  18. Comparative study of phrenic nerve transfers with and without nerve graft for elbow flexion after global brachial plexus injury.

    Science.gov (United States)

    Liu, Yuzhou; Lao, Jie; Gao, Kaiming; Gu, Yudong; Zhao, Xin

    2014-01-01

    Nerve transfer is a valuable surgical technique in peripheral nerve reconstruction, especially in brachial plexus injuries. Phrenic nerve transfer for elbow flexion was proved to be one of the optimal procedures in the treatment of brachial plexus injuries in the study of Gu et al. The aim of this study was to compare phrenic nerve transfers with and without nerve graft for elbow flexion after brachial plexus injury. A retrospective review of 33 patients treated with phrenic nerve transfer for elbow flexion in posttraumatic global root avulsion brachial plexus injury was carried out. All the 33 patients were confirmed to have global root avulsion brachial plexus injury by preoperative and intraoperative electromyography (EMG), physical examination and especially by intraoperative exploration. There were two types of phrenic nerve transfers: type1 - the phrenic nerve to anterolateral bundle of anterior division of upper trunk (14 patients); type 2 - the phrenic nerve via nerve graft to anterolateral bundle of musculocutaneous nerve (19 patients). Motor function and EMG evaluation were performed at least 3 years after surgery. The efficiency of motor function in type 1 was 86%, while it was 84% in type 2. The two groups were not statistically different in terms of Medical Research Council (MRC) grade (p=1.000) and EMG results (p=1.000). There were seven patients with more than 4 month's delay of surgery, among whom only three patients regained biceps power to M3 strength or above (43%). A total of 26 patients had reconstruction done within 4 months, among whom 25 patients recovered to M3 strength or above (96%). There was a statistically significant difference of motor function between the delay of surgery within 4 months and more than 4 months (p=0.008). Phrenic nerve transfers with and without nerve graft for elbow flexion after brachial plexus injury had no significant difference for biceps reinnervation according to MRC grading and EMG. A delay of the surgery

  19. γ-diketone central neuropathy: quantitative morphometric analysis of axons in rat spinal cord white matter regions and nerve roots

    International Nuclear Information System (INIS)

    LoPachin, Richard M.; Jortner, Bernard S.; Reid, Maria L.; Das, Soma

    2003-01-01

    A quantitative analytical method was used to measure myelinated axon morphometric parameters (e.g., axon area, ratio of axon area/fiber area, and index of circularity) in rat nervous tissue during intoxication with 2,5-hexanedione (HD). Parameters were assessed in nerve roots (dorsal and ventral) and in ascending (gracile fasciculus and spinocerebellar tract) and descending (corticospinal and rubrospinal tracts) spinal cord white matter tracts (L4-L5) of rats intoxicated with HD at two different daily dose-rates (175 or 400 mg HD/kg/day, gavage). For each dose-rate, tissue was sampled at four neurological endpoints: unaffected, slight, moderate, and severe toxicity, as determined by gait analysis and measurements of grip strength. Results indicate that, regardless of the HD dose-rate, axon atrophy (reduced axon area) was a widespread, abundant effect that developed in concert with neurological deficits. The atrophy response occurred contemporaneously in both ascending and descending spinal tracts, which suggests that loss of caliber developed simultaneously along the proximodistal axon axis. In contrast, swollen axons were a numerically small component and were present in nerve roots and spinal tracts only during subchronic intoxication at the lower HD dose-rate (i.e., 175 mg/kg/day). Intoxication at the higher dose-rate (400 mg/kg/day) produced neurological deficits in the absence of axonal swellings. These observations in conjunction with our previous studies of HD-induced peripheral neuropathy (Toxicol. Appl. Pharmacol. 135 (1995) 58; and Toxicol. Appl. Pharmacol. 165 (2000) 127) indicate that axon atrophy, and not axonal swelling, is a primary neuropathic phenomenon

  20. Glenoid fossa position in Class III malocclusion associated with mandibular protrusion.

    Science.gov (United States)

    Innocenti, Cristina; Giuntini, Veronica; Defraia, Efisio; Baccetti, Tiziano

    2009-04-01

    Our aim in this study was to investigate the position of the glenoid fossa in subjects with Class III malocclusion associated with mandibular protrusion to better clarify the role of this craniofacial component in Class III skeletal disharmony. A sample of 30 subjects, aged 8 years +/- 6 months, with skeletal and dental Class III malocclusion associated with mandibular protrusion, normal skeletal vertical relationships, and normal mandibular dimensions, was compared with a control group of 33 subjects with skeletal and dental Class I relationships. The comparisons between the Class III group and the control group on the cephalometric measures for the assessment of glenoid fossa position were performed with the Mann-Whitney U test at P <0.05. Subjects with Class III malocclusion had a significantly more mesial position of the glenoid fossa, when compared with the control group as measured with 3 parameters. An anterior position of the glenoid fossa is a possible diagnostic anatomic feature of Class III malocclusion associated with mandibular protrusion. An effective measurement to evaluate glenoid fossa position in craniofacial relationships is the cephalometric distance from the glenoid fossa to the frontomaxillary-nasal suture.

  1. Agenesis of mandibular second premolar in patient with dental bimaxillary protrusion

    Directory of Open Access Journals (Sweden)

    Carlos Alberto Estevanell Tavares

    Full Text Available ABSTRACT The present study reports the treatment carried out in a patient with mandibular second premolar agenesis associated with early loss of a deciduous second molar, deep overbite, severe overjet and dentoalveolar bimaxillary protrusion, which led to lip incompetence and a convex facial profile. The main objectives of this treatment were: to eliminate the spaces in mandibular arch, correct overbite, as well as eliminate bimaxillary protrusion and lip incompetence, thus leading to a balanced profile. The case was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO as part of the requirements to obtain the title of BBO diplomate.

  2. Neurolymphomatosis as a late relapse of non-Hodgkin's lymphoma detected by 18F-FDG PET/CT: a case report.

    Science.gov (United States)

    Kajáry, K; Molnár, Z; Mikó, I; Barsi, P; Lengyel, Z; Szakáll, S

    2014-01-01

    Neurolymphomatosis is a rare condition defined as an infiltration of nerves, nerve roots or nervous plexuses by haematological malignancy. Its diagnosis may sometimes be difficult with conventional imaging techniques. This paper aims to emphasize the importance of this entity and the role of (18)F-FDG PET/CT in this indication. We present the case of a 53-year-old male who complained of sharp pain in his right hip and right leg paresthesia after 2 years of complete remission from Non-Hodgkin's lymphoma. Physical examination and CT scan were negative and the lumbar MRI showed protrusion of L5-S1 disc. Physiotherapy, nonsteroid antiinflammatory drugs and steroids were inefficient. PET/CT was performed four months after the onset of the symptoms, revealing focal FDG uptake in the right S1 nerve root and linear FDG uptake along the right sacral plexus suggesting relapse. This was confirmed by histology. Copyright © 2013 Elsevier España, S.L. and SEMNIM. All rights reserved.

  3. Patients with low back pain differ from those who also have leg pain or signs of nerve root involvement

    DEFF Research Database (Denmark)

    Kongsted, Alice; Kent, Peter; Albert, Hanne

    2012-01-01

    ABSTRACT: BACKGROUND: Leg pain associated with low back pain (LBP) is recognized as a risk factor for a poor prognosis, and is included as a component in most LBP classification systems. The location of leg pain relative to the knee and the presence of a positive straight leg raise test have been...... only, 2) LBP and pain above the knee, 3) LBP and pain below the knee, and 4) LBP and signs of nerve root involvement. METHODS: Analysis of routine clinical data from an outpatient department. Based on patient reported data and clinical findings, patients were allocated to the QTF subgroups...

  4. Gap junctions are selectively associated with interlocking ball-and-sockets but not protrusions in the lens.

    Science.gov (United States)

    Biswas, Sondip K; Lee, Jai Eun; Brako, Lawrence; Jiang, Jean X; Lo, Woo-Kuen

    2010-11-09

    Ball-and-sockets and protrusions are specialized interlocking membrane domains between lens fibers of all species studied. Ball-and-sockets and protrusions are similar in their shape, size, and surface morphology, and are traditionally believed to play a key role in maintaining fiber-to-fiber stability. Here, we evaluate the hypothesis that ball-and-sockets and protrusions possess important structural and functional differences during fiber cell differentiation and maturation. Intact lenses of leghorn chickens (E7 days to P62 weeks old) and rhesus monkeys (1.5-20 years old) were studied with SEM, freeze-fracture TEM, freeze-fracture immunogold labeling (FRIL), and filipin cytochemistry for membrane cholesterol detection. SEM showed that ball-and-sockets were distributed along the long and short sides of hexagonal fiber cells, whereas protrusions were located along the cell corners, from superficial to deep cortical regions in both chicken and monkey lenses. Importantly, by freeze-fracture TEM, we discovered the selective association of gap junctions with all ball-and-sockets examined, but not with protrusions, in both species. In the embryonic chicken lens (E18), the abundant distribution of ball-and-socket gap junctions was regularly found in an approximate zone extending at least 300 μm deep from the equatorial surface of the superficial cortical fibers. Many ball-and-socket gap junctions often protruded deeply into neighboring cells. However, in the mature fibers of monkey lenses, several ball-and-sockets exhibited only partial occupancy of gap junctions with disorganized connexons, possibly due to degradation of gap junctions during fiber maturation and aging. FRIL analysis confirmed that both connexin46 (Cx46) and connexin50 (Cx50) antibodies specifically labeled ball-and-socket gap junctions, but not protrusions. Furthermore, filipin cytochemistry revealed that the ball-and-socket gap junctions contained different amounts of cholesterol (i.e., cholesterol

  5. Anomalous Innervation of the Median Nerve in the Arm in the Absence of the Musculocutaneous Nerve

    Directory of Open Access Journals (Sweden)

    Khursheed Raza

    2017-03-01

    Full Text Available The brachial plexus innervates the upper extremities. While variations in the formation of the brachial plexus and its terminal branches are quite common, it is uncommon for the median nerve to innervate the muscles of the arm. During the dissection of an elderly male cadaver at the Department of Anatomy, All India Institute of Medical Sciences, New Delhi, India, in 2016, the coracobrachialis muscle was found to be supplied by a direct branch from the lateral root of the median nerve and the musculocutaneous nerve was absent. The branches of the median nerve supplied the biceps brachii and brachialis muscles and the last branch continued as the lateral cutaneous nerve of the forearm. These variations may present atypically in cases of arm flexor paralysis or sensory loss on the lateral forearm. Knowledge of these variations is important in surgeries and during the administration of regional anaesthesia near the shoulder joint and upper arm.

  6. Fluxes of water through aquaporin 9 weaken membrane-cytoskeleton anchorage and promote formation of membrane protrusions.

    Directory of Open Access Journals (Sweden)

    Thommie Karlsson

    Full Text Available All modes of cell migration require rapid rearrangements of cell shape, allowing the cell to navigate within narrow spaces in an extracellular matrix. Thus, a highly flexible membrane and a dynamic cytoskeleton are crucial for rapid cell migration. Cytoskeleton dynamics and tension also play instrumental roles in the formation of different specialized cell membrane protrusions, viz. lamellipodia, filopodia, and membrane blebs. The flux of water through membrane-anchored water channels, known as aquaporins (AQPs has recently been implicated in the regulation of cell motility, and here we provide novel evidence for the role of AQP9 in the development of various forms of membrane protrusion. Using multiple imaging techniques and cellular models we show that: (i AQP9 induced and accumulated in filopodia, (ii AQP9-associated filopodial extensions preceded actin polymerization, which was in turn crucial for their stability and dynamics, and (iii minute, local reductions in osmolarity immediately initiated small dynamic bleb-like protrusions, the size of which correlated with the reduction in osmotic pressure. Based on this, we present a model for AQP9-induced membrane protrusion, where the interplay of water fluxes through AQP9 and actin dynamics regulate the cellular protrusive and motile activity of cells.

  7. Bilateral absence of musculocutaneous nerve

    Directory of Open Access Journals (Sweden)

    Mathada V Ravishankar

    2012-01-01

    Full Text Available Brachial plexus is an important group of spinal nerve plexus that supplies the muscles of the upper limb via the ventral rami of the Cervical 5 - Thoracic 1 fibers of the spinal nerves. It is not uncommon to notice the variations during cadaveric dissections in many regions of the body, at different levels, such as, roots, trunks, division, cords, communications, and branches as reported in the literature. Although the nerve supply of the body musculature takes place in the fetal life itself, its course, branching pattern, innervations, and communication can show variable patterns as the fetal development progresses. One such anomaly was noticed during our routine cadaveric dissection in the Department of Anatomy, Jawaharlal Nehru Medical College, Belgaum, showing bilateral absence of the musculocutaneous nerve, which obviously drew the attention of the students of medicine, physiotherapy, and learning clinicians as well.

  8. Redundant nerve roots of cauda equina in clinically neurologically asymptomatic patients. A clinical and radiographic study

    International Nuclear Information System (INIS)

    Otoshi, Ken-ichi; Kikuchi, Shin-ichi; Konno, Shin-ichi; Arai, Itaru

    2005-01-01

    A radiographic study was conducted to determine the incidence of redundant nerve roots of the cauda equina (RNR) in neurologically asymptomatic patients, and to clarify whether RNR has an impact on the clinical symptom. 50 patients who had spine disease such as spondylosis and compression fracture were examined by MRI. They didn't have neurological symptom such as sciatica, leg numbness, and motor weakness of lower extremities. There were 18 men and 32 women, and their mean age was 72.4 years (range: 32-87 years). RNR was found in 18 of the 50 patients (36.0%) and in a higher percentage of the patients who had lumber spinal canal stenosis. We concluded that RNR was only a morphological change of the cauda equine and had little effect on the neurological symptom. (author)

  9. Lower bounds for protrusion replacement by counting equivalence classes

    NARCIS (Netherlands)

    Jansen, B.M.P.; Wulms, J.J.H.M.; Guo, J.; Hermelin, D.

    2017-01-01

    Garnero et al. [SIAM J. Discrete Math. 2015, 29(4):1864-1894] recently introduced a framework based on dynamic programming to make applications of the protrusion replacement technique constructive and to obtain explicit upper bounds on the involved constants. They show that for several graph

  10. Lower bounds for protrusion replacement by counting equivalence classes

    NARCIS (Netherlands)

    Jansen, B.M.P.; Wulms, J.J.H.M.

    2016-01-01

    Garnero et al. [SIAM J. Discrete Math. 2015, 29(4):1864--1894] recently introduced a framework based on dynamic programming to make applications of the protrusion replacement technique constructive and to obtain explicit upper bounds on the involved constants. They show that for several graph

  11. Hindlimb spasticity after unilateral motor cortex lesion in rats is reduced by contralateral nerve root transfer.

    Science.gov (United States)

    Zong, Haiyang; Ma, Fenfen; Zhang, Laiyin; Lu, Huiping; Gong, Jingru; Cai, Min; Lin, Haodong; Zhu, Yizhun; Hou, Chunlin

    2016-12-01

    Lower extremity spasticity is a common sequela among patients with acquired brain injury. The optimum treatment remains controversial. The aim of our study was to test the feasibility and effectiveness of contralateral nerve root transfer in reducing post stroke spasticity of the affected hindlimb muscles in rats. In our study, we for the first time created a novel animal hindlimb spastic hemiplegia model in rats with photothrombotic lesion of unilateral motor cortex and we established a novel surgical procedure in reducing motor cortex lesion-induced hindlimb spastic hemiplegia in rats. Thirty six rats were randomized into three groups. In group A, rats received sham operation. In group B, rats underwent unilateral hindlimb motor cortex lesion. In group C, rats underwent unilateral hindlimb cortex lesion followed by contralateral L4 ventral root transfer to L5 ventral root of the affected side. Footprint analysis, Hoffmann reflex (H-reflex), cholera toxin subunit B (CTB) retrograde tracing of gastrocnemius muscle (GM) motoneurons and immunofluorescent staining of vesicle glutamate transporter 1 (VGLUT1) on CTB-labelled motoneurons were used to assess spasticity of the affected hindlimb. Sixteen weeks postoperatively, toe spread and stride length recovered significantly in group C compared with group B (Pmotor cortex lesion-induced hindlimb spasticity in rats. Our data indicated that this could be an alternative treatment for unilateral lower extremity spasticity after brain injury. Therefore, contralateral neurotization may exert a potential therapeutic candidate to improve the function of lower extremity in patients with spastic hemiplegia. © 2016 The Author(s).

  12. Drug Delivery for Peripheral Nerve Regeneration

    Science.gov (United States)

    2015-11-01

    enhancement in dorsal root ganglion ( DRG ) cells with the released drug. In the first year of this 18 month project we have completed device fabrication of...the nerve guide conduit and drug delivery reservoir. We were able to release NGF at a concentration that enhancing DRG nerve growth in vitro. We next...KrF excimer laser system (Optec) and with diameters larger than 100μm using the VLS3.60 CO2 system (Universal Laser Systems )) (Figure 3). The laser

  13. Evaluation of the anatomic effect of physical therapy exercises for mobilization of lumbar spinal nerves and the dura mater in dogs.

    Science.gov (United States)

    Gruenenfelder, Fredrik I; Boos, Alois; Mouwen, Marco; Steffen, Frank

    2006-10-01

    To adapt and standardize neural tissue mobilization exercises, quantify nerve root movement, and assess the anatomic effects of lumbar spinal nerve and dural mobilization in dogs. 15 canine cadavers. 5 cadavers were used in the preliminary part of the study to adapt 3 neural tissue mobilization physical therapy exercises to canine anatomy. In the other 10 cadavers, the L4 to L7 nerve roots and the dura at the level of T13 and L1 were isolated and marked. Movements during the physical therapy exercises were standardized by means of goniometric control. Movement of the nerve roots in response to each exercise was digitally measured. The effects of body weight and crownrump length on the distance of nerve root movement achieved during each exercise were also assessed. Each exercise was divided into 4 steps, and the overall distance of neural movement achieved was compared with distances achieved between steps. Neural tissue mobilization exercises elicited visible and measurable movement of nerve roots L4 to L7 and of the dura at T13 and L1 in all cadavers. The physical therapy exercises evaluated had measurable effects on nerve roots L4 to L7 and the dura mater in the T13 and L1 segments. These exercises should be evaluated in clinical trials to validate their efficacy as primary treatments or ancillary postsurgical therapy in dogs with disorders of the thoracolumbar and lumbosacral segments of the vertebral column.

  14. Axon-Sorting Multifunctional Nerve Guides: Accelerating Restoration of Nerve Function

    Science.gov (United States)

    2014-10-01

    factor (singly & in selected combinations) in the organotypic model system for preferential sensory or motor axon extension. Use confocal microscopy to...track axon extension of labeled sensory or motor neurons from spinal cord slices (motor) or dorsal root ganglia ( DRG ) (sensory). 20 Thy1-YFP mice...RESEARCH ACCOMPLISHMENTS: • Established a system of color-coded mixed nerve tracking using GFP and RFP expressing motor and sensory neurons (Figure 1

  15. Optimal measurement for "posterolateral protrusion" of the vertebral artery at the craniovertebral junction using computed tomography angiography

    Directory of Open Access Journals (Sweden)

    Junichi Ohya

    2014-01-01

    Full Text Available Purpose: Among extraosseous abnormalities of the vertebral artery (VA at the craniovertebral junction (CVJ, available evidence regarding "posterolateral protrusion," the VA running distant from the groove over the superior surface of the posterior arch of the atlas, is limited. The purpose of this study was to determine the optimal measurement to indicate posterolateral protrusion of the VA. Materials and Methods: Computed tomography angiography (CTA images of 40 consecutive patients with cervical disease were reviewed. Ultimately, 66 arteries were included in this study. Five parameters predicted to indicate posterolateral protrusion of the VA were defined (A-E and measured by two surgeons twice over a 2-week interval. Intraclass correlation coefficients (ICC were used to examine intra-observer reproducibility and inter-observer reliability. Receiver operating characteristic (ROC curve analysis was performed to determine the most optimal parameter to predict posterolateral protrusion of the VA. Results: Excellent inter-observer reliability and intra-observer reproducibility were obtained for all parameters (ICC = 0.87-0.99. Among them, parameter A, defined as the maximal length from the outer surface of the VA to the outer surface of the posterior arch of the atlas, was most accurately described posterolateral protrusion of the VA. The optimal cut-off value of parameter A obtained with ROC curves was 8.3 mm (sensitivity 97.5%, specificity 100%. Conclusions: The measurement in this study can quantitatively evaluate the posterolateral protrusion of the VA. Before posterior surgery at the CVJ, pre-operative CTA can help surgeons detect anomalous VA and reduce the risk of intra-operative VA injury.

  16. Short Lives with Long-Lasting Effects: Filopodia Protrusions in Neuronal Branching Morphogenesis.

    Directory of Open Access Journals (Sweden)

    George Leondaritis

    Full Text Available The branching behaviors of both dendrites and axons are part of a neuronal maturation process initiated by the generation of small and transient membrane protrusions. These are highly dynamic, actin-enriched structures, collectively called filopodia, which can mature in neurons to form stable branches. Consequently, the generation of filopodia protrusions is crucial during the formation of neuronal circuits and involves the precise control of an interplay between the plasma membrane and actin dynamics. In this issue of PLOS Biology, Hou and colleagues identify a Ca2+/CaM-dependent molecular machinery in dendrites that ensures proper targeting of branch formation by activation of the actin nucleator Cobl.

  17. The significance of diagnostic MRI for visualisation of trauma-induced cervical nerve root avulsion. Case report; Die Bedeutung der MRT-Diagnostik zur Darstellung traumatisch bedingter zervikaler Wurzelausrisse. Kasuistik

    Energy Technology Data Exchange (ETDEWEB)

    Muth, C P [Carl-Thiem-Klinikum, Cottbus (Germany). Inst. fuer Radiologie; Biemelt, F [Carl-Thiem-Klinikum, Cottbus (Germany). Inst. fuer Radiologie; Kamenz, M [Carl-Thiem-Klinikum, Cottbus (Germany). Inst. fuer Radiologie

    1996-11-01

    The article is intended to show the value of MRI for diagnostic visualisation and evaluation of posttraumatic nerve root avulsion as a brachial plexus injury. (orig./MG) [Deutsch] Das Ziel der Arbeit besteht in der Darstellung des Wertes der MRT-Diagnostik bei der Abklaerung traumatischer Wurzelausrisse im Bereich des Plexus brachialis. (orig./MG)

  18. Cervical Spinal Cord and Dorsal Nerve Root Stimulation for Neuropathic Upper Limb Pain.

    Science.gov (United States)

    Levine, Adrian B; Parrent, Andrew G; MacDougall, Keith W

    2017-01-01

    Spinal cord stimulation (SCS) is a well-established treatment for chronic neuropathic pain in the lower limbs. Upper limb pain comprises a significant proportion of neuropathic pain patients, but is often difficult to target specifically and consistently with paresthesias. We hypothesized that the use of dorsal nerve root stimulation (DNRS), as an option along with SCS, would help us better relieve pain in these patients. All 35 patients trialed with spinal stimulation for upper limb pain between July 1, 2011, and October 31, 2013, were included. We performed permanent implantation in 23/35 patients based on a visual analogue scale pain score decrease of ≥50% during trial stimulation. Both the SCS and DNRS groups had significant improvements in average visual analogue scale pain scores at 12 months compared with baseline, and the majority of patients in both groups obtained ≥50% pain relief. The majority of patients in both groups were able to reduce their opioid use, and on average had improvements in Short Form-36 quality of life scores. Complication rates did not differ significantly between the two groups. Treatment with SCS or DNRS provides meaningful long-term relief of chronic neuropathic pain in the upper limbs.

  19. Trigeminal nerve anatomy in neuropathic and non-neuropathic orofacial pain patients.

    Science.gov (United States)

    Wilcox, Sophie L; Gustin, Sylvia M; Eykman, Elizabeth N; Fowler, Gordon; Peck, Christopher C; Murray, Greg M; Henderson, Luke A

    2013-08-01

    Trigeminal neuralgia, painful trigeminal neuropathy, and painful temporomandibular disorders (TMDs) are chronic orofacial pain conditions that are thought to have fundamentally different etiologies. Trigeminal neuralgia and neuropathy are thought to arise from damage to or pressure on the trigeminal nerve, whereas TMD results primarily from peripheral nociceptor activation. This study sought to assess the volume and microstructure of the trigeminal nerve in these 3 conditions. In 9 neuralgia, 18 neuropathy, 20 TMD, and 26 healthy controls, the trigeminal root entry zone was selected on high-resolution T1-weighted magnetic resonance images and the volume (mm(3)) calculated. Additionally, using diffusion-tensor images (DTIs), the mean diffusivity and fractional anisotropy values of the trigeminal nerve root were calculated. Trigeminal neuralgia patients displayed a significant (47%) decrease in nerve volume but no change in DTI values. Conversely, trigeminal neuropathy subjects displayed a significant (40%) increase in nerve volume but again no change in DTI values. In contrast, TMD subjects displayed no change in volume or DTI values. The data suggest that the changes occurring within the trigeminal nerve are not uniform in all orofacial pain conditions. These structural and volume changes may have implications in diagnosis and management of different forms of chronic orofacial pain. This study reveals that neuropathic orofacial pain conditions are associated with changes in trigeminal nerve volume, whereas non-neuropathic orofacial pain is not associated with any change in nerve volume. Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.

  20. Aspects of the History of the Nerves: Bell's Theory, the Bell-Magendie Law and Controversy, and Two Forgotten Works by P.W. Lund and D.F. Eschricth

    DEFF Research Database (Denmark)

    Jørgensen, C. Barker

    2003-01-01

    History of nerves, Bell's Idea, Bell-Magendie law, Bell-Magendie controversy, Charles Bell, Francois Magendie, P.W. Lund, D.F. Eschricht, Herbert Mayo, Johannes Müller, Claude Bernard, spinal nerve roots, cranial nerves, recurrent sensitivity......History of nerves, Bell's Idea, Bell-Magendie law, Bell-Magendie controversy, Charles Bell, Francois Magendie, P.W. Lund, D.F. Eschricht, Herbert Mayo, Johannes Müller, Claude Bernard, spinal nerve roots, cranial nerves, recurrent sensitivity...

  1. Field emission study from an array of hierarchical micro protrusions on stainless steel surface generated by femtosecond pulsed laser irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Singh, A.K., E-mail: anilks@barc.gov.in [Laser & Plasma Technology Division, BARC, Mumbai, 400085 (India); Suryawanshi, Sachin R.; More, M.A. [Department of Physics, Savitribai Phule Pune University, Pune, 411007 (India); Basu, S. [Solid State Physics Division, BARC, Mumbai, 40085 (India); Sinha, Sucharita [Laser & Plasma Technology Division, BARC, Mumbai, 400085 (India)

    2017-02-28

    Highlights: • Array of self assembled micro-protrusions have been generated on stainless steel surfaces by femtosecond pulsed laser irradiation. • Density of the formed micro-protrusions is ∼5.6 × 105 protrusions/cm{sup 2}. • Laser treated surface is mainly composed of iron oxide and cementite phases. • Micro-structured sample has shown good field emission properties – low turn on field, high field enhancement factor and stable emission current. - Abstract: This paper reports our results on femtosecond (fs) pulsed laser induced surface micro/nano structuring of stainless steel 304 (SS 304) samples and their characterization in terms of surface morphology, formed material phases on laser irradiation and field emission studies. Our investigations reveal that nearly uniform and dense array of hierarchical micro-protrusions (density: ∼5.6 × 10{sup 5} protrusions/cm{sup 2}) is formed upon laser treatment. Typical tip diameters of the generated protrusions are in the range of 2–5 μm and these protrusions are covered with submicron sized features. Grazing incidence X-ray diffraction (GIXRD) analysis of the laser irradiated sample surface has shown formation mainly of iron oxides and cementite (Fe{sub 3}C) phases in the treated region. These laser micro-structured samples have shown good field emission properties such as low turn on field (∼4.1 V/μm), high macroscopic field enhancement factor (1830) and stable field emission current under ultra high vacuum conditions.

  2. The effects of anticonvulsants on 4-aminopyridine-induced bursting: in vitro studies on rat peripheral nerve and dorsal roots.

    Science.gov (United States)

    Lees, G.

    1996-01-01

    1. Aminopyridines have been used as beneficial symptomatic treatments in a variety of neurological conditions including multiple sclerosis but have been associated with considerable toxicity in the form of abdominal pain, paraesthesias and (rarely) convulsions. 2. Extracellular and intracellular recording was used to characterize action potentials in rat sciatic nerves and dorsal roots and the effects of 4-aminopyridine (4-AP). 3. In sciatic nerve trunks, 1 mM 4-AP produced pronounced after potentials at room temperature secondary to regenerative firing in affected axons (5-10 spikes per stimulus). At physiological temperatures, after potentials (2-3 spikes) were greatly attenuated in peripheral axons. 4. 4-AP evoked more pronounced and prolonged after discharges in isolated dorsal roots at 37 degrees C (3-5.5 mV and 80-100 ms succeeded by a smaller inhibitory/depolarizing voltage shift) which were used to assess the effects of anticonvulsants. 5. Phenytoin, carbamazepine and lamotrigine dose-dependently reduced the area of 4-AP-induced after potentials at 100 and 320 microM but the amplitude of compound action potentials (evoked at 0.5 Hz) was depressed in parallel. 6. The tonic block of sensory action potentials by all three drugs (at 320 microM) was enhanced by high frequency stimulation (5-500 Hz). 7. The lack of selectivity of these frequency-dependent Na+ channel blockers for burst firing compared to low-frequency spikes, is discussed in contrast to their effects on 4-AP-induced seizures and paroxysmal activity in CNS tissue (which is associated with large and sustained depolarizing plateau potentials). 8. In conclusion, these in vitro results confirm the marked sensitivity of sensory axons to 4-AP (the presumptive basis for paraesthesias). Burst firing was not preferentially impaired at relatively high concentrations suggesting that anticonvulsants will not overcome the toxic peripheral actions of 4-AP in neurological patients. PMID:8821551

  3. Tratamento da má oclusão de Classe II, divisão 1 de Angle, com protrusão maxilar utilizando-se recursos ortopédicos Class II, division 1, with maxillar protrusion's treatment employing orthopedic approachs

    Directory of Open Access Journals (Sweden)

    Carla Maria Melleiro Gimenez

    2007-12-01

    Full Text Available OBJETIVO: o presente trabalho tem o propósito de apresentar uma revisão da literatura acerca do tratamento da má oclusão de Classe II, divisão 1 de Angle, tendo a protrusão maxilar como o principal componente dessa má oclusão, durante a fase de crescimento e desenvolvimento craniofacial. Serão apresentadas as características de cada um desses aparelhos, os seus componentes, a forma adequada de utilização, os seus mecanismos de ação e, principalmente, os seus efeitos em todo o complexo dentofacial. CONCLUSÃO: nos casos em que se verifica apenas a protrusão maxilar, sem envolvimento mandibular, e se faz necessário o controle vertical, pode ser indicado o AEB, conjugado ao aparelho removível derivado do aparelho preconizado por Thurow. Já nas situações de combinação da protrusão maxilar com a retrusão mandibular, uma opção de tratamento é o ativador combinado à ancoragem extrabucal.AIM: The purpose of this research is to review the literature about the treatment of Class II, division 1 malocclusion with maxillary protrusion, during the growth and development period. This review addresses the characteristics of these appliances, their components, correct use, action mechanisms, and mainly their consequences in dentofacial complex. CONCLUSIONS: In patients with maxillary protrusion and with no mandibular component, it may be indicated the use of a maxillary splint similar to the one suggested by Thurow. However, in patients with maxillary protrusion and mandibular retrusion, it may be indicated an activator associated with extra oral anchorage.

  4. Evaluation of Effect of Pudendal Nerve Block on Post Hemmorrhoidectomy Pain

    Directory of Open Access Journals (Sweden)

    M.H. Sarmast Shoshtari

    2008-10-01

    Full Text Available Introduction & Objective: Hemorrhoid is one of the most common anorectal disease which presents with pain, bleeding and mass protrusion from anus. One of the most important reasons to avoid operation in these patients fears of the pain. Pain control specially during the first 24 hour postoperation period results in decreasing urinary retension and constipation as well as increasing patients pleasant. In this study we assisted the effect of pudendal nerve block to reduce pain in posthemorrhoidectomy period and compared with those patients without pudendal nerve block.Materials & Methods: We randomized 120 patients with average age of 37.7 year who referred to the hospitals of Ahwaz university for hemorrhoidectomy into 2 groups (N1: 60 N2:60. In the first group pudendal nerve block was done but in the second group we didn't. Then pain scores by analogue scale method were calculated in each group at 2, 6, 12& 24 hours after operations. The scores were matched with Chi- Square test. Also we calculated and compared the dosages of injected narcotics.Results: The average pain scores at 2, 6, 12, 24 hours after operation in the first group (with nerve block. Were 2.53, 2.4, 1.91, 2.7, 2.38, and in the second group (without nerve block were 3.43, 3.23, 2.98, 2.81, 3.11. The average of narcotic dosage in the first group was 0.69 and in the second group was 1.3. P-value in two groups in those times were 0.001, 0.002, 0.001, 0.66. P-value for comparison of two groups was 0.01. P-value for comparison of narcotic consumption was 0.003Conclusions: In this study, we showed that pudendal nerve block in post hemorrhoidectomy period, reduced pain significantly and decreased narcotic consumption as well.

  5. Different functional reorganization of motor cortex after transfer of the contralateral C7 to different recipient nerves in young rats with total brachial plexus root avulsion.

    Science.gov (United States)

    Pan, Feng; Wei, Hai-feng; Chen, Liang; Gu, Yu-dong

    2012-12-07

    Clinically, contralateral C7 transfer is used for nerve reconstruction in brachial plexus injuries. Postoperatively, synchronous motions at the donor limb are noteworthy. This study studied if different recipient nerves influenced transhemispheric functional reorganization of motor cortex after this procedure. 90 young rats with total root avulsion of the brachial plexus were divided into groups 1-3 of contralateral C7 transfer to anterior division of the upper trunk, to both the musculocutaneous and median nerves, and to the median nerve, respectively. After reinnervation of target muscles, number of sites for forelimb representations in bilateral motor cortices was determined by intracortical microstimulation at 1.5, 3, 6, 9, and 12 months postoperatively. At nine months, transhemispheric reorganization of nerves neurotized by contralateral C7 was fulfilled in four of six rats in group 1, one of six in group 2 and none in group 3, respectively; at 12 months, that was fulfilled in five of six in group 1, four of six in groups 2 and 3, respectively. Logistic regression analysis showed that rate of fulfilled transhemispheric reorganization in group 1 was 12.19 times that in group 3 (95% CI 0.006-0.651, p=0.032). At 12 months, number of sites for hindlimb representations which had encroached upon original forelimb representations on the uninjured side was statistically more in group 3 than in group 2 (t=9.5, pmotor cortex than that to median nerve alone in rats. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  6. An Accounting Mechanism of the Protrusion Effect in the Annular Channel When Calculating the Leontiev Tube

    Directory of Open Access Journals (Sweden)

    N. A. Kiselev

    2017-01-01

    Full Text Available The paper analyses a technique to calculate the Leontiev tube and shows that there are several ways to increase operating efficiency of this device of gas-dynamic energy separation. Application of regular relief (dimples and protrusions on the wall between supersonic and subsonic channels is one of them.Analyses the results available in publications of experimentally numerically investigated influence of semi-spherical protrusions in the slot channels on the enhancement of heat transfer and drag coefficients at various Reynolds numbers.Shows that at the laminar flow owing to semi-spherical protrusions in the slot channel a heat transfer coefficient can be 1.1‑2.6 times increased with simultaneous 1.7‑4.8 times growth of drag coefficient (as compared to the smooth channel.At transition and turbulent flows the heat transfer enhancement, because of shallow dimples (depth-to-print diameter ratio is from 0.1 to 0.25, can reach 1.1‑2.4 times, with simultaneous 1.2‑7.9 times growth of the drag coefficient (as compared to smooth channel.Using the higher protrusions can provide up to 3.0‑3.5 times heat transfer intensification, but in this case there is an outrunning growth of the drag coefficient.It is shown that the staggered array of the shallow spherical protrusions is advisable to use for heat transfer enhancement in the subsonic channel of the Leontiev tube. The shallow spherical dimples correspond to them and operate as heat transfer intensifiers in the supersonic channel.The paper proposes a mechanism that enables taking into consideration an impact of the protrusions in the slot channel on the intensification of the heat transfer and momentum processes when calculating the gas-dynamic energy separation device (Leontiev tube using the known (earlier published technique.The study has been implemented under supporting Grant no. 15-08-08428 of the Russian Foundation for Basic Research.

  7. Thickening of the cauda equina roots: a common finding in Krabbe disease

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Misun; Rodriguez, David [Department of Radiology of University of Pittsburgh Medical Center, Pittsburgh, PA (United States); Zuccoli, Giulio; Panigrahy, Ashok [Section of Neuroradiology, Children' s Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, PA (United States); Poe, Michele D.; Escolar, Maria L. [Department of Pediatrics at Children' s Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, PA (United States)

    2016-10-15

    Evaluation of Krabbe disease burden and eligibility for hematopoietic stem cell transplantation are often based on neuroimaging findings using the modified Loes scoring system, which encompasses central but not peripheral nervous system changes. We show that quantitative evaluation of thickened cauda equina nerve roots may improve the evaluation of Krabbe disease and therapeutic guidance. Lumbar spine MRI scans of patients obtained between March 2013 and September 2013 were retrospectively evaluated and compared to those of controls. Quantitative evaluation of cauda equina roots was performed on the axial plane obtained approximately 5 mm below the conus medullaris. The largest nerves in the right and left anterior quadrants of the spinal canal were acquired. Fifteen symptomatic patients with Krabbe disease (5-44 months old) and eleven age-matched controls were evaluated. The average areas (mm{sup 2}) of anterior right and left nerves were 1.40 and 1.23, respectively, for patients and 0.61 and 0.60 for controls (differences: 0.79 and 0.63; p < 0.001). Cauda equina nerve root thickening is associated with Krabbe disease in both treated and untreated patients. Adding lumbar spine MRI to the current neurodiagnostic protocols, which fails to account for peripheral nerve abnormalities, will likely facilitate the diagnosis of Krabbe disease. (orig.)

  8. Condylar guidance: correlation between protrusive interocclusal record and panoramic radiographic image: a pilot study.

    Science.gov (United States)

    Tannamala, Pavan Kumar; Pulagam, Mahesh; Pottem, Srinivas R; Swapna, B

    2012-04-01

    The purpose of this study was to compare the sagittal condylar angles set in the Hanau articulator by use of a method of obtaining an intraoral protrusive record to those angles found using a panoramic radiographic image. Ten patients, free of signs and symptoms of temporomandibular disorder and with intact dentition were selected. The dental stone casts of the subjects were mounted on a Hanau articulator with a springbow and poly(vinyl siloxane) interocclusal records. For all patients, the protrusive records were obtained when the mandible moved forward by approximately 6 mm. All procedures for recording, mounting, and setting were done in the same session. The condylar guidance angles obtained were tabulated. A panoramic radiographic image of each patient was made with the Frankfurt horizontal plane parallel to the floor of the mouth. Tracings of the radiographic images were made. The horizontal reference line was marked by joining the orbitale and porion. The most superior and most inferior points of the curvatures were identified. These two lines were connected by a straight line representing the mean curvature line. Angles made by the intersection of the mean curvature line and the horizontal reference line were measured. The results were subjected to statistical analysis with a significance level of p record method. The mean condylar guidance angle between the right and left side by both the methods was not statistically significant. The comparison of mean condylar guidance angles between the right side of the protrusive record method and the right side of the panoramic radiographic method and the left side of the protrusive record method and the left side of the panoramic radiographic method (p= 0.071 and p= 0.057, respectively) were not statistically significant. Within the limitations of this study, it was concluded that the protrusive condylar guidance angles obtained by panoramic radiograph may be used in programming semi-adjustable articulators. © 2012

  9. Automated characterization of nerve fibers labeled fluorescently: determination of size, class and spatial distribution.

    Science.gov (United States)

    Prodanov, Dimiter; Feirabend, Hans K P

    2008-10-03

    Morphological classification of nerve fibers could help interpret the assessment of neural regeneration and the understanding of selectivity of nerve stimulation. Specific populations of myelinated nerve fibers can be investigated by retrograde tracing from a muscle followed by microscopic measurements of the labeled fibers at different anatomical levels. Gastrocnemius muscles of adult rats were injected with the retrograde tracer Fluoro-Gold. After a survival period of 3 days, cross-sections of spinal cords, ventral roots, sciatic, and tibial nerves were collected and imaged on a fluorescence microscope. Nerve fibers were classified using a variation-based criterion acting on the distribution of their equivalent diameters. The same criterion was used to classify the labeled axons using the size of the fluorescent marker. Measurements of the axons were paired to those of the entire fibers (axons+myelin sheaths) in order to establish the correspondence between so-established axonal and fiber classifications. It was found that nerve fibers in L6 ventral roots could be classified into four populations comprising two classes of Aalpha (denoted Aalpha1 and Aalpha2), Agamma, and an additional class of Agammaalpha fibers. Cut-off borders between Agamma and Agammaalpha fiber classes were estimated to be 5.00+/-0.09 microm (SEM); between Agammaalpha and Aalpha1 fiber classes to be 6.86+/-0.11 microm (SEM); and between Aalpha1 and Aalpha2 fiber classes to be 8.66+/-0.16 microm (SEM). Topographical maps of the nerve fibers that innervate the gastrocnemius muscles were constructed per fiber class for the spinal root L6. The major advantage of the presented approach consists of the combined indirect classification of nerve fiber types and the construction of topographical maps of so-identified fiber classes.

  10. Absence of musculocutaneous nerve and accessory head of biceps brachii: a case report

    Directory of Open Access Journals (Sweden)

    Arora L

    2005-01-01

    Full Text Available During dissection of a 55-year-old female cadaver, we observed that three nerve roots contributed to the formation of Median nerve in her right upper limb. Along with this variation, absence of Musculocutaneous nerve was noticed. The muscles of front of arm i.e. Biceps Brachii, Brachialis and Coracobrachialis received their nerve supply from Median nerve. The Lateral cutaneous nerve of forearm was derived from Median nerve. Also an accessory head of Biceps Brachii muscle was present in the right arm of the same cadaver. It is extremely important to be aware of these variations while planning a surgery in the region of axilla or arm as these nerves are more liable to be injured during operations.

  11. A Graphical User Interface for Software-assisted Tracking of Protein Concentration in Dynamic Cellular Protrusions.

    Science.gov (United States)

    Saha, Tanumoy; Rathmann, Isabel; Galic, Milos

    2017-07-11

    Filopodia are dynamic, finger-like cellular protrusions associated with migration and cell-cell communication. In order to better understand the complex signaling mechanisms underlying filopodial initiation, elongation and subsequent stabilization or retraction, it is crucial to determine the spatio-temporal protein activity in these dynamic structures. To analyze protein function in filopodia, we recently developed a semi-automated tracking algorithm that adapts to filopodial shape-changes, thus allowing parallel analysis of protrusion dynamics and relative protein concentration along the whole filopodial length. Here, we present a detailed step-by-step protocol for optimized cell handling, image acquisition and software analysis. We further provide instructions for the use of optional features during image analysis and data representation, as well as troubleshooting guidelines for all critical steps along the way. Finally, we also include a comparison of the described image analysis software with other programs available for filopodia quantification. Together, the presented protocol provides a framework for accurate analysis of protein dynamics in filopodial protrusions using image analysis software.

  12. Effect of nerve injury on the number of dorsal root ganglion neurons and autotomy behavior in adult Bax-deficient mice

    Directory of Open Access Journals (Sweden)

    Lyu C

    2017-08-01

    Full Text Available Chuang Lyu,1,2 Gong-Wei Lyu,3 Aurora Martinez,4 Tie-Jun Sten Shi4 1State Key Laboratory of Veterinary Biotechnology, Harbin Veterinary Research Institute of Chinese Academy of Agricultural Sciences, Harbin, People’s Republic of China; 2Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden; 3Department of Neurology, 1st Hospital of Harbin Medical University, Harbin, People’s Republic of China; 4Department of Biomedicine, University of Bergen, Bergen, Norway Background: The proapoptotic molecule BAX, plays an important role in mitochondrial apoptotic pathway. Dorsal root ganglion (DRG neurons depend on neurotrophic factors for survival at early developmental stages. Withdrawal of neurotrophic factors will induce apoptosis in DRG neurons, but this type of cell death can be delayed or prevented in neonatal Bax knockout (KO mice. In adult animals, evidence also shows that DRG neurons are less dependent upon neurotrophic factors for survival. However, little is known about the effect of Bax deletion on the survival of normal and denervated DRG neurons in adult mice. Methods: A unilateral sciatic nerve transection was performed in adult Bax KO mice and wild-type (WT littermates. Stereological method was employed to quantify the number of lumbar-5 DRG neurons 1 month post-surgery. Nerve injury-induced autotomy behavior was also examined on days 1, 3, and 7 post-surgery. Results: There were significantly more neurons in contralateral DRGs of KO mice as compared with WT mice. The number of neurons was reduced in ipsilateral DRGs in both KO and WT mice. No changes in size distributions of DRG neuron profiles were detected before or after nerve injury. Injury-induced autotomy behavior developed much earlier and was more serious in KO mice. Conclusion: Although postnatal death or loss of DRG neurons is partially prevented by Bax deletion, this effect cannot interfere with long-term nerve injury-induced neuronal loss. The exaggerated self

  13. ATF3 upregulation in glia during Wallerian degeneration: differential expression in peripheral nerves and CNS white matter

    Directory of Open Access Journals (Sweden)

    Coffin Robert S

    2004-03-01

    Full Text Available Abstract Background Many changes in gene expression occur in distal stumps of injured nerves but the transcriptional control of these events is poorly understood. We have examined the expression of the transcription factors ATF3 and c-Jun by non-neuronal cells during Wallerian degeneration following injury to sciatic nerves, dorsal roots and optic nerves of rats and mice, using immunohistochemistry and in situ hybridization. Results Following sciatic nerve injury – transection or transection and reanastomosis – ATF3 was strongly upregulated by endoneurial, but not perineurial cells, of the distal stumps of the nerves by 1 day post operation (dpo and remained strongly expressed in the endoneurium at 30 dpo when axonal regeneration was prevented. Most ATF3+ cells were immunoreactive for the Schwann cell marker, S100. When the nerve was transected and reanastomosed, allowing regeneration of axons, most ATF3 expression had been downregulated by 30 dpo. ATF3 expression was weaker in the proximal stumps of the injured nerves than in the distal stumps and present in fewer cells at all times after injury. ATF3 was upregulated by endoneurial cells in the distal stumps of injured neonatal rat sciatic nerves, but more weakly than in adult animals. ATF3 expression in transected sciatic nerves of mice was similar to that in rats. Following dorsal root injury in adult rats, ATF3 was upregulated in the part of the root between the lesion and the spinal cord (containing Schwann cells, beginning at 1 dpo, but not in the dorsal root entry zone or in the degenerating dorsal column of the spinal cord. Following optic nerve crush in adult rats, ATF3 was found in some cells at the injury site and small numbers of cells within the optic nerve displayed weak immunoreactivity. The pattern of expression of c-Jun in all types of nerve injury was similar to that of ATF3. Conclusion These findings raise the possibility that ATF3/c-Jun heterodimers may play a role in

  14. Primary extra-skeletal Ewing's sarcoma mimicking a disc protrusion.

    Science.gov (United States)

    Ruelle, A; Boccardo, M

    1987-07-01

    One of the rarest cases of primary epidural neoplasm is a soft tissue sarcoma histologically similar to Ewing's sarcoma of the bone. In the literature only eleven cases of such an extra-skeletal Ewing's sarcoma have been described. The authors report an additional case presenting as a disc protrusion in a young male. The authors include some diagnostic, prognostic and nosologic remarks about this condition.

  15. Experimental and numerical investigation of dimplelike protrusions employed in recent heat exchangers

    International Nuclear Information System (INIS)

    Preibisch, S; Dietzel, D; Buschmann, M H; Friebe, C

    2011-01-01

    This study is motivated by the observation that recent investigations of dimpled surfaces employed for enhancing heat transfer rarely go beyond general parameters like pressure losses and heat transfer performance. Here, we explore a real world dimpled cross-flow heat exchanger. In particular, we are interested in the global parameters, but also in the local flow situation around a single dimplelike protrusion. Detailed PIV-experiments and simulations of the local flow around single protrusions and groups of them reveal the flow structures essential for heat transfer. These local results are brought in conjunction with the general performance of the heat exchanger. Based on local results, simulations of the complete heat exchanger are carried out which are found to be in reasonable agreement with the global parameters found experimentally.

  16. A Physicochemically Optimized and Neuroconductive Biphasic Nerve Guidance Conduit for Peripheral Nerve Repair.

    Science.gov (United States)

    Ryan, Alan J; Lackington, William A; Hibbitts, Alan J; Matheson, Austyn; Alekseeva, Tijna; Stejskalova, Anna; Roche, Phoebe; O'Brien, Fergal J

    2017-12-01

    Clinically available hollow nerve guidance conduits (NGCs) have had limited success in treating large peripheral nerve injuries. This study aims to develop a biphasic NGC combining a physicochemically optimized collagen outer conduit to bridge the transected nerve, and a neuroconductive hyaluronic acid-based luminal filler to support regeneration. The outer conduit is mechanically optimized by manipulating crosslinking and collagen density, allowing the engineering of a high wall permeability to mitigate the risk of neuroma formation, while also maintaining physiologically relevant stiffness and enzymatic degradation tuned to coincide with regeneration rates. Freeze-drying is used to seamlessly integrate the luminal filler into the conduit, creating a longitudinally aligned pore microarchitecture. The luminal stiffness is modulated to support Schwann cells, with laminin incorporation further enhancing bioactivity by improving cell attachment and metabolic activity. Additionally, this biphasic NGC is shown to support neurogenesis and gliogenesis of neural progenitor cells and axonal outgrowth from dorsal root ganglia. These findings highlight the paradigm that a successful NGC requires the concerted optimization of both a mechanical support phase capable of bridging a nerve defect and a neuroconductive phase with an architecture capable of supporting both Schwann cells and neurons in order to achieve functional regenerative outcome. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  17. Investigation of thermo-fluid behavior of mixed convection heat transfer of different dimples-protrusions wall patterns to heat transfer enhancement

    Science.gov (United States)

    Sobhani, M.; Behzadmehr, A.

    2018-05-01

    This study is a numerical investigation of the effect of improving heat transfer namely, modified rough (dimples and protrusions) surfaces on the mixed convective heat transfer of a turbulent flow in a horizontal tube. The effects of different dimples-protrusions arrangements on the improving the thermal performance of a rough tube are investigated at various Richardson numbers. Three dimensional governing equations are discretized by the finite-volume technique. Based on the obtained results the dimples-protrusions arrangements are modified to find a suitable configuration for which heat transfer coefficient and pressure drop to be balanced. Modified dimples-protrusions arrangements that shows higher performance is presented. Its average thermal performance 18% and 11% is higher than the other arrangements. In addition, the results show that roughening a smooth tube is more effective at the higher Richardson number.

  18. [Comparison between J-hook and micro-implant anchorage in the treatment of patients with bimaxillary protrusion].

    Science.gov (United States)

    Chen, Wen-Jing; Li, Qing-Yi; Gong, Ai-Xiu; Hu, Fang; Gu, Yong-Jia

    2008-02-01

    To compare the difference between J-hook and micro-implant anchorage in the treatment of patient with bimaxillary protrusion. Thirty patients with bimaxillary protrusion were divided into two groups (J-hook and micro-implant groups) and treated with MBT appliance. Four first premolars were extracted in all patients. Cephalometric analyses were carried out before and after treatment. In J-hook group and micro-implant group,computerized cephalometric analysis revealed that before treatment U6C-PP was (12.4 +/- 0.2) mm and (12.5 +/- 0.1) mm, respectively,and after treatment U6C-PP was (12.6 +/- 0.1) mm and (12.8 +/- 0.1) mm,respectively. The difference between J-hook group and microimplant group was significant (P micro-implant group was not significant. Both J-hook and micro-implant could provide adequate anchorage in the treatment of patients with bimaxillary protrusion.

  19. The Strategy and Early Clinical Outcome of Percutaneous Full-Endoscopic Interlaminar or Extraforaminal Approach for Treatment of Lumbar Disc Herniation

    Directory of Open Access Journals (Sweden)

    Weijun Kong

    2016-01-01

    Full Text Available Objective is to analyze the surgical strategy, safety, and clinical results of percutaneous full-endoscopic discectomy through interlaminar or extraforaminal puncture technique for LDH. Preoperative CT and MRI were analyzed, which were based on the main location of the herniated disc and its relationship with compressed nerve root. Sixty-two patients satisfied the inclusion criteria during the period from August 2012 to March 2014. We use percutaneous full-endoscopic discectomy through different puncture technique to remove the protrusive NP for LDH. Sixty patients completed the full-endoscopic operation successfully. Their removed disc tissue volume ranged from 1.5 mL to 3.8 mL each time. Postoperative ODI and VAS of low back and sciatica pain were significantly decreased in each time point compared to preoperative ones. No nerve root injury, infection, and other complications occurred. The other two patients were shifted to open surgery. No secondary surgery was required and 91.6% of excellent-to-good ratio was achieved on the basis of Macnab criteria at postoperative 12 months. Acquired benefits are fewer complications, rapid recovery, complete NP removal, effective nerve root decompression, and satisfactory cosmetic effect as well. This is a safe, effective, and rational minimally invasive spine-surgical technology with excellent clinical outcome.

  20. Unilateral duplicated abducens nerve coursing through both the sphenopetroclival venous gulf and cavernous sinus: a case report.

    Science.gov (United States)

    Coquet, Thomas; Lefranc, Michel; Chenin, Louis; Foulon, Pascal; Havet, Éric; Peltier, Johann

    2018-03-15

    In this anatomy report, we describe the first case of abducens nerve duplication limited to the sphenopetroclival venous gulf and the cavernous sinus. The objective point of division of the two duplicated roots was localized at the gulfar face of the dural porus, just distal to the unique cisternal trunk of the abducens nerve, as it pierced the petroclival dural mater. In the gulfar segment, both roots traveled through a variant of Dorello's canal called the "petrosphenoidal canal" and remained separated through the posterior half of the cavernous sinus. Both roots finally fused in the anterior half of the cavernous sinus to innervate the lateral rectus muscle as a single trunk. Although many variants of the abducens nerve have been reported over the recent decades, this anatomic variation has never been previously described and enriches the continuum of abducens nerve variations reported in the literature data. Awareness of this variation is crucial for neurosurgeons, especially during clival or petrosal surgical approaches used for resection of skull base chordomas.

  1. Observations at the CNS-PNS border of ventral roots connected to a neuroma

    Directory of Open Access Journals (Sweden)

    Sten Remahl

    2010-10-01

    Full Text Available Previous studies have shown that numerous sprouts originating from a neuroma, after nerve injury in neonatal animals, can invade spinal nerve roots. In this study the border between the central and peripheral nervous system (CNS-PNS border of ventral roots in kittens was examined with both light and electron microscopy after early postnatal sciatic nerve resection. A transient ingrowth of substance P positive axons was observed into the CNS, but no spouts remained 6 weeks after the injury. Using serial sections and electron microscopy it was possible to identify small bundles of unmyelinated axons that penetrated from the root fascicles for a short distance into the CNS. These axons ended blindly, sometimes with a growth cone-like terminal swelling filled with vesicles. The axon bundles were accompanied by p75 positive cells in both the root fascicles and the pia mater, but not in the CNS. It may thus be suggested that neurotrophin presenting p75 positive cells could facilitate axonal growth into the pia mater and that the lack of such cells in the CNS compartment might contribute to the failure of growth into the CNS. A maldevelopment of myelin sheaths at the CNS-PNS border of motor axons was observed and it seems possible that this could have consequences for the propagation of action potential across this region after neonatal nerve injury.

  2. Application of flat plate cavitation data to the analysis of limited cavitation from an isolated triangular surface protrusion

    International Nuclear Information System (INIS)

    Holl, J.W.

    1985-01-01

    Isolated surface roughness can cause significant localized pressure reductions which can lead to premature cavitation and degradation of the cavitation performance of a marine vehicle. The characteristic velocity theory was developed to analyze the limited cavitation characteristics of isolated surface protrusions. This theory is dependent upon knowing the boundary layer velocity profile in the vicinity of the roughness and the limited cavitation number for the roughness in a uniform stream. In the investigation described in this paper, the equation for triangular surface protrusions was determined experimentally by testing sharpedged flat plates in a water tunnel. These data were then employed in the characteristic velocity theory to calculate the cavitation characteristics of a triangular protrusion in a turbulent boundary layer for comparison with experimental data

  3. Treatment of Angle Class I Malocclusion with Severe Bimaxillary Protrusion using Miniscrew Implants and Periodontal Ligament Distraction

    Directory of Open Access Journals (Sweden)

    K C Prabhat

    2014-01-01

    Full Text Available Bimaxillary dentoalveolar protrusion is common in Asian population. In this patient with procumbent upper and lower lips, excessive lip strain, proclined and protruded maxillary and mandibular incisors with vertical growth pattern, an acceptable treatment result, was achieved with 4-first-premolar extractions. This case report is presented with the aim, to describe the treatment approach for bimaxillary dentoalveolar protrusion using miniscrew implants for anchorage in upper arch and periodontal ligament distraction for canine retraction in lower arch and then retraction of incisors into the newly formed bone distal to lateral incisor. Treatment was completed in 18 months. The patient profile was improved, with reduction in lip procumbency, decrease in lip eversion and protrusion, and decrease mentalis strain. Dentally, the interincisal angulation improved significantly because both the maxillary and mandibular incisors were uprighted after space closer.

  4. Complicated Crown-Root Fracture Treated Using Reattachment Procedure: A Single Visit Technique

    Directory of Open Access Journals (Sweden)

    Akhil Rajput

    2011-01-01

    Full Text Available Complicated crown-root fracture of maxillary central and lateral incisors is common in case of severe trauma or sports-related injury. It happens because of their anterior positioning in oral cavity and protrusive eruptive pattern. On their first dental visit, these patients are in pain and need emergency care. Because of impaired function, esthetics, and phonetics, such patients are quite apprehensive during their emergency visit. Successful pain management with immediate restoration of function, esthetics and phonetics should be the prime objective while handling such cases. This paper describes immediate treatment of oblique crown root fracture of maxillary right lateral incisor with reattachment procedure using light transmitting fiber post. After two and half years, the reattached fragment still has satisfying esthetics and excellent function.

  5. Neuroprotective Drug for Nerve Trauma Revealed Using Artificial Intelligence

    OpenAIRE

    Romeo-Guitart, David; Forés, Joaquim; Herrando-Grabulosa, Mireia; Valls, Raquel; Leiva-Rodríguez, Tatiana; Galea, Elena; González-Pérez, Francisco; Navarro, Xavier; Petegnief, Valerie; Bosch, Assumpció; Coma, Mireia; Mas, José Manuel; Casas, Caty

    2018-01-01

    Here we used a systems biology approach and artificial intelligence to identify a neuroprotective agent for the treatment of peripheral nerve root avulsion. Based on accumulated knowledge of the neurodegenerative and neuroprotective processes that occur in motoneurons after root avulsion, we built up protein networks and converted them into mathematical models. Unbiased proteomic data from our preclinical models were used for machine learning algorithms and for restrictions to be imposed on m...

  6. Mast Cells and Nerve Signal Conduction in Acupuncture

    Directory of Open Access Journals (Sweden)

    Na Yin

    2018-01-01

    Full Text Available Nerve and mast cells are densely distributed around acupoints in connective tissue. To explore the internal relations between them in acupuncture effect, we examined dorsal root potential (DRP response to acupuncture at Zusanli (ST36 under sodium cromoglicate (DSCG, a mast cell stabilizer intervention in anesthetized Sprague-Dawley (SD rats. We used single unit nerve recording techniques to collect nerve signals from DRP afferent nerves for a 45-minute period that includes 4 stages, that is, base, drug absorption, acupuncture, and recovery stages. We analyzed the recorded signals from time-domain and frequency-domain perspectives. The results showed that once acupuncture needle was inserted, twisting needle excited more nerves discharges than those at base discharges in ACU (from 35.1 ± 7.2 to 47 ± 9.2 Hz, P=0.004, and there existed the same trend in Saline + ACU group (from 23.8 ± 2.6 to 29.8 ± 4.2 Hz, P=0.059. There was no change of nerve discharges under twisting needle with injection of DSCG (from 34.8 ± 5.3 to 34.7 ± 4.4 Hz, P=0.480. We conclude that acupuncture manipulation promotes neural signal production and DSCG could partly inhibit nerve discharges.

  7. Reactive Oxygen Species Generated by NADPH Oxidases Promote Radicle Protrusion and Root Elongation during Rice Seed Germination

    Directory of Open Access Journals (Sweden)

    Wen-Yan Li

    2017-01-01

    Full Text Available Seed germination is a complicated biological process that requires regulation through various enzymatic and non-enzymatic mechanisms. Although it has been recognized that reactive oxygen species (ROS regulate radicle emergence and root elongation in a non-enzymatic manner during dicot seed germination, the role of ROS in monocot seed germination remains unknown. NADPH oxidases (NOXs are the major ROS producers in plants; however, whether and how NOXs regulate rice seed germination through ROS generation remains unclear. Here, we report that diphenyleneiodinium (DPI, a specific NOX inhibitor, potently inhibited embryo and seedling growth—especially that of the radicle and of root elongation—in a dose-dependent manner. Notably, the DPI-mediated inhibition of radicle and root growth could be eliminated by transferring seedlings from DPI to water. Furthermore, ROS production/accumulation during rice seed germination was quantified via histochemistry. Superoxide radicals (O2−, hydrogen peroxide (H2O2 and hydroxyl radicals (•OH accumulated steadily in the coleorhiza, radicle and seedling root of germinating rice seeds. Expression profiles of the nine typical NOX genes were also investigated. According to quantitative PCR, OsNOX5, 7 and 9 were expressed relatively higher. When seeds were incubated in water, OsNOX5 expression progressively increased in the embryo from 12 to 48 h, whereas OsNOX7 and 9 expressions increased from 12 to 24 h and decreased thereafter. As expected, DPI inhibits the expression at predetermined time points for each of these genes. Taken together, these results suggest that ROS produced by NOXs are involved in radicle and root elongation during rice seed germination, and OsNOX5, 7 and 9 could play crucial roles in rice seed germination. These findings will facilitate further studies of the roles of ROS generated by NOXs during seed germination and seedling establishment and also provide valuable information for the

  8. Novel drug delivering conduit for peripheral nerve regeneration

    Science.gov (United States)

    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  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.

  9. Does the presence of the nerve root sedimentation sign on MRI correlate with the operative level in patients undergoing posterior lumbar decompression for lumbar stenosis?

    Science.gov (United States)

    Fazal, Akil; Yoo, Andrew; Bendo, John A

    2013-08-01

    Recent research describes the use of a nerve root sedimentation sign to diagnose lumbar spinal stenosis (LSS). The lack of sedimentation of the nerve roots (positive sedimentation sign) to the dorsal part of the dural sac is the characteristic feature of this new radiological parameter. To demonstrate how the nerve root sedimentation sign compares with other more traditional radiological parameters in patients who have been operated for LSS. A retrospective chart and image review. Preoperative magnetic resonance images (MRIs) were reviewed from 71 consecutive operative patients who presented with LSS and received spinal decompression surgery from 2006 to 2010. Preoperative T2-weighted MRIs were reviewed for each patient. One hundred thirty-four vertebral levels from L1 to L5 were measured for: sedimentation sign, cross-sectional area (CSA) and anterior/posterior (A/P) diameter of the dural sac, thickness of the ligamentum flavum, and Fujiwara grade of facet hypertrophy. Radiological measurements were made using Surgimap 1.1.2.169 software (Nemaris, Inc., New York, NY, USA). Statistical analyses were performed using the SPSS 17.0 statistical software (SPSS Inc., Chicago, IL, USA). Significance was demonstrated using unpaired t tests and chi-squared tests. Study funding was departmental. There were no study-specific conflicts of interest-associated biases. A positive sedimentation sign was determined in 120 operated levels (89.5%), whereas 14 levels (10.5%) had no sign (negative sedimentation sign). The mean CSA and A/P diameter were 140.62 mm(2) (standard deviation [SD]=53) and 11.76 mm (SD=3), respectively, for the no-sign group; the mean CSA and A/P diameter were 81.87 mm(2) (SD=35) and 8.76 mm (SD=2.2), respectively, for the sedimentation sign group (p<.001). We found that 60% of levels with Fujiwara Grade A facet hypertrophy did not have a sedimentation sign, whereas 86.3% of levels with Grade B, 93.2% of levels with Grade C, and 100.0% of levels with Grade D

  10. Do clinical features and MRI suggest the same nerve root in acute cervical radiculopathy

    Directory of Open Access Journals (Sweden)

    M. Conradie

    2006-02-01

    Full Text Available Different proposed pathophysiological mechanisms can result in variable clinical presentations of cervical radiculopathy (CR, often making it difficult to detect minor nerve root (NR conditions. This descriptive study determined (1 the level(s of  NR involvement suggested by the distribution patterns of clinical features and detected by magnetic resonance imaging (MRI and (2 the most common associations between the different variables in patients diagnosed with acute CR by a neurosurgeon. A physiotherapist blinded to the level(s of NR involvement performed a standardized interview on 21 subjects to determine the distribution patterns of pain and paraesthesia, and a neurological examination. The Fisher exact test was used to determine associations between the different variables. Only seven subjects presented clinically and radiologically with the same single-level NR involvement. Multiple- level presentations occurred which might be due to dermatomal overlapping, central sensitization or the possible involvement of two adjacent NR levels. Distribution patterns of motor weakness, pain and paraesthesia, and to a lesser extent sensory and reflex changes, have value in identifying the compressed NR level. For this sample the distri-bution patterns of radicular features identified C6 and C8 with more certainty than C7.

  11. Self-organized antireflection CuIn(S,Se)_2 nano-protrusions on flexible substrates by ion erosion based on CuInS_2 nanocrystal precursor inks

    International Nuclear Information System (INIS)

    Yen, Yu-Ting; Wang, Yi-Chung; Chen, Chia-Wei; Tsai, Hung-Wei; Chen, Yu-Ze; Hu, Fan; Chueh, Yu-Lun

    2015-01-01

    Highlights: • CuIn(S,Se)_2 nano-protrusions were demonstrated on 36-cm"2 flexible substrates. • Nano-protrusions were created by ion erosion on selenized CuInS_2 nanocrystal precursor inks. • Tilt orientations and remarkable anti-reflectance characteristics of nano-protrusions can be precisely controlled. - Abstract: In this work, an approach to achieve surface nano-protrusions on a chalcopyrite CuIn(S,Se)_2 thin film was demonstrated. Home-made CuInS_2 nanocrystals with average diameter of 20 nm were prepared and characterized. By applying ion erosion process on the CuIn(S,Se)_2 film, large-area self-aligned nano-protrusions can be formed. Interestingly, the process can be applied on flexible substrate where the CuIn(S,Se)_2 film remains intact with no visible cracking after several bending tests. In addition, reflectance spectra reveal the extraordinary anti-reflectance characteristics of nano-protrusions on the CuIn(S,Se)_2 film with the incident light from 350 to 2000 nm. A 36-cm"2 CuIn(S,Se)_2 film with nano-protrusions on flexible molybdenum foil substrate has been demonstrated, which demonstrated the feasibility of developing low cost with a high optical absorption CuIn(S,Se)_2 flexible thin film.

  12. Histological and morphological evaluation of condylar cartilage of young rats in response to stimulation of mandibular protrusion

    OpenAIRE

    Milena Peixoto Nogueira de Sá; Adilson Luiz Ramos; Jacqueline Nelises Zanoni; Fabrício Dias de Souza; Daniele Esteves Pepelascov; Raquel Sano Suga Terada

    2017-01-01

    The aim of this study was to evaluate the histogical and morphological aspects of the condyle in response to mandibular protrusion induced by composite resin occlusal planes. Thirty five-week-old male Wistar rats were selected and randomly divided in two groups. One group received a composite resin type of oclusal plane that induced mandibular protrusion, and the other was the control group, without treatment. Animals were euthanized after experimental time intervals of 7, 21 and 30 days. For...

  13. Salient Point Detection in Protrusion Parts of 3D Object Robust to Isometric Variations

    Science.gov (United States)

    Mirloo, Mahsa; Ebrahimnezhad, Hosein

    2018-03-01

    In this paper, a novel method is proposed to detect 3D object salient points robust to isometric variations and stable against scaling and noise. Salient points can be used as the representative points from object protrusion parts in order to improve the object matching and retrieval algorithms. The proposed algorithm is started by determining the first salient point of the model based on the average geodesic distance of several random points. Then, according to the previous salient point, a new point is added to this set of points in each iteration. By adding every salient point, decision function is updated. Hence, a condition is created for selecting the next point in which the iterative point is not extracted from the same protrusion part so that drawing out of a representative point from every protrusion part is guaranteed. This method is stable against model variations with isometric transformations, scaling, and noise with different levels of strength due to using a feature robust to isometric variations and considering the relation between the salient points. In addition, the number of points used in averaging process is decreased in this method, which leads to lower computational complexity in comparison with the other salient point detection algorithms.

  14. Human amniotic epithelial cell transplantation for the repair of injured brachial plexus nerve: evaluation of nerve viscoelastic properties

    Directory of Open Access Journals (Sweden)

    Hua Jin

    2015-01-01

    Full Text Available The transplantation of embryonic stem cells can effectively improve the creeping strength of nerves near an injury site in animals. Amniotic epithelial cells have similar biological properties as embryonic stem cells; therefore, we hypothesized that transplantation of amniotic epithelial cells can repair peripheral nerve injury and recover the creeping strength of the brachial plexus nerve. In the present study, a brachial plexus injury model was established in rabbits using the C 6 root avulsion method. A suspension of human amniotic epithelial cells was repeatedly injected over an area 4.0 mm lateral to the cephal and caudal ends of the C 6 brachial plexus injury site (1 × 10 6 cells/mL, 3 μL/injection, 25 injections immediately after the injury. The results showed that the decrease in stress and increase in strain at 7,200 seconds in the injured rabbit C 6 brachial plexus nerve were mitigated by the cell transplantation, restoring the viscoelastic stress relaxation and creep properties of the brachial plexus nerve. The forepaw functions were also significantly improved at 26 weeks after injury. These data indicate that transplantation of human amniotic epithelial cells can effectively restore the mechanical properties of the brachial plexus nerve after injury in rabbits and that viscoelasticity may be an important index for the evaluation of brachial plexus injury in animals.

  15. Progranulin contributes to endogenous mechanisms of pain defense after nerve injury in mice.

    Science.gov (United States)

    Lim, Hee-Young; Albuquerque, Boris; Häussler, Annett; Myrczek, Thekla; Ding, Aihao; Tegeder, Irmgard

    2012-04-01

    Progranulin haploinsufficiency is associated with frontotemporal dementia in humans. Deficiency of progranulin led to exaggerated inflammation and premature aging in mice. The role of progranulin in adaptations to nerve injury and neuropathic pain are still unknown. Here we found that progranulin is up-regulated after injury of the sciatic nerve in the mouse ipsilateral dorsal root ganglia and spinal cord, most prominently in the microglia surrounding injured motor neurons. Progranulin knockdown by continuous intrathecal spinal delivery of small interfering RNA after sciatic nerve injury intensified neuropathic pain-like behaviour and delayed the recovery of motor functions. Compared to wild-type mice, progranulin-deficient mice developed more intense nociceptive hypersensitivity after nerve injury. The differences escalated with aging. Knockdown of progranulin reduced the survival of dissociated primary neurons and neurite outgrowth, whereas addition of recombinant progranulin rescued primary dorsal root ganglia neurons from cell death induced by nerve growth factor withdrawal. Thus, up-regulation of progranulin after neuronal injury may reduce neuropathic pain and help motor function recovery, at least in part, by promoting survival of injured neurons and supporting regrowth. A deficiency in this mechanism may increase the risk for injury-associated chronic pain. © 2011 The Authors Journal of Cellular and Molecular Medicine © 2011 Foundation for Cellular and Molecular Medicine/Blackwell Publishing Ltd.

  16. The pain drawing as an instrument for identifying cervical spine nerve involvement in chronic whiplash-associated disorders.

    Science.gov (United States)

    Bernhoff, Gabriella; Landén Ludvigsson, Maria; Peterson, Gunnel; Bertilson, Bo Christer; Elf, Madeleine; Peolsson, Anneli

    2016-01-01

    The aim of the study was to investigate the psychometric properties of a standardized assessment of pain drawing with regard to clinical signs of cervical spine nerve root involvement. This cross-sectional study included data collected in a randomized controlled study. Two hundred and sixteen patients with chronic (≥6 months) whiplash-associated disorders, grade 2 or 3, were included in this study. The validity, sensitivity, and specificity of a standardized pain drawing assessment for determining nerve root involvement were analyzed, compared to the clinical assessment. In addition, we analyzed the interrater reliability with 50 pain drawings. Agreement was poor between the standardized pain drawing assessment and the clinical assessment (kappa =0.11, 95% CI: -0.03 to 0.20). Sensitivity was high (93%), but specificity was low (19%). Interrater reliability was good (kappa =0.64, 95% CI: 0.53 to 0.76). The standardized pain drawing assessment of nerve root involvement in chronic whiplash-associated disorders was not in agreement with the clinical assessment. Further research is warranted to optimize the utilization of a pain/discomfort drawing as a supportive instrument for identifying nerve involvement in cervical spinal injuries.

  17. PERFORATION OF INFERIOR ALVEOLAR NERVE BY MAXILLARY ARTERY. Perforation of inferior alveolar nerve by maxillary artery

    Directory of Open Access Journals (Sweden)

    Prakash B Billakanti

    2016-03-01

    Full Text Available La fosa infratemporal es un área anatómica clínicamente importante para la administración de agentes anestésicos locales en odontología y cirugía maxilofacial. Fueron estudiadas variaciones en la anatomía del nervio alveolar inferior y la arteria maxilar en la disección infratemporal. Durante la disección rutinaria de la cabeza en el cadáver de un varón adulto, fue observada una variación excepcional en el origen del nervio alveolar inferior y su relación con las estructuras circundantes. El nervio alveolar inferior se originaba en el nervio mandibular por dos raíces y la primera parte de la arteria maxilar estaba incorporada entre ambas. El origen embriológico de esta variación y sus implicaciones clínicas es debatido. Dado que la arteria maxilar transcurría entre las dos raíces del nervio alveolar inferior, y el nervio estaba fijado entre el foramen oval y el foramen mandibular, el atrapamiento vásculo-nervioso pudo causar entume-cimiento o dolor de cabeza e interferir con la inyección de anestésicos locales en la fosa infratemporal.  Variaciones anatómicas en esta región deben ser tenidas en cuenta, especialmente en casos de tratamiento fallido de neuralgia del trigémino. Infratemporal fossa is clinically important anatomical area for the delivery of local anesthetic agents in dentistry and maxillofacial surgery. Variations in the anatomy of the inferior alveolar nerve and maxillary artery were studied in infratemporal dissection. During routine dissection of the head in an adult male cadaver an unusual variation in the origin of the inferior alveolar nerve and its relationship with the surrounding structures was observed. The inferior alveolar nerve originated from the mandibular nerve by two roots and the first part of the maxillary artery was incorporated between them. An embryologic origin of this variation and its clinical implications is discussed. Because the maxillary artery runs between the two roots of

  18. The sensory-motor bridge neurorraphy: an anatomic study of feasibility between sensory branch of the musculocutaneous nerve and deep branch of the radial nerve.

    Science.gov (United States)

    Goubier, Jean-Noel; Teboul, Frédéric

    2011-05-01

    Restoring elbow flexion remains the first step in the management of total palsy of the brachial plexus. Non avulsed upper roots may be grafted on the musculocutaneous nerve. When this nerve is entirely grafted, some motor fibres regenerate within the sensory fibres quota. Aiming potential utilization of these lost motor fibres, we attempted suturing the sensory branch of the musculocutaneous nerve onto the deep branch of the radial nerve. The objective of our study was to assess the anatomic feasibility of such direct suturing of the terminal sensory branch of the musculocutaneous nerve onto the deep branch of the radial nerve. The study was carried out with 10 upper limbs from fresh cadavers. The sensory branch of the musculocutaneous muscle was dissected right to its division. The motor branch of the radial nerve was identified and dissected as proximally as possible into the radial nerve. Then, the distance separating the two nerves was measured so as to assess whether direct neurorraphy of the two branches was feasible. The excessive distance between the two branches averaged 6 mm (1-13 mm). Thus, direct neurorraphy of the sensory branch of the musculocutaneous nerve and the deep branch of the radial nerve was possible. When the whole musculocutaneous nerve is grafted, some of its motor fibres are lost amongst the sensory fibres (cutaneous lateral antebrachial nerve). By suturing this sensory branch onto the deep branch of the radial nerve, "lost" fibres may be retrieved, resulting in restoration of digital extension. Copyright © 2011 Wiley-Liss, Inc.

  19. Temporomandibular joint movement; Evaluation of protrusive splint therapy with GRASS MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Maeda, M.; Itou, S.; Ishii, Y.; Yamamoto, K.; Kawamura, Y.; Matsuda, T.; Hayashi, N.; Ishii, J. (Dept. of Radiology, Dept. of Oral and Maxillofacial Surgery, Fukui Medical School (Japan))

    1992-09-01

    Ten temporomandibular joints (TMJs) of 5 healthy volunteers and 19 TMJs of internal derangements in 16 patients with splint therapy were examined with MR imaging. T1-weighted images were obtained only in the closed mouth position, and gradient recalled acquisition in steady state (GRASS) images were obtained in active opening and closing phases, allowing a pseudodynamic display of TMJ movement. All patients received protrusive splint treatment. The usefulness of MR imaging to assess the efficacy of splint therapy was evaluated. Corrected disk position with the splint in place was clearly demonstrated in 9 TMJs, corresponding with elimination of reciprocal clicking. Ten other TMJs of anterior disk displacement without reduction showed uncorrected disk position by the splint. This information could confirm the therapeutic efficacy, or suggest other treatment alternatives. GRASS MR imaging can provide accurate and physiologic information about disk function in initial and follow-up assessment of protrusive splint therapy. (orig.).

  20. Apoptosis-inducing effect of selective sensory or motor nerve injury on skeletal muscle atrophy

    Directory of Open Access Journals (Sweden)

    Lei ZHAO

    2011-09-01

    Full Text Available Objective To explore the apoptosis-inducing effect of selective sensory or motor nerve injury on skeletal muscle atrophy.Methods Thirty healthy adult SD rats were randomly divided into three groups,namely,ventral root transection group(VRT group,received left L4-L6 ventral rhizotomy,dorsal root transection group(DRT group,received left L4-L6 dorsal rhizotomy,and sciatic nerve transection group(SNT group,received left sciatic nerve transection.Each group comprised 10 SD rats.The bilateral gastrocnemius was harvested 10 weeks after operation to observe the apoptosis and Fas/FasL expression of the skeletal muscle cells through fluorescent labeling,transmission electron microscopy,and immunohistochemistry.Result Ten weeks after the denervation,apoptosis-related changes,especially obvious changes of the nuclear apoptotic morphology,were observed in the skeletal muscle cells.The aggregation degree of the nucleus and the expression of Fas/FasL increased in the following order: DRT group,VRT group,and SNT group.No apoptotic body,but early apoptotic morphology,was found in the denervated gastrocnemius through transmission electron microscopy.Conclusions The effect of motor nerve injury on skeletal muscle atrophy is more serious than that of sensory nerve injury.The rebuilding of motor nerves should be preferentially considered in the clinical treatment of muscle atrophy induced by denervation.

  1. Report of a Class I bimaxillary dental protrusion case with extraction of first premolars treated with Clarity™ SL MBT appliances

    Directory of Open Access Journals (Sweden)

    Hugo Trevisi

    2013-01-01

    Full Text Available Bimaxillary protrusion cases are common in orthodontic practice. For the best facial outcome, the biomechanics can often be challenging. A class I bimaxillary protrusion case is presented below illustrating the careful application of extractions and bracket prescription. The case highlights how self-ligating brackets and high precision bracket positioning can reduce the need for additional anchorage.

  2. Homeobox gene expression in adult dorsal root ganglia: Is regeneration a recapitulation of development?

    NARCIS (Netherlands)

    Vogelaar, C.F.

    2003-01-01

    Neurons of the peripheral nervous system are able to regenerate their peripheral axons after injury, leading to complete recovery of sensory and motor function. The sciatic nerve crush model is frequently used to study peripheral nerve regeneration. Sensory neurons in the dorsal root ganglia (DRGs)

  3. Influence of oculomotor nerve afferents on central endings of primary trigeminal fibers.

    Science.gov (United States)

    Manni, E; Bortolami, R; Pettorossi, V E; Lucchi, M L; Callegari, E; Draicchio, F

    1987-12-01

    Painful fibers running in the third nerve and originating from the ophthalmic trigeminal area send their central projections at level of substantia gelatinosa of nucleus caudalis trigemini. The central endings of these fibers form axoaxonic synapses with trigeminal fibers entering the brain stem through the trigeminal root. The effect of electrical stimulation of the third nerve central stump on the central endings of trigeminal afferent fibers consists in an increased excitability, possibly resulting in a presynaptic inhibition. This inhibitory influence is due to both direct and indirect connections of the third nerve afferent fibers with the trigeminal ones.

  4. Orthodontic Treatment of Maxillary Incisors with Severe Root Resorption Caused by Bilateral Canine Impaction in a Class II Division 1 Patient.

    Science.gov (United States)

    Chang, Na-Young; Park, Jae Hyun; Lee, Mi-Young; Cho, Jin-Woo; Cho, Jin-Hyoung; An, Ki-Yong; Chae, Jong-Moon

    2016-01-01

    This case report shows the successful alignment of bilateral impacted maxillary canines. A 12-year-old male with the chief complaint of the protrusion of his maxillary anterior teeth happened to have bilateral maxillary canine impaction on the labial side of his maxillary incisors. Four maxillary incisors showed severe root resorption because of the impacted canines. The patient was diagnosed as skeletal Class II malocclusion with proclined maxillary incisors. The impacted canine was carefully retracted using sectional buccal arch wires to avoid further root resorption of the maxillary incisors. To distalize the maxillary dentition, two palatal miniscrews were used. After 25 months of treatment, the maxillary canines were well aligned without any additional root resorption of the maxillary incisors.

  5. PROTRUSION OF THE DEVICE - A COMPLICATION OF CATHETER CLOSURE OF PATENT DUCTUS-ARTERIOSUS

    NARCIS (Netherlands)

    OTTENKAMP, J; HESS, J; TALSMA, MD; BUISLIEM, TN

    Objective-To assess the medium term results of percutaneous transvenous closure of patent ductus arteriosus, in particular with regard to protrusion of the device with or without turbulence of the bloodflow. Design-Clinical examination and echocardiographic study (cross sectional Doppler, and colour

  6. Neurotization of the biceps muscle by end-to-side neurorraphy between ulnar and musculocutaneous nerves. A series of five cases.

    Science.gov (United States)

    Franciosi, L F; Modestti, C; Mueller, S F

    1998-01-01

    Three patients with avulsed C5, C6, and C7 roots and two patients with avulsed C5 and C6 roots after trauma of the brachial plexus, were treated by neurotization of the biceps using nerve fibers derived from the ulnar nerve and obtained by end-to-side neurorraphy between the ulnar and musculocutaneous nerves. The age of patients ranged from 19 to 45. The interval between the accident and surgery was 2 to 13 months. Return of biceps contraction was observed 4 to 6 months after surgery. Four patients recovered grade 4 elbow flexion. One 45-year-old patient did not obtain any biceps contraction after 9 months.

  7. Diaphragm-Sparing Nerve Blocks for Shoulder Surgery.

    Science.gov (United States)

    Tran, De Q H; Elgueta, Maria Francisca; Aliste, Julian; Finlayson, Roderick J

    Shoulder surgery can result in significant postoperative pain. Interscalene brachial plexus blocks (ISBs) constitute the current criterion standard for analgesia but may be contraindicated in patients with pulmonary pathology due to the inherent risk of phrenic nerve block and symptomatic hemidiaphragmatic paralysis. Although ultrasound-guided ISB with small volumes (5 mL), dilute local anesthetic (LA) concentrations, and LA injection 4 mm lateral to the brachial plexus have been shown to reduce the risk of phrenic nerve block, no single intervention can decrease its incidence below 20%. Ultrasound-guided supraclavicular blocks with LA injection posterolateral to the brachial plexus may anesthetize the shoulder without incidental diaphragmatic dysfunction, but further confirmatory trials are required. Ultrasound-guided C7 root blocks also seem to offer an attractive, diaphragm-sparing alternative to ISB. However, additional large-scale studies are needed to confirm their efficacy and to quantify the risk of periforaminal vascular breach. Combined axillary-suprascapular nerve blocks may provide adequate postoperative analgesia for minor shoulder surgery but do not compare favorably to ISB for major surgical procedures. One intriguing solution lies in the combined use of infraclavicular brachial plexus blocks and suprascapular nerve blocks. Theoretically, the infraclavicular approach targets the posterior and lateral cords, thus anesthetizing the axillary nerve (which supplies the anterior and posterior shoulder joint), as well as the subscapular and lateral pectoral nerves (both of which supply the anterior shoulder joint), whereas the suprascapular nerve block anesthetizes the posterior shoulder. Future randomized trials are required to validate the efficacy of combined infraclavicular-suprascapular blocks for shoulder surgery.

  8. Morphological pattern of intrinsic nerve plexus distributed on the rabbit heart and interatrial septum

    Science.gov (United States)

    Saburkina, Inga; Gukauskiene, Ligita; Rysevaite, Kristina; Brack, Kieran E; Pauza, Audrys G; Pauziene, Neringa; Pauza, Dainius H

    2014-01-01

    Although the rabbit is routinely used as the animal model of choice to investigate cardiac electrophysiology, the neuroanatomy of the rabbit heart is not well documented. The aim of this study was to examine the topography of the intrinsic nerve plexus located on the rabbit heart surface and interatrial septum stained histochemically for acetylcholinesterase using pressure-distended whole hearts and whole-mount preparations from 33 Californian rabbits. Mediastinal cardiac nerves entered the venous part of the heart along the root of the right cranial vein (superior caval vein) and at the bifurcation of the pulmonary trunk. The accessing nerves of the venous part of the heart passed into the nerve plexus of heart hilum at the heart base. Nerves approaching the heart extended epicardially and innervated the atria, interatrial septum and ventricles by five nerve subplexuses, i.e. left and middle dorsal, dorsal right atrial, ventral right and left atrial subplexuses. Numerous nerves accessed the arterial part of the arterial part of the heart hilum between the aorta and pulmonary trunk, and distributed onto ventricles by the left and right coronary subplexuses. Clusters of intrinsic cardiac neurons were concentrated at the heart base at the roots of pulmonary veins with some positioned on the infundibulum. The mean number of intrinsic neurons in the rabbit heart is not significantly affected by aging: 2200 ± 262 (range 1517–2788; aged) vs. 2118 ± 108 (range 1513–2822; juvenile). In conclusion, despite anatomic differences in the distribution of intrinsic cardiac neurons and the presence of well-developed nerve plexus within the heart hilum, the topography of all seven subplexuses of the intrinsic nerve plexus in rabbit heart corresponds rather well to other mammalian species, including humans. PMID:24527844

  9. Infantile Perineal Protrusion in Two Monochorionic Twins

    Directory of Open Access Journals (Sweden)

    Paola Cavicchioli

    2014-11-01

    Full Text Available Case Report - Two female monochorionic-monoamniotic twins showed the same kind of infantile perineal protrusion (IPP at birth. Lesions in both twins progressively healed until resolution in 6 weeks' time; none of the twins have manifested, till date, alvus disturbances. Discussion and Literature Review - A literature review numbers approximately 100 reports of IPP. This condition has been classically classified into three categories: congenital/familiar (i.e., female sex, positive parental history of IPP, acquired (mainly due to constipation, and associated with lichen sclerosus et atrophicus. Conclusions and Final Remarks - This case report describes, for the first time, the presence of IPP in monochorionic-monoamniotic twins, supporting the existence of hereditary/genetic factors in the developing of this condition.

  10. The origin of X-ray protrusions in the VELA supernova remnant

    Science.gov (United States)

    Gvaramadze, V. V.

    We propose a possible explanation for the formation of X-ray protrusions in the Vela SNR, recently observed by the ROSAT X-ray telescope (Aschenbach, Egger & Trumper, 1995, Nature, 373, 587). We suggest that the highly asymmetric shape of the Vela SNR is the result of the interaction of the SN ejecta/shock with the pre-existing wind-driven shell blown-up in a medium with a density gradient (perpendicular to the Galactic plane). The interaction of the radiative (north-east) half of the remnant, approaching towards the Galactic plane, with dense obstacles (cloudlets or wind zones of stars) can produce X-ray "bullets" radially moving beyond the SNR boundary. These "bullets" originate due to the cooling and condensation of a gas swept-up by converging conical shocks arising behind the dense obstacles overtaken by the SN shock. The X-ray protrusions observed in the western part of the remnant might be explained by outflows of hot gas of the SNR's interior emanating through the gaps in the shell. The origin of the X-ray "jet" (Markwardt & Ogelman, 1995, Nature, 375, 40) in the central part of the Vela SNR is also discussed.

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

    KAUST Repository

    Morrison, Brett M.; Tsingalia, Akivaga; Vidensky, Svetlana; Lee, Youngjin; Jin, Lin; Farah, Mohamed H.; Lengacher, Sylvain; Magistretti, Pierre J.; Pellerin, Luc; Rothsteinb, Jeffrey D.

    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.

  12. Afferent fibers and sensory ganglion cells within the oculomotor nerve in some mammals and man. II. Electrophysiological investigations.

    Science.gov (United States)

    Manni, E; Bortolami, R; Pettorossi, V E; Lucchi, M L; Callegari, E

    1978-01-01

    The main aim of the present study was to localize with electrophysiological techniques the central projections and terminations of the aberrant trigeminal fibres contained in the oculomotor nerve of the lamb. After severing a trigeminal root, single-shock electrical stimulation of the trigeminal axons present in the central stump of the ipsilateral oculomotor nerve evoked field potentials in the area of, i) the subnucleus gelatinosus of the nucleus caudalis trigemini at the level of C1-C2; ii) the main sensory trigeminal nucleus; iii) the descending trigeminal nucleus and tract; iv) the adjacent reticular formation. Units whose discharge rate was influenced by such a stimulation were also found in the same territories. These regions actually exhibited degenerations after cutting an oculomotor nerve. We conclude, therefore, that the trigeminal fibres which leave the Vth nerve at the level of the cavernous sinus and enter the brain stem through the IIIrd nerve, end in the same structures which receive the terminations of the afferent fibres entering the brain stem through the sensory trigeminal root.

  13. Concepts of nerve regeneration and repair applied to brachial plexus reconstruction.

    Science.gov (United States)

    Bertelli, Jayme Augusto; Ghizoni, Marcos Flávio

    2006-01-01

    Brachial plexus injury is a serious condition that usually affects young adults. Progress in brachial plexus repair is intimately related to peripheral nerve surgery, and depends on clinical and experimental studies. We review the rat brachial plexus as an experimental model, together with its behavioral evaluation. Techniques to repair nerves, such as neurolysis, nerve coaptation, nerve grafting, nerve transfer, fascicular transfer, direct muscle neurotization, and end-to-side neurorraphy, are discussed in light of the authors' experimental studies. Intradural repair of the brachial plexus by graft implants into the spinal cord and motor rootlet transfer offer new possibilities in brachial plexus reconstruction. The clinical experience of intradural repair is presented. Surgical planning in root rupture or avulsion is proposed. In total avulsion, the authors are in favor of the reconstruction of thoraco-brachial and abdomino-antebrachial grasping, and on the transfer of the brachialis muscle to the wrist extensors if it is reinnervated. Surgical treatment of painful conditions and new drugs are also discussed.

  14. Boosted Regeneration and Reduced Denervated Muscle Atrophy by NeuroHeal in a Pre-clinical Model of Lumbar Root Avulsion with Delayed Reimplantation.

    Science.gov (United States)

    Romeo-Guitart, David; Forés, Joaquim; Navarro, Xavier; Casas, Caty

    2017-09-20

    The "gold standard" treatment of patients with spinal root injuries consists of delayed surgical reconnection of nerves. The sooner, the better, but problems such as injury-induced motor neuronal death and muscle atrophy due to long-term denervation mean that normal movement is not restored. Herein we describe a preclinical model of root avulsion with delayed reimplantation of lumbar roots that was used to establish a new adjuvant pharmacological treatment. Chronic treatment (up to 6 months) with NeuroHeal, a new combination drug therapy identified using a systems biology approach, exerted long-lasting neuroprotection, reduced gliosis and matrix proteoglycan content, accelerated nerve regeneration by activating the AKT pathway, promoted the formation of functional neuromuscular junctions, and reduced denervation-induced muscular atrophy. Thus, NeuroHeal is a promising treatment for spinal nerve root injuries and axonal regeneration after trauma.

  15. Pulsed Radiofrequency Applied to the Sciatic Nerve Improves Neuropathic Pain by Down-regulating The Expression of Calcitonin Gene-related Peptide in the Dorsal Root Ganglion

    Science.gov (United States)

    Ren, Hao; Jin, Hailong; Jia, Zipu; Ji, Nan; Luo, Fang

    2018-01-01

    Background: Clinical studies have shown that applying pulsed radiofrequency (PRF) to the neural stem could relieve neuropathic pain (NP), albeit through an unclear analgesic mechanism. And animal experiments have indicated that calcitonin gene-related peptide (CGRP) expressed in the dorsal root ganglion (DRG) is involved in generating and maintaining NP. In this case, it is uncertain whether PRF plays an analgesic role by affecting CGRP expression in DRG. Methods: Rats were randomly divided into four groups: Groups A, B, C, and D. In Groups C and D, the right sciatic nerve was ligated to establish the CCI model, while in Groups A and B, the sciatic nerve was isolated without ligation. After 14 days, the right sciatic nerve in Groups B and D re-exposed and was treated with PRF on the ligation site. Thermal withdrawal latency (TWL) and hindpaw withdrawal threshold (HWT) were measured before PRF treatment (Day 0) as well as after 2, 4, 8, and 14 days of treatment. At the same time points of the behavioral tests, the right L4-L6 DRG was sampled and analyzed for CGRP expression using RT-qPCR and an enzyme-linked immunosorbent assay (ELISA). Results: Fourteen days after sciatic nerve ligation, rats in Groups C and D had a shortened TWL (P 0.05). On the 8th and 14th days, the mRNA levels in Group D were restored to those of Groups A and B. Meanwhile, the CGRP content of Group D gradually dropped over time, from 76.4 pg/mg (Day 0) to 57.5 pg/mg (Day 14). Conclusions: In this study, we found that, after sciatic nerve ligation, rats exhibited apparent hyperalgesia and allodynia, and CGRP mRNA and CGRP contents in the L4-L6 DRG increased significantly. Through lowering CGRP expression in the DRG, PRF treatment might relieve the pain behaviors of NP. PMID:29333099

  16. Diagnosis of cauda equina abnormalities by using electromyography, discography, and epidurography in dogs

    International Nuclear Information System (INIS)

    Sisson, A.F.; LeCouteur, R.A.; Ingram, J.T.; Park, R.D.; Child, G.

    1992-01-01

    Electromyography (EMG), L7-S1 discography and epidurography were investigated in 15 dogs with clinical signs of cauda equina dysfunction and in 7 control dogs without such clinical signs. Electromyography of paraspinal and pelvic limb muscles was done in 13 of 15 affected dogs. An L7-S1 discogram followed by an epidurogram was performed in all 22 dogs using 20% iopamidol. Results of discograms, epidurograms, and gross necropsy examinations were normal in six of seven control dogs. The one dog in which these studies were abnormal had a mild L7-S1 disc protrusion that did not result in nerve root compression at necropsy. Electromyographic analysis was 100% accurate in predicting the presence or absence of cauda equina disease. None of the results of discograms were falsely negative. Twelve of 15 discograms in clinically affected dogs indicated dorsal disc protrusion, but 2 of these protrusions were found to be noncompressive at surgery (13% error). Abnormal epidurograms occurred in 9 of 15 clinically affected dogs. There was one false positive and two false negatives (20% error). Electromyography was a sensitive screening technique for the presence of cauda equina disease. Discography may be more sensitive for detection of L7-S1 disc protrusion than epidurography. An abnormal radiographic contrast study of the cauda equina may only be useful when combined with an abnormal EMG

  17. Optical stimulation of peripheral nerves in vivo

    Science.gov (United States)

    Wells, Jonathon D.

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

  18. Anatomical etiology of “pseudo-sciatica” from superior cluneal nerve entrapment: a laboratory investigation

    Directory of Open Access Journals (Sweden)

    Konno T

    2017-11-01

    Full Text Available Tomoyuki Konno,1 Yoichi Aota,2 Hiroshi Kuniya,1 Tomoyuki Saito,1 Ning Qu,3 Shogo Hayashi,3 Shinichi Kawata,3 Masahiro Itoh3 1Department of Orthopaedic Surgery, Yokohama City University Graduate School of Medicine, 2Department of Spine & Spinal Cord Surgery, Yokohama Brain and Spine Center, Yokohama, 3Department of Anatomy, Tokyo Medical University, Tokyo, Japan Objective: The superior cluneal nerve (SCN may become entrapped where it pierces the thoracolumbar fascia over the iliac crest; this can cause low back pain (LBP and referred pain radiating into the posterior thigh, calf, and occasionally the foot, producing the condition known as “pseudo-sciatica.” Because the SCN was thought to be a cutaneous branch of the lumbar dorsal rami, originating from the dorsal roots of L1–L3, previous anatomical studies failed to explain why SCN causes “pseudo-sciatica”. The purpose of the present anatomical study was to better elucidate the anatomy and improve the understanding of “pseudo-sciatica” from SCN entrapment. Materials and methods: SCN branches were dissected from their origin to termination in subcutaneous tissue in 16 cadavers (5 male and 11 female with a mean death age of 88 years (range 81–101 years. Special attention was paid to identify SCNs from their emergence from nerve roots and passage through the fascial attachment to the iliac crest. Results: Eighty-one SCN branches were identified originating from T12 to L5 nerve roots with 13 branches passing through the osteofibrous tunnel. These 13 branches originated from L3 (two sides, L4 (six sides, and L5 (five sides. Ten of the 13 branches showed macroscopic entrapment in the tunnel. Conclusion: The majority of SCNs at risk of nerve entrapment originated from the lower lumbar nerve. These anatomical results may explain why patients with SCN entrapment often evince leg pain or tingling that mimics sciatica. Keywords: superior cluneal nerve, entrapment neuropathy, dorsal rami

  19. Terminal nerve: cranial nerve zero

    Directory of Open Access Journals (Sweden)

    Jorge Eduardo Duque Parra

    2006-12-01

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

  20. Anomalous rostral lumbosacral root emergence from the thecal sac

    International Nuclear Information System (INIS)

    Peyster, R.G.; Parghi, A.; Siegal, T.; Hershey, B.L.; Yablon, J.; Jaffe, S.

    1989-01-01

    Anomalous rostral lumbosacral root emergence (AARE) has important clinical implications and has received little attention. The authors have studied the occurrence of this anomaly and presentation of cases in which it was paramount in causing radiculopathy. AARE was noted with the following occurrence rates in 500 cases: L3, 0%; L4, 1%; L5, 9%, and S1, 16%. In ARRE, the roots lie laterally between the superior facet and the annulus and are subject to compression by minimal disk bulging or facet hypertrophy. One must track the individual nerve roots on lumbar CT and MR imaging to detect this subtle condition

  1. Wet cupping therapy improves local blood perfusion and analgesic effects in patients with nerve-root type cervical spondylosis.

    Science.gov (United States)

    Meng, Xiang-Wen; Wang, Ying; Piao, Sheng-Ai; Lv, Wen-Tao; Zhu, Cheng-Hui; Mu, Ming-Yuan; Li, Dan-Dan; Liu, Hua-Peng; Guo, Yi

    2018-01-15

    To observe wet cupping therapy (WCT) on local blood perfusion and analgesic effects in patients with nerve-root type cervical spondylosis (NT-CS). Fifty-seven NT-CS patients were randomly divided into WCT group and Jiaji acupoint-acupuncture (JA) group according a random number table. WCT group (30 cases) was treated with WCT for 10 min, and JA group (27 cases) was treated with acupuncture for 10 min. The treatment effificacies were evaluated with a Visual Analogue Scale (VAS). Blood perfusion at Dazhui (GV 14) and Jianjing (GB 21) acupoints (affected side) was observed with a laser speckle flflowmetry, and its variations before and after treatment in both groups were compared as well. In both groups, the VAS scores signifificantly decreased after the intervention (P<0.01), while the blood perfusion at the two acupoints signifificantly increased after intervention (P<0.05); however, the increasement magnitude caused by WCT was obvious compared with JA (P<0.05). WCT could improve analgesic effects in patients with NT-CS, which might be related to increasing local blood perfusion of acupunct points.

  2. Comparison of the fastest regenerating motor and sensory myelinated axons in the same peripheral nerve

    DEFF Research Database (Denmark)

    Moldovan, Mihai; Sørensen, Jesper; Krarup, Christian

    2006-01-01

    Functional outcome after peripheral nerve regeneration is often poor, particularly involving nerve injuries far from their targets. Comparison of sensory and motor axon regeneration before target reinnervation is not possible in the clinical setting, and previous experimental studies addressing...... the question of differences in growth rates of different nerve fibre populations led to conflicting results. We developed an animal model to compare growth and maturation of the fastest growing sensory and motor fibres within the same mixed nerve after Wallerian degeneration. Regeneration of cat tibial nerve...... after crush (n = 13) and section (n = 7) was monitored for up to 140 days, using implanted cuff electrodes placed around the sciatic and tibial nerves and wire electrodes at plantar muscles. To distinguish between sensory and motor fibres, recordings were carried out from L6-S2 spinal roots using cuff...

  3. A mechanism of leading-edge protrusion in the absence of Arp2/3 complex.

    Science.gov (United States)

    Suraneni, Praveen; Fogelson, Ben; Rubinstein, Boris; Noguera, Philippe; Volkmann, Niels; Hanein, Dorit; Mogilner, Alex; Li, Rong

    2015-03-01

    Cells employ protrusive leading edges to navigate and promote their migration in diverse physiological environments. Classical models of leading-edge protrusion rely on a treadmilling dendritic actin network that undergoes continuous assembly nucleated by the Arp2/3 complex, forming ruffling lamellipodia. Recent work demonstrated, however, that, in the absence of the Arp2/3 complex, fibroblast cells adopt a leading edge with filopodia-like protrusions (FLPs) and maintain an ability to move, albeit with altered responses to different environmental signals. We show that formin-family actin nucleators are required for the extension of FLPs but are insufficient to produce a continuous leading edge in fibroblasts lacking Arp2/3 complex. Myosin II is concentrated in arc-like regions of the leading edge in between FLPs, and its activity is required for coordinated advancement of these regions with formin-generated FLPs. We propose that actomyosin contraction acting against membrane tension advances the web of arcs between FLPs. Predictions of this model are verified experimentally. The dependence of myosin II in leading-edge advancement helps explain the previously reported defect in directional movement in the Arpc3-null fibroblasts. We provide further evidence that this defect is cell autonomous during chemotaxis. © 2015 Suraneni et al. This article is distributed by The American Society for Cell Biology under license from the author(s). Two months after publication it is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

  4. Radiation impairs perineural invasion by modulating the nerve microenvironment.

    Directory of Open Access Journals (Sweden)

    Richard L Bakst

    Full Text Available Perineural invasion (PNI by cancer cells is an ominous clinical event that is associated with increased local recurrence and poor prognosis. Although radiation therapy (RT may be delivered along the course of an invaded nerve, the mechanisms through which radiation may potentially control PNI remain undefined.An in vitro co-culture system of dorsal root ganglia (DRG and pancreatic cancer cells was used as a model of PNI. An in vivo murine sciatic nerve model was used to study how RT to nerve or cancer affects nerve invasion by cancer.Cancer cell invasion of the DRG was partially dependent on DRG secretion of glial-derived neurotrophic factor (GDNF. A single 4 Gy dose of radiation to the DRG alone, cultured with non-radiated cancer cells, significantly inhibited PNI and was associated with decreased GDNF secretion but intact DRG viability. Radiation of cancer cells alone, co-cultured with non-radiated nerves, inhibited PNI through predominantly compromised cancer cell viability. In a murine model of PNI, a single 8 Gy dose of radiation to the sciatic nerve prior to implantation of non-radiated cancer cells resulted in decreased GDNF expression, decreased PNI by imaging and histology, and preservation of sciatic nerve motor function.Radiation may impair PNI through not only direct effects on cancer cell viability, but also an independent interruption of paracrine mechanisms underlying PNI. RT modulation of the nerve microenvironment may decrease PNI, and hold significant therapeutic implications for RT dosing and field design for patients with cancers exhibiting PNI.

  5. Diagnosis of cervical intervertebral disc protrusion and the relation between localization of the lesion and the neurological symptoms

    International Nuclear Information System (INIS)

    Isu, Toyohiko; Iwasaki, Yoshinobu; Abe, Hiroshi; Miyasaka, Kazuo; Tashiro, Kunio; Tsuru, Mitsuo; Ito, Terufumi.

    1985-01-01

    In the cervical disc disease, computed tomography (CT) myelographic and conventional myelographic findings were surgically confirmed. The authors classified the disc protrusion into two types, and demonstrated the characteristic features of these two types in CT myelography and conventional myelography. Moreover, the correlation with the localization of the disc protrusion and the laterality of the myelopathy are discussed. All cases were obtained using a late generation scanner and the patient in the supine position with the neck in the neutral position. Using conventional myelography, all examinations were obtained with the neck in a flexion, neutral and extended positions. Twenty-two patients with cervical disc disease operated on by an anterior approach were studied by CT myelography and conventional myelography. According to the style of the compression on the spinal cord, the cervical disc protrusion was classified into two main groups, the subligamentous type and epiligamentous type. This study included 10 patients of the subligamentous type and 12 patients of the epiligamentous type. The localization of the disc protrusion and the laterality of the myelopathy often corresponded with each other. Not only the localization of the lesion, but also the pincer effect, especially the oblique pincer effect, which is reinforced by dynamic factors, are important in the understanding of the manifestations of myelopathy. In the subligamentous type, the main cause of the myelopathy is considered to be the mechanical pressure by the prolapsed nucleus pulposus. In the epiligamentous type, on the other hand, it is believed to be the pincer effect, reinforced by dynamic factors. (author)

  6. Multiple locations of nerve compression: an unusual cause of persistent lower limb paresthesia.

    Science.gov (United States)

    Ang, Chia-Liang; Foo, Leon Siang Shen

    2014-01-01

    A paucity of appreciation exists that the "double crush" phenomenon can account for persistent leg symptoms even after spinal neural decompression surgery. We present an unusual case of multiple locations of nerve compression causing persistent lower limb paresthesia in a 40-year old male patient. The patient's lower limb paresthesia was persistent after an initial spinal surgery to treat spinal lateral recess stenosis thought to be responsible for the symptoms. It was later discovered that he had peroneal muscle herniations that had caused superficial peroneal nerve entrapments at 2 separate locations. The patient obtained much symptomatic relief after decompression of the peripheral nerve. The "double crush" phenomenon and multiple levels of nerve compression should be considered when evaluating lower limb neurogenic symptoms, especially after spinal nerve root surgery. Copyright © 2014 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  7. Retrograde tracing and toe spreading after experimental autologous nerve transplantation and crush injury of the sciatic nerve: a descriptive methodological study

    Directory of Open Access Journals (Sweden)

    van Neerven Sabien GA

    2012-04-01

    Full Text Available Abstract Evaluation of functional and structural recovery after peripheral nerve injury is crucial to determine the therapeutic effect of a nerve repair strategy. In the present study, we examined the relationship between the structural evaluation of regeneration by means of retrograde tracing and the functional analysis of toe spreading. Two standardized rat sciatic nerve injury models were used to address this relationship. As such, animals received either a 2 cm sciatic nerve defect (neurotmesis followed by autologous nerve transplantation (ANT animals or a crush injury with spontaneous recovery (axonotmesis; CI animals. Functional recovery of toe spreading was observed over an observation period of 84 days. In contrast to CI animals, ANT animals did not reach pre-surgical levels of toe spreading. After the observation period, the lipophilic dye DiI was applied to label sensory and motor neurons in dorsal root ganglia (DRG; sensory neurons and spinal cord (motor neurons, respectively. No statistical difference in motor or sensory neuron counts could be detected between ANT and CI animals. In the present study we could indicate that there was no direct relationship between functional recovery (toe spreading measured by SSI and the number of labelled (motor and sensory neurons evaluated by retrograde tracing. The present findings demonstrate that a multimodal approach with a variety of independent evaluation tools is essential to understand and estimate the therapeutic benefit of a nerve repair strategy.

  8. Impact of the surgical strategy on the incidence of C5 nerve root palsy in decompressive cervical surgery.

    Directory of Open Access Journals (Sweden)

    Theresa Krätzig

    Full Text Available Our aim was to identify the impact of different surgical strategies on the incidence of C5 palsy.Degenerative cervical spinal stenosis is a steadily increasing morbidity in the ageing population. Postoperative C5 nerve root palsy is a common complication with severe impact on the patients´ quality of life.We identified 1708 consecutive patients who underwent cervical decompression surgery due to degenerative changes. The incidence of C5 palsy and surgical parameters including type and level of surgery were recorded to identify predictors for C5 nerve palsy.The overall C5 palsy rate was 4.8%, with 18.3% of cases being bilateral. For ACDF alone the palsy rate was low (1.13%, compared to 14.0% of C5 palsy rate after corpectomy. The risk increased with extension of the procedures. Hybrid constructs with corpectomy plus ACDF at C3-6 showed significantly lower rates of C5 palsy (10.7% than corpectomy of two vertebrae (p = 0.005. Multiple regression analysis identified corpectomy of C4 or C5 as a significant predictor. We observed a lower overall incidence for ventral (4.3% compared to dorsal (10.9% approaches (p<0.001. When imaging detected a postoperative shift of the spinal cord at index segment C4/5, palsy rate increased significantly (33.3% vs. 12.5%, p = 0.034.Extended surgical strategies, such as dorsal laminectomies, multilevel corpectomies and procedures with extensive spinal cord shift were shown to display a high risk of C5 palsy. The use of extended procedures should therefore be employed cautiously. Switching to combined surgical methods like ACDF plus corpectomy can reduce the rate of C5 palsy.

  9. Space Closure with Loop Mechanics for Treatment of Bimaxillary Protrusion: A Case Report

    Science.gov (United States)

    Sanjay, N; Rajesh, R N G; Scindia, Rajat; Ajith, Sreedevi D

    2015-01-01

    This case report intends to highlight the space closure with tear drop loop mechanics for bimaxillary protrusion. Loops can be fabricated in a sectional or full arch wire, and closing loops are usually used in loop mechanics for extraction space closure. The major advantage of loop mechanics is the lack of friction between the bracket and arch wire during space closure. An adult patient with bimaxillary protrusion reported to the clinic. The patient was treated successfully by maximum retraction of maxillary and mandibular anterior teeth after extraction of all first premolars. Space closure was begun using a moment differential between posterior and anterior segments created by a Tear drop loop. Anterior teeth were moved with bodily movement, and no anchorage loss of the posterior segments was seen using a Tear drop loop spring. A stable result with normal over jet and overbite was achieved with retraction of maxillary and mandibular anterior teeth. With a Tear drop loop, individual biomechanical responses can be achieved, and it is possible to calculate force magnitude for every patient. PMID:26028908

  10. A study on normal value of eyeball protrusion in Korean adult using CT

    International Nuclear Information System (INIS)

    Song, Chi Sung; Chang, Kee Hyun

    1984-01-01

    CT may be valuably used in determination of proptosis. Normal value of eyeball protrusion was measured in normal Koreans using CT. Among 86 Koreans, 26 have normal both eyes, but 60 have one normal eye with one abnormal eye (chiefly, proptosis and and eyeball tumor). The results of 112 eyes are as follows: Absolute measurement of 'a', that is, the distance between cornea and IZL (interzygomatic line) is 16.0±3.4 mm in male (for 63 eye), 15.7±4.0 mm in female for 49 eyes. Ratio of 'a' over 'A' (A-P diameter of eyeball) is 57±12% is male (for 63 eye), 57±14% in female (for 49 eye) Discrepancy of eyeball protrusion between both eyes is 0.67±1.5 mm (for 26 adults). Practically, normal range of eyeball prtotrusion ('a') is 12.6 mm < male < 19.4 mm, 11.7 mm < female < 19.7 mm. 'a/A' ratio over 70% and over 2mm discrepancy between both eyes are also suggested as genuine exophthalmos

  11. Phrenic Nerve Palsy and Regional Anesthesia for Shoulder Surgery: Anatomical, Physiologic, and Clinical Considerations.

    Science.gov (United States)

    El-Boghdadly, Kariem; Chin, Ki Jinn; Chan, Vincent W S

    2017-07-01

    Regional anesthesia has an established role in providing perioperative analgesia for shoulder surgery. However, phrenic nerve palsy is a significant complication that potentially limits the use of regional anesthesia, particularly in high-risk patients. The authors describe the anatomical, physiologic, and clinical principles relevant to phrenic nerve palsy in this context. They also present a comprehensive review of the strategies for reducing phrenic nerve palsy and its clinical impact while ensuring adequate analgesia for shoulder surgery. The most important of these include limiting local anesthetic dose and injection volume and performing the injection further away from the C5-C6 nerve roots. Targeting peripheral nerves supplying the shoulder, such as the suprascapular and axillary nerves, may be an effective alternative to brachial plexus blockade in selected patients. The optimal regional anesthetic approach in shoulder surgery should be tailored to individual patients based on comorbidities, type of surgery, and the principles described in this article.

  12. Electron microscopy of human peripheral nerves of clinical relevance to the practice of nerve blocks. A structural and ultrastructural review based on original experimental and laboratory data.

    Science.gov (United States)

    Reina, M A; Arriazu, R; Collier, C B; Sala-Blanch, X; Izquierdo, L; de Andrés, J

    2013-12-01

    The goal is to describe the ultrastructure of normal human peripheral nerves, and to highlight key aspects that are relevant to the practice of peripheral nerve block anaesthesia. Using samples of sciatic nerve obtained from patients, and dural sac, nerve root cuff and brachial plexus dissected from fresh human cadavers, an analysis of the structure of peripheral nerve axons and distribution of fascicles and topographic composition of the layers that cover the nerve is presented. Myelinated and unmyelinated axons, fascicles, epineurium, perineurium and endoneurium obtained from patients and fresh cadavers were studied by light microscopy using immunohistochemical techniques, and transmission and scanning electron microscopy. Structure of perineurium and intrafascicular capillaries, and its implications in blood-nerve barrier were revised. Each of the anatomical elements is analyzed individually with regard to its relevance to clinical practice to regional anaesthesia. Routine practice of regional anaesthetic techniques and ultrasound identification of nerve structures has led to conceptions, which repercussions may be relevant in future applications of these techniques. In this regard, the ultrastructural and histological perspective accomplished through findings of this study aims at enlightening arising questions within the field of regional anaesthesia. Copyright © 2013 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights reserved.

  13. On the nature of the afferent fibers of oculomotor nerve.

    Science.gov (United States)

    Manni, E; Draicchio, F; Pettorossi, V E; Carobi, C; Grassi, S; Bortolami, R; Lucchi, M L

    1989-03-01

    The oculogyric nerves contain afferent fibers originating from the ophthalmic territory, the somata of which are located in the ipsilateral semilunar ganglion. These primary sensory neurons project to the Subnucleus Gelatinosus of the Nucleus Caudalis Trigemini, where they make presynaptic contact with the central endings of the primary trigeminal afferents running in the fifth cranial nerve. After complete section of the trigeminal root, the antidromic volleys elicited in the trunk of the third cranial nerve by stimulating SG of NCT consisted of two waves belonging to the A delta and C groups. The area of both components of the antidromic volleys decreased both after bradykinin and hystamine injection into the corresponding cutaneous region and after thermic stimulation of the ipsilateral trigeminal ophthalmic territory. The reduction of such potentials can be explained in terms of collision between the antidromic volleys and those elicited orthodromically by chemical and thermic stimulation. Also, capsaicin applied on the nerve induced an immediate increase, followed by a long lasting decrease, of orthodromic evoked response area. These findings bring further support to the nociceptive nature of the afferent fibers running into the oculomotor nerve.

  14. Reduced Renshaw Recurrent Inhibition after Neonatal Sciatic Nerve Crush in Rats

    Directory of Open Access Journals (Sweden)

    Liang Shu

    2014-01-01

    Full Text Available Renshaw recurrent inhibition (RI plays an important gated role in spinal motion circuit. Peripheral nerve injury is a common disease in clinic. Our current research was designed to investigate the change of the recurrent inhibitory function in the spinal cord after the peripheral nerve crush injury in neonatal rat. Sciatic nerve crush was performed on 5-day-old rat puppies and the recurrent inhibition between lateral gastrocnemius-soleus (LG-S and medial gastrocnemius (MG motor pools was assessed by conditioning monosynaptic reflexes (MSR elicited from the sectioned dorsal roots and recorded either from the LG-S and MG nerves by antidromic stimulation of the synergist muscle nerve. Our results demonstrated that the MSR recorded from both LG-S or MG nerves had larger amplitude and longer latency after neonatal sciatic nerve crush. The RI in both LG-S and MG motoneuron pools was significantly reduced to virtual loss (15–20% of the normal RI size even after a long recovery period upto 30 weeks after nerve crush. Further, the degree of the RI reduction after tibial nerve crush was much less than that after sciatic nerve crush indicatig that the neuron-muscle disconnection time is vital to the recovery of the spinal neuronal circuit function during reinnervation. In addition, sciatic nerve crush injury did not cause any spinal motor neuron loss but severally damaged peripheral muscle structure and function. In conclusion, our results suggest that peripheral nerve injury during neonatal early development period would cause a more sever spinal cord inhibitory circuit damage, particularly to the Renshaw recurrent inhibition pathway, which might be the target of neuroregeneration therapy.

  15. [Comparing the anchorage effects of micro-implant and J hook on treating patients with maxillary protrusion].

    Science.gov (United States)

    Wu, Xin; Liu, Guo-yuan; Jiang, Yong-lian

    2015-10-01

    To investigate the differences in anchorage effects between micro-implants and J hook in treating patients with Class II division 1 maxillary protrusion. Thirty-one cases of adult patients with Class II division 1 maxillary protrusion were treated. They were divided into 2 groups depending on their selection. The first group included 17 patients for micro-implant anchorage, who adopted micro-implant and sliding mechanism to close maxillary extraction space and depress the mandibular molar. The second group encompassed 14 cases for J hook, who adopted sliding mechanism, J hooks in high traction and Class II intermaxillary traction to close extraction space. X-ray lateral cephalometric radiographs were measured before and after treatment, and SPSS16.0 software package was employed to compare the differences in soft and hard tissue changes before and after treatment between 2 groups. There were statistically significant differences in SNB, ANB, MP-FH, U1-Y, U6-Y, L6-MP, NLA, and UL-Y between the 2 groups before and after treatment, while there was no significant difference in SNA, U1-SN, U1-X, and U6-X between the 2 groups. In treating patients with Class II division 1 maxillary protrusion, micro-implant has stronger anchorage effects than J hook, while at the same time depressing the mandibular molars, and making it more favorable to improve Class II faces.

  16. APC/β-catenin-rich complexes at membrane protrusions regulate mammary tumor cell migration and mesenchymal morphology

    International Nuclear Information System (INIS)

    Odenwald, Matthew A; Prosperi, Jenifer R; Goss, Kathleen H

    2013-01-01

    The APC tumor suppressor is mutated or downregulated in many tumor types, and is prominently localized to punctate clusters at protrusion tips in migratory cells, such as in astrocytes where it has been implicated in directed cell motility. Although APC loss is considered an initiating event in colorectal cancer, for example, it is less clear what role APC plays in tumor cell motility and whether loss of APC might be an important promoter of tumor progression in addition to initiation. The localization of APC and β-catenin was analyzed in multiple cell lines, including non-transformed epithelial lines treated with a proteasome inhibitor or TGFβ to induce an epithelial-to-mesenchymal transition (EMT), as well as several breast cancer lines, by immunofluorescence. APC expression was knocked down in 4T07 mammary tumor cells using lentiviral-mediated delivery of APC-specific short-hairpin (sh) RNAs, and assessed using quantitative (q) reverse-transcriptase (RT)-PCR and western blotting. Tumor cell motility was analyzed by performing wound-filling assays, and morphology via immunofluorescence (IF) and phase-contrast microscopy. Additionally, proliferation was measured using BrdU incorporation, and TCF reporter assays were performed to determine β-catenin/TCF-mediated transcriptional activity. APC/β-catenin-rich complexes were observed at protrusion ends of migratory epithelial cells treated with a proteasome inhibitor or when EMT has been induced and in tumor cells with a mesenchymal, spindle-like morphology. 4T07 tumor cells with reduced APC levels were significantly less motile and had a more rounded morphology; yet, they did not differ significantly in proliferation or β-catenin/TCF transcriptional activity. Furthermore, we found that APC/β-catenin-rich complexes at protrusion ends were dependent upon an intact microtubule cytoskeleton. These findings indicate that membrane protrusions with APC/β-catenin-containing puncta control the migratory potential and

  17. APC/β-catenin-rich complexes at membrane protrusions regulate mammary tumor cell migration and mesenchymal morphology

    Science.gov (United States)

    2013-01-01

    Background The APC tumor suppressor is mutated or downregulated in many tumor types, and is prominently localized to punctate clusters at protrusion tips in migratory cells, such as in astrocytes where it has been implicated in directed cell motility. Although APC loss is considered an initiating event in colorectal cancer, for example, it is less clear what role APC plays in tumor cell motility and whether loss of APC might be an important promoter of tumor progression in addition to initiation. Methods The localization of APC and β-catenin was analyzed in multiple cell lines, including non-transformed epithelial lines treated with a proteasome inhibitor or TGFβ to induce an epithelial-to-mesenchymal transition (EMT), as well as several breast cancer lines, by immunofluorescence. APC expression was knocked down in 4T07 mammary tumor cells using lentiviral-mediated delivery of APC-specific short-hairpin (sh) RNAs, and assessed using quantitative (q) reverse-transcriptase (RT)-PCR and western blotting. Tumor cell motility was analyzed by performing wound-filling assays, and morphology via immunofluorescence (IF) and phase-contrast microscopy. Additionally, proliferation was measured using BrdU incorporation, and TCF reporter assays were performed to determine β-catenin/TCF-mediated transcriptional activity. Results APC/β-catenin-rich complexes were observed at protrusion ends of migratory epithelial cells treated with a proteasome inhibitor or when EMT has been induced and in tumor cells with a mesenchymal, spindle-like morphology. 4T07 tumor cells with reduced APC levels were significantly less motile and had a more rounded morphology; yet, they did not differ significantly in proliferation or β-catenin/TCF transcriptional activity. Furthermore, we found that APC/β-catenin-rich complexes at protrusion ends were dependent upon an intact microtubule cytoskeleton. Conclusions These findings indicate that membrane protrusions with APC/β-catenin-containing puncta

  18. Expression patterns and role of PTEN in rat peripheral nerve development and injury.

    Science.gov (United States)

    Chen, Hui; Xiang, Jianping; Wu, Junxia; He, Bo; Lin, Tao; Zhu, Qingtang; Liu, Xiaolin; Zheng, Canbin

    2018-05-29

    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 Elsevier B.V. All rights reserved.

  19. Endogenous neurotrophin-3 promotes neuronal sprouting from dorsal root ganglia.

    Science.gov (United States)

    Wang, Xu-Yang; Gu, Pei-Yuan; Chen, Shi-Wen; Gao, Wen-Wei; Tian, Heng-Li; Lu, Xiang-He; Zheng, Wei-Ming; Zhuge, Qi-Chuan; Hu, Wei-Xing

    2015-11-01

    In the present study, we investigated the role of endogenous neurotrophin-3 in nerve terminal sprouting 2 months after spinal cord dorsal root rhizotomy. The left L1-5 and L7-S2 dorsal root ganglia in adult cats were exposed and removed, preserving the L6 dorsal root ganglia. Neurotrophin-3 was mainly expressed in large neurons in the dorsal root ganglia and in some neurons in spinal lamina II. Two months after rhizotomy, the number of neurotrophin-3-positive neurons in the spared dorsal root ganglia and the density of neurite sprouts emerging from these ganglia were increased. Intraperitoneal injection of an antibody against neurotrophin-3 decreased the density of neurite sprouts. These findings suggest that endogenous neurotrophin-3 is involved in spinal cord plasticity and regeneration, and that it promotes axonal sprouting from the dorsal root ganglia after spinal cord dorsal root rhizotomy.

  20. Comparison of ultrasound and ultrasound plus nerve stimulator guidance axillary plexus block

    International Nuclear Information System (INIS)

    Demirelli, G.; Baskan, S.; Karabeyoglu, I.; Aytac, I.; Omek, D.H.; Erdogmus, A.; Baydar, M.

    2017-01-01

    To evaluate the characteristics of axillary plexus blockade applied using ultrasound only and using ultrasound together with nerve stimulator in patients undergoing planned forearm, wrist or hand surgery. Methods: This randomised, prospective, double-blinded, single-centre study was conducted at Ankara Numune Training and Research Hospital, Ankara, Turkey, from November 2014 to August 2015, and comprised patients undergoing forearm, wrist or hand surgery. Participants were separated into 2 groups. In Group 1, the nerve roots required for the surgical site were located one by one and local anaesthetic was applied separately to each nerve for the block. In Group 2, the vascular nerve bundle was located under ultrasound guidance and a total block was achieved by administering all the local anaesthetic within the nerve sheath. In the operating room, standard monitorisation was applied. Following preparation of the skin, the axillary region nerve roots and branches and vascular structures were observed by examination with a high-frequency ultrasound probe. In both groups, a 22-gauge, 5cm block needle was entered to the axillary region with visualisation of the whole needle on ultrasound and 20ml local anaesthetic of 0.5% bupivacaine was injected. SPSS 19 was used for data analysis. Results: Of the 60 participants, there were 30(50%) in each group. The mean age was 39.1+-15 years in the group 1 which was the ultrasound nerve stimulation group, and 41.5+-14.3 years in group 2. The duration of the procedure was longer in group I than in group 2 (p<0.05). Patient satisfaction values during the procedure were higher in group 2(p<0.05). In the ulnar sensory examination, the values of the patients in group 1 were higher at 10, 15, 20 and 25 minutes (p<0.05). In the median, radial and ulnar motor examination, the values of the patients in group 1were higher at 15 and 20 minutes (p<0.05). Conclusion: Brachial plexus blockade via axillary approach guided by ultrasound offered

  1. Inferior alveolar nerve paresthesia after overfilling of endodontic sealer into the mandibular canal.

    Science.gov (United States)

    González-Martín, Maribel; Torres-Lagares, Daniel; Gutiérrez-Pérez, José Luis; Segura-Egea, Juan José

    2010-08-01

    The present study describes a case of endodontic sealer (AH Plus) penetration within and along the mandibular canal from the periapical zone of a lower second molar after endodontic treatment. The clinical manifestations comprised anesthesia of the left side of the lower lip, paresthesia and anesthesia of the gums in the third quadrant, and paresthesia and anesthesia of the left mental nerve, appearing immediately after endodontic treatment. The paresthesia and anesthesia of the lip and gums were seen to decrease, but the mental nerve paresthesia and anesthesia persisted after 3.5 years. This case illustrates the need to expend great care with all endodontic techniques when performing nonsurgical root canal therapy, especially when the root apices are in close proximity to vital anatomic structures such as the inferior alveolar canal. Copyright 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  2. Unusual facial pain secondary to inferior alveolar nerve compression caused by impacted mandibular second molar

    Directory of Open Access Journals (Sweden)

    Urvashi Sharma

    2014-01-01

    Full Text Available Symptoms of inferior alveolar nerve (IAN compression are reported during endodontic procedures, placement of implants, third molar surgeries, inferior alveolar nerve block injections, trauma, orthognathic injuries, ablative surgeries or use of medicaments. Presented is a rare case of a 15-year-old girl who reported severe pain in relation to an impacted permanent mandibular left second molar, the roots of which had entrapped the mandibular canal causing compression of IAN. Timely surgical intervention and sectional removal of the impacted molar is indicated to relieve the symptoms and avoid permanent damage to the nerve.

  3. Anatomical relationship between mental foramen, mandibular teeth and risk of nerve injury with endodontic treatment.

    Science.gov (United States)

    Chong, Bun San; Gohil, Kajal; Pawar, Ravikiran; Makdissi, Jimmy

    2017-01-01

    The objective of the present study was to evaluate the anatomical relationship between mental foramen (MF), including the incidence of the anterior loop of the inferior alveolar nerve (AL), and roots of mandibular teeth in relation to risk of nerve injury with endodontic treatment. Cone-beam computed tomography (CBCT) images, which included teeth either side of the MF, were randomly selected. The anonymised CBCT images were reconstructed and examined in coronal, axial and sagittal planes, using three-dimensional viewing software, to determine the relationship and distance between MF and adjacent mandibular teeth. The actual distance between the root apex and MF was calculated mathematically using Pythagoras' theorem. If present, the incidence of an AL in the axial plane was also recorded. The root apex of the mandibular second premolar (70 %), followed by the first premolar (18 %) and then the first molar (12 %), was the closest to the MF. Ninety-six percent of root apices evaluated were >3 mm from the MF. An AL was present in 88 % of the cases. With regards to endodontic treatment, the risk of nerve injury in the vicinity of the MF would appear to be low. However, the high incidence of the AL highlights the need for clinicians to be aware and careful of this important anatomical feature. The risk of injury to the MN with endodontic treatment would appear to be low, but given the high incidence, it is important to be aware and be careful of the AL.

  4. Diabetes does not accelerate neuronal loss following nerve injury

    DEFF Research Database (Denmark)

    Severinsen, Kaare; Jakobsen, Johannes

    2007-01-01

    To determine the resistance of neuronal dorsal root ganglion (DRG) cells in experimental diabetes, we studied the neuronal cell loss after severe axonal injury in streptozotocin (STZ) diabetic rats with unilateral transection of the L5 spinal nerve for 12 weeks. Fifty 18-week-old inbred male Wistar...... nondiabetic control rats at 18 weeks and five nondiabetic control rats at 30 weeks were included to determine whether DRG cell changes occur without nerve injury during the study period. In group 1, the stereologically determined number of all neuronal DRG cells was unchanged after 12 weeks of diabetes....... The mean perikaryal volume of neuronal DRG cells of the A and B subtypes was reduced by 10% each (p

  5. [Peculiarities of clinico-neurological signs of the intervertebral discs protrusions in lumbar portion of vertebral column in patients of various age].

    Science.gov (United States)

    Khyzniak, M V; Pryĭmak, E V

    2013-11-01

    Clinico-neurological signs of the discogenic pain syndromes, caused by intervertebral disc (IVD) protrusion in a lumbar portion of vertebral column, were analyzed. The strict indications were substantiated for application of the puncture treatment methods for the discogenic pain syndromes in patients of various ages. Clinico-neurological signs of the IVD protrusions constitute the important criterion while the treatment method selection. Differentiated application of the puncture methods permits to improve the treatment results in the patients of various age.

  6. Relationship of specific MRI findings to treatment outcomes in patients receiving transforaminal epidural steroid injections

    Energy Technology Data Exchange (ETDEWEB)

    Lechmann, Marco; Rosskopf, Andrea; Ehrmann, Christine; Sutter, Reto; Pfirrmann, Christian W.A.; Peterson, Cynthia K. [University of Zuerich, Department of Radiology, Orthopaedic University Hospital Balgrist, Zuerich (Switzerland)

    2016-12-15

    To determine whether specific MRI findings are related to outcomes after lumbar transforaminal epidural steroid injections (TFESI) and to assess the inter-rater reliability of imaging diagnosis. A prospective outcomes study on 156 consecutive patients with 1-month follow-up outcomes data and MRI within 3 months of TFESI was conducted. Pain levels (numerical rating scale) (NRS) were recorded prior to injection. Overall 'improvement' was determined using the Patients Global Impression of Change (PGIC) scale and NRS data were collected at three time points post injection. Two radiologists independently evaluated all images blinded to treatment outcome for reliability of diagnosis. The Chi-square test compared MRI findings for the senior radiologist to 'improvement'. NRS change scores were compared to MRI findings with the unpaired t-test or ANOVA. Kappa and percent agreement assessed inter-rater agreement of diagnosis. The only abnormality linked to 'improvement' (p = 0.03) and higher NRS change scores (p = 0.0001) at 1 month was the disc herniation morphology 'protrusion + sequestration'. Patients with degeneration by osteophytes (p = 0.034), grade 3 foraminal nerve root compression (p = 0.01) and foraminal/extraforaminal location of herniation (p = 0.014) also had higher 1 month NRS change scores. Reliability of diagnosis was 'fair' to 'substantial' depending on MRI findings. Patients with disc protrusion plus sequestration were significantly more likely to report overall improvement and more pain reduction at 1 month. Higher pain reduction was noted in patients with degeneration by osteophytes, grade 3 foraminal nerve root compression, or foraminal/extraforaminal disc herniation location. (orig.)

  7. Hericium erinaceus (Bull.: Fr.) Pers., a medicinal mushroom, activates peripheral nerve regeneration.

    Science.gov (United States)

    Wong, Kah-Hui; Kanagasabapathy, Gowri; Naidu, Murali; David, Pamela; Sabaratnam, Vikineswary

    2016-10-01

    To study the ability of aqueous extract of Hericium erinaceus mushroom in the treatment of nerve injury following peroneal nerve crush in Sprague-Dawley rats. Aqueous extract of Hericium erinaceus was given by daily oral administration following peroneal nerve crush injury in Sprague-Dawley rats. The expression of protein kinase B (Akt) and mitogen-activated protein kinase (MAPK) signaling pathways; and c-Jun and c-Fos genes were studied in dorsal root ganglia (DRG) whereas the activity of protein synthesis was assessed in peroneal nerves by immunohistochemical method. Peripheral nerve injury leads to changes at the axonal site of injury and remotely located DRG containing cell bodies of sensory afferent neurons. Immunofluorescence studies showed that DRG neurons ipsilateral to the crush injury in rats of treated groups expressed higher immunoreactivities for Akt, MAPK, c-Jun and c-Fos as compared with negative control group (P <0.05). The intensity of nuclear ribonucleoprotein in the distal segments of crushed nerves of treated groups was significantly higher than in the negative control group (P <0.05). H. erinaceus is capable of promoting peripheral nerve regeneration after injury. Potential signaling pathways include Akt, MAPK, c-Jun, and c-Fos, and protein synthesis have been shown to be involved in its action.

  8. Primary olfactory projections and the nervus terminalis in the African lungfish: implications for the phylogeny of cranial nerves.

    Science.gov (United States)

    von Bartheld, C S; Claas, B; Münz, H; Meyer, D L

    1988-08-01

    Primary olfactory and central projections of the nervus terminalis were investigated by injections of horseradish peroxidase into the olfactory epithelium in the African lungfish. In addition, gonadotropin-releasing hormone (GnRH) immunoreactivity of the nervus terminalis system was investigated. The primary olfactory projections are restricted to the olfactory bulb located at the rostral pole of the telencephalon; they do not extend into caudal parts of the telencephalon. A vomeronasal nerve and an accessory olfactory bulb could not be identified. The nervus terminalis courses through the dorsomedial telencephalon. Major targets include the nucleus of the anterior commissure and the nucleus praeopticus pars superior. some fibers cross to the contralateral side. A few fibers reach the diencephalon and mesencephalon. No label is present in the "posterior root of the nervus terminalis" (= "Pinkus's nerve" or "nervus praeopticus"). GnRH immunoreactivity is lacking in the "anterior root of the nervus terminalis," whereas it is abundant in nervus praeopticus (Pinkus's nerve). These findings may suggest that the nervus terminalis system originally consisted of two distinct cranial nerves, which have fused-in evolution-in most vertebrates. Theories of cranial nerve phylogeny are discussed in the light of the assumed "binerval origin" of the nervus terminalis system.

  9. Functional outcome of tongue motions with selective hypoglossal nerve stimulation in patients with obstructive sleep apnea.

    Science.gov (United States)

    Heiser, C; Maurer, J T; Steffen, A

    2016-05-01

    Selective upper airway stimulation of the hypoglossal nerve is a novel therapy option for obstructive sleep apnea. Different tongue motions were observed after surgery during active therapy. We examined tongue motions in 14 patients (mean age 51 ± 10 years) who received an implantation of an upper airway stimulation system (Inspire Medical Systems) from September 2013 to February 2014 in three different implantation centers in Germany after surgery. Sleep recording was performed preoperatively: 2 months (M02) and 6 months (M06) after surgery. There were three different tongue motions observed after surgery at 1 month (M01), M02, and M06 after surgery: bilateral protrusion (BP), right protrusion (RP), and mixed activation (MA). At M01: 10 BP, 2 RP, and 2 MA; at M02: 12 BP, 0 RP, and 2 MA; and at M06: 12 BP, 0 RP, and 2 MA could be detected. The average apnea-hypopnea index (AHI) was reduced from 32.5 ± 14.2/h before surgery to 17.9 ± 23.3/h at M02 and 14.1 ± 19.8/h at M06. An increased reduction in AHI was found in BP and RP group (Baseline: 29.6 ± 12.6/h; M02: 12.06 ± 14.1/h; M06: 9.7 ± 12.6/h) compared to the MA group (Baseline 49.6 ± 13.8/h; M02: 49.7 ± 5.1/h; M06: 40.5 ± 4.1/h). These findings suggest that the postoperative tongue motions in upper airway stimulation are associated with the therapy outcome. The stimulation electrode placement on the hypoglossal nerve for selective muscle recruitment may play a role in the mechanism of action.

  10. Topographical and functional anatomy of trapezius muscle innervation by spinal accessory nerve and C2 to C4 nerves of cervical plexus.

    Science.gov (United States)

    Gavid, M; Mayaud, A; Timochenko, A; Asanau, A; Prades, J M

    2016-10-01

    The aim of this study was to determine the existence and the frequency of communicating branches between the spinal accessory nerve (SAN) and the C2, C3 and C4 roots of the cervical plexus. The present study also aimed to elucidate whether these branches contain motor fibers or not. Dissection of the cervical region was performed on twelve adult cadavers. A powered operating microscope was necessary to dissect the SAN and its branches and also to dissect C2, C3 and C4 nerve branches. In a second step, data from 13 patients who underwent 25 modified neck dissections under trapezius muscle's monitoring were collected. At the end of surgery, intraoperative stimulation on the SAN, C2, C3 and C4 nerve branches was performed. Registered potentials in the three parts of the trapezius muscle, using the NIM Medtronic system, were analyzed. During cadaver dissection, 18 (78 %) communicating branches were identified between the SAN and C2, 11 (48 %) between the SAN and C3, 12 (52 %) between the SAN and C4. Intraoperative stimulation of the SAN and its branch for the trapezius muscle provided a significant electroneurographic response in the three parts of the trapezius muscle in all subjects. Intraoperative stimulation of C3 led to recordable contractions of the trapezius muscle in 5 (20 %) modified neck surgeries, stimulation of C4 led to recordable contractions during 5 (20 %) modified neck dissections. One case of contraction was recorded after intraoperative stimulation of C2 (7 %). Although we were able to identify at least one communicating branch between the SAN and the roots of the cervical plexus in each cadaver dissection, the cervical plexus is not always involved in trapezius motor innervation. Intraoperative electroneurography demonstrated that a motor input from the cervical plexus to the trapezius muscle was provided in only 32 % of cases. Therefore, SAN trunk and C3-C4 roots should be carefully preserved during modified neck dissection to protect

  11. MR imaging of peripheral nervous system involvement: Parsonage-Turner syndrome.

    Science.gov (United States)

    Zara, Gabriella; Gasparotti, Roberto; Manara, Renzo

    2012-04-15

    A 55-year-old woman complained of right scapular pain, like burning, radiating down his right arm and numbness in the first three fingers of the hand. Neurologic examination showed a slight deficit of the right brachial triceps muscle. Neurophysiological assessment showed a mild involvement of the seventh right spinal root (C7). Conventional MR imaging of the cervical spine showed mild disc protrusion at level C5-C6 without spinal root compression. High resolution MR neurography with multiplanar reconstruction along the course of the right brachial plexus showed a mild increase in signal intensity and thickening of the C7 root, middle trunk and posterior cord, consistent with Parsonage-Turner Syndrome. STIR images showed increased signal intensity in the right infraspinatus muscle innervated by the suprascapular nerve. In our case, sensitivity and specificity of the new MR sequences are higher than the clinical and neurophysiological evaluations. Copyright © 2011 Elsevier B.V. All rights reserved.

  12. Cellular blebs: pressure-driven, axisymmetric, membrane protrusions

    KAUST Repository

    Woolley, Thomas E.

    2013-07-16

    Blebs are cellular protrusions that are used by cells for multiple purposes including locomotion. A mechanical model for the problem of pressure-driven blebs based on force and moment balances of an axisymmetric shell model is proposed. The formation of a bleb is initiated by weakening the shell over a small region, and the deformation of the cellular membrane from the cortex is obtained during inflation. However, simply weakening the shell leads to an area increase of more than 4 %, which is physically unrealistic. Thus, the model is extended to include a reconfiguration process that allows large blebs to form with small increases in area. It is observed that both geometric and biomechanical constraints are important in this process. In particular, it is shown that although blebs are driven by a pressure difference across the cellular membrane, it is not the limiting factor in determining bleb size. © 2013 Springer-Verlag Berlin Heidelberg.

  13. Administration of Oxygen Ultra-Fine Bubbles Improves Nerve Dysfunction in a Rat Sciatic Nerve Crush Injury Model

    Directory of Open Access Journals (Sweden)

    Hozo Matsuoka

    2018-05-01

    Full Text Available Ultra-fine bubbles (<200 nm in diameter have several unique properties and have been tested in various medical fields. The purpose of this study was to investigate the effects of oxygen ultra-fine bubbles (OUBs on a sciatic nerve crush injury (SNC model rats. Rats were intraperitoneally injected with 1.5 mL saline, OUBs diluted in saline, or nitrogen ultra-fine bubbles (NUBs diluted in saline three times per week for 4 weeks in four groups: (1 control, (sham operation + saline; (2 SNC, (crush + saline; (3 SNC+OUB, (crush + OUB-saline; (4 SNC+NUB, (crush + NUB-saline. The effects of the OUBs on dorsal root ganglion (DRG neurons and Schwann cells (SCs were examined by serial dilution of OUB medium in vitro. Sciatic functional index, paw withdrawal thresholds, nerve conduction velocity, and myelinated axons were significantly decreased in the SNC group compared to the control group; these parameters were significantly improved in the SNC+OUB group, although NUB treatment did not affect these parameters. In vitro, OUBs significantly promoted neurite outgrowth in DRG neurons by activating AKT signaling and SC proliferation by activating ERK1/2 and JNK/c-JUN signaling. OUBs may improve nerve dysfunction in SNC rats by promoting neurite outgrowth in DRG neurons and SC proliferation.

  14. Coronectomy - A viable alternative to prevent inferior alveolar nerve injury

    Directory of Open Access Journals (Sweden)

    Alok Sagtani

    2015-12-01

    Full Text Available Background and Objectives: Coronectomy is a relatively new method to prevent the risk of Inferior Alveolar Nerve (IAN injury during removal of lower third molars with limited scientific literature among Nepalese patients. Thus, a study was designed to evaluate coronectomy regarding its use, outcomes and complications.Materials and Methods: A descriptive study was conducted from December 2012 to December 2013 among patients attending Department of Oral and Maxillofacial Surgery, College of Dental Sciences, BP Koirala Institute of Health Sciences, Dharan, Nepal for removal of mandibular third molars. After reviewing the radiograph for proximity of third molar to the IAN, coronectomy was advised. A written informed consent was obtained from the patients and coronectomy was performed. Patients were recalled after one week. The outcome measures in the follow-up visit were primary healing, pain, infection, dry socket, root exposure and IAN injury. The prevalence of IAN proximity of lower third molars and incidence of complications were calculated.Results: A total 300 mandibular third molars were extracted in 278 patients during the study period. Out of 300 impacted mandibular third molar, 41 (13.7% showed close proximity to inferior alveolar nerve . The incidence of complications and failed procedure was 7.4% among the patients who underwent coronectomy. During the follow up visit, persistent pain and root exposure was reported while other complications like inferior alveolar nerve injury, dry socket and infection was not experienced by the study patients.Conclusion: With a success rate of 92.6% among the 41 patients, coronectomy is a viable alternative to conventional total extraction for mandibular third molars who have a higher risk for damage to the inferior alveolar nerve.JCMS Nepal. 2015;11(3:1-5.

  15. Temporary Mental Nerve Paresthesia Originating from Periapical Infection

    OpenAIRE

    Genc Sen, Ozgur; Kaplan, Volkan

    2015-01-01

    Many systemic and local factors can cause paresthesia, and it is rarely caused by infections of dental origin. This report presents a case of mental nerve paresthesia caused by endodontic infection of a mandibular left second premolar. Resolution of the paresthesia began two weeks after conventional root canal treatment associated with antibiotic therapy and was completed in eight weeks. One year follow-up radiograph indicated complete healing of the radiolucent periapical lesion. The too...

  16. Restoration of diaphragmatic function after diaphragm reinnervation by inferior laryngeal nerve; experimental study in rabbits

    Directory of Open Access Journals (Sweden)

    de Barros Angelique

    2006-01-01

    Full Text Available Abstract Objectives To assess the possibilities of reinnervation in a paralyzed hemidiaphragm via an anastomosis between phrenic nerve and inferior laryngeal nerve in rabbits. Reinnervation of a paralyzed diaphragm could be an alternative to treat patients with ventilatory insufficiency due to upper cervical spine injuries. Material and method Rabbits were divided into five groups of seven rabbits each. Groups I and II were respectively the healthy and the denervated control groups. The 3 other groups were all reinnervated using three different surgical procedures. In groups III and IV, phrenic nerve was respectively anastomosed with the abductor branch of the inferior laryngeal nerve and with the trunk of the inferior laryngeal nerve. In group V, the fifth and fourth cervical roots were respectively anastomosed with the abductor branch of the inferior laryngeal nerve and with the nerve of the sternothyroid muscle (originating from the hypoglossal nerve. Animals were evaluated 4 months later using electromyography, transdiaphragmatic pressure measurements, sonomicrometry and histological examination. Results A poor inspiratory activity was found in quiet breathing in the reinnervated groups, with an increasing pattern of activity during effort. In the reinnervated groups, transdiaphragmatic pressure measurements and sonomicrometry were higher in group III with no significant differencewith groups IV and V. Conclusion Inspiratory contractility of an hemidiaphragm could be restored with immediate anastomosis after phrenic nerve section between phrenic nerve and inferior laryngeal nerve.

  17. Effect of cochlear nerve electrocautery on the adult cochlear nucleus.

    Science.gov (United States)

    Iseli, Claire E; Merwin, William H; Klatt-Cromwell, Cristine; Hutson, Kendall A; Ewend, Matthew G; Adunka, Oliver F; Fitzpatrick, Douglas C; Buchman, Craig A

    2015-04-01

    Electrocauterization and subsequent transection of the cochlear nerve induce greater injury to the cochlear nucleus than sharp transection alone. Some studies show that neurofibromatosis Type 2 (NF2) patients fit with auditory brainstem implants (ABIs) fail to achieve speech perception abilities similar to ABI recipients without NF2. Reasons for these differences remain speculative. One hypothesis posits poorer performance to surgically induced trauma to the cochlear nucleus from electrocautery. Sustained electrosurgical depolarization of the cochlear nerve may cause excitotoxic-induced postsynaptic nuclear injury. Equally plausible is that cautery in the vicinity of the cochlear nucleus induces necrosis. The cochlear nerve was transected in anesthetized adult gerbils sharply with or without bipolar electrocautery at varying intensities. Gerbils were perfused at 1, 3, 5, and 7 days postoperatively; their brainstem and cochleas were embedded in paraffin and sectioned at 10 μm. Alternate sections were stained with flourescent markers for neuronal injury or Nissl substance. In additional experiments, anterograde tracers were applied directly to a sectioned eighth nerve to verify that fluorescent-labeled profiles seen were terminating auditory nerve fibers. Cochlear nerve injury was observed from 72 hours postoperatively and was identical across cases regardless of surgical technique. Postsynaptic cochlear nucleus injury was not seen after distal transection of the nerve. By contrast, proximal transection was associated with trauma to the cochlear nucleus. Distal application of bipolar electrocautery seems safe for the cochlear nucleus. Application near the root entry zone must be used cautiously because this may compromise nuclear viability needed to support ABI stimulation.

  18. Outcomes and prognostic factors in revision hip arthroplasty for severe intra-pelvic cup protrusion: 246 cases.

    Science.gov (United States)

    Epinette, J-A; Mertl, P; Combourieu, B; Goncalves, H; Blairon, A; Ehlinger, M; Tabutin, J

    2015-10-01

    The outcome of revision total hip arthroplasty (THA) for intra-pelvic cup protrusion is unclear. Hence, we conducted a large retrospective study to clarify the surgical strategy (hip lever arm and cup mechanical fixation) and the outcomes of reconstruction for severe intra-pelvic cup protrusion. We hypothesized that restoration of the anatomic hip centre in such acetabular revisions decreased the risk of recurrent loosening. The study included 246 THA procedures (in 220 patients), with a follow-up of 5.2 ± 4.9 years (1-24.2) after the index surgery. Bone loss was estimated using the SOFCOT classification (grade III or IV in 80% of cases) and the Paprosky classification (IIIA or IIIB in 58% of cases). Quality of the reconstruction was assessed on X-rays according to the correction of the protrusion and position of the hip centre of rotation. After a clinical follow-up of at least 5 years, with a mean of 9.9 ± 4.1 years (5-24 years), the mean Postel-Merle d'Aubigné score was 14.2 ± 3.1 and the mean Harris Hip Score was 78.0 ± 18.7. Cup protrusion was partially or completely corrected in every case and cup position was normal in 27 (11%) cases. The centre of rotation was within 10mm of the physiological position in 158 (64.2%) cases, acceptable in 77 (31.3%) cases, ascended in 9 (3.7%) cases, and worsened in 1 (0.4%) case. Revision for cup or cup and femoral failures was required in 24 (9.8%) cases. Cumulative survival rates with cup loosening as the endpoint were 88.5% after 5 years, 79.9% after 10 years, and 63.9% at last follow-up at 13.6 years. Our hypothesis that restoration of anatomic hip centre decreased the risk of recurrent loosening was not verified: success or failure in restoring the normal centre of rotation did not correlate significantly with final cup status. Recurrent aseptic loosening was the cause of failure in 9.8% of cases. Ensuring long-term effective mechanical stability had a greater impact on global outcomes than restoring an ideal

  19. Root resorption: Focus on signs and symptoms of importance for avoiding root resorption during orthodontic treatment

    Directory of Open Access Journals (Sweden)

    Inger Kjaer

    2014-01-01

    Full Text Available Introduction: This paper summarizes the different conditions, which have a well-known influence on the resorption of tooth roots, exemplified by trauma and orthodontic treatment. The concept of the paper is to summarize and explain symptoms and signs of importance for avoiding resorption during orthodontic treatment. The Hypothesis: The hypothesis in this paper is that three different tissue layers covering the root in the so-called periroot sheet can explain signs and symptoms of importance for avoiding root resorption during orthodontic treatment. These different tissue layers are; outermost - an ectodermal tissue layer (Malassez′s epithelium, a middle layer - composed by the collagen-mesodermal tissue layer, and an innermost root-close innervation layer. Abnormalities in one of these tissue layers are thought to cause inflammatory processes in the periodontal membrane comparable to inflammatory processes provoked by trauma and orthodontic pressure. Inflammatory reactions are followed by resorptive processes in the periroot sheet and along the root surface. Evaluation of the Hypothesis: Different morphologies in the dentition are signs of abnormal epithelium or an abnormal mesodermal layer. It has formerly been demonstrated how demyelinization of the myelin sheaths in the peripheral nerves close to the root provoke resorption. Accordingly, conditions affecting these tissue layers can be associated not only with different morphologies but also with general symptoms and diseases (e.g., ectodermal dysplasia and hypophosphatasia.

  20. Nerve Blocks

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Nerve Blocks A nerve block is an injection to ... the limitations of Nerve Block? What is a Nerve Block? A nerve block is an anesthetic and/ ...

  1. Observation of a Ag protrusion on a Ag2S island using a scanning tunneling microscope

    Directory of Open Access Journals (Sweden)

    Takeo Ohno

    2015-01-01

    Full Text Available A silver sulfide (Ag2S island as an ionic conductor in resistive switching memories was formed and a protrusion of silver from the Ag2S formed by an electrochemical reaction was observed using a scanning tunneling microscope.

  2. Reversal of negative charges on the surface of Escherichia coli thioredoxin: pockets versus protrusions.

    Science.gov (United States)

    Mancusso, Romina; Cruz, Eduardo; Cataldi, Marcela; Mendoza, Carla; Fuchs, James; Wang, Hsin; Yang, Xiaomin; Tasayco, María Luisa

    2004-04-06

    Recent studies of proteins with reversed charged residues have demonstrated that electrostatic interactions on the surface can contribute significantly to protein stability. We have used the approach of reversing negatively charged residues using Arg to evaluate the effect of the electrostatics context on the transition temperature (T(m)), the unfolding Gibbs free energy change (DeltaG), and the unfolding enthalpy change (DeltaH). We have reversed negatively charged residues at a pocket (Asp9) and protrusions (Asp10, Asp20, Glu85), all located in interconnecting segments between elements of secondary structure on the surface of Arg73Ala Escherichia coli thioredoxin. DSC measurements indicate that reversal of Asp in a pocket (Asp9Arg/Arg73Ala, DeltaT(m) = -7.3 degrees C) produces a larger effect in thermal stability than reversal at protrusions: Asp10Arg/Arg73Ala, DeltaT(m) = -3.1 degrees C, Asp20Arg/Arg73Ala, DeltaT(m) = 2.0 degrees C, Glu85Arg/Arg73Ala, DeltaT(m) = 3.9 degrees ). The 3D structure of thioredoxin indicates that Asp20 and Glu85 have no nearby charges within 8 A, while Asp9 does not only have Asp10 as sequential neighbor, but it also forms a 5-A long-range ion pair with the solvent-exposed Lys69. Further DSC measurements indicate that neutralization of the individual charges of the ion pair Asp9-Lys69 with nonpolar residues produces a significant decrease in stability in both cases: Asp9Ala/Arg73Ala, DeltaT(m) = -3.7 degrees C, Asp9Met/Arg73Ala, DeltaT(m) = -5.5 degrees C, Lys69Leu/Arg73Ala, DeltaT(m) = -5.1 degrees C. However, thermodynamic analysis shows that reversal or neutralization of Asp9 produces a 9-15% decrease in DeltaH, while both reversal of Asp at protrusions and neutralization of Lys69 produce negligible changes. These results correlate well with the NMR analysis, which demonstrates that only the substitution of Asp9 produces extensive conformational changes and these changes occur in the surroundings of Lys69. Our results led us to

  3. Rehabilitation, Using Guided Cerebral Plasticity, of a Brachial Plexus Injury Treated with Intercostal and Phrenic Nerve Transfers.

    Science.gov (United States)

    Dahlin, Lars B; Andersson, Gert; Backman, Clas; Svensson, Hampus; Björkman, Anders

    2017-01-01

    Recovery after surgical reconstruction of a brachial plexus injury using nerve grafting and nerve transfer procedures is a function of peripheral nerve regeneration and cerebral reorganization. A 15-year-old boy, with traumatic avulsion of nerve roots C5-C7 and a non-rupture of C8-T1, was operated 3 weeks after the injury with nerve transfers: (a) terminal part of the accessory nerve to the suprascapular nerve, (b) the second and third intercostal nerves to the axillary nerve, and (c) the fourth to sixth intercostal nerves to the musculocutaneous nerve. A second operation-free contralateral gracilis muscle transfer directly innervated by the phrenic nerve-was done after 2 years due to insufficient recovery of the biceps muscle function. One year later, electromyography showed activation of the biceps muscle essentially with coughing through the intercostal nerves, and of the transferred gracilis muscle by deep breathing through the phrenic nerve. Voluntary flexion of the elbow elicited clear activity in the biceps/gracilis muscles with decreasing activity in intercostal muscles distal to the transferred intercostal nerves (i.e., corresponding to eighth intercostal), indicating cerebral plasticity, where neural control of elbow flexion is gradually separated from control of breathing. To restore voluntary elbow function after nerve transfers, the rehabilitation of patients operated with intercostal nerve transfers should concentrate on transferring coughing function, while patients with phrenic nerve transfers should focus on transferring deep breathing function.

  4. A preconditioning nerve lesion inhibits mechanical pain hypersensitivity following subsequent neuropathic injury

    Directory of Open Access Journals (Sweden)

    Wu Ann

    2011-01-01

    Full Text Available Abstract Background A preconditioning stimulus can trigger a neuroprotective phenotype in the nervous system - a preconditioning nerve lesion causes a significant increase in axonal regeneration, and cerebral preconditioning protects against subsequent ischemia. We hypothesized that a preconditioning nerve lesion induces gene/protein modifications, neuronal changes, and immune activation that may affect pain sensation following subsequent nerve injury. We examined whether a preconditioning lesion affects neuropathic pain and neuroinflammation after peripheral nerve injury. Results We found that a preconditioning crush injury to a terminal branch of the sciatic nerve seven days before partial ligation of the sciatic nerve (PSNL; a model of neuropathic pain induced a significant attenuation of pain hypersensitivity, particularly mechanical allodynia. A preconditioning lesion of the tibial nerve induced a long-term significant increase in paw-withdrawal threshold to mechanical stimuli and paw-withdrawal latency to thermal stimuli, after PSNL. A preconditioning lesion of the common peroneal induced a smaller but significant short-term increase in paw-withdrawal threshold to mechanical stimuli, after PSNL. There was no difference between preconditioned and unconditioned animals in neuronal damage and macrophage and T-cell infiltration into the dorsal root ganglia (DRGs or in astrocyte and microglia activation in the spinal dorsal and ventral horns. Conclusions These results suggest that prior exposure to a mild nerve lesion protects against adverse effects of subsequent neuropathic injury, and that this conditioning-induced inhibition of pain hypersensitivity is not dependent on neuroinflammation in DRGs and spinal cord. Identifying the underlying mechanisms may have important implications for the understanding of neuropathic pain due to nerve injury.

  5. The evolution of jaw protrusion mechanics is tightly coupled to bentho-pelagic divergence in damselfishes (Pomacentridae).

    Science.gov (United States)

    Cooper, W James; Carter, Casey B; Conith, Andrew J; Rice, Aaron N; Westneat, Mark W

    2017-02-15

    Most species-rich lineages of aquatic organisms have undergone divergence between forms that feed from the substrate (benthic feeding) and forms that feed from the water column (pelagic feeding). Changes in trophic niche are frequently accompanied by changes in skull mechanics, and multiple fish lineages have evolved highly specialized biomechanical configurations that allow them to protrude their upper jaws toward the prey during feeding. Damselfishes (family Pomacentridae) are an example of a species-rich lineage with multiple trophic morphologies and feeding ecologies. We sought to determine whether bentho-pelagic divergence in the damselfishes is tightly coupled to changes in jaw protrusion ability. Using high-speed video recordings and kinematic analysis, we examined feeding performance in 10 species that include three examples of convergence on herbivory, three examples of convergence on omnivory and two examples of convergence on planktivory. We also utilized morphometrics to characterize the feeding morphology of an additional 40 species that represent all 29 damselfish genera. Comparative phylogenetic analyses were then used to examine the evolution of trophic morphology and biomechanical performance. We find that pelagic-feeding damselfishes (planktivores) are strongly differentiated from extensively benthic-feeding species (omnivores and herbivores) by their jaw protrusion ability, upper jaw morphology and the functional integration of upper jaw protrusion with lower jaw abduction. Most aspects of cranial form and function that separate these two ecological groups have evolved in correlation with each other and the evolution of the functional morphology of feeding in damselfishes has involved repeated convergence in form, function and ecology. © 2017. Published by The Company of Biologists Ltd.

  6. Low Frequency Electroacupuncture Alleviated Spinal Nerve Ligation Induced Mechanical Allodynia by Inhibiting TRPV1 Upregulation in Ipsilateral Undamaged Dorsal Root Ganglia in Rats

    Directory of Open Access Journals (Sweden)

    Yong-Liang Jiang

    2013-01-01

    Full Text Available Neuropathic pain is an intractable problem in clinical practice. Accumulating evidence shows that electroacupuncture (EA with low frequency can effectively relieve neuropathic pain. Transient receptor potential vanilloid type 1 (TRPV1 plays a key role in neuropathic pain. The study aimed to investigate whether neuropathic pain relieved by EA administration correlates with TRPV1 inhibition. Neuropathic pain was induced by right L5 spinal nerve ligation (SNL in rats. 2 Hz EA stimulation was administered. SNL induced mechanical allodynia in ipsilateral hind paw. SNL caused a significant reduction of TRPV1 expression in ipsilateral L5 dorsal root ganglia (DRG, but a significant up-regulation in ipsilateral L4 and L6 DRGs. Calcitonin gene-related peptide (CGRP change was consistent with that of TRPV1. EA alleviated mechanical allodynia, and inhibited TRPV1 and CGRP overexpressions in ipsilateral L4 and L6 DRGs. SNL did not decrease pain threshold of contralateral hind paw, and TRPV1 expression was not changed in contralateral L5 DRG. 0.001, 0.01 mg/kg TRPV1 agonist 6′-IRTX fully blocked EA analgesia in ipsilateral hind paw. 0.01 mg/kg 6′-IRTX also significantly decreased pain threshold of contralateral paw. These results indicated that inhibition of TRPV1 up-regulation in ipsilateral adjacent undamaged DRGs contributed to low frequency EA analgesia for mechanical allodynia induced by spinal nerve ligation.

  7. Percutaneous closure of patent ductus arteriosus in children using amplatzer duct occluder II: relationship between PDA type and risk of device protrusion into the descending aorta.

    Science.gov (United States)

    Masri, Samer; El Rassi, Issam; Arabi, Mariam; Tabbakh, Anas; Bitar, Fadi

    2015-08-01

    To compare the efficacy and safety of Amplatzer Duct Occluder II (ADOII) among the various patent ductus arteriosus (PDA) types, and to assess the association between development of aortic obstruction and the PDA type in terms of measurable parameters as the device angulation and distance of upper end protrusion into the aortic lumen. Retrospective cohort study involving 50 consecutive subjects who underwent ADO II device closure of PDA. The median age and weight at intervention were 13 months (5.5 months to 18 years) and 11 (6-67) kg respectively. The median smallest ductal diameter by angiography was 3.2 (1.9-5.4) mm. Thirty two patients had type A PDA, 5 had type C, 5 had type D, and 8 had type E. Residual shunt was seen in only 1 patient who had a tubular PDA and resolved within 2 months of the procedure. No device embolization or pulmonary side protrusion were noted. There was a 16% aortic protrusion rate. The median distance of protrusion of the upper end of the device into the aortic lumen was 3.1 (0-9) mm and the median angle formed between the aortic end of the device and the PDA take-off was 10.4 (0-80.6) degrees. These latter parameters of aortic obstruction were significantly higher in the non-conical PDA group as compared to the conical PDA. Nevertheless, there was no significant coarctation due to aortic retention disc protrusion. Device closure of PDA using the ADO II is a safe procedure for chosen types of PDA. We demonstrated a novel technique for objective assessment of device protrusion into the descending aorta based on measurable parameters. ADOII device closure of non-conical PDAs warrants closer follow ups. © 2015 Wiley Periodicals, Inc.

  8. Human umbilical cord mesenchymal stem cells promote peripheral nerve repair via paracrine mechanisms

    Directory of Open Access Journals (Sweden)

    Zhi-yuan Guo

    2015-01-01

    Full Text Available Human umbilical cord-derived mesenchymal stem cells (hUCMSCs represent a promising young-state stem cell source for cell-based therapy. hUCMSC transplantation into the transected sciatic nerve promotes axonal regeneration and functional recovery. To further clarify the paracrine effects of hUCMSCs on nerve regeneration, we performed human cytokine antibody array analysis, which revealed that hUCMSCs express 14 important neurotrophic factors. Enzyme-linked immunosorbent assay and immunohistochemistry showed that brain-derived neurotrophic factor, glial-derived neurotrophic factor, hepatocyte growth factor, neurotrophin-3, basic fibroblast growth factor, type I collagen, fibronectin and laminin were highly expressed. Treatment with hUCMSC-conditioned medium enhanced Schwann cell viability and proliferation, increased nerve growth factor and brain-derived neurotrophic factor expression in Schwann cells, and enhanced neurite growth from dorsal root ganglion explants. These findings suggest that paracrine action may be a key mechanism underlying the effects of hUCMSCs in peripheral nerve repair.

  9. Raman spectroscopic detection of peripheral nerves towards nerve-sparing surgery

    Science.gov (United States)

    Minamikawa, Takeo; Harada, Yoshinori; Takamatsu, Tetsuro

    2017-02-01

    The peripheral nervous system plays an important role in motility, sensory, and autonomic functions of the human body. Preservation of peripheral nerves in surgery, namely nerve-sparing surgery, is now promising technique to avoid functional deficits of the limbs and organs following surgery as an aspect of the improvement of quality of life of patients. Detection of peripheral nerves including myelinated and unmyelinated nerves is required for the nerve-sparing surgery; however, conventional nerve identification scheme is sometimes difficult to identify peripheral nerves due to similarity of shape and color to non-nerve tissues or its limited application to only motor peripheral nerves. To overcome these issues, we proposed a label-free detection technique of peripheral nerves by means of Raman spectroscopy. We found several fingerprints of peripheral myelinated and unmyelinated nerves by employing a modified principal component analysis of typical spectra including myelinated nerve, unmyelinated nerve, and adjacent tissues. We finally realized the sensitivity of 94.2% and the selectivity of 92.0% for peripheral nerves including myelinated and unmyelinated nerves against adjacent tissues. Although further development of an intraoperative Raman spectroscopy system is required for clinical use, our proposed approach will serve as a unique and powerful tool for peripheral nerve detection for nerve-sparing surgery in the future.

  10. Morphometric analysis of the fiber populations of the rat sciatic nerve, its spinal roots, and its major branches

    NARCIS (Netherlands)

    Prodanov, D.P.; Feierabend, H.K.P.

    2007-01-01

    Correspondence between the nerve composition and the functional characteristics of its fiber populations is not always evident. To investigate such correspondence and to give a systematic picture of the morphology of the rat hind limb nerves, extensive morphometric study was performed on the sciatic

  11. Three-dimensional matrix fiber alignment modulates cell migration and MT1-MMP utility by spatially and temporally directing protrusions

    Science.gov (United States)

    Fraley, Stephanie I.; Wu, Pei-Hsun; He, Lijuan; Feng, Yunfeng; Krisnamurthy, Ranjini; Longmore, Gregory D.; Wirtz, Denis

    2015-10-01

    Multiple attributes of the three-dimensional (3D) extracellular matrix (ECM) have been independently implicated as regulators of cell motility, including pore size, crosslink density, structural organization, and stiffness. However, these parameters cannot be independently varied within a complex 3D ECM protein network. We present an integrated, quantitative study of these parameters across a broad range of complex matrix configurations using self-assembling 3D collagen and show how each parameter relates to the others and to cell motility. Increasing collagen density resulted in a decrease and then an increase in both pore size and fiber alignment, which both correlated significantly with cell motility but not bulk matrix stiffness within the range tested. However, using the crosslinking enzyme Transglutaminase II to alter microstructure independently of density revealed that motility is most significantly predicted by fiber alignment. Cellular protrusion rate, protrusion orientation, speed of migration, and invasion distance showed coupled biphasic responses to increasing collagen density not predicted by 2D models or by stiffness, but instead by fiber alignment. The requirement of matrix metalloproteinase (MMP) activity was also observed to depend on microstructure, and a threshold of MMP utility was identified. Our results suggest that fiber topography guides protrusions and thereby MMP activity and motility.

  12. Acellular Nerve Allografts in Peripheral Nerve Regeneration: A Comparative Study

    Science.gov (United States)

    Moore, Amy M.; MacEwan, Matthew; Santosa, Katherine B.; Chenard, Kristofer E.; Ray, Wilson Z.; Hunter, Daniel A.; Mackinnon, Susan E.; Johnson, Philip J.

    2011-01-01

    Background Processed nerve allografts offer a promising alternative to nerve autografts in the surgical management of peripheral nerve injuries where short deficits exist. Methods Three established models of acellular nerve allograft (cold-preserved, detergent-processed, and AxoGen® -processed nerve allografts) were compared to nerve isografts and silicone nerve guidance conduits in a 14 mm rat sciatic nerve defect. Results All acellular nerve grafts were superior to silicone nerve conduits in support of nerve regeneration. Detergent-processed allografts were similar to isografts at 6 weeks post-operatively, while AxoGen®-processed and cold-preserved allografts supported significantly fewer regenerating nerve fibers. Measurement of muscle force confirmed that detergent-processed allografts promoted isograft-equivalent levels of motor recovery 16 weeks post-operatively. All acellular allografts promoted greater amounts of motor recovery compared to silicone conduits. Conclusions These findings provide evidence that differential processing for removal of cellular constituents in preparing acellular nerve allografts affects recovery in vivo. PMID:21660979

  13. Histologic effects of mandibular protrusion splints in antigen-induced TMJ arthritis in rabbits

    OpenAIRE

    von Bremen, Julia; K?hler, Kernt; Siudak, Krystyna; Zahner, Daniel; Ruf, Sabine

    2017-01-01

    Background Although it is common clinical practice to treat children with Juvenile Idiopathic Arthritis (JIA) with functional appliances, the scientific evidence for this is limited. The aim of this study was to study the histologic effects of mandibular protrusion splints in temporomandibular joint (TMJ) arthritis in rabbits. Methods Twenty-eight ten-week old New Zealand white rabbits were randomly divided into four groups: AO (TMJ arthritis, no splint), AS (TMJ arthritis, mandibular splint ...

  14. A Case of Maxillary Protrusion with Congenitally Missing Canine Teeth in the Mandible

    OpenAIRE

    松井, 啓至; 酒徳, 明彦

    1996-01-01

    A patient that had a maxillary protrusion with congenitally missing canine teeth in the mandible was successfully treated with the extraction of the maxillary first premolars. The patient's cooperation in wearing headgear appliance was highly favorable. Her profile changes were pronounced and esthetically pleasing. A review of her post-treatment records revealed an excellent esthetic and occlusal result even though the first premolars were aligned instead of the canine teeth in the mandible. ...

  15. The imaging of abducens nerve in normal volunteers and palsy cases using 1.5T MRI 3-D CISS

    International Nuclear Information System (INIS)

    Takahashi, Mayu; Ezuka, Isamu; Kakinuma, Kenichi; Yamada, Haruyuki; Harada, Atsukuni; Kanazawa, Tsutomu

    2002-01-01

    The purpose of this study was to identify the cisternal segment of the abducens nerve and to investigate its anatomical features using three-dimensional Fourier transform constructive interference in steady-state (3-D CISS) sequence with a 1.5-tesla magnetic resonance (MR) imaging system. Images of abducens nerve palsy were also studied. Using this imaging system, the following procedures were performed to identify the abducens nerve. First, gray scale of the original images was inverted (inverted image). Second, Dollero's canal was identified, which contains the abducens nerve, and third, the nerve was followed to the root exit zone with a multiple-planar reconstruction method. Twenty-one volunteers and 3 patients with abducens nerve palsies participated in this study and following results were derived: all nerves in volunteers were clearly identified in the coronal and sagittal planes, the images closely resembled autopsy cases, seven nerves in asymptomatic cases were remarkably distorted by the vessels, and the cause of the palsy was not clear by their shapes in the images; this technique, however, can play a great role in evaluating abducens nerve palsy. (author)

  16. Vascularized nerve grafts for lower extremity nerve reconstruction.

    Science.gov (United States)

    Terzis, Julia K; Kostopoulos, Vasileios K

    2010-02-01

    Vascularized nerve grafts (VNG) were introduced in 1976 but since then, there have been no reports of their usage in lower extremity reconstruction systematically. The factors influencing outcomes as well as a comparison with conventional nerve grafts will be presented.Since 1981, 14 lower extremity nerve injuries in 12 patients have been reconstructed with VNG. Common peroneal nerve was injured in 12 and posterior tibial nerve in 5 patients. The level of the injury was at the knee or thigh. Twelve sural nerves were used as VNG with or without concomitant vascularized posterior calf fascia.All patients regained improved sensibility and adequate posterior tibial nerve function. For common peroneal nerve reconstructions, all patients with denervation time less than 6 months regained muscle strength of grade at least 4, even when long grafts were used for defects of 20 cm or more. Late cases, yielded inadequate muscle function even with the use of VNG.Denervation time of 6 months or less was critical for reconstruction with vascularized nerve graft. Not only the results were statistically significant compared with late cases, but also all early operated patients achieved excellent results. VNG are strongly recommended in traction avulsion injuries of the lower extremity with lengthy nerve damage.

  17. Proper Measurement of the Prostate Volume by Transrectal Ultrasound: Experimental Study about the Prostate with Focal Intravesical Protrusion of the Enlarged Central Gland

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Sung Kyoung; Kim, Hyoung Jung; Lim, Joo Won; Lee, Dong Ho; Ko, Young Tae [Kyung Hee University Hospital, Seoul (Korea, Republic of)

    2008-06-15

    To evaluate the proper volume measurement of prostate with focal intravesical protrusion of enlarged central gland by comparison between methods using craniocaudal length from top of protruded central gland and from prostate base near bladder neck to prostate apex. We made 20 prostate models with focal intravesical protrusion (volume range: 20{approx}50 mL, height of protrusion: about 1 cm) using devil's tongue jelly. Two radiologists measured volume of models 3 times by two kinds of methods using craniocaudal length from top of protruded central gland (method 1) and from prostate base near bladder neck (method 2) by transrectal ultrasound. The accuracy of volume measurement of models was evaluated statistically by comparing their average volume to true volume. Intra- and interobserver agreement was also evaluated. Average true volume of models was 31.05 mL. Each average volume using method 1 by two observers was 37.07 mL and 38.56 mL. Each average volume using method 2 was 30.69 mL and 31.55 mL. Volume measurement using method 2 was approximated to true volume of prostate statistically (p = .654, .823). There was no significant inter- and intra-observer variation in both methods. To measure the accurate volume of prostate with focal intravesical protrusion of enlarged central gland, its craniocaudal length should be measured from prostate base near bladder neck

  18. Nerve Cross-Bridging to Enhance Nerve Regeneration in a Rat Model of Delayed Nerve Repair

    Science.gov (United States)

    2015-01-01

    There are currently no available options to promote nerve regeneration through chronically denervated distal nerve stumps. Here we used a rat model of delayed nerve repair asking of prior insertion of side-to-side cross-bridges between a donor tibial (TIB) nerve and a recipient denervated common peroneal (CP) nerve stump ameliorates poor nerve regeneration. First, numbers of retrogradely-labelled TIB neurons that grew axons into the nerve stump within three months, increased with the size of the perineurial windows opened in the TIB and CP nerves. Equal numbers of donor TIB axons regenerated into CP stumps either side of the cross-bridges, not being affected by target neurotrophic effects, or by removing the perineurium to insert 5-9 cross-bridges. Second, CP nerve stumps were coapted three months after inserting 0-9 cross-bridges and the number of 1) CP neurons that regenerated their axons within three months or 2) CP motor nerves that reinnervated the extensor digitorum longus (EDL) muscle within five months was determined by counting and motor unit number estimation (MUNE), respectively. We found that three but not more cross-bridges promoted the regeneration of axons and reinnervation of EDL muscle by all the CP motoneurons as compared to only 33% regenerating their axons when no cross-bridges were inserted. The same 3-fold increase in sensory nerve regeneration was found. In conclusion, side-to-side cross-bridges ameliorate poor regeneration after delayed nerve repair possibly by sustaining the growth-permissive state of denervated nerve stumps. Such autografts may be used in human repair surgery to improve outcomes after unavoidable delays. PMID:26016986

  19. Clinical efficacy of computed tomography and coronectomy for prevention of postoperative inferior alveolar nerve injury occurring after impacted mandibular third molar surgery

    International Nuclear Information System (INIS)

    Hata, Tsuyoshi; Mandai, Toshiko; Ishida, Kohsei; Deguchi, Hiroyo; Hosoda, Masaru

    2012-01-01

    Our aim was to evaluate the clinical efficacy of computed tomography and coronectomy for preventing postoperative inferior alveolar nerve injury after impacted mandibular third molar surgery. Among the patients who visited Kawasaki Medical School Hospital between January 2009 and December 2010, 12 patients with high-risk signs of inferior alveolar nerve injury on panoramic imaging were examined for the extraction of impacted mandibular third molar by computed tomography (CT). CT examinations were performed in order to examine the relationship between the root apex of impacted mandibular third molar and inferior alveolar canal for 16 teeth. Based on the imaging findings, the patients were informed about treatment methods and their consent was obtained. We compared the CT and panoramic findings and discussed the relationship between the impacted third molar and the inferior alveolar nerve. Medical records were also examined for the presence of abnormal postoperative complications. Interruption of the cortical white line of the inferior alveolar canal was identified in 13 panoramic radiographs, and bending of the inferior alveolar canal was observed in 2 panoramic radiographs. CT findings indicated type 2 inferior alveolar nerve proximity in 13 teeth, and there was no proximity in 3 teeth. The observation was selected in 10 teeth showing nerve proximity in CT findings. Traditional third molar removal was performed for the 3 teeth with no nerve proximity. Coronectomy was performed in 3 teeth with nerve proximity. The clinical course was uneventful. To prevent inferior alveolar nerve injury, coronectomy may be a better means of removing the crown of an impacted third molar while leaving the roots intact, in cases where teeth might be in proximity with the inferior alveolar nerve. (author)

  20. Membrane Protrusion Coarsening and Nanotubulation within Giant Unilamellar Vesicles

    KAUST Repository

    Węgrzyn, Ilona

    2011-11-16

    Hydrophobic side groups on a stimuli-responsive polymer, encapsulated within a single giant unilamellar vesicle, enable membrane attachment during compartment formation at elevated temperatures. We thermally modulated the vesicle through implementation of an IR laser via an optical fiber, enabling localized directed heating. Polymer-membrane interactions were monitored using confocal imaging techniques as subsequent membrane protrusions occurred and lipid nanotubes formed in response to the polymer hydrogel contraction. These nanotubes, bridging the vesicle membrane to the contracting hydrogel, were retained on the surface of the polymer compartment, where they were transformed into smaller vesicles in a process reminiscent of cellular endocytosis. This development of a synthetic vesicle system containing a stimuli-responsive polymer could lead to a new platform for studying inter/intramembrane transport through lipid nanotubes. © 2011 American Chemical Society.

  1. Nerve conduction and excitability studies in peripheral nerve disorders

    DEFF Research Database (Denmark)

    Krarup, Christian; Moldovan, Mihai

    2009-01-01

    counterparts in the peripheral nervous system, in some instances without peripheral nervous system symptoms. Both hereditary and acquired demyelinating neuropathies have been studied and the effects on nerve pathophysiology have been compared with degeneration and regeneration of axons. SUMMARY: Excitability......PURPOSE OF REVIEW: The review is aimed at providing information about the role of nerve excitability studies in peripheral nerve disorders. It has been known for many years that the insight into peripheral nerve pathophysiology provided by conventional nerve conduction studies is limited. Nerve...... excitability studies are relatively novel but are acquiring an increasingly important role in the study of peripheral nerves. RECENT FINDINGS: By measuring responses in nerve that are related to nodal function (strength-duration time constant, rheobase and recovery cycle) and internodal function (threshold...

  2. Allotransplanted DRG neurons or Schwann cells affect functional recovery in a rodent model of sciatic nerve injury.

    Science.gov (United States)

    Dayawansa, Samantha; Wang, Ernest W; Liu, Weimin; Markman, John D; Gelbard, Harris A; Huang, Jason H

    2014-11-01

    In this study, the functional recoveries of Sprague-Dawley rats following repair of a complete sciatic nerve transection using allotransplanted dorsal root ganglion (DRG) neurons or Schwann cells were examined using a number of outcome measures. Four groups were compared: (1) repair with a nerve guide conduit seeded with allotransplanted Schwann cells harvested from Wistar rats, (2) repair with a nerve guide conduit seeded with DRG neurons, (3) repair with solely a nerve guide conduit, and (4) sham-surgery animals where the sciatic nerve was left intact. The results corroborated our previous reported histology findings and measures of immunogenicity. The Wistar-DRG-treated group achieved the best recovery, significantly outperforming both the Wistar-Schwann group and the nerve guide conduit group in the Von Frey assay of touch response (P DRG and Wistar-Schwann seeded repairs showed lower frequency and severity in an autotomy measure of the self-mutilation of the injured leg because of neuralgia. These results suggest that in complete peripheral nerve transections, surgical repair using nerve guide conduits with allotransplanted DRG and Schwann cells may improve recovery, especially DRG neurons, which elicit less of an immune response.

  3. Temporary Mental Nerve Paresthesia Originating from Periapical Infection

    Science.gov (United States)

    Genc Sen, Ozgur; Kaplan, Volkan

    2015-01-01

    Many systemic and local factors can cause paresthesia, and it is rarely caused by infections of dental origin. This report presents a case of mental nerve paresthesia caused by endodontic infection of a mandibular left second premolar. Resolution of the paresthesia began two weeks after conventional root canal treatment associated with antibiotic therapy and was completed in eight weeks. One year follow-up radiograph indicated complete healing of the radiolucent periapical lesion. The tooth was asymptomatic and functional. PMID:26345692

  4. Coronectomy versus surgical removal of the lower third molars with a high risk of injury to the inferior alveolar nerve. A bibliographical review

    Science.gov (United States)

    Moreno-Vicente, Javier; Schiavone-Mussano, Rocío; Clemente-Salas, Enrique; Marí-Roig, Antoni; Jané-Salas, Enric

    2015-01-01

    Background Coronectomy is the surgical removal of the crown of the tooth deliberately leaving part of its roots. This is done with the hope of eliminating the pathology caused, and since the roots are still intact, the integrity of the inferior alveolar nerve is preserved. Objectives The aim is to carry out a systematic review in order to be able to provide results and conclusions with the greatest scientific evidence possible. Material and Methods A literature review is carried out through the following search engines: Pubmed MEDLINE, Scielo, Cochrane library and EMI. The level of evidence criteria from the Agency for Healthcare Research and Quality was applied, and the clinical trials’ level of quality was analyzed by means of the JADAD criteria. Results The following articles were obtained which represents a total of 17: 1 systematic review, 2 randomized clinical trials and 2 non-randomized clinical trials, 3 cohort studies, 2 retrospective studies, 3 case studies and 4 literature reviews. Conclusions Coronectomy is an adequate preventative technique in protecting the inferior alveolar nerve, which is an alternative to the conventional extraction of third molars, which unlike the former technique, presents a high risk of injury to the inferior alveolar nerve. However, there is a need for new clinical studies, with a greater number of samples and with a longer follow-up period in order to detect potential adverse effects of the retained roots. Key words: Coronectomy, inferior alveolar nerve, nerve injury, wisdom tooth removal, paresthesia, and systematic review. PMID:25858081

  5. Histological and morphological evaluation of condylar cartilage of young rats in response to stimulation of mandibular protrusion

    Directory of Open Access Journals (Sweden)

    Milena Peixoto Nogueira de Sá

    2017-08-01

    Full Text Available The aim of this study was to evaluate the histogical and morphological aspects of the condyle in response to mandibular protrusion induced by composite resin occlusal planes. Thirty five-week-old male Wistar rats were selected and randomly divided in two groups. One group received a composite resin type of oclusal plane that induced mandibular protrusion, and the other was the control group, without treatment. Animals were euthanized after experimental time intervals of 7, 21 and 30 days. For histological analysis, thickness of the proliferative, serial and hypertrophic layers was measured, as well as each layer separately. The highest difference in cartilage thickness was observed at day 21, showing a significant increase of the proliferative layer. There were also other histomorphological changes related to occlusal plane interference. Condylar forward repositioning induced by composite occlusal planes influenced the endochondral ossification, increasing the proliferative layer.

  6. Constriction of the buccal branch of the facial nerve produces unilateral craniofacial allodynia.

    Science.gov (United States)

    Lewis, Susannah S; Grace, Peter M; Hutchinson, Mark R; Maier, Steven F; Watkins, Linda R

    2017-08-01

    Despite pain being a sensory experience, studies of spinal cord ventral root damage have demonstrated that motor neuron injury can induce neuropathic pain. Whether injury of cranial motor nerves can also produce nociceptive hypersensitivity has not been addressed. Herein, we demonstrate that chronic constriction injury (CCI) of the buccal branch of the facial nerve results in long-lasting, unilateral allodynia in the rat. An anterograde and retrograde tracer (3000MW tetramethylrhodamine-conjugated dextran) was not transported to the trigeminal ganglion when applied to the injury site, but was transported to the facial nucleus, indicating that this nerve branch is not composed of trigeminal sensory neurons. Finally, intracisterna magna injection of interleukin-1 (IL-1) receptor antagonist reversed allodynia, implicating the pro-inflammatory cytokine IL-1 in the maintenance of neuropathic pain induced by facial nerve CCI. These data extend the prior evidence that selective injury to motor axons can enhance pain to supraspinal circuits by demonstrating that injury of a facial nerve with predominantly motor axons is sufficient for neuropathic pain, and that the resultant pain has a neuroimmune component. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. External laryngeal nerve in thyroid surgery: is the nerve stimulator necessary?

    Science.gov (United States)

    Aina, E N; Hisham, A N

    2001-09-01

    To find out the incidence and type of external laryngeal nerves during operations on the thyroid, and to assess the role of a nerve stimulator in detecting them. Prospective, non-randomised study. Teaching hospital, Malaysia. 317 patients who had 447 dissections between early January 1998 and late November 1999. Number and type of nerves crossing the cricothyroid space, and the usefulness of the nerve stimulator in finding them. The nerve stimulator was used in 206/447 dissections (46%). 392 external laryngeal nerves were seen (88%), of which 196/206 (95%) were detected with the stimulator. However, without the stimulator 196 nerves were detected out of 241 dissections (81%). The stimulator detected 47 (23%) Type I nerves (nerve > 1 cm from the upper edge of superior pole); 86 (42%) Type IIa nerves (nerve edge of superior pole); and 63 (31%) Type IIb nerves (nerve below upper edge of superior pole). 10 nerves were not detected. When the stimulator was not used the corresponding figures were 32 (13%), 113 (47%), and 51 (21%), and 45 nerves were not seen. If the nerve cannot be found we recommend dissection of capsule close to the medial border of the upper pole of the thyroid to avoid injury to the nerve. Although the use of the nerve stimulator seems desirable, it confers no added advantage in finding the nerve. In the event of uncertainty about whether a structure is the nerve, the stimulator may help to confirm it. However, exposure of the cricothyroid space is most important for good exposure in searching for the external laryngeal nerve.

  8. Increase of transcription factor EB (TFEB) and lysosomes in rat DRG neurons and their transportation to the central nerve terminal in dorsal horn after nerve injury.

    Science.gov (United States)

    Jung, J; Uesugi, N; Jeong, N Y; Park, B S; Konishi, H; Kiyama, H

    2016-01-28

    In the spinal dorsal horn (DH), nerve injury activates microglia and induces neuropathic pain. Several studies clarified an involvement of adenosine triphosphate (ATP) in the microglial activation. However, the origin of ATP together with the release mechanism is unclear. Recent in vitro study revealed that an ATP marker, quinacrine, in lysosomes was released from neurite terminal of dorsal root ganglion (DRG) neurons to extracellular space via lysosomal exocytosis. Here, we demonstrate a possibility that the lysosomal ingredient including ATP released from DRG neurons by lysosomal-exocytosis is an additional source of the glial activation in DH after nerve injury. After rat L5 spinal nerve ligation (SNL), mRNA for transcription factor EB (TFEB), a transcription factor controlling lysosomal activation and exocytosis, was induced in the DRG. Simultaneously both lysosomal protein, LAMP1- and vesicular nuclear transporter (VNUT)-positive vesicles were increased in L5 DRG neurons and ipsilateral DH. The quinacrine staining in DH was increased and co-localized with LAMP1 immunoreactivity after nerve injury. In DH, LAMP1-positive vesicles were also co-localized with a peripheral nerve marker, Isolectin B4 (IB4) lectin. Injection of the adenovirus encoding mCherry-LAMP1 into DRG showed that mCherry-positive lysosomes are transported to the central nerve terminal in DH. These findings suggest that activation of lysosome synthesis including ATP packaging in DRG, the central transportation of the lysosome, and subsequent its exocytosis from the central nerve terminal of DRG neurons in response to nerve injury could be a partial mechanism for activation of microglia in DH. This lysosome-mediated microglia activation mechanism may provide another clue to control nociception and pain. Copyright © 2015 IBRO. Published by Elsevier Ltd. All rights reserved.

  9. Chitin biological absorbable catheters bridging sural nerve grafts transplanted into sciatic nerve defects promote nerve regeneration.

    Science.gov (United States)

    Wang, Zhi-Yong; Wang, Jian-Wei; Qin, Li-Hua; Zhang, Wei-Guang; Zhang, Pei-Xun; Jiang, Bao-Guo

    2018-06-01

    To investigate the efficacy of chitin biological absorbable catheters in a rat model of autologous nerve transplantation. A segment of sciatic nerve was removed to produce a sciatic nerve defect, and the sural nerve was cut from the ipsilateral leg and used as a graft to bridge the defect, with or without use of a chitin biological absorbable catheter surrounding the graft. The number and morphology of regenerating myelinated fibers, nerve conduction velocity, nerve function index, triceps surae muscle morphology, and sensory function were evaluated at 9 and 12 months after surgery. All of the above parameters were improved in rats in which the nerve graft was bridged with chitin biological absorbable catheters compared with rats without catheters. The results of this study indicate that use of chitin biological absorbable catheters to surround sural nerve grafts bridging sciatic nerve defects promotes recovery of structural, motor, and sensory function and improves muscle fiber morphology. © 2018 John Wiley & Sons Ltd.

  10. A novel method of lengthening the accessory nerve for direct coaptation during nerve repair and nerve transfer procedures.

    Science.gov (United States)

    Tubbs, R Shane; Maldonado, Andrés A; Stoves, Yolanda; Fries, Fabian N; Li, Rong; Loukas, Marios; Oskouian, Rod J; Spinner, Robert J

    2018-01-01

    OBJECTIVE The accessory nerve is frequently repaired or used for nerve transfer. The length of accessory nerve available is often insufficient or marginal (under tension) for allowing direct coaptation during nerve repair or nerve transfer (neurotization), necessitating an interpositional graft. An attractive maneuver would facilitate lengthening of the accessory nerve for direct coaptation. The aim of the present study was to identify an anatomical method for such lengthening. METHODS In 20 adult cadavers, the C-2 or C-3 connections to the accessory nerve were identified medial to the sternocleidomastoid (SCM) muscle and the anatomy of the accessory nerve/cervical nerve fibers within the SCM was documented. The cervical nerve connections were cut. Lengths of the accessory nerve were measured. Samples of the cut C-2 and C-3 nerves were examined using immunohistochemistry. RESULTS The anatomy and adjacent neural connections within the SCM are complicated. However, after the accessory nerve was "detethered" from within the SCM and following transection, the additional length of the accessory nerve increased from a mean of 6 cm to a mean of 10.5 cm (increase of 4.5 cm) after cutting the C-2 connections, and from a mean of 6 cm to a mean length of 9 cm (increase of 3.5 cm) after cutting the C-3 connections. The additional length of accessory nerve even allowed direct repair of an infraclavicular target (i.e., the proximal musculocutaneous nerve). The cervical nerve connections were shown not to contain motor fibers. CONCLUSIONS An additional length of the accessory nerve made available in the posterior cervical triangle can facilitate direct repair or neurotization procedures, thus eliminating the need for an interpositional nerve graft, decreasing the time/distance for regeneration and potentially improving clinical outcomes.

  11. 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

    of axons. Axonal counts do not reflect the number of regenerated neurons because of axonal branching and because myelinated axons form unmyelinated sprouts. Two days to 10 weeks after crushing, the distal sural or peroneal nerves were cut and exposed to fluoro-dextran. Large and small dorsal root ganglion...

  12. Modeling the synergy of cofilin and Arp2/3 in lamellipodial protrusive activity.

    Science.gov (United States)

    Tania, Nessy; Condeelis, John; Edelstein-Keshet, Leah

    2013-11-05

    Rapid polymerization of actin filament barbed ends generates protrusive forces at the cell edge, leading to cell migration. Two important regulators of free barbed ends, cofilin and Arp2/3, have been shown to work in synergy (net effect greater than additive). To explore this synergy, we model the dynamics of F-actin at the leading edge, motivated by data from EGF-stimulated mammary carcinoma cells. We study how synergy depends on the localized rates and relative timing of cofilin and Arp2/3 activation at the cell edge. The model incorporates diffusion of cofilin, membrane protrusion, F-actin capping, aging, and severing by cofilin and branch nucleation by Arp2/3 (but not G-actin recycling). In a well-mixed system, cofilin and Arp2/3 can each generate a large pulse of barbed ends on their own, but have little synergy; high synergy occurs only at low activation rates, when few barbed ends are produced. In the full spatially distributed model, both synergy and barbed-end production are significant over a range of activation rates. Furthermore, barbed-end production is greatest when Arp2/3 activation is delayed relative to cofilin. Our model supports a direct role for cofilin-mediated actin polymerization in stimulated cell migration, including chemotaxis and cancer invasion. Copyright © 2013 Biophysical Society. Published by Elsevier Inc. All rights reserved.

  13. Genomic and pathogenic analysis of a Muscovy duck parvovirus strain causing short beak and dwarfism syndrome without tongue protrusion.

    Science.gov (United States)

    Fu, Qiuling; Huang, Yu; Wan, Chunhe; Fu, Guanghua; Qi, Baomin; Cheng, Longfei; Shi, Shaohua; Chen, Hongmei; Liu, Rongchang; Chen, Zhenhai

    2017-12-01

    In 2008, clinical cases of short beak and dwarfism syndrome (SBDS) caused by Muscovy duck parvovirus (MDPV) infection were found in mule duck and Taiwan white duck farms in Fujian, China. A MDPV LH strain causing duck SBDS without tongue protrusion was isolated in this study. Phylogenetic analysis show that the MDPV LH strain was clustered together with other MDPV strains, but divergent from GPV isolates. Two major fragment deletions were found in the inverted terminal repeats (ITR) of MDPV LH similar to the ones in the ITR of MDPV GX5, YY and SAAS-SHNH strains. To investigate the pathogenicity of the MDPV LH strain, virus infection of young mule ducks was performed. The infected ducks showed SBDS symptoms including retard growth and shorten beaks without tongue protrusion. Atrophy of thymus, spleen and bursa of Fabricius was identified in the infected ducks. The results show that MDPV LH strain is moderately pathogenic to mule duck, leading to occurrence of SBDS. As far as we know, it is the first study showing that SBDS without tongue protrusion, and atrophy of thymus, spleen and bursa of Fabricius possibly associated with immunosuppression were found in the MDPV-infected ducks. The established duck-MDPV-SBDS system will help us to further work on the virus pathogenesis and develop efficacious vaccine against MDPV infection. Copyright © 2017. Published by Elsevier Ltd.

  14. Post-surgical functional recovery, lumbar lordosis, and range of motion associated with MR-detectable redundant nerve roots in lumbar spinal stenosis.

    Science.gov (United States)

    Chen, Jinshui; Wang, Juying; Wang, Benhai; Xu, Hao; Lin, Songqing; Zhang, Huihao

    2016-01-01

    T1- and T2-weighted magnetic resonance images (MRI) can reveal lumbar redundant nerve roots (RNRs), a result of chronic compression and nerve elongation associated with pathogenesis of cauda equina claudication (CEC) in degenerative lumbar canal stenosis (DLCS). The study investigated effects of lumbar lordosis angle and range of motion on functional recovery in lumbar stenosis patents with and without RNRs. A retrospective study was conducted of 93 lumbar spinal stenosis patients who underwent decompressive surgery. Eligible records were assessed by 3 independent blinded radiologists for presence or absence of RNRs on sagittal T2-weighted MR (RNR and non-RNR groups), pre- and post-operative JOA score, lumbar lordosis angle, and range of motion. Of 93 total patients, the RNR group (n=37, 21/37 female) and non-RNR group (n=56; 31/56 female) had similar preoperative conditions (JOA score) and were not significantly different in age (mean 64.19 ± 8.25 vs. 62.8 ± 9.41 years), symptom duration (30.92 ± 22.43 vs. 28.64 ± 17.40 months), or follow-up periods (17.35 ± 4.02 vs. 17.75 ± 4.29 mo) (all p>0.4). The non-RNR group exhibited significantly better final JOA score (p=0.015) and recovery rate (p=0.002). RNR group patients exhibited larger lumbar lordosis angles in the neutral position (p=0.009) and extension (p=0.021) and larger range of motion (p=0.008). Poorer surgical outcomes in patients with RNRs indicated that elevated lumbar lordosis angle and range of motion increased risks of RNR formation, which in turn may cause poorer post-surgical recovery, this information is possibly useful in prognostic assessment of lumbar stenosis complicated by RNRs. Copyright © 2015 Elsevier B.V. All rights reserved.

  15. Interest of Electrostimulation of Peripheral Motor Nerves during Percutaneous Thermal Ablation

    International Nuclear Information System (INIS)

    Tsoumakidou, Georgia; Garnon, Julien; Ramamurthy, Nitin; Buy, Xavier; Gangi, Afshin

    2013-01-01

    Purpose: We present our experience of utilizing peripheral nerve electrostimulation as a complementary monitoring technique during percutaneous thermal ablation procedures; and we highlight its utility and feasibility in the prevention of iatrogenic neurologic thermal injury. Methods: Peripheral motor nerve electrostimulation was performed in 12 patients undergoing percutaneous image-guided thermal ablations of spinal/pelvic lesions in close proximity to the spinal cord and nerve roots. Electrostimulation was used in addition to existing insulation (active warming/cooling with hydrodissection, passive insulation with CO 2 insufflation) and temperature monitoring (thermocouples) techniques. Impending neurologic deficit was defined as a visual reduction of muscle response or need for a stronger electric current to evoke muscle contraction, compared with baseline. Results: Significant reduction of the muscle response to electrostimulation was observed in three patients during the ablation, necessitating temporary interruption, followed by injection of warm/cool saline. This resulted in complete recovery of the muscle response in two cases, while for the third patient the response did not improve and the procedure was terminated. No patient experienced postoperative motor deficit. Conclusion: Peripheral motor nerve electrostimulation is a simple, easily accessible technique allowing early detection of impending neurologic injury during percutaneous image-guided thermal ablation. It complements existing monitoring techniques and provides a functional assessment along the whole length of the nerve

  16. Interest of Electrostimulation of Peripheral Motor Nerves during Percutaneous Thermal Ablation

    Energy Technology Data Exchange (ETDEWEB)

    Tsoumakidou, Georgia, E-mail: gtsoumakidou@yahoo.com; Garnon, Julien, E-mail: juliengarnon@gmail.com; Ramamurthy, Nitin, E-mail: nitin_ramamurthy@hotmail.com; Buy, Xavier, E-mail: xbuy@ymail.com; Gangi, Afshin, E-mail: gangi@unistra.fr [University Hospital of Strasbourg (France)

    2013-12-15

    Purpose: We present our experience of utilizing peripheral nerve electrostimulation as a complementary monitoring technique during percutaneous thermal ablation procedures; and we highlight its utility and feasibility in the prevention of iatrogenic neurologic thermal injury. Methods: Peripheral motor nerve electrostimulation was performed in 12 patients undergoing percutaneous image-guided thermal ablations of spinal/pelvic lesions in close proximity to the spinal cord and nerve roots. Electrostimulation was used in addition to existing insulation (active warming/cooling with hydrodissection, passive insulation with CO{sub 2} insufflation) and temperature monitoring (thermocouples) techniques. Impending neurologic deficit was defined as a visual reduction of muscle response or need for a stronger electric current to evoke muscle contraction, compared with baseline. Results: Significant reduction of the muscle response to electrostimulation was observed in three patients during the ablation, necessitating temporary interruption, followed by injection of warm/cool saline. This resulted in complete recovery of the muscle response in two cases, while for the third patient the response did not improve and the procedure was terminated. No patient experienced postoperative motor deficit. Conclusion: Peripheral motor nerve electrostimulation is a simple, easily accessible technique allowing early detection of impending neurologic injury during percutaneous image-guided thermal ablation. It complements existing monitoring techniques and provides a functional assessment along the whole length of the nerve.

  17. Nanofiber Nerve Guide for Peripheral Nerve Repair and Regeneration

    Science.gov (United States)

    2016-04-01

    1 Award Number: W81XWH-11-2-0047 TITLE: Nanofiber Nerve Guide for Peripheral Nerve Repair and Regeneration PRINCIPAL INVESTIGATOR: Ahmet Höke...TITLE AND SUBTITLE 5a. CONTRACT NUMBER W81XWH-11-2-0047 Nanofiber nerve guide for peripheral nerve repair and regeneration 5b. GRANT NUMBER...goal of this collaborative research project was to develop next generation engineered nerve guide conduits (NGCs) with aligned nanofibers and

  18. Radial nerve dysfunction

    Science.gov (United States)

    Neuropathy - radial nerve; Radial nerve palsy; Mononeuropathy ... Damage to one nerve group, such as the radial nerve, is called mononeuropathy . Mononeuropathy means there is damage to a single nerve. Both ...

  19. Malignant peripheral nerve sheath tumor of the oculomotor nerve

    DEFF Research Database (Denmark)

    Kozic, D; Nagulic, M; Ostojic, J

    2006-01-01

    We present the short-term follow-up magnetic resonance (MR) studies and 1H-MR spectroscopy in a child with malignant peripheral nerve sheath tumor of the oculomotor nerve associated with other less aggressive cranial nerve schwannomas. The tumor revealed perineural extension and diffuse nerve...

  20. Scaffoldless tissue-engineered nerve conduit promotes peripheral nerve regeneration and functional recovery after tibial nerve injury in rats

    Institute of Scientific and Technical Information of China (English)

    Aaron M. Adams; Keith W. VanDusen; Tatiana Y. Kostrominova; Jacob P. Mertens; Lisa M. Larkin

    2017-01-01

    Damage to peripheral nerve tissue may cause loss of function in both the nerve and the targeted muscles it innervates. This study compared the repair capability of engineered nerve conduit (ENC), engineered fibroblast conduit (EFC), and autograft in a 10-mm tibial nerve gap. ENCs were fabricated utilizing primary fibroblasts and the nerve cells of rats on embryonic day 15 (E15). EFCs were fabricated utilizing primary fi-broblasts only. Following a 12-week recovery, nerve repair was assessed by measuring contractile properties in the medial gastrocnemius muscle, distal motor nerve conduction velocity in the lateral gastrocnemius, and histology of muscle and nerve. The autografts, ENCs and EFCs reestablished 96%, 87% and 84% of native distal motor nerve conduction velocity in the lateral gastrocnemius, 100%, 44% and 44% of native specific force of medical gastrocnemius, and 63%, 61% and 67% of native medial gastrocnemius mass, re-spectively. Histology of the repaired nerve revealed large axons in the autograft, larger but fewer axons in the ENC repair, and many smaller axons in the EFC repair. Muscle histology revealed similar muscle fiber cross-sectional areas among autograft, ENC and EFC repairs. In conclusion, both ENCs and EFCs promot-ed nerve regeneration in a 10-mm tibial nerve gap repair, suggesting that the E15 rat nerve cells may not be necessary for nerve regeneration, and EFC alone can suffice for peripheral nerve injury repair.

  1. Communication between radial nerve and medial cutaneous nerve of forearm

    Directory of Open Access Journals (Sweden)

    R R Marathe

    2010-01-01

    Full Text Available Radial nerve is usually a branch of the posterior cord of the brachial plexus. It innervates triceps, anconeous, brachialis, brachioradialis, extensor carpi radialis longus muscles and gives the posterior cutaneous nerve of the arm, lower lateral cutaneous nerve of arm, posterior cutaneous nerve of forearm; without exhibiting any communication with the medial cutaneous nerve of forearm or any other nerve. We report communication between the radial nerve and medial cutaneous nerve of forearm on the left side in a 58-year-old male cadaver. The right sided structures were found to be normal. Neurosurgeons should keep such variations in mind while performing the surgeries of axilla and upper arm.

  2. Arterial relationships to the nerves and some rigid structures in the posterior cranial fossa.

    Science.gov (United States)

    Surchev, N

    2008-09-01

    The close relationships between the cranial nerves and the arterial vessels in the posterior cranial fossa are one of the predisposing factors for artery-nerve compression. The aim of this study was to examine the relationships of the vertebral and basilar arteries to some skull and dural structures and the nerves in the posterior cranial fossa. For this purpose, the skull bases and brains of 70 cadavers were studied. The topographic relationships of the vertebral and basilar arteries to the cranial nerves in the posterior cranial fossa were studied and the distances between the arteries and some osseous formations were measured. The most significant variations in arterial position were registered in the lower half of the basilar artery. Direct contact with an artery was established for the hypoglossal canal, jugular tubercle, and jugular foramen. The results reveal additional information about the relationships of the nerves and arteries to the skull and dural formations in the posterior cranial fossa. New quantitative information is given to illustrate them. The conditions for possible artery-nerve compression due to arterial dislocation are discussed and two groups (lines) of compression points are suggested. The medial line comprises of the brain stem points, usually the nerve root entry/exit zone. The lateral line includes the skull eminences, on which the nerves lie, or skull and dural foramina through which they exit the cranial cavity. (c) 2008 Wiley-Liss, Inc.

  3. Ulnar nerve dysfunction

    Science.gov (United States)

    Neuropathy - ulnar nerve; Ulnar nerve palsy; Mononeuropathy; Cubital tunnel syndrome ... Damage to one nerve group, such as the ulnar nerve, is called mononeuropathy . Mononeuropathy means there is damage to a single nerve. Both ...

  4. Intramuscular Distribution of the Abducens Nerve in the Lateral Rectus Muscle for the Management of Strabismus.

    Science.gov (United States)

    Shin, Hyun Jin; Lee, Shin-Hyo; Shin, Kang-Jae; Koh, Ki-Seok; Song, Wu-Chul

    2018-06-01

    To elucidate the intramuscular distribution and branching patterns of the abducens nerve in the lateral rectus (LR) muscle so as to provide anatomical confirmation of the presence of compartmentalization, including for use in clinical applications such as botulinum toxin injections. Thirty whole-mount human cadaver specimens were dissected and then Sihler's stain was applied. The basic dimensions of the LR and its intramuscular nerve distribution were investigated. The distances from the muscle insertion to the point at which the abducens nerve enters the LR and to the terminal nerve plexus were also measured. The LR was 46.0 mm long. The abducens nerve enters the muscle on the posterior one-third of the LR and then typically divides into a few branches (average of 1.8). This supports a segregated abducens nerve selectively innervating compartments of the LR. The intramuscular nerve distribution showed a Y-shaped ramification with root-like arborization. The intramuscular nerve course finished around the middle of the LR (24.8 mm posterior to the insertion point) to form the terminal nerve plexus. This region should be considered the optimal target site for botulinum toxin injections. We have also identified the presence of an overlapping zone and communicating nerve branches between the neighboring LR compartments. Sihler's staining is a useful technique for visualizing the entire nerve network of the LR. Improving the knowledge of the nerve distribution patterns is important not only for researchers but also clinicians to understand the functions of the LR and the diverse pathophysiology of strabismus.

  5. Peripheral Nerve Regeneration by Secretomes of Stem Cells from Human Exfoliated Deciduous Teeth.

    Science.gov (United States)

    Sugimura-Wakayama, Yukiko; Katagiri, Wataru; Osugi, Masashi; Kawai, Takamasa; Ogata, Kenichi; Sakaguchi, Kohei; Hibi, Hideharu

    2015-11-15

    Peripheral nerve regeneration across nerve gaps is often suboptimal, with poor functional recovery. Stem cell transplantation-based regenerative therapy is a promising approach for axon regeneration and functional recovery of peripheral nerve injury; however, the mechanisms remain controversial and unclear. Recent studies suggest that transplanted stem cells promote tissue regeneration through a paracrine mechanism. We investigated the effects of conditioned media derived from stem cells from human exfoliated deciduous teeth (SHED-CM) on peripheral nerve regeneration. In vitro, SHED-CM-treated Schwann cells exhibited significantly increased proliferation, migration, and the expression of neuron-, extracellular matrix (ECM)-, and angiogenesis-related genes. SHED-CM stimulated neuritogenesis of dorsal root ganglia and increased cell viability. Similarly, SHED-CM enhanced tube formation in an angiogenesis assay. In vivo, a 10-mm rat sciatic nerve gap model was bridged by silicon conduits containing SHED-CM or serum-free Dulbecco's modified Eagle's medium. Light and electron microscopy confirmed that the number of myelinated axons and axon-to-fiber ratio (G-ratio) were significantly higher in the SHED-CM group at 12 weeks after nerve transection surgery. The sciatic functional index (SFI) and gastrocnemius (target muscle) wet weight ratio demonstrated functional recovery. Increased compound muscle action potentials and increased SFI in the SHED-CM group suggested sciatic nerve reinnervation of the target muscle and improved functional recovery. We also observed reduced muscle atrophy in the SHED-CM group. Thus, SHEDs may secrete various trophic factors that enhance peripheral nerve regeneration through multiple mechanisms. SHED-CM may therefore provide a novel therapy that creates a more desirable extracellular microenvironment for peripheral nerve regeneration.

  6. Absence of the musculocutaneous nerve with innervation of coracobrachialis, biceps brachii, brachialis and the lateral border of the forearm by branches from the lateral cord of the brachial plexus

    Science.gov (United States)

    NAKATANI, TOSHIO; TANAKA, SHIGENORI; MIZUKAMI, SHIGEKI

    1997-01-01

    Anomalies of the brachial plexus and its terminal branches are not uncommon. Variations in the course and branches of the musculocutaneous nerve have been noted (Clemente, 1985; Bergman et al. 1988) and its absence was reported by Le Minor (1990). Several anomalies were present in the left plexus of a 59-y-old Japanese man (Fig.). There were no anterior and posterior divisions of the middle trunk, although there were communications between the posterior, medial and lateral cords. The musculocutaneous nerve was absent (Le Minor, 1990) and the medial and lateral roots of the median nerve did not unite in the axillary fossa but in the upper arm about 5 cm distal to the lower border of latissimus dorsi (Adachi, 1928; Buch-Hansen, 1955). The hitherto unreported findings were branches arising directly from the lateral cord to supply coracobrachialis, both heads of biceps brachii and brachialis. The lateral cutaneous nerve of the forearm was derived from the lateral cord with a small contribution from the medial root of the median nerve. Since there were communications between the posterior cord (a continuation of the middle trunk) and the medial and lateral cords, it is theoretically possibly, but not proven, that the root values of branches innervating the flexor muscles of the arm and forearm and the skin of lateral border of the forearm were normal. PMID:9419004

  7. The First Experience of Triple Nerve Transfer in Proximal Radial Nerve Palsy.

    Science.gov (United States)

    Emamhadi, Mohammadreza; Andalib, Sasan

    2018-01-01

    Injury to distal portion of posterior cord of brachial plexus leads to palsy of radial and axillary nerves. Symptoms are usually motor deficits of the deltoid muscle; triceps brachii muscle; and extensor muscles of the wrist, thumb, and fingers. Tendon transfers, nerve grafts, and nerve transfers are options for surgical treatment of proximal radial nerve palsy to restore some motor functions. Tendon transfer is painful, requires a long immobilization, and decreases donor muscle strength; nevertheless, nerve transfer produces promising outcomes. We present a patient with proximal radial nerve palsy following a blunt injury undergoing triple nerve transfer. The patient was involved in a motorcycle accident with complete palsy of the radial and axillary nerves. After 6 months, on admission, he showed spontaneous recovery of axillary nerve palsy, but radial nerve palsy remained. We performed triple nerve transfer, fascicle of ulnar nerve to long head of the triceps branch of radial nerve, flexor digitorum superficialis branch of median nerve to extensor carpi radialis brevis branch of radial nerve, and flexor carpi radialis branch of median nerve to posterior interosseous nerve, for restoration of elbow, wrist, and finger extensions, respectively. Our experience confirmed functional elbow, wrist, and finger extensions in the patient. Triple nerve transfer restores functions of the upper limb in patients with debilitating radial nerve palsy after blunt injuries. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Iatrogenic nerve injury in a national no-fault compensation scheme: an observational cohort study.

    Science.gov (United States)

    Moore, A E; Zhang, J; Stringer, M D

    2012-04-01

    Iatrogenic nerve injury causes distress and disability, and often leads to litigation. The scale and profile of these injuries has only be estimated from published case reports/series and analyses of medicolegal claims.   To determine the current spectrum of iatrogenic nerve injury in New Zealand by analysing treatment injury claims accepted by a national no-fault compensation scheme. The Accident Compensation Corporation (ACC) provides national no-fault personal accident insurance cover, which extends to patients who have sustained a treatment injury from a registered healthcare professional. Nerve injury claims identified from 5227 treatment injury claims accepted by the ACC in 2009 were analysed. From 327 claims, 292 (89.3%) documenting 313 iatrogenic nerve injuries contained sufficient information for analysis. Of these, 211 (67.4%) occurred in 11 surgical specialties, particularly orthopaedics and general surgery; the remainder involved phlebotomy services, anaesthesia and various medical specialties. The commonest causes of injury were malpositioning (n = 40), venepuncture (n = 26), intravenous cannulation (n = 21) and hip arthroplasty (n = 21). Most commonly injured were the median nerve and nerve roots (n = 32 each), brachial plexus (n = 26), and the ulnar nerve (n = 25). At least 34 (11.6%) patients were referred for surgical management of their nerve injury. Iatrogenic nerve injuries are not rare and occur in almost all branches of medicine, with malpositioning under general anaesthesia and venepuncture as leading causes. Some of these injuries are probably unavoidable, but greater awareness of which nerves are at risk and in what context should facilitate the development and/or wider implementation of preventive strategies. © 2012 Blackwell Publishing Ltd.

  9. Morphology and nanomechanics of sensory neurons growth cones following peripheral nerve injury.

    Directory of Open Access Journals (Sweden)

    Marta Martin

    Full Text Available A prior peripheral nerve injury in vivo, promotes a rapid elongated mode of sensory neurons neurite regrowth in vitro. This in vitro model of conditioned axotomy allows analysis of the cellular and molecular mechanisms leading to an improved neurite re-growth. Our differential interference contrast microscopy and immunocytochemistry results show that conditioned axotomy, induced by sciatic nerve injury, did not increase somatic size of adult lumbar sensory neurons from mice dorsal root ganglia sensory neurons but promoted the appearance of larger neurites and growth cones. Using atomic force microscopy on live neurons, we investigated whether membrane mechanical properties of growth cones of axotomized neurons were modified following sciatic nerve injury. Our data revealed that neurons having a regenerative growth were characterized by softer growth cones, compared to control neurons. The increase of the growth cone membrane elasticity suggests a modification in the ratio and the inner framework of the main structural proteins.

  10. Modulating the nanorods protrusion from poly(allylamine hydrochloride)-g-pyrene microcapsules by 1-pyrenesulfonic acid sodium salt.

    Science.gov (United States)

    Guan, Erjia; Wang, Tianxiang; Wang, Zhipeng; Gao, Changyou

    2013-09-01

    It was found previously that the Schiff base bonds in poly(allylamine hydrochloride)-g-pyrene (PAH-Py) microcapsules (MCs) are hydrolyzed at pH 2 within 1 h, leading to disassembly of the MCs and protrusion of pyrene aldehyde (Py) nanorods (NRs) on the capsule surface. Herein, we found a new way to modulate the protrusion of NRs by addition of 1-pyrenesulfonic acid sodium salt (PySO3Na). Along with the increase in PySO3Na to Py molar ratio in the MCs solution, the protrusion of NRs was progressively blocked and even inhibited at a ratio of 2.3, and at this condition, the microcapsules were stable under pH 2 for 24 h. After the composite microcapsules with excess PySO3Na were washed with a pH 10 solution and then incubated in a pH 2 solution, the NRs could be protruded from the MCs again. The fluorescence peak position of the PAH-Py/PySO3Na MCs gradually red-shifted with a decrease in pH value, and a sharp transition occurred at p H3.6, demonstrating the formation of pyrene excimers between the PySO3Na small molecules and the pendant Py groups on the PAH chain. The formed excimers take the role of blocking the self-assembly of cleaved Py molecules instead of inhibiting the hydrolysis of the Schiff base, whereas the MCs were stabilized by the charge interaction between PySO3Na and PAH backbone and the hydrophobic interaction between the pyrene rings. Copyright © 2013 Elsevier Inc. All rights reserved.

  11. One-stage human acellular nerve allograft reconstruction for digital nerve defects

    Directory of Open Access Journals (Sweden)

    Xue-yuan Li

    2015-01-01

    Full Text Available Human acellular nerve allografts have a wide range of donor origin and can effectively avoid nerve injury in the donor area. Very little is known about one-stage reconstruction of digital nerve defects. The present study observed the feasibility and effectiveness of human acellular nerve allograft in the reconstruction of < 5-cm digital nerve defects within 6 hours after injury. A total of 15 cases of nerve injury, combined with nerve defects in 18 digits from the Department of Emergency were enrolled in this study. After debridement, digital nerves were reconstructed using human acellular nerve allografts. The patients were followed up for 6-24 months after reconstruction. Mackinnon-Dellon static two-point discrimination results showed excellent and good rates of 89%. Semmes-Weinstein monofilament test demonstrated that light touch was normal, with an obvious improvement rate of 78%. These findings confirmed that human acellular nerve allograft for one-stage reconstruction of digital nerve defect after hand injury is feasible, which provides a novel trend for peripheral nerve reconstruction.

  12. Nerves and nerve endings in the skin of tropical cattle.

    Science.gov (United States)

    Amakiri, S F; Ozoya, S E; Ogunnaike, P O

    1978-01-01

    The nerves and nerve endings in the skin of tropical cattle were studied using histological and histochemical techniques. Many nerve trunks and fibres were present in the reticular and papillary dermis in both hairy and non-hairy skin sites. In non-hairy skin locations such as the muzzle and lower lip, encapsulated endings akin to Krause and Ruffini end bulbs, which arise from myelinated nerve trunks situated lower down the dermis were observed at the upper papillary layer level. Some fibre trunks seen at this level extended upwards to terminate within dermal papillae as bulb-shaped longitudinally lamellated Pacinian-type endings, while other onion-shaped lamellated nerve structures were located either within dermal papillae or near the dermo-epidermal area. Intraepidermal free-ending nerve fibres, appearing non-myelinated were observed in areas with thick epidermis. Intraepidermal free-ending nerve fibres, appearing non-myelinated were observed in areas with thick epidermis. On hairy skin sites, however, organized nerve endings or intraepidermal nerve endings were not readily identifiable.

  13. Diagnostic nerve ultrasonography

    International Nuclear Information System (INIS)

    Baeumer, T.; Grimm, A.; Schelle, T.

    2017-01-01

    For the diagnostics of nerve lesions an imaging method is necessary to visualize peripheral nerves and their surrounding structures for an etiological classification. Clinical neurological and electrophysiological investigations provide functional information about nerve lesions. The information provided by a standard magnetic resonance imaging (MRI) examination is inadequate for peripheral nerve diagnostics; however, MRI neurography is suitable but on the other hand a resource and time-consuming method. Using ultrasonography for peripheral nerve diagnostics. With ultrasonography reliable diagnostics of entrapment neuropathies and traumatic nerve lesions are possible. The use of ultrasonography for neuropathies shows that a differentiation between different forms is possible. Nerve ultrasonography is an established diagnostic tool. In addition to the clinical examination and clinical electrophysiology, structural information can be obtained, which results in a clear improvement in the diagnostics. Ultrasonography has become an integral part of the diagnostic work-up of peripheral nerve lesions in neurophysiological departments. Nerve ultrasonography is recommended for the diagnostic work-up of peripheral nerve lesions in addition to clinical and electrophysiological investigations. It should be used in the clinical work-up of entrapment neuropathies, traumatic nerve lesions and spacy-occupying lesions of nerves. (orig.) [de

  14. Nerve ultrasound shows subclinical peripheral nerve involvement in neurofibromatosis type 2.

    Science.gov (United States)

    Telleman, Johan A; Stellingwerff, Menno D; Brekelmans, Geert J; Visser, Leo H

    2018-02-01

    Neurofibromatosis type 2 (NF2) is mainly associated with central nervous system (CNS) tumors. Peripheral nerve involvement is described in symptomatic patients, but evidence of subclinical peripheral nerve involvement is scarce. We conducted a cross-sectional pilot study in 2 asymptomatic and 3 minimally symptomatic patients with NF2 to detect subclinical peripheral nerve involvement. Patients underwent clinical examination, nerve conduction studies (NCS), and high-resolution ultrasonography (HRUS). A total of 30 schwannomas were found, divided over 20 nerve segments (33.9% of all investigated nerve segments). All patients had at least 1 schwannoma. Schwannomas were identified with HRUS in 37% of clinically unaffected nerve segments and 50% of nerve segments with normal NCS findings. HRUS shows frequent subclinical peripheral nerve involvement in NF2. Clinicians should consider peripheral nerve involvement as a cause of weakness and sensory loss in the extremities in patients with this disease. Muscle Nerve 57: 312-316, 2018. © 2017 Wiley Periodicals, Inc.

  15. 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

    cells that had been labelled, i.e., that had regenerated axons towards or beyond the injection site, were counted in serial sections. Large and small neurons with presumably myelinated and unmyelinated axons, respectively, were classified by immunostaining for neurofilaments. The axonal growth rate......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...... of axons. Axonal counts do not reflect the number of regenerated neurons because of axonal branching and because myelinated axons form unmyelinated sprouts. Two days to 10 weeks after crushing, the distal sural or peroneal nerves were cut and exposed to fluoro-dextran. Large and small dorsal root ganglion...

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

    Institute of Scientific and Technical Information of China (English)

    G DAI; X NIU; J YIN

    2016-01-01

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

  17. Tissue-engineered spiral nerve guidance conduit for peripheral nerve regeneration.

    Science.gov (United States)

    Chang, Wei; Shah, Munish B; Lee, Paul; Yu, Xiaojun

    2018-06-01

    Recently in peripheral nerve regeneration, preclinical studies have shown that the use of nerve guidance conduits (NGCs) with multiple longitudinally channels and intra-luminal topography enhance the functional outcomes when bridging a nerve gap caused by traumatic injury. These features not only provide guidance cues for regenerating nerve, but also become the essential approaches for developing a novel NGC. In this study, a novel spiral NGC with aligned nanofibers and wrapped with an outer nanofibrous tube was first developed and investigated. Using the common rat sciatic 10-mm nerve defect model, the in vivo study showed that a novel spiral NGC (with and without inner nanofibers) increased the successful rate of nerve regeneration after 6 weeks recovery. Substantial improvements in nerve regeneration were achieved by combining the spiral NGC with inner nanofibers and outer nanofibrous tube, based on the results of walking track analysis, electrophysiology, nerve histological assessment, and gastrocnemius muscle measurement. This demonstrated that the novel spiral NGC with inner aligned nanofibers and wrapped with an outer nanofibrous tube provided a better environment for peripheral nerve regeneration than standard tubular NGCs. Results from this study will benefit for future NGC design to optimize tissue-engineering strategies for peripheral nerve regeneration. We developed a novel spiral nerve guidance conduit (NGC) with coated aligned nanofibers. The spiral structure increases surface area by 4.5 fold relative to a tubular NGC. Furthermore, the aligned nanofibers was coated on the spiral walls, providing cues for guiding neurite extension. Finally, the outside of spiral NGC was wrapped with randomly nanofibers to enhance mechanical strength that can stabilize the spiral NGC. Our nerve histological data have shown that the spiral NGC had 50% more myelinated axons than a tubular structure for nerve regeneration across a 10 mm gap in a rat sciatic nerve

  18. Sensation, mechanoreceptor, and nerve fiber function after nerve regeneration

    DEFF Research Database (Denmark)

    Krarup, Christian; Rosén, Birgitta; Boeckstyns, Michel

    2017-01-01

    Objective: Sensation is essential for recovery after peripheral nerve injury. However, the relationship between sensory modalities and function of regenerated fibers is uncertain. We have investigated the relationships between touch threshold, tactile gnosis, and mechanoreceptor and sensory fiber...... function after nerve regeneration. Methods: Twenty-one median or ulnar nerve lesions were repaired by a collagen nerve conduit or direct suture. Quantitative sensory hand function and sensory conduction studies by near-nerve technique, including tactile stimulation of mechanoreceptors, were followed for 2...... years, and results were compared to noninjured hands. Results: At both repair methods, touch thresholds at the finger tips recovered to 81 ± 3% and tactile gnosis only to 20 ± 4% (p nerve action potentials (SNAPs) remained dispersed and areas recovered to 23 ± 2...

  19. Comparative study of phrenic and intercostal nerve transfers for elbow flexion after global brachial plexus injury.

    Science.gov (United States)

    Liu, Yuzhou; Lao, Jie; Zhao, Xin

    2015-04-01

    Global brachial plexus injuries (BPIs) are devastating events frequently resulting in severe functional impairment. The widely used nerve transfer sources for elbow flexion in patients with global BPIs include intercostal and phrenic nerves. The aim of this study was to compare phrenic and intercostal nerve transfers for elbow flexion after global BPI. A retrospective review of 33 patients treated with phrenic and intercostal nerve transfer for elbow flexion in posttraumatic global root avulsion BPI was carried out. In the phrenic nerve transfer group, the phrenic nerve was transferred to the anterolateral bundle of the anterior division of the upper trunk (23 patients); in the intercostal nerve transfer group, three intercostal nerves were coapted to the anterolateral bundles of the musculocutaneous nerve. The British Medical Research Council (MRC) grading system, angle of elbow flexion, and electromyography (EMG) were used to evaluate the recovery of elbow flexion at least 3 years postoperatively. The efficiency of motor function in the phrenic nerve transfer group was 83%, while it was 70% in the intercostal nerve transfer group. The two groups were not statistically different in terms of the MRC grade (p=0.646) and EMG results (p=0.646). The outstanding rates of angle of elbow flexion were 48% and 40% in the phrenic and intercostal nerve transfer groups, respectively. There was no significant difference of outstanding rates in the angle of elbow flexion between the two groups. Phrenic nerve transfer had a higher proportion of good prognosis for elbow flexion than intercostal nerve transfer, but the effective and outstanding rate had no significant difference for biceps reinnervation between the two groups according to MRC grading, angle of elbow flexion, and EMG. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. The role of great auricular-facial nerve neurorrhaphy in facial nerve damage

    OpenAIRE

    Sun, Yan; Liu, Limei; Han, Yuechen; Xu, Lei; Zhang, Daogong; Wang, Haibo

    2015-01-01

    Background: Facial nerve is easy to be damaged, and there are many reconstructive methods for facial nerve reconstructive, such as facial nerve end to end anastomosis, the great auricular nerve graft, the sural nerve graft, or hypoglossal-facial nerve anastomosis. However, there is still little study about great auricular-facial nerve neurorrhaphy. The aim of the present study was to identify the role of great auricular-facial nerve neurorrhaphy and the mechanism. Methods: Rat models of facia...

  1. Fuxianhuiid ventral nerve cord and early nervous system evolution in Panarthropoda.

    Science.gov (United States)

    Yang, Jie; Ortega-Hernández, Javier; Butterfield, Nicholas J; Liu, Yu; Boyan, George S; Hou, Jin-Bo; Lan, Tian; Zhang, Xi-Guang

    2016-03-15

    Panarthropods are typified by disparate grades of neurological organization reflecting a complex evolutionary history. The fossil record offers a unique opportunity to reconstruct early character evolution of the nervous system via exceptional preservation in extinct representatives. Here we describe the neurological architecture of the ventral nerve cord (VNC) in the upper-stem group euarthropod Chengjiangocaris kunmingensis from the early Cambrian Xiaoshiba Lagerstätte (South China). The VNC of C. kunmingensis comprises a homonymous series of condensed ganglia that extend throughout the body, each associated with a pair of biramous limbs. Submillimetric preservation reveals numerous segmental and intersegmental nerve roots emerging from both sides of the VNC, which correspond topologically to the peripheral nerves of extant Priapulida and Onychophora. The fuxianhuiid VNC indicates that ancestral neurological features of Ecdysozoa persisted into derived members of stem-group Euarthropoda but were later lost in crown-group representatives. These findings illuminate the VNC ground pattern in Panarthropoda and suggest the independent secondary loss of cycloneuralian-like neurological characters in Tardigrada and Euarthropoda.

  2. 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

  3. The role of great auricular-facial nerve neurorrhaphy in facial nerve damage.

    Science.gov (United States)

    Sun, Yan; Liu, Limei; Han, Yuechen; Xu, Lei; Zhang, Daogong; Wang, Haibo

    2015-01-01

    Facial nerve is easy to be damaged, and there are many reconstructive methods for facial nerve reconstructive, such as facial nerve end to end anastomosis, the great auricular nerve graft, the sural nerve graft, or hypoglossal-facial nerve anastomosis. However, there is still little study about great auricular-facial nerve neurorrhaphy. The aim of the present study was to identify the role of great auricular-facial nerve neurorrhaphy and the mechanism. Rat models of facial nerve cut (FC), facial nerve end to end anastomosis (FF), facial-great auricular neurorrhaphy (FG), and control (Ctrl) were established. Apex nasi amesiality observation, electrophysiology and immunofluorescence assays were employed to investigate the function and mechanism. In apex nasi amesiality observation, it was found apex nasi amesiality of FG group was partly recovered. Additionally, electrophysiology and immunofluorescence assays revealed that facial-great auricular neurorrhaphy could transfer nerve impulse and express AChR which was better than facial nerve cut and worse than facial nerve end to end anastomosis. The present study indicated that great auricular-facial nerve neurorrhaphy is a substantial solution for facial lesion repair, as it is efficiently preventing facial muscles atrophy by generating neurotransmitter like ACh.

  4. Pinched Nerve

    Science.gov (United States)

    ... You are here Home » Disorders » All Disorders Pinched Nerve Information Page Pinched Nerve Information Page What research is being done? Within the NINDS research programs, pinched nerves are addressed primarily through studies associated with pain ...

  5. Facial nerve ganglioneuroblastoma in a feline leukemia virus-positive cat

    Directory of Open Access Journals (Sweden)

    Paula Reis Pereira

    Full Text Available ABSTRACT: Neuroblastic tumors can originate from the central neuraxis, olfactory epithelium, adrenal medullary region or autonomous system. Ganglioneuroblastoma are a type of neuroblastic tumor, with very few case descriptions in animals. Diagnosis of facial nerve ganglioneuroblastoma was made in a feline leukemia virus-positive 11-month-old cat. The cat had hyporexia, left head tilt, depressed mental state, horizontal nystagmus, inability to retract the pinched left lip, anisocoria, ptosis, and absence of the menace reflex. Gross necropsy showed a mass at the left facial nerve root region. Histological examination of this mass showed neoplastic proliferation of neuroblasts arranged in a cohesive pattern and mature ganglion cells. Ganglion cells were positive for neurofilament, neuron-specific enolase, S100, and glial fibrillary acidic protein by immunohistochemistry, while neuroblasts were positive for vimentin, S100, neuron-specific enolase and feline leukemia virus.

  6. Replicate high-density rat genome oligonucleotide microarrays reveal hundreds of regulated genes in the dorsal root ganglion after peripheral nerve injury.

    Directory of Open Access Journals (Sweden)

    Mannion James W

    2002-10-01

    Full Text Available Abstract Background Rat oligonucleotide microarrays were used to detect changes in gene expression in the dorsal root ganglion (DRG 3 days following sciatic nerve transection (axotomy. Two comparisons were made using two sets of triplicate microarrays, naïve versus naïve and naïve versus axotomy. Results Microarray variability was assessed using the naïve versus naïve comparison. These results support use of a P 1.5-fold expression change and P 1.5-fold and P in situ hybridization verified the expression of 24 transcripts. These data showed an 83% concordance rate with the arrays; most mismatches represent genes with low expression levels reflecting limits of array sensitivity. A significant correlation was found between actual mRNA differences and relative changes between microarrays (r2 = 0.8567. Temporal patterns of individual genes regulation varied. Conclusions We identify parameters for microarray analysis which reduce error while identifying many putatively regulated genes. Functional classification of these genes suggest reorganization of cell structural components, activation of genes expressed by immune and inflammatory cells and down-regulation of genes involved in neurotransmission.

  7. Assessment of nerve regeneration across nerve allografts treated with tacrolimus.

    Science.gov (United States)

    Haisheng, Han; Songjie, Zuo; Xin, Li

    2008-01-01

    Although regeneration of nerve allotransplant is a major concern in the clinic, there have been few papers quantitatively assessing functional recovery of animals' nerve allografts in the long term. In this study, functional recovery, histopathological study, and immunohistochemistry changes of rat nerve allograft with FK506 were investigated up to 12 weeks without slaughtering. C57 and SD rats were used for transplantation. The donor's nerve was sliced and transplanted into the recipient. The sciatic nerve was epineurally sutured with 10-0 nylon. In total, 30 models of transplantation were performed and divided into 3 groups that were either treated with FK506 or not. Functional recovery of the grafted nerve was serially assessed by the pin click test, walking track analysis and electrophysiological evaluations. A histopathological study and immunohistochemistry study were done in the all of the models. Nerve allografts treated with FK506 have no immune rejection through 12 weeks. Sensibility had similarly improved in both isografts and allografts. There has been no difference in each graft. Walk track analysis demonstrates significant recovery of motor function of the nerve graft. No histological results of difference were found up to 12 weeks in each graft. In the rodent nerve graft model, FK506 prevented nerve allograft rejection across a major histocompatibility barrier. Sensory recovery seems to be superior to motor function. Nerve isograft and allograft treated with FK506 have no significant difference in function recovery, histopathological result, and immunohistochemistry changes.

  8. Peripheral nerve regeneration through P(DLLA-epsilon-CL) nerve guides

    NARCIS (Netherlands)

    Den Dunnen, WFA; Meek, MF; Robinson, PH; Schakernraad, JM

    1998-01-01

    P(DLLA-epsilon-CL) nerve guides can be used perfectly for short nerve gaps in rats, and are even better than short autologous nerve grafts. The tube dimensions, such as the internal diameter and wall thickness, are very important for the final outcome of peripheral nerve regeneration, as well as the

  9. Ineficácia da laserterapia aplicada no trajeto do nervo e nas raízes medulares correspondentes Lack of effectiveness of laser therapy applied to the nerve course and the correspondent medullary roots

    Directory of Open Access Journals (Sweden)

    Fausto Fernandes de Almeida Sousa

    2013-04-01

    Full Text Available OBJETIVO: Verificar a influência da irradiação do laser de baixa intensidade na regeneração do nervo fibular comum de ratos após lesão por esmagamento. MÉTODOS: Foram utilizados 25 ratos, divididos em três grupos: 1 nervo intacto, e não tratados; 2 nervo lesado, e não tratado; 3 nervo lesado, e laser irradiado sobre a região medular correspondente às raízes do nervo ciático e subsequentemente no trajeto do nervo lesado. A irradiação foi realizada por 14 dias consecutivos. RESULTADOS: Foram avaliados por meio da análise funcional da marcha, através do índice funcional do peroneiro, e por análise morfométrica através do número total de fibras nervosas mielinizadas e sua densidade, número total de células de Schwann, número total de vasos sanguíneos e sua área, diâmetro mínimo da fibra e razão-G. CONCLUSÃO: De acordo com a análise estatística, não houve diferença significativa entre os grupos, e os autores concluem que a irradiação do laser de baixa intensidade possui pouca ou nenhuma influência na regeneração nervosa e recuperação funcional. Trabalho experimental.OBJECTIVE: to investigate the influence of low intensity laser irradiation on the regeneration of the fibular nerve of rats after crush injury. METHODS: twenty-five rats were used, divided into three groups: 1 intact nerve, no treatment; 2 crushed nerve, no treatment; 3 crush injury, laser irradiation applied on the medullary region corresponding to the roots of the sciatic nerve and subsequently on the course of the damaged nerve. laser irradiation was carried out for 14 consecutive days. RESULTS: animals were evaluated by functional gait analysis with the peroneal functional index and by histomorphometric analysis using the total number of myelinated nerve fibers and their density, total number of schwann cells, total number of blood vessels and the occupied area, minimum diameter of the fiber diameter and g-quotient. CONCLUSION: according to

  10. Sacral root neuromodulation in idiopathic nonobstructive chronic urinary retention.

    Science.gov (United States)

    Shaker, H S; Hassouna, M

    1998-05-01

    Sacral root neuromodulation is becoming a superior alternative to the standard treatment of idiopathic nonobstructive urinary retention. We report results in 20 successive patients who underwent sacral foramen implantation to restore bladder function. After an initial, thorough baseline assessment 20 patients 19.43 to 55.66 years old with idiopathic nonobstructive urinary retention underwent percutaneous nerve evaluation. Response was assessed by a detailed voiding diary. Responders underwent implantation with an S3 foramen implant, and were followed 1, 3 and 6 months postoperatively, and every 6 months thereafter. Sacral root neuromodulation restored voiding capability in these patients. Bladders were emptied with minimal post-void residual urine, which decreased from 78.3 to 5.5 to 10.2% of the total voided volume from baseline to postoperative followup. These results were reflected in uroflowmetry and pressure-flow studies, which were almost normal after implantation. Furthermore, the urinary tract infection rate decreased significantly and associated pelvic pain improved substantially. The Beck depression inventory and SF-36 quality of life questionnaire indicated some improvement but reached significance in only 1 item. In addition, cystometrography showed no significant difference after 6 months of implantation compared with baseline values. Complications were minimal and within expectations. Sacral root neuromodulation is an appealing, successful modality for nonobstructive urinary retention. Only patients who have a good response to percutaneous nerve evaluation are candidates for implantation. The high efficacy in patients who undergo implantation, relative simplicity of the procedure and low complication rate make this a treatment breakthrough in this difficult group.

  11. [Accidental injection of sodium hypochlorite in inferior alveolar nerve block anesthesia].

    Science.gov (United States)

    Hongyan, Li; Jian, Xu; Baorong, Zhang; Yue, Jia; Minhua, Liu; Yilang, Luo; Jing, Zhao

    2016-12-01

    Sodium hypochlorite (NaClO) has been widely used in clinical practice as one of the most efficient root canal irrigants. Its properties include broad-spectrum antimicrobial activity and ability to dissolve necrotic tissues. However, when used improperly, NaClO can cause a series of adverse reactions, such as mucosal inflammation, irritation, or injury. This paper presents a case of accidental injection of NaClO in inferior alveolar nerve block anesthesia.

  12. Matrix metalloproteinases regulate the formation of dendritic spine head protrusions during chemically induced long-term potentiation.

    Directory of Open Access Journals (Sweden)

    Zsuzsanna Szepesi

    Full Text Available Dendritic spines are are small membranous protrusions that extend from neuronal dendrites and harbor the majority of excitatory synapses. Increasing evidence has shown that matrix metalloproteinases (MMPs, a family of extracellularly acting and Zn(2+-dependent endopeptidases, are able to rapidly modulate dendritic spine morphology. Spine head protrusions (SHPs are filopodia-like processes that extend from the dendritic spine head, representing a form of postsynaptic structural remodeling in response to altered neuronal activity. Herein, we show that chemically induced long-term potentiation (cLTP in dissociated hippocampal cultures upregulates MMP-9 activity that controls the formation of SHPs. Blocking of MMPs activity or microtubule dynamics abolishes the emergence of SHPs. In addition, autoactive recombinant MMP-9, promotes the formation of SHPs in organotypic hippocampal slices. Furthermore, spines with SHPs gained postsynaptic α-amino-3-hydroxyl-5-methyl-4-isoxazole propionic acid (AMPA receptors upon cLTP and the synaptic delivery of AMPA receptors was controlled by MMPs. The present results strongly imply that MMP-9 is functionally involved in the formation of SHPs and the control of postsynaptic receptor distribution upon cLTP.

  13. Inflammatory lesions of the spinal cord and the nerve roots in magnetic resonance imaging; Entzuendliche Erkrankungen des Rueckenmarks und der Nervenwurzeln in der MRT

    Energy Technology Data Exchange (ETDEWEB)

    Sartoretti-Schefer, S. [Inst. fuer Neuroradiologie, Universitaetsspital Zuerich (Switzerland); Wichmann, W. [Inst. fuer Neuroradiologie, Universitaetsspital Zuerich (Switzerland); Valavanis, A. [Inst. fuer Neuroradiologie, Universitaetsspital Zuerich (Switzerland)

    1996-11-01

    The MRI examinations of 52 patients with proven inflammatory lesions (39 patients) or tumorous/postactinic lesions of the spinal cord (6 patients) and vasuclar malformations of the spinal cord (7 patients) were retrospectively analyzed. All examinations were performed on a 1.5 T MR unit, using bi- or triplanar T1-w pre- and postcontrast as well as T2-w SE sequences. Clinical and radiological examinations allow a subdivision of inflammations of the spinal cord and the nerve roots into (mening-oradiculo) myelitis and meningoradiculo (myelitis). The MRI patterns of these two inflammatory subtypes vary: Meningoradiculitis presents with an enhancement of the nerve roots and the leptomeninges; myelitis itself is characterized by single or multiple, diffuse or multifocal, with or without nodular, patchy or diffusely enhancing intramedullary lessions, with or without thickening of the cord and leptomeningeal inflammation. The immunologically suppressed patient suffers from viral infections (especially herpes simplex, varicella-zoster virus, cytomegalovirus), bacterial infections (tuberculosis), but rarely viral infections, sarcoidosis and demyelinating diseases. Idiopathic myelitis is also common. Secondary ischemic and demyelinating processes result in a complex morphology of inflammatory lesions on MRI, and therefore the whole spectrum of demyelinating, ischemic and inflammatory lesions has to be included in the differential diagnosis. Even tumors may imitate inflammatory myelitis and radiculitis. Most commonly, meningoradiculitis can be separated from myelitis. A reliable diagnosis of a specific inflammatory lesion is difficult and is mostly achieved in patients with multiple sclerosis and in patients with HIV-associated cytomegalovirus infection. (orig.) [Deutsch] Entzuendliche Erkrankungen des Rueckenmarks und der Nervenwurzeln werden aus klinischer und radiologischer Sicht in eine (Meningo)-Myeloradikulitis und eine Meningoradikulo-(Myelitis) beim immunsupprimierten

  14. Nerve growth factor expression by PLG-mediated lipofection.

    Science.gov (United States)

    Whittlesey, Kevin J; Shea, Lonnie D

    2006-04-01

    Biomaterials capable of efficient gene delivery provide a fundamental tool for basic and applied research models, such as promoting neural regeneration. We developed a system for the encapsulation and sustained release of plasmid DNA complexed with a cationic lipid and investigated their efficacy using in vitro models of neurite outgrowth. Sustained lipoplex release was obtained for up to 50 days, with rates controlled by the fabrication conditions. Released lipoplexes retained their activity, transfecting 48.2+/-8.3% of NIH3T3 cells with luciferase activity of 3.97x10(7)RLU/mg. Expression of nerve growth factor (NGF) was employed in two models of neurite outgrowth: PC12 and primary dorsal root ganglia (DRG) co-culture. Polymer-mediated lipofection of PC12 produced bioactive NGF, eliciting robust neurite outgrowth. An EGFP/NGF dual-expression vector identified transfected cells (GFP-positive) while neurite outgrowth verified NGF secretion. A co-culture model examined the ability of NGF secretion by an accessory cell population to stimulate DRG neurite outgrowth. Polymer-mediated transfection of HEK293T with an NGF-encoding plasmid induced outgrowth by DRG neurons. This system could be fabricated as implants or nerve guidance conduits to support cellular and tissue regeneration. Combining this physical support with the ability to locally express neurotrophic factors will potentiate regeneration in nerve injury and disease models.

  15. Electrophysiology of Cranial Nerve Testing: Spinal Accessory and Hypoglossal Nerves.

    Science.gov (United States)

    Stino, Amro M; Smith, Benn E

    2018-01-01

    Multiple techniques have been developed for the electrodiagnostic evaluation of cranial nerves XI and XII. Each of these carries both benefits and limitations, with more techniques and data being available in the literature for spinal accessory than hypoglossal nerve evaluation. Spinal accessory and hypoglossal neuropathy are relatively uncommon cranial mononeuropathies that may be evaluated in the outpatient electrodiagnostic laboratory setting. A review of available literature using PubMed was conducted regarding electrodiagnostic technique in the evaluation of spinal accessory and hypoglossal nerves searching for both routine nerve conduction studies and repetitive nerve conduction studies. The review provided herein provides a resource by which clinical neurophysiologists may develop and implement clinical and research protocols for the evaluation of both of these lower cranial nerves in the outpatient setting.

  16. Release of axonally transported material from an in vitro amphibian sciatic nerve preparation

    International Nuclear Information System (INIS)

    Snyder, R.E.

    1988-01-01

    The rapid axonal transport of a pulse of [35S]methionine-labelled material was used to study the release of transported material from amphibian nerve maintained in vitro. Following creation of a moving pulse of activity in a dorsal root ganglion-sciatic nerve preparation, the ganglion was removed and the nerve placed in a three-compartment tray, the section of nerve in the middle compartment containing no truncated branches (unbranched section). All three compartments were filled with a saline solution that in some studies contained nonradioactive methionine (1.0 mmol/L). Analysis of studies in which nonradioactive methionine was absent revealed that labelled material appeared in the bathing solution of the end compartments that contained truncated branches, but not in the solution of the middle (unbranched) compartment. The quantity of label released in the branched compartments was approximately 6% of that remaining in the corresponding section of nerve following an 18-20 h incubation period. However, when nonradioactive methionine was present, all compartments showed an additional activity in the bathing solution of approximately 10% of that remaining in the nerve. In another study in which a position-sensitive detector of ionizing radiation was used to monitor progress of the pulse, it was found that activity did not enter the bathing solution of a compartment prior to the pulse of activity. It is concluded that in the absence of methionine from the bathing solution, axonally transported material is released only from regions of nerve that contain severed axons; however, the presence of methionine allows transported material to be released from nerve containing intact axons. Ultrafiltration studies and thin-layer chromatography revealed the majority of material released to be of low-molecular weight (less than 30,000 daltons) and not free [35S]methionine

  17. [Relevance of nerve blocks in treating and diagnosing low back pain--is the quality decisive?].

    Science.gov (United States)

    Hildebrandt, J

    2001-12-01

    Diagnostic nerve blocks: The popularity of neural blockade as a diagnostic tool in painful conditions, especially in the spine, is due to features like the unspecific character of spinal pain, the irrelevance of radiological findings and the purely subjective character of pain. It is said that apart from specific causes of pain and clear radicular involvement with obvious neurological deficits and corresponding findings of a prolapsed disc in MRI or CT pictures, a diagnosis of the anatomical cause of the pain can only be established if invasive tests are used [5]. These include zygapophyseal joint blocks, sacroiliacal joint blocks, disc stimulation and nerve root blocks. Under controlled conditions, it has been shown that among patients with chronic nonradicular low back pain, some 10-15% have zygapophyseal joint pain [58], some 15-20% have sacroiliacal joint pain [36, 59] and 40% have pain from internal disc disruption [60]. The diagnostic use of neural blockade rests on three premises. First, pathology causing pain is located in an exact peripheral location, and impulses from this site travel via a unique and consistent neural root. Second, injection of local aneasthetic totally abolishes sensory function of intended nerves and does not affect other nerves. Third, relief of pain after local anaesthetic block is attributable solely to block of the target afferent neural pathway. The validity of these assumptions is limited by complexities of anatomy, physiology, and psychology of pain perception and the effect of local anaesthetics on impulse conduction [28]. Facet joints: The prevalence of zygapophyseal joint pain among patients with low back pain seems to be between 15% and 40% [62], but apparently only 7% of patients have pure facet pain [8, 29]. Facet blockade is achieved either by injection of local anaesthetic into the joint space or around the medial branches of the posterior medial rami of the spinal nerves that innervate the joint. There are several

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

    Directory of Open Access Journals (Sweden)

    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.

  19. [Facial nerve neurinomas].

    Science.gov (United States)

    Sokołowski, Jacek; Bartoszewicz, Robert; Morawski, Krzysztof; Jamróz, Barbara; Niemczyk, Kazimierz

    2013-01-01

    Evaluation of diagnostic, surgical technique, treatment results facial nerve neurinomas and its comparison with literature was the main purpose of this study. Seven cases of patients (2005-2011) with facial nerve schwannomas were included to retrospective analysis in the Department of Otolaryngology, Medical University of Warsaw. All patients were assessed with history of the disease, physical examination, hearing tests, computed tomography and/or magnetic resonance imaging, electronystagmography. Cases were observed in the direction of potential complications and recurrences. Neurinoma of the facial nerve occurred in the vertical segment (n=2), facial nerve geniculum (n=1) and the internal auditory canal (n=4). The symptoms observed in patients were analyzed: facial nerve paresis (n=3), hearing loss (n=2), dizziness (n=1). Magnetic resonance imaging and computed tomography allowed to confirm the presence of the tumor and to assess its staging. Schwannoma of the facial nerve has been surgically removed using the middle fossa approach (n=5) and by antromastoidectomy (n=2). Anatomical continuity of the facial nerve was achieved in 3 cases. In the twelve months after surgery, facial nerve paresis was rated at level II-III° HB. There was no recurrence of the tumor in radiological observation. Facial nerve neurinoma is a rare tumor. Currently surgical techniques allow in most cases, the radical removing of the lesion and reconstruction of the VII nerve function. The rate of recurrence is low. A tumor of the facial nerve should be considered in the differential diagnosis of nerve VII paresis. Copyright © 2013 Polish Otorhinolaryngology - Head and Neck Surgery Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.

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

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    Samuel Ribak

    2016-02-01

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

  1. Progranulin promotes peripheral nerve regeneration and reinnervation: role of notch signaling.

    Science.gov (United States)

    Altmann, Christine; Vasic, Verica; Hardt, Stefanie; Heidler, Juliana; Häussler, Annett; Wittig, Ilka; Schmidt, Mirko H H; Tegeder, Irmgard

    2016-10-22

    Peripheral nerve injury is a frequent cause of lasting motor deficits and chronic pain. Although peripheral nerves are capable of regrowth they often fail to re-innervate target tissues. Using newly generated transgenic mice with inducible neuronal progranulin overexpression we show that progranulin accelerates axonal regrowth, restoration of neuromuscular synapses and recovery of sensory and motor functions after injury of the sciatic nerve. Oppositely, progranulin deficient mice have long-lasting deficits in motor function tests after nerve injury due to enhanced losses of motor neurons and stronger microglia activation in the ventral horn of the spinal cord. Deep proteome and gene ontology (GO) enrichment analysis revealed that the proteins upregulated in progranulin overexpressing mice were involved in 'regulation of transcription' and 'response to insulin' (GO terms). Transcription factor prediction pointed to activation of Notch signaling and indeed, co-immunoprecipitation studies revealed that progranulin bound to the extracellular domain of Notch receptors, and this was functionally associated with higher expression of Notch target genes in the dorsal root ganglia of transgenic mice with neuronal progranulin overexpression. Functionally, these transgenic mice recovered normal gait and running, which was not achieved by controls and was stronger impaired in progranulin deficient mice. We infer that progranulin activates Notch signaling pathways, enhancing thereby the regenerative capacity of partially injured neurons, which leads to improved motor function recovery.

  2. Hypertrophic Synovitis of the Facet Joint Causing Root Pain

    Directory of Open Access Journals (Sweden)

    Koichi Iwatsuki M.D.

    2008-01-01

    Full Text Available Osteoarthritic changes in the facet joints are common in the presence of degenerative disc disease. Changes in the joint capsule accompany changes in the articular surfaces. Intraspinal synovial cysts that cause radicular pain, cauda equina syndrome, and myelopathy have been reported; however, there have been few reports in orthopedic or neurosurgical literature regarding hypertrophic synovitis of the facet joint presenting as an incidental para-articular mass. Here, we report a case of hypertrophic synovitis causing root pain. We describe the case of a 65-year-old man suffering from right sciatica and right leg pain in the L5 nerve-root dermatome for 1 year; magnetic resonance imaging (MRI revealed an enhanced mass around the L4–5 facet joint. We investigated this mass pathologically. After right medial facetectomy, the symptoms resolved. Pathological investigation revealed this mass was hypertrophic synovitis. Hypertrophic synovitis of the facet joint might cause root pain.

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

    Science.gov (United States)

    Gordon, Tessa; Eva, Placheta; Borschel, Gregory H

    2015-10-01

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

  4. Peripheral injury of pelvic visceral sensory nerves alters GFRa (GDNF family receptor alpha localization in sensory and autonomic pathways of the sacral spinal cord

    Directory of Open Access Journals (Sweden)

    Shelley Lynne Forrest

    2015-04-01

    Full Text Available GDNF (glial cell line-derived neurotrophic factor, neurturin and artemin use their co-receptors (GFRα1, GFRα2 and GFRα3, respectively and the tyrosine kinase Ret for downstream signalling. In rodent dorsal root ganglia (DRG most of the unmyelinated and some myelinated sensory afferents express at least one GFRα. The adult function of these receptors is not completely elucidated but their activity after peripheral nerve injury can facilitate peripheral and central axonal regeneration, recovery of sensation, and sensory hypersensitivity that contributes to pain. Our previous immunohistochemical studies of spinal cord and sciatic nerve injuries in adult rodents have identified characteristic changes in GFRα1, GFRα2 or GFRα3 in central spinal cord axons of sensory neurons located in dorsal root ganglia. Here we extend and contrast this analysis by studying injuries of the pelvic and hypogastric nerves that contain the majority of sensory axons projecting to the pelvic viscera (e.g., bladder and lower bowel. At 7 d, we detected some effects of pelvic but not hypogastric nerve transection on the ipsilateral spinal cord. In sacral (L6-S1 cord ipsilateral to nerve injury, GFRα1-immunoreactivity (IR was increased in medial dorsal horn and CGRP-IR was decreased in lateral dorsal horn. Pelvic nerve injury also upregulated GFRα1- and GFRα3-IR terminals and GFRα1-IR neuronal cell bodies in the sacral parasympathetic nucleus that provides the spinal parasympathetic preganglionic output to the pelvic nerve. This evidence suggests peripheral axotomy has different effects on somatic and visceral sensory input to the spinal cord, and identifies sensory-autonomic interactions as a possible site of post-injury regulation.

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

    NARCIS (Netherlands)

    den Dunnen, WFA; Meek, MF

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

  6. Tissue-engineered rhesus monkey nerve grafts for the repair of long ulnar nerve defects: similar outcomes to autologous nerve grafts

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    Chang-qing Jiang

    2016-01-01

    Full Text Available Acellular nerve allografts can help preserve normal nerve structure and extracellular matrix composition. These allografts have low immunogenicity and are more readily available than autologous nerves for the repair of long-segment peripheral nerve defects. In this study, we repaired a 40-mm ulnar nerve defect in rhesus monkeys with tissue-engineered peripheral nerve, and compared the outcome with that of autograft. The graft was prepared using a chemical extract from adult rhesus monkeys and seeded with allogeneic Schwann cells. Pathomorphology, electromyogram and immunohistochemistry findings revealed the absence of palmar erosion or ulcers, and that the morphology and elasticity of the hypothenar eminence were normal 5 months postoperatively. There were no significant differences in the mean peak compound muscle action potential, the mean nerve conduction velocity, or the number of neurofilaments between the experimental and control groups. However, outcome was significantly better in the experimental group than in the blank group. These findings suggest that chemically extracted allogeneic nerve seeded with autologous Schwann cells can repair 40-mm ulnar nerve defects in the rhesus monkey. The outcomes are similar to those obtained with autologous nerve graft.

  7. Tissue-engineered rhesus monkey nerve gratfs for the repair of long ulnar nerve defects:similar outcomes to autologous nerve gratfs

    Institute of Scientific and Technical Information of China (English)

    Chang-qing Jiang; Jun Hu; Jian-ping Xiang; Jia-kai Zhu; Xiao-lin Liu; Peng Luo

    2016-01-01

    Acellular nerve allogratfs can help preserve normal nerve structure and extracellular matrix composition. These allogratfs have low immu-nogenicity and are more readily available than autologous nerves for the repair of long-segment peripheral nerve defects. In this study, we repaired a 40-mm ulnar nerve defect in rhesus monkeys with tissue-engineered peripheral nerve, and compared the outcome with that of autogratf. The gratf was prepared using a chemical extract from adult rhesus monkeys and seeded with allogeneic Schwann cells. Pathomo-rphology, electromyogram and immunohistochemistry ifndings revealed the absence of palmar erosion or ulcers, and that the morphology and elasticity of the hypothenar eminence were normal 5 months postoperatively. There were no signiifcant differences in the mean peak compound muscle action potential, the mean nerve conduction velocity, or the number of neuroiflaments between the experimental and control groups. However, outcome was signiifcantly better in the experimental group than in the blank group. These ifndings suggest that chemically extracted allogeneic nerve seeded with autologous Schwann cells can repair 40-mm ulnar nerve defects in the rhesus monkey. The outcomes are similar to those obtained with autologous nerve gratf.

  8. AFM tip-sample convolution effects for cylinder protrusions

    Science.gov (United States)

    Shen, Jian; Zhang, Dan; Zhang, Fei-Hu; Gan, Yang

    2017-11-01

    A thorough understanding about the AFM tip geometry dependent artifacts and tip-sample convolution effect is essential for reliable AFM topographic characterization and dimensional metrology. Using rigid sapphire cylinder protrusions (diameter: 2.25 μm, height: 575 nm) as the model system, a systematic and quantitative study about the imaging artifacts of four types of tips-two different pyramidal tips, one tetrahedral tip and one super sharp whisker tip-is carried out through comparing tip geometry dependent variations in AFM topography of cylinders and constructing the rigid tip-cylinder convolution models. We found that the imaging artifacts and the tip-sample convolution effect are critically related to the actual inclination of the working cantilever, the tip geometry, and the obstructive contacts between the working tip's planes/edges and the cylinder. Artifact-free images can only be obtained provided that all planes and edges of the working tip are steeper than the cylinder sidewalls. The findings reported here will contribute to reliable AFM characterization of surface features of micron or hundreds of nanometers in height that are frequently met in semiconductor, biology and materials fields.

  9. Optic nerve oxygenation

    DEFF Research Database (Denmark)

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

    2005-01-01

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

  10. Bimaxillary protrusion with an atrophic alveolar defect: orthodontics, autogenous chin-block graft, soft tissue augmentation, and an implant.

    Science.gov (United States)

    Chiu, Grace S C; Chang, Chris H N; Roberts, W Eugene

    2015-01-01

    Bimaxillary protrusion in a 28-year-old woman was complicated by multiple missing, restoratively compromised, or hopeless teeth. The maxillary right central incisor had a history of avulsion and replantation that subsequently evolved into generalized external root resorption with Class III mobility and severe loss of the supporting periodontium. This complex malocclusion had a discrepancy index of 21, and 8 additional points were scored for the atrophic dental implant site (maxillary right central incisor). The comprehensive treatment plan included extraction of 4 teeth (both maxillary first premolars, the maxillary right central incisor, and the mandibular right first molar), orthodontic closure of all spaces except for the future implant site (maxillary right central incisor), augmentation of the alveolar defect with an autogenous chin-block graft, enhancement of the gingival biotype with a connective tissue graft, and an implant-supported prosthesis. Orthodontists must understand the limitations of bone grafts. Augmented alveolar defects are slow to completely turn over to living bone, so they are usually good sites for implants but respond poorly to orthodontic space closure. However, postsurgical orthodontic treatment is often indicated to optimally finish the esthetic zone before placing the final prosthesis. The latter was effectively performed for this patient, resulting in a total treatment time of about 36 months for comprehensive interdisciplinary care. An excellent functional and esthetic result was achieved. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

  11. Mechanisms mediating the trophic effect of nerves during vertebrate limb regeneration

    International Nuclear Information System (INIS)

    Munaim, S.I.

    1986-01-01

    Salamanders regenerate their appendages after amputation and nerves are required for this process. Experiments were designed to test the idea that one way nerves could affect blastema cell proliferation is by influencing the metabolism of extracellular matrix (ECM) components and to identify neurotrophic factors which promote blastema cell mitosis. Temporal and spatial differences of glycosaminoglycans (GAGs) synthesis is innervated and denervated limbs were examined. Hyaluronic acid (HA) was found to be the major GAG produced during the proliferative period and chondroitin sulfate during differentiation. Denervation reduced synthesis of both these components by half. Dorsal root ganglia and fibroblast growth factor (FGF), a brain-derived mitogen, similarly doubled GAG synthesis in cultured blastemas, the FGF-effect being primarily on HA production. Histochemical and autoradiographical results confirmed the biochemical data. Autoradiography of the limb tissue showed heaviest labeling of the ECM with 3 H-acetate in areas which also stained most intensely with the dye, carbocyanine DBTC. Denervation reduced the staining and the radioactive labeling. These data indicate that nerves affect synthesis and accumulation of GAGs in the regenerating limb, which may be one way blastema cell proliferation is promoted

  12. The Role of Nerve Exploration in Supracondylar Humerus Fracture in Children with Nerve Injury

    Directory of Open Access Journals (Sweden)

    Anuar RIM

    2015-11-01

    Full Text Available The supracondylar humerus fracture (SCHF in children is common and can be complicated with nerve injury either primarily immediate post-trauma or secondarily posttreatment. The concept of neurapraxic nerve injury makes most surgeons choose to ‘watch and see’ the nerve recovery before deciding second surgery if the nerve does not recover. We report three cases of nerve injury in SCHF, all of which underwent nerve exploration for different reasons. Early reduction in the Casualty is important to release the nerve tension before transferring the patient to the operation room. If close reduction fails, we proceed to explore the nerve together with open reduction of the fracture. In iatrogenic nerve injury, we recommend nerve exploration to determine the surgical procedure that is causing the injury. Primary nerve exploration will allow early assessment of the injured nerve and minimize subsequent surgery.

  13. Clostridium difficile toxin CDT induces formation of microtubule-based protrusions and increases adherence of bacteria.

    Directory of Open Access Journals (Sweden)

    Carsten Schwan

    2009-10-01

    Full Text Available Clostridium difficile causes antibiotic-associated diarrhea and pseudomembranous colitis by production of the Rho GTPase-glucosylating toxins A and B. Recently emerging hypervirulent Clostridium difficile strains additionally produce the binary ADP-ribosyltransferase toxin CDT (Clostridium difficile transferase, which ADP-ribosylates actin and inhibits actin polymerization. Thus far, the role of CDT as a virulence factor is not understood. Here we report by using time-lapse- and immunofluorescence microscopy that CDT and other binary actin-ADP-ribosylating toxins, including Clostridium botulinum C2 toxin and Clostridium perfringens iota toxin, induce redistribution of microtubules and formation of long (up to >150 microm microtubule-based protrusions at the surface of intestinal epithelial cells. The toxins increase the length of decoration of microtubule plus-ends by EB1/3, CLIP-170 and CLIP-115 proteins and cause redistribution of the capture proteins CLASP2 and ACF7 from microtubules at the cell cortex into the cell interior. The CDT-induced microtubule protrusions form a dense meshwork at the cell surface, which wrap and embed bacterial cells, thereby largely increasing the adherence of Clostridia. The study describes a novel type of microtubule structure caused by less efficient microtubule capture and offers a new perspective for the pathogenetic role of CDT and other binary actin-ADP-ribosylating toxins in host-pathogen interactions.

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

    NARCIS (Netherlands)

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

    1996-01-01

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

  15. Neural stem cells enhance nerve regeneration after sciatic nerve injury in rats.

    Science.gov (United States)

    Xu, Lin; Zhou, Shuai; Feng, Guo-Ying; Zhang, Lu-Ping; Zhao, Dong-Mei; Sun, Yi; Liu, Qian; Huang, Fei

    2012-10-01

    With the development of tissue engineering and the shortage of autologous nerve grafts in nerve reconstruction, cell transplantation in a conduit is an alternative strategy to improve nerve regeneration. The present study evaluated the effects and mechanism of brain-derived neural stem cells (NSCs) on sciatic nerve injury in rats. At the transection of the sciatic nerve, a 10-mm gap between the nerve stumps was bridged with a silicon conduit filled with 5 × 10(5) NSCs. In control experiments, the conduit was filled with nerve growth factor (NGF) or normal saline (NS). The functional and morphological properties of regenerated nerves were investigated, and expression of hepatocyte growth factor (HGF) and NGF was measured. One week later, there was no connection through the conduit. Four or eight weeks later, fibrous connections were evident between the proximal and distal segments. Motor function was revealed by measurement of the sciatic functional index (SFI) and sciatic nerve conduction velocity (NCV). Functional recovery in the NSC and NGF groups was significantly more advanced than that in the NS group. NSCs showed significant improvement in axon myelination of the regenerated nerves. Expression of NGF and HGF in the injured sciatic nerve was significantly lower in the NS group than in the NSCs and NGF groups. These results and other advantages of NSCs, such as ease of harvest and relative abundance, suggest that NSCs could be used clinically to enhance peripheral nerve repair.

  16. 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.

  17. An analysis of facial nerve function in irradiated and unirradiated facial nerve grafts

    International Nuclear Information System (INIS)

    Brown, Paul D.; Eshleman, Jeffrey S.; Foote, Robert L.; Strome, Scott E.

    2000-01-01

    Purpose: The effect of high-dose radiation therapy on facial nerve grafts is controversial. Some authors believe radiotherapy is so detrimental to the outcome of facial nerve graft function that dynamic or static slings should be performed instead of facial nerve grafts in all patients who are to receive postoperative radiation therapy. Unfortunately, the facial function achieved with dynamic and static slings is almost always inferior to that after facial nerve grafts. In this retrospective study, we compared facial nerve function in irradiated and unirradiated nerve grafts. Methods and Materials: The medical records of 818 patients with neoplasms involving the parotid gland who received treatment between 1974 and 1997 were reviewed, of whom 66 underwent facial nerve grafting. Fourteen patients who died or had a recurrence less than a year after their facial nerve graft were excluded. The median follow-up for the remaining 52 patients was 10.6 years. Cable nerve grafts were performed in 50 patients and direct anastomoses of the facial nerve in two. Facial nerve function was scored by means of the House-Brackmann (H-B) facial grading system. Twenty-eight of the 52 patients received postoperative radiotherapy. The median time from nerve grafting to start of radiotherapy was 5.1 weeks. The median and mean doses of radiation were 6000 and 6033 cGy, respectively, for the irradiated grafts. One patient received preoperative radiotherapy to a total dose of 5000 cGy in 25 fractions and underwent surgery 1 month after the completion of radiotherapy. This patient was placed, by convention, in the irradiated facial nerve graft cohort. Results: Potential prognostic factors for facial nerve function such as age, gender, extent of surgery at the time of nerve grafting, preoperative facial nerve palsy, duration of preoperative palsy if present, or number of previous operations in the parotid bed were relatively well balanced between irradiated and unirradiated patients. However

  18. The Safety of EXPAREL ® (Bupivacaine Liposome Injectable Suspension Administered by Peripheral Nerve Block in Rabbits and Dogs

    Directory of Open Access Journals (Sweden)

    Brigitte M. Richard

    2012-01-01

    Full Text Available A sustained-release DepoFoam injection formulation of bupivacaine (EXPAREL, 15 mg/mL is currently being investigated for postsurgical analgesia via peripheral nerve block (PNB. Single-dose toxicology studies of EXPAREL (9, 18, and 30 mg/kg, bupivacaine solution (Bsol, 9 mg/kg, and saline injected around the brachial plexus nerve bundle were performed in rabbits and dogs. The endpoints included clinical pathology, pharmacokinetics, and histopathology evaluation on Day 3 and Day 15 (2/sex/group/period. EXPAREL resulted in a nearly 4-fold lower Cmax versus Bsol at the same dose. EXPAREL was well tolerated at doses up to 30 mg/kg. The only EXPAREL-related effect seen was minimal to mild granulomatous inflammation of adipose tissue around nerve roots (8 of 24 rabbits and 7 of 24 dogs in the brachial plexus sites. The results indicate that EXPAREL was well tolerated in these models and did not produce nerve damage after PNB in rabbits and dogs.

  19. Optic Nerve Imaging

    Science.gov (United States)

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

  20. POROSITY OF THE WALL OF A NEUROLAC (R) NERVE CONDUIT HAMPERS NERVE REGENERATION

    NARCIS (Netherlands)

    Meek, Marcel F.; Den Dunnen, Wilfred F. A.

    2009-01-01

    One way to improve nerve regeneration and bridge longer nerve gaps may be the use of semipermeable/porous conduits. With porosity less biomaterial is used for the nerve conduit. We evaluated the short-term effects of porous Neurolac (R) nerve conduits for in vivo peripheral nerve regeneration. In 10

  1. 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.

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

    OpenAIRE

    Gordon, Tessa; Eva, Placheta; Borschel, Gregory H.

    2015-01-01

    Despite the capacity of Schwann cells to support peripheral nerve regeneration, functional recovery after nerve injuries is frequently poor, especially for proximal injuries that require regenerating axons to grow over long distances to reinnervate distal targets. Nerve transfers, where small fascicles from an adjacent intact nerve are coapted to the nerve stump of a nearby denervated muscle, allow for functional return but at the expense of reduced numbers of innervating nerves. A 1-hour per...

  3. Electrophysiology of Cranial Nerve Testing: Trigeminal and Facial Nerves.

    Science.gov (United States)

    Muzyka, Iryna M; Estephan, Bachir

    2018-01-01

    The clinical examination of the trigeminal and facial nerves provides significant diagnostic value, especially in the localization of lesions in disorders affecting the central and/or peripheral nervous system. The electrodiagnostic evaluation of these nerves and their pathways adds further accuracy and reliability to the diagnostic investigation and the localization process, especially when different testing methods are combined based on the clinical presentation and the electrophysiological findings. The diagnostic uniqueness of the trigeminal and facial nerves is their connectivity and their coparticipation in reflexes commonly used in clinical practice, namely the blink and corneal reflexes. The other reflexes used in the diagnostic process and lesion localization are very nerve specific and add more diagnostic yield to the workup of certain disorders of the nervous system. This article provides a review of commonly used electrodiagnostic studies and techniques in the evaluation and lesion localization of cranial nerves V and VII.

  4. Morphological evaluation of lumbar dorsal root ganglion on three-dimensional magnetic resonance imaging

    International Nuclear Information System (INIS)

    Shen Jun; Chen Jianyu; Zhou Cuiping; Liang Biling; Xu Xiaomao

    2007-01-01

    Objective: To investigate the morphological features of normal lumbar dorsal root ganglia using a three-dimensional (3D) coronal MR imaging. Methods: One hundred and fifteen volunteers were included. Ages ranged from 15 to 75 years, with a mean of 40 years. Coronal 3D fast field echo (FFE) with water selective excitation (Proset) MR examination of 1150 dorsal root ganglia were underwent at nerve root levels from L1 to L5. The source coronal images were further reconstructed into a series of rotational alignment coronal images with an interval angel of 12 degree using maximum intensity projection (MIP) technique. All DRGs of bilateral spinal nerve from L1 to L5 were morphologically analyzed on the original and MIP images including qualitative evaluation of the location, signal intensity, architecture and quantitative dimensional measurement. Results: There were 225, 225, 219, 210 and 160 foraminal ganglia from L1 to L5 level, respectively. The incidence of intraspinal ganglia from L3 to L5 gradually increased with a maximum at L5 level of 29.1% (X 2 =188.371, P<0.01). One thousand one hundred and thirteen (96.8%) DRGs were intermediate intensity on MIP images. The width and length of L1 DRGs were from 2. 00 to 5.50 mm (3.38±0.77) mm, 2.00 to 7.00 mm (4.35±0.89) mm, respectively. The width and length of L5 DRGs were from 3.50 to 9.00 mm (6.40±0.91) mm, 6.00 to 19.00 mm [(11.58± 2.25) mm], respectively. There was statistically significant difference in the dimension of DRGs from L5 to L1 (F=41.527-205.998, P<0.01). In 1150 DRGs, three types of architecture of DRGs including 822 singular, 317 bi- and 11 tri-ganglion DRGs could be found with a high prevalence of the bi-ganglia in L4 and L3 DRGs and a higher incidence of the singular ganglia in the L5 and L2 and L1 DRGs. Conclusions: The normal anatomy and variant of the lumbar dorsal root ganglia could be clearly demonstrated by 3D FFE MR imaging with Proset. As the level of the nerve root traveled down caudally

  5. Miconazole enhances nerve regeneration and functional recovery after sciatic nerve crush injury.

    Science.gov (United States)

    Lin, Tao; Qiu, Shuai; Yan, Liwei; Zhu, Shuang; Zheng, Canbin; Zhu, Qingtang; Liu, Xiaolin

    2018-05-01

    Improving axonal outgrowth and remyelination is crucial for peripheral nerve regeneration. Miconazole appears to enhance remyelination in the central nervous system. In this study we assess the effect of miconazole on axonal regeneration using a sciatic nerve crush injury model in rats. Fifty Sprague-Dawley rats were divided into control and miconazole groups. Nerve regeneration and myelination were determined using histological and electrophysiological assessment. Evaluation of sensory and motor recovery was performed using the pinprick assay and sciatic functional index. The Cell Counting Kit-8 assay and Western blotting were used to assess the proliferation and neurotrophic expression of RSC 96 Schwann cells. Miconazole promoted axonal regrowth, increased myelinated nerve fibers, improved sensory recovery and walking behavior, enhanced stimulated amplitude and nerve conduction velocity, and elevated proliferation and neurotrophic expression of RSC 96 Schwann cells. Miconazole was beneficial for nerve regeneration and functional recovery after peripheral nerve injury. Muscle Nerve 57: 821-828, 2018. © 2017 Wiley Periodicals, Inc.

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

    Directory of Open Access Journals (Sweden)

    Tessa Gordon

    2015-01-01

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

  7. Perineural pretreatment of bee venom attenuated the development of allodynia in the spinal nerve ligation injured neuropathic pain model; an experimental study.

    Science.gov (United States)

    Koh, Won Uk; Choi, Seong Soo; Lee, Jong Hyuk; Lee, So Hee; Lee, Sun Kyung; Lee, Yoon Kyung; Leem, Jeong Gil; Song, Jun Gol; Shin, Jin Woo

    2014-11-04

    Diluted bee venom (BV) is known to have anti-nociceptive and anti-inflammatory effects. We therefore assessed whether perineural bee venom pretreatment could attenuate the development of neuropathic pain in the spinal nerve ligation injured animal model. Neuropathic pain was surgically induced in 30 male Sprague Dawley rats by ligation of the L5 and L6 spinal nerves, with 10 rats each treated with saline and 0.05 and 0.1 mg BV. Behavioral testing for mechanical, cold, and thermal allodynia was conducted on postoperative days 3 to 29. Three rats in each group and 9 sham operated rats were sacrificed on day 9, and the expression of transient receptor potential vanilloid type 1 (TRPV1), ankyrin type 1 (TRPA1), and melastatin type 8 (TRPM8) receptors in the ipsilateral L5 dorsal root ganglion was analyzed. The perineural administration of BV to the spinal nerves attenuated the development of mechanical, thermal, and cold allodynia, and the BV pretreatment reduced the expression of TRPV1, TRPA1, TRPM8 and c - Fos in the ipsilateral dorsal root ganglion. The current study demonstrates that the perineural pretreatment with diluted bee venom before the induction of spinal nerve ligation significantly suppresses the development of neuropathic pain. Furthermore, this bee venom induced suppression was strongly related with the involvement of transient receptor potential family members.

  8. Optic Nerve Disorders

    Science.gov (United States)

    The optic nerve is a bundle of more than 1 million nerve fibers that carry visual messages. You have one connecting ... retina) to your brain. Damage to an optic nerve can cause vision loss. The type of vision ...

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

    Directory of Open Access Journals (Sweden)

    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.

  10. Progress of nerve bridges in the treatment of peripheral nerve disruptions

    OpenAIRE

    Ao,Qiang

    2016-01-01

    Qiang Ao Department of Tissue Engineering, School of Fundamental Science, China Medical University, Shenyang, Liaoning, Peoples’ Republic of China Abstract: Clinical repair of a nerve defect is one of the most challenging surgical problems. Autologous nerve grafting remains the gold standard treatment in addressing peripheral nerve injuries that cannot be bridged by direct epineural suturing. However, the autologous nerve graft is not readily available, and the process of harvesting...

  11. Optic Nerve Pit

    Science.gov (United States)

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

  12. Neuroprotective Drug for Nerve Trauma Revealed Using Artificial Intelligence.

    Science.gov (United States)

    Romeo-Guitart, David; Forés, Joaquim; Herrando-Grabulosa, Mireia; Valls, Raquel; Leiva-Rodríguez, Tatiana; Galea, Elena; González-Pérez, Francisco; Navarro, Xavier; Petegnief, Valerie; Bosch, Assumpció; Coma, Mireia; Mas, José Manuel; Casas, Caty

    2018-01-30

    Here we used a systems biology approach and artificial intelligence to identify a neuroprotective agent for the treatment of peripheral nerve root avulsion. Based on accumulated knowledge of the neurodegenerative and neuroprotective processes that occur in motoneurons after root avulsion, we built up protein networks and converted them into mathematical models. Unbiased proteomic data from our preclinical models were used for machine learning algorithms and for restrictions to be imposed on mathematical solutions. Solutions allowed us to identify combinations of repurposed drugs as potential neuroprotective agents and we validated them in our preclinical models. The best one, NeuroHeal, neuroprotected motoneurons, exerted anti-inflammatory properties and promoted functional locomotor recovery. NeuroHeal endorsed the activation of Sirtuin 1, which was essential for its neuroprotective effect. These results support the value of network-centric approaches for drug discovery and demonstrate the efficacy of NeuroHeal as adjuvant treatment with surgical repair for nervous system trauma.

  13. The vestibulocochlear nerve (VIII).

    Science.gov (United States)

    Benoudiba, F; Toulgoat, F; Sarrazin, J-L

    2013-10-01

    The vestibulocochlear nerve (8th cranial nerve) is a sensory nerve. It is made up of two nerves, the cochlear, which transmits sound and the vestibular which controls balance. It is an intracranial nerve which runs from the sensory receptors in the internal ear to the brain stem nuclei and finally to the auditory areas: the post-central gyrus and superior temporal auditory cortex. The most common lesions responsible for damage to VIII are vestibular Schwannomas. This report reviews the anatomy and various investigations of the nerve. Copyright © 2013. Published by Elsevier Masson SAS.

  14. 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

  15. The Use of Degradable Nerve Conduits for Human Nerve Repair: A Review of the Literature

    Directory of Open Access Journals (Sweden)

    M. F. Meek

    2005-01-01

    Full Text Available The management of peripheral nerve injury continues to be a major clinical challenge. The most widely used technique for bridging defects in peripheral nerves is the use of autologous nerve grafts. This technique, however, has some disadvantages. Many alternative experimental techniques have thus been developed, such as degradable nerve conduits. Degradable nerve guides have been extensively studied in animal experimental studies. However, the repair of human nerves by degradable nerve conduits has been limited to only a few clinical studies. In this paper, an overview of the available international published literature on degradable nerve conduits for bridging human peripheral nerve defects is presented for literature available until 2004. Also, the philosophy on the use of nerve guides and nerve grafts is given.

  16. [Glaucoma and optic nerve drusen: Limitations of optic nerve head OCT].

    Science.gov (United States)

    Poli, M; Colange, J; Goutagny, B; Sellem, E

    2017-09-01

    Optic nerve head drusen are congenital calcium deposits located in the prelaminar section of the optic nerve head. Their association with visual field defects has been classically described, but the diagnosis of glaucoma is not easy in these cases of altered optic nerve head anatomy. We describe the case of a 67-year-old man with optic nerve head drusen complicated by glaucoma, which was confirmed by visual field and OCT examination of the peripapillary retinal nerve fiber layer (RNFL), but the measurement of the minimum distance between the Bruch membrane opening and the internal limiting membrane (minimum rim width, BMO-MRW) by OCT was normal. OCT of the BMO-MRW is a new diagnostic tool for glaucoma. Superficial optic nerve head drusen, which are found between the internal limiting membrane and the Bruch's membrane opening, overestimate the value of this parameter. BMO-MRW measurement is not adapted to cases of optic nerve head drusen and can cause false-negative results for this parameter, and the diagnosis of glaucoma in this case should be based on other parameters such as the presence of a fascicular defect in the retinal nerve fibers, RNFL or macular ganglion cell complex thinning, as well as visual field data. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  17. Transient facial nerve palsy after occipital nerve block: a case report.

    Science.gov (United States)

    Strauss, Lauren; Loder, Elizabeth; Rizzoli, Paul

    2014-01-01

    Occipital nerve blocks are commonly performed to treat a variety of headache syndromes and are generally believed to be safe and well tolerated. We report the case of an otherwise healthy 24-year-old woman with left side-locked occipital, parietal, and temporal pain who was diagnosed with probable occipital neuralgia. She developed complete left facial nerve palsy within minutes of blockade of the left greater and lesser occipital nerves with a solution of bupivicaine and triamcinolone. Magnetic resonance imaging of the brain with gadolinium contrast showed no abnormalities, and symptoms had completely resolved 4-5 hours later. Unintended spread of the anesthetic solution along tissue planes seems the most likely explanation for this adverse event. An aberrant course of the facial nerve or connections between the facial and occipital nerves also might have played a role, along with the patient's prone position and the use of a relatively large injection volume of a potent anesthetic. Clinicians should be aware that temporary facial nerve palsy is a possible complication of occipital nerve block. © 2014 American Headache Society.

  18. 142 Key words: Brachialis, radial nerve, musculocutaneous nerve.

    African Journals Online (AJOL)

    AWORI KIRSTEEN

    The innervation of brachialis muscle by the musculocutaneous nerve has been described as either type I or type II and the main trunk to this muscle is rarely absent. The contribution .... brachialis muscle by fiber analysis of supply nerves].

  19. [Key-Gaskell syndrome in a cat in Switzerland].

    Science.gov (United States)

    Litschi, B; Dieth, V

    1989-01-01

    As far as the authors know this is the first case of Key-Gaskell-syndrome being described in Switzerland. The clinical signs of megaoesophagus, anorexia, constipation, dryness of all mucous membranes, reduced tear production, protrusion of the membrana nictitans, mydriasis, regurgitation and bradycardia are pathognomonic and can't be mistaken by any other disease. The subject of the Key-Gaskell-syndrome is a dysfunction of the autonomic nervous system. Histopathological changes are exclusively related to the autonomic nervous system and to neurons of some nuclei in the cranial nerves. Less severe changes can be found in the neurons of the spinal cord or in the dorsal root ganglia. The etiology remains still unclear. There is a relationship to the grass sickness syndrome in horses and to dysautonomia of man and dog.

  20. Hemorrhagic intracranial inflammatory pseudotumor originating from the trigeminal nerve: a case report.

    Science.gov (United States)

    Jung, Tae-Young; Jung, Shin; Lee, Min-Cheol; Moon, Kyung-Sub; Kim, In-Young; Kang, Sam-Suk; Kim, Soo-Han

    2006-01-01

    We report here on a case of intracranial inflammatory pseudotumor arising from the trigeminal nerve. A 52-year-old man presented with sudden onset severe headache. He had had facial numbness several months earlier and no signs indicating infection. On the computerized tomography scan, intracranial hemorrhage was detected at the cerebellopontine angle. Magnetic resonance imaging demonstrated a 2.7-cm-sized, homogenously enhancing mass. A provisional diagnosis of trigeminal schwannoma was made, and suboccipital craniotomy was then performed. The mass was encapsulated and had multiple capsular veins. There was a evidence of intratumoral bleeding. It originated from the trigeminal root and was adhered to the 4th cranial nerve. Pathologic examination showed fibrovascular tissue with dense infiltrates of plasma cells and lymphocytes, some histiocytes, and occasional neutrophils and eosinophils. It showed immunopositivity for leukocyte common antigen (LCA) and immunonegativity for S-100 and lysozyme. It was also immunopositive for EBV antigen. Intracranial inflammatory pseudotumors mostly arise from dural/meningeal structures in the intracranial location. This case is the first to describe an intracranial inflammatory pseudotumor originating from a cranial nerve. The pathologic examination supported the postinfection hypothesis out of several possible pathologic mechanisms.

  1. Facial reanimation by muscle-nerve neurotization after facial nerve sacrifice. Case report.

    Science.gov (United States)

    Taupin, A; Labbé, D; Babin, E; Fromager, G

    2016-12-01

    Recovering a certain degree of mimicry after sacrifice of the facial nerve is a clinically recognized finding. The authors report a case of hemifacial reanimation suggesting a phenomenon of neurotization from muscle-to-nerve. A woman benefited from a parotidectomy with sacrifice of the left facial nerve indicated for recurrent tumor in the gland. The distal branches of the facial nerve, isolated at the time of resection, were buried in the masseter muscle underneath. The patient recovered a voluntary hémifacial motricity. The electromyographic analysis of the motor activity of the zygomaticus major before and after block of the masseter nerve showed a dependence between mimic muscles and the masseter muscle. Several hypotheses have been advanced to explain the spontaneous reanimation of facial paralysis. The clinical case makes it possible to argue in favor of muscle-to-nerve neurotization from masseter muscle to distal branches of the facial nerve. It illustrates the quality of motricity that can be obtained thanks to this procedure. The authors describe a simple implantation technique of distal branches of the facial nerve in the masseter muscle during a radical parotidectomy with facial nerve sacrifice and recovery of resting tone but also a quality voluntary mimicry. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  2. 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.

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

    Science.gov (United States)

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

    2015-01-01

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

  4. Microvascular Cranial Nerve Palsy

    Science.gov (United States)

    ... Español Eye Health / Eye Health A-Z Microvascular Cranial Nerve Palsy Sections What Is Microvascular Cranial Nerve Palsy? ... Microvascular Cranial Nerve Palsy Treatment What Is Microvascular Cranial Nerve Palsy? Leer en Español: ¿Qué es una parálisis ...

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

    Science.gov (United States)

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

    2013-02-01

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

  6. Allotransplanted neurons used to repair peripheral nerve injury do not elicit overt immunogenicity.

    Directory of Open Access Journals (Sweden)

    Weimin Liu

    Full Text Available A major problem hindering the development of autograft alternatives for repairing peripheral nerve injuries is immunogenicity. We have previously shown successful regeneration in transected rat sciatic nerves using conduits filled with allogeneic dorsal root ganglion (DRG cells without any immunosuppression. In this study, we re-examined the immunogenicity of our DRG neuron implanted conduits as a potential strategy to overcome transplant rejection. A biodegradable NeuraGen® tube was infused with pure DRG neurons or Schwann cells cultured from a rat strain differing from the host rats and used to repair 8 mm gaps in the sciatic nerve. We observed enhanced regeneration with allogeneic cells compared to empty conduits 16 weeks post-surgery, but morphological analyses suggest recovery comparable to the healthy nerves was not achieved. The degree of regeneration was indistinguishable between DRG and Schwann cell allografts although immunogenicity assessments revealed substantially increased presence of Interferon gamma (IFN-γ in Schwann cell allografts compared to the DRG allografts by two weeks post-surgery. Macrophage infiltration of the regenerated nerve graft in the DRG group 16 weeks post-surgery was below the level of the empty conduit (0.56 fold change from NG; p<0.05 while the Schwann cell group revealed significantly higher counts (1.29 fold change from NG; p<0.001. Major histocompatibility complex I (MHC I molecules were present in significantly increased levels in the DRG and Schwann cell allograft groups compared to the hollow NG conduit and the Sham healthy nerve. Our results confirmed previous studies that have reported Schwann cells as being immunogenic, likely due to MHC I expression. Nerve gap injuries are difficult to repair; our data suggest that DRG neurons are superior medium to implant inside conduit tubes due to reduced immunogenicity and represent a potential treatment strategy that could be preferable to the current gold

  7. Transfer of obturator nerve for femoral nerve injury: an experiment study in rats.

    Science.gov (United States)

    Meng, Depeng; Zhou, Jun; Lin, Yaofa; Xie, Zheng; Chen, Huihao; Yu, Ronghua; Lin, Haodong; Hou, Chunlin

    2018-07-01

    Quadriceps palsy is mainly caused by proximal lesions in the femoral nerve. The obturator nerve has been previously used to repair the femoral nerve, although only a few reports have described the procedure, and the outcomes have varied. In the present study, we aimed to confirm the feasibility and effectiveness of this treatment in a rodent model using the randomized control method. Sixty Sprague-Dawley rats were randomized into two groups: the experimental group, wherein rats underwent femoral neurectomy and obturator nerve transfer to the femoral nerve motor branch; and the control group, wherein rats underwent femoral neurectomy without nerve transfer. Functional outcomes were measured using the BBB score, muscle mass, and histological assessment. At 12 and 16 weeks postoperatively, the rats in the experimental group exhibited recovery to a stronger stretch force of the knee and higher BBB score, as compared to the control group (p nerve with myelinated and unmyelinated fibers was observed in the experimental group. No significant differences were observed between groups at 8 weeks postoperatively (p > 0.05). Obturator nerve transfer for repairing femoral nerve injury was feasible and effective in a rat model, and can hence be considered as an option for the treatment of femoral nerve injury.

  8. Enhanced peripheral nerve regeneration through asymmetrically porous nerve guide conduit with nerve growth factor gradient.

    Science.gov (United States)

    Oh, Se Heang; Kang, Jun Goo; Kim, Tae Ho; Namgung, Uk; Song, Kyu Sang; Jeon, Byeong Hwa; Lee, Jin Ho

    2018-01-01

    In this study, we fabricated a nerve guide conduit (NGC) with nerve growth factor (NGF) gradient along the longitudinal direction by rolling a porous polycaprolactone membrane with NGF concentration gradient. The NGF immobilized on the membrane was continuously released for up to 35 days, and the released amount of the NGF from the membrane gradually increased from the proximal to distal NGF ends, which may allow a neurotrophic factor gradient in the tubular NGC for a sufficient period. From the in vitro cell culture experiment, it was observed that the PC12 cells sense the NGF concentration gradient on the membrane for the cell proliferation and differentiation. From the in vivo animal experiment using a long gap (20 mm) sciatic nerve defect model of rats, the NGC with NGF concentration gradient allowed more rapid nerve regeneration through the NGC than the NGC itself and NGC immobilized with uniformly distributed NGF. The NGC with NGF concentration gradient seems to be a promising strategy for the peripheral nerve regeneration. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 106A: 52-64, 2018. © 2017 Wiley Periodicals, Inc.

  9. Primary nerve-sheath tumours of the trigeminal nerve: clinical and MRI findings

    International Nuclear Information System (INIS)

    Majoie, C.B.L.M.; Hulsmans, F.J.H.; Sie, L.H.; Castelijns, J.A.; Valk, J.; Walter, A.; Albrecht, K.W.

    1999-01-01

    We reviewed the clinical and MRI findings in primary nerve-sheath tumours of the trigeminal nerve. We retrospectively reviewed the medical records, imaging and histological specimens of 10 patients with 11 primary tumours of the trigeminal nerve. We assessed whether tumour site, size, morphology or signal characteristics were related to symptoms and signs or histological findings. Histological proof was available for 8 of 11 tumours: six schwannomas and two plexiform neurofibromas. The other three tumours were thought to be schwannomas, because they were present in patients with neurofibromatosis type 2 and followed the course of the trigeminal nerve. Uncommon MRI appearances were observed in three schwannomas and included a large intratumoral haemorrhage, a mainly low-signal appearance on T2-weighted images and a rim-enhancing, multicystic appearance. Only four of nine schwannomas caused trigeminal nerve symptoms, including two with large cystic components, one haemorrhagic and one solid tumor. Of the five schwannomas which did not cause any trigeminal nerve symptoms, two were large. Only one of the plexiform neurofibromas caused trigeminal nerve symptoms. Additional neurological symptoms and signs, not related to the trigeminal nerve, could be attributed to the location of the tumour in three patients. (orig.)

  10. Treatment of peroneal nerve injuries with simultaneous tendon transfer and nerve exploration.

    Science.gov (United States)

    Ho, Bryant; Khan, Zubair; Switaj, Paul J; Ochenjele, George; Fuchs, Daniel; Dahl, William; Cederna, Paul; Kung, Theodore A; Kadakia, Anish R

    2014-08-06

    Common peroneal nerve palsy leading to foot drop is difficult to manage and has historically been treated with extended bracing with expectant waiting for return of nerve function. Peroneal nerve exploration has traditionally been avoided except in cases of known traumatic or iatrogenic injury, with tendon transfers being performed in a delayed fashion after exhausting conservative treatment. We present a new strategy for management of foot drop with nerve exploration and concomitant tendon transfer. We retrospectively reviewed a series of 12 patients with peroneal nerve palsies that were treated with tendon transfer from 2005 to 2011. Of these patients, seven were treated with simultaneous peroneal nerve exploration and repair at the time of tendon transfer. Patients with both nerve repair and tendon transfer had superior functional results with active dorsiflexion in all patients, compared to dorsiflexion in 40% of patients treated with tendon transfers alone. Additionally, 57% of patients treated with nerve repair and tendon transfer were able to achieve enough function to return to running, compared to 20% in patients with tendon transfer alone. No patient had full return of native motor function resulting in excessive dorsiflexion strength. The results of our limited case series for this rare condition indicate that simultaneous nerve repair and tendon transfer showed no detrimental results and may provide improved function over tendon transfer alone.

  11. A STUDY OF TUMOURS OF THE CRANIAL NERVE AND PARASPINAL NERVE

    Directory of Open Access Journals (Sweden)

    Sudesh Shetty

    2016-03-01

    Full Text Available INTRODUCTION One of the frequent sites of tumour formation is the cranial nerves and paraspinal nerves. The cranial nerves perform a plethora of functions and so the signs and symptoms caused may be different. They are mainly classified into four different types. The aim of the study is: 1. To study the tumours arising from the cranial nerves in an epidemiological point of view. 2. To study the tumours histopathologically. 3. To classify the tumours according to WHO classification. Thirty-eight brain tumor cases were studied in the Department of Medicine, A. J. Shetty Institute of Medical Sciences, Mangalore. Cranial nerve tumours accounts for 4(10% among the intracranial tumours. Schwannomas makes up 3(7.39% among the Intracranial tumours. and constituted 3(75% among cranial nerve tumours. All the 3 schwannomas were located in CP angle. The geographic distribution of cases was found to be 28 cases from Mangalore and 10 cases from Kerala.

  12. Voluntary Exercise Training: Analysis of Mice in Uninjured, Inflammatory, and Nerve-Injured Pain States.

    Directory of Open Access Journals (Sweden)

    Tayler D Sheahan

    Full Text Available Both clinical and animal studies suggest that exercise may be an effective way to manage inflammatory and neuropathic pain conditions. However, existing animal studies commonly use forced exercise paradigms that incorporate varying degrees of stress, which itself can elicit analgesia, and thus may complicate the interpretation of the effects of exercise on pain. We investigated the analgesic potential of voluntary wheel running in the formalin model of acute inflammatory pain and the spared nerve injury model of neuropathic pain in mice. In uninjured, adult C57BL/6J mice, 1 to 4 weeks of exercise training did not alter nociceptive thresholds, lumbar dorsal root ganglia neuronal excitability, or hindpaw intraepidermal innervation. Further, exercise training failed to attenuate formalin-induced spontaneous pain. Lastly, 2 weeks of exercise training was ineffective in reversing spared nerve injury-induced mechanical hypersensitivity or in improving muscle wasting or hindpaw denervation. These findings indicate that in contrast to rodent forced exercise paradigms, short durations of voluntary wheel running do not improve pain-like symptoms in mouse models of acute inflammation and peripheral nerve injury.

  13. The nerve protection and in vivo therapeutic effect of Acalypha indica extract in frogs

    Directory of Open Access Journals (Sweden)

    Ernie H. Purwaningsih

    2010-05-01

    Full Text Available Aim To demonstrate nerve protection and/or treatment effect of Acalypha indica Linn. extract on nerve paralysis induced by subcutaneus injection of pancuronium bromide on frog’s back.Methods The study was performed on sixty frogs (Bufo melanostictus Schneider that divided into two groups, i.e. the neuro-protection and neuro-therapy group. Each group was divided further into 6 sub-treatment groups: negative control group treated by water and positive control group treated by piracetam, treatment groups received the extracts 200, 300, 400, 500 mg/kgBW. Pancuronium bromide 0.2% (1 : 20 dilutions were injected subcutaneously as muscle relaxant. The protective effect was studied by giving the extract orally, 1 hour prior to injection; while the therapeutic effect of the extract was studied by 10 minute treatment after injecting pancuronium bromide solution. The parameters measured were the onset and duration of paralysis (in minutes and the recovery time (time needed to recover into normal condition.Results The study showed significantly different protective effect of Acalypha indica Linn. root water extract at 400 and 500 mg/KgBW compared to negative control group and positive control group (piracetam (p < 0.05; while the therapeutic effect was obvious at the dose 200-500 mg/KgBW compared to negative control group (p = 0.000. There was no significant difference compared to positive control group (piracetam, except at 300 mg/KgBW (p = 0.012.Conclusion These results have proven that the water extract of Acalypha indica Linn. root has comparable protective and treatment effect on nerves system, as piracetam, but further studies should be performed to provide more evidences particularly pharmacokinetic and pharmacodynamic studies on two animal models that commonly used. (Med J Indones 2010; 19:96-102Keywords: Acalypha indica Linn, Bufo melanostictus Schneider, nerve-protection

  14. Apical root resorption in maxillary incisors when employing micro-implant and J-hook headgear anchorage: a 4-month radiographic study.

    Science.gov (United States)

    Wang, Qingzhu; Chen, Wenjing; Smales, Roger J; Peng, Hui; Hu, Xiaokun; Yin, Lu

    2012-10-01

    This study evaluated, over a 4-month study period, the amount of apical root resorption occurring in maxillary central incisors following their retraction when employing either micro-implant or J-hook headgear anchorage. The prospective randomised clinical trial was conducted in Orthodontic Clinic, College of Stomatology, China from 2008-2009. Subjects are patients requiring fixed appliances on waiting list (n=20). In female Han Chinese patients aged from 16-26 years, standardized periapical radiographs from 10 randomly assigned patients with maxillary protrusions comprising the micro-implant group, and from 10 similar patients comprising the J-hook headgear group, were assessed for maxillary central incisor apical root resorption. Measurements before and after orthodontic therapy were also obtained from lateral cephalometric radiographs to calculate incisor horizontal retraction and vertical intrusion distances. Estimated retraction force vectors were calculated in horizontal and vertical directions for both treatment groups. Data analysis employed t-tests and the Pearson correlation test, with α=0.05 for statistical significance. The results showed that when compared with the J-hook group, significantly more apical root resorption shortening of the maxillary central incisors was observed in the micro-implant group (1.27 mm difference, 95% CI=0.70-1.84, Pmicro-implant group resulted in significantly more apical root resorption shortening and maxillary central incisor retraction than when intermittent J-hook retraction was employed. The employment of continuous duration orthodontic forces presents a risk for increased apical root resorption that requires careful radiographic monitoring.

  15. Electrophysiology of Cranial Nerve Testing: Cranial Nerves IX and X.

    Science.gov (United States)

    Martinez, Alberto R M; Martins, Melina P; Moreira, Ana Lucila; Martins, Carlos R; Kimaid, Paulo A T; França, Marcondes C

    2018-01-01

    The cranial nerves IX and X emerge from medulla oblongata and have motor, sensory, and parasympathetic functions. Some of these are amenable to neurophysiological assessment. It is often hard to separate the individual contribution of each nerve; in fact, some of the techniques are indeed a composite functional measure of both nerves. The main methods are the evaluation of the swallowing function (combined IX and X), laryngeal electromyogram (predominant motor vagal function), and heart rate variability (predominant parasympathetic vagal function). This review describes, therefore, the techniques that best evaluate the major symptoms presented in IX and X cranial nerve disturbance: dysphagia, dysphonia, and autonomic parasympathetic dysfunction.

  16. Silk fibroin enhances peripheral nerve regeneration by improving vascularization within nerve conduits.

    Science.gov (United States)

    Wang, Chunyang; Jia, Yachao; Yang, Weichao; Zhang, Cheng; Zhang, Kuihua; Chai, Yimin

    2018-07-01

    Silk fibroin (SF)-based nerve conduits have been widely used to bridge peripheral nerve defects. Our previous study showed that nerve regeneration in a SF-blended poly (l-lactide-co-ɛ-caprolactone) [P(LLA-CL)] nerve conduit is better than that in a P(LLA-CL) conduit. However, the involved mechanisms remain unclarified. Because angiogenesis within a nerve conduit plays an important role in nerve regeneration, vascularization of SF/P(LLA-CL) and P(LLA-CL) conduits was compared both in vitro and in vivo. In the present study, we observed that SF/P(LLA-CL) nanofibers significantly promoted fibroblast proliferation, and vascular endothelial growth factor secreted by fibroblasts seeded in SF/P(LLA-CL) nanofibers was more than seven-fold higher than that in P(LLA-CL) nanofibers. Conditioned medium of fibroblasts in the SF/P(LLA-CL) group stimulated more human umbilical vein endothelial cells (HUVEC) to form capillary-like networks and promoted faster HUVEC migration. The two kinds of nerve conduits were used to bridge 10-mm-length nerve defects in rats. At 3 weeks of reparation, the blood vessel area in the SF/P(LLA-CL) group was significantly larger than that in the P(LLA-CL) group. More regenerated axons and Schwann cells were also observed in the SF/P(LLA-CL) group, which was consistent with the results of blood vessels. Collectively, our data revealed that the SF/P(LLA-CL) nerve conduit enhances peripheral nerve regeneration by improving angiogenesis within the conduit. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 106A: 2070-2077, 2018. © 2018 Wiley Periodicals, Inc.

  17. Vascularization of the dorsal root ganglia and peripheral nerve of the mouse: Implications for chemical-induced peripheral sensory neuropathies

    Directory of Open Access Journals (Sweden)

    Melemedjian Ohannes K

    2008-03-01

    Full Text Available Abstract Although a variety of industrial chemicals, as well as several chemotherapeutic agents used to treat cancer or HIV, preferentially induce a peripheral sensory neuropathy what remains unclear is why these agents induce a sensory vs. a motor or mixed neuropathy. Previous studies have shown that the endothelial cells that vascularize the dorsal root ganglion (DRG, which houses the primary afferent sensory neurons, are unique in that they have large fenestrations and are permeable to a variety of low and high molecular weight agents. In the present report we used whole-mount preparations, immunohistochemistry, and confocal laser scanning microscopy to show that the cell body-rich area of the L4 mouse DRG has a 7 fold higher density of CD31+ capillaries than cell fiber rich area of the DRG or the distal or proximal aspect of the sciatic nerve. This dense vascularization, coupled with the high permeability of these capillaries, may synergistically contribute, and in part explain, why many potentially neurotoxic agents preferentially accumulate and injure cells within the DRG. Currently, cancer survivors and HIV patients constitute the largest and most rapidly expanding groups that have chemically induced peripheral sensory neuropathy. Understanding the unique aspects of the vascularization of the DRG and closing the endothelial fenestrations of the rich vascular bed of capillaries that vascularize the DRG before intravenous administration of anti-neoplastic or anti-HIV therapies, may offer a mechanism based approach to attenuate these chemically induced peripheral neuropathies in these patients.

  18. The Pseudopod System for Axon-Glia Interactions: Stimulation and Isolation of Schwann Cell Protrusions that Form in Response to Axonal Membranes.

    Science.gov (United States)

    Poitelon, Yannick; Feltri, M Laura

    2018-01-01

    In the peripheral nervous system, axons dictate the differentiation state of Schwann cells. Most of this axonal influence on Schwann cells is due to juxtacrine interactions between axonal transmembrane molecules (e.g., the neuregulin growth factor) and receptors on the Schwann cell (e.g., the ErbB2/ErbB3 receptor). The fleeting nature of this interaction together with the lack of synchronicity in the development of the Schwann cell population limits our capability to study this phenomenon in vivo. Here we present a simple Boyden Chamber-based method to study this important cell-cell interaction event. We isolate the early protrusions of Schwann cells that are generated in response to juxtacrine stimulation by sensory neuronal membranes. This method is compatible with a large array of current biochemical analyses and provides an effective approach to study biomolecules that are differentially localized in Schwann cell protrusions and cell bodies in response to axonal signals. A similar approach can be extended to different kinds of cell-cell interactions.

  19. Pre-differentiation of mesenchymal stromal cells in combination with a microstructured nerve guide supports peripheral nerve regeneration in the rat sciatic nerve model.

    Science.gov (United States)

    Boecker, Arne Hendrik; van Neerven, Sabien Geraldine Antonia; Scheffel, Juliane; Tank, Julian; Altinova, Haktan; Seidensticker, Katrin; Deumens, Ronald; Tolba, Rene; Weis, Joachim; Brook, Gary Anthony; Pallua, Norbert; Bozkurt, Ahmet

    2016-02-01

    Many bioartificial nerve guides have been investigated pre-clinically for their nerve regeneration-supporting function, often in comparison to autologous nerve transplantation, which is still regarded as the current clinical gold standard. Enrichment of these scaffolds with cells intended to support axonal regeneration has been explored as a strategy to boost axonal regeneration across these nerve guides Ansselin et al. (1998). In the present study, 20 mm rat sciatic nerve defects were implanted with a cell-seeded microstructured collagen nerve guide (Perimaix) or an autologous nerve graft. Under the influence of seeded, pre-differentiated mesenchymal stromal cells, axons regenerated well into the Perimaix nerve guide. Myelination-related parameters, like myelin sheath thickness, benefitted from an additional seeding with pre-differentiated mesenchymal stromal cells. Furthermore, both the number of retrogradely labelled sensory neurons and the axon density within the implant were elevated in the cell-seeded scaffold group with pre-differentiated mesenchymal stromal cells. However, a pre-differentiation had no influence on functional recovery. An additional cell seeding of the Perimaix nerve guide with mesenchymal stromal cells led to an extent of functional recovery, independent of the differentiation status, similar to autologous nerve transplantation. These findings encourage further investigations on pre-differentiated mesenchymal stromal cells as a cellular support for peripheral nerve regeneration. © 2015 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

  20. Should we routinely expose recurrent laryngeal nerve(s) during thyroid surgery

    International Nuclear Information System (INIS)

    Ahmed, M.; Aurangzeb, A.; Rashid, A.Z.; Qureshi, M.A.; Iqbal, N.; Boota, M.; Ashfaq, M.

    2013-01-01

    Objective: To compare the frequency of recurrent laryngeal nerve(s) (RLNs) palsy after various thyroid procedures with and without identification of recurrent laryngeal nerve during the operation. Study Design: Randomized controlled trial. Place and Duration of Study: Department of Surgery, Military Hospital, Rawalpindi, from August 2008 to April 2010. Methodology: Patients undergoing indirect laryngoscopy with normal vocal cords and those with carcinoma and re-do surgery having normal vocal cord were included in the study. Patients with hoarseness of voice, abnormal vocal cord movements and with solitary nodule in the isthmus were excluded. These patients were randomly divided into 2 groups of 50 each using random number tables. RLN was identified by exposing the inferior thyroid artery and traced along its entire course in group-A. Whereas, in group-B, nerves were not identified during the operations. Immediate postoperative direct laryngoscopy was performed by a surgeon with the help of an anaesthesiologist for the assessment of vocal cords. Patients with persistent hoarseness of voice were followed-up with indirect laryngoscopy at 3 and 6 months. Results: Temporary unilateral recurrent laryngeal nerve palsies occurred in 2 (4%) patients in group-A where the voice and cord movements returned to normal in 6 months. In group-B, it occurred in 8 (16%) patients, 2 bilateral (4%) injuries requiring tracheostomy and 6 unilateral injuries (12%). Among the 2 bilateral recurrent laryngeal nerve injuries, the tracheostomy was removed in one case after 6 months with persistent hoarseness of voice but no respiratory difficulty during routine activities. Tracheostomy was permanent in the other case. Among the 6 cases of unilateral nerve injuries, the voice improved considerably in 4 cases within 6 months but in 2 cases hoarseness persisted even after 6 months. Frequency of recurrent laryngeal nerve palsies was significantly lower in group-A as compared to group-B (p = 0

  1. No further loss of dorsal root ganglion cells after axotomy in p75 neurotrophin receptor knockout mice

    DEFF Research Database (Denmark)

    Sørensen, B.; Lamm, Trine Tandrup; Koltzenburg, M.

    2003-01-01

    The role of the p75 neurotrophin receptor for neuronal survival after nerve crush was studied in L5 dorsal root ganglia (DRG) of knockout mice and controls with assumption-free stereological methods. Numbers of neuronal A- and B-cells were obtained using the optical fractionator and optical...

  2. Intraoperative cranial nerve monitoring.

    Science.gov (United States)

    Harper, C Michel

    2004-03-01

    The purpose of intraoperative monitoring is to preserve function and prevent injury to the nervous system at a time when clinical examination is not possible. Cranial nerves are delicate structures and are susceptible to damage by mechanical trauma or ischemia during intracranial and extracranial surgery. A number of reliable electrodiagnostic techniques, including nerve conduction studies, electromyography, and the recording of evoked potentials have been adapted to the study of cranial nerve function during surgery. A growing body of evidence supports the utility of intraoperative monitoring of cranial nerve nerves during selected surgical procedures.

  3. Short-term observations of the regenerative potential of injured proximal sensory nerves crossed with distal motor nerves

    Directory of Open Access Journals (Sweden)

    Xiu-xiu Zhang

    2017-01-01

    Full Text Available Motor nerves and sensory nerves conduct signals in different directions and function in different ways. In the surgical treatment of peripheral nerve injuries, the best prognosis is obtained by keeping the motor and sensory nerves separated and repairing the nerves using the suture method. However, the clinical consequences of connections between sensory and motor nerves currently remain unknown. In this study, we analyzed the anatomical structure of the rat femoral nerve, and observed the motor and sensory branches of the femoral nerve in the quadriceps femoris. After ligation of the nerves, the proximal end of the sensory nerve was connected with the distal end of the motor nerve, followed by observation of the changes in the newly-formed regenerated nerve fibers. Acetylcholinesterase staining was used to distinguish between the myelinated and unmyelinated motor and sensory nerves. Denervated muscle and newly formed nerves were compared in terms of morphology, electrophysiology and histochemistry. At 8 weeks after connection, no motor nerve fibers were observed on either side of the nerve conduit and the number of nerve fibers increased at the proximal end. The proportion of newly-formed motor and sensory fibers was different on both sides of the conduit. The area occupied by autonomic nerves in the proximal regenerative nerve was limited, but no distinct myelin sheath was visible in the distal nerve. These results confirm that sensory and motor nerves cannot be effectively connected. Moreover, the change of target organ at the distal end affects the type of nerves at the proximal end.

  4. Adult Stem Cell Based Enhancement of Nerve Conduit for Peripheral Nerve Repair

    Science.gov (United States)

    2016-10-01

    accompanied by injuries to peripheral nerves; if not repaired, the trauma can lead to significant dysfunction and disability . While nerves have the ability to...recovery, minimized disability , and increased quality of life for our wounded warriors. 2. KEYWORDS: Stem Cell, Nerve Conduit, Peripheral Nerve...would be a paradigm shift away from ordering X-rays at 10-12 weeks and only ordering a CT scan. It has the potential to change the standard of care

  5. Microsurgical reconstruction of large nerve defects using autologous nerve grafts.

    Science.gov (United States)

    Daoutis, N K; Gerostathopoulos, N E; Efstathopoulos, D G; Misitizis, D P; Bouchlis, G N; Anagnostou, S K

    1994-01-01

    Between 1986 and 1993, 643 patients with peripheral nerve trauma were treated in our clinic. Primary neurorraphy was performed in 431 of these patients and nerve grafting in 212 patients. We present the functional results after nerve grafting in 93 patients with large nerve defects who were followed for more than 2 years. Evaluation of function was based on the Medical Research Council (MRC) classification for motor and sensory recovery. Factors affecting functional outcome, such as age of the patient, denervation time, length of the defect, and level of the injury were noted. Good results according to the MRC classification were obtained in the majority of cases, although function remained less than that of the uninjured side.

  6. Gradual nerve elongation affects nerve cell bodies and neuro-muscular junctions.

    Science.gov (United States)

    Kazuo Ikeda, K I; Masaki Matsuda, M M; Daisuke Yamauchi, D Y; Katsuro Tomita, K T; Shigenori Tanaka, S T

    2005-07-01

    The purpose of this study is to clarify the reactions of the neuro-muscular junction and nerve cell body to gradual nerve elongation. The sciatic nerves of Japanese white rabbits were lengthened by 30 mm in increments of 0.8 mm/day, 2.0 mm/day and 4.0 mm/day. A scanning electron microscopic examination showed no degenerative change at the neuro-muscular junction, even eight weeks after elongation in the 4-mm group. Hence, neuro-muscular junction is not critical for predicting damage from gradual nerve elongation. There were no axon reaction cells in the 0.8-mm group, a small amount in the 2-mm group, and a large amount in the 4-mm group. The rate of growth associated protein-43 positive nerve cells was significant in the 4-mm group. Hence, the safe speed for nerve cells appeared to be 0.8-mm/day, critical speed to be 2.0-mm/day, and dangerous speed to be 4.0-mm/day in this elongation model.

  7. 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)

  8. Gasserian Ganglion and Retrobulbar Nerve Block in the Treatment of Ophthalmic Postherpetic Neuralgia: A Case Report.

    Science.gov (United States)

    Huang, Jie; Ni, Zhongge; Finch, Philip

    2017-09-01

    Varicella zoster virus reactivation can cause permanent histological changes in the central and peripheral nervous system. Neural inflammatory changes or damage to the dorsal root ganglia sensory nerve fibers during reactivation can lead to postherpetic neuralgia (PHN). For PHN of the first division of the fifth cranial nerve (ophthalmic division of the trigeminal ganglion), there is evidence of inflammatory change in the ganglion and adjacent ocular neural structures. First division trigeminal nerve PHN can prove to be difficult and sometimes even impossible to manage despite the use of a wide range of conservative measures, including anticonvulsant and antidepressant medication. Steroids have been shown to play an important role by suppressing neural inflammatory processes. We therefore chose the trigeminal ganglion as an interventional target for an 88-year-old woman with severe ophthalmic division PHN after she failed to respond to conservative treatment. Under fluoroscopic guidance, a trigeminal ganglion nerve block was performed with lidocaine combined with dexamethasone. A retrobulbar block with lidocaine and triamcinolone settled residual oculodynia. At 1-year follow-up, the patient remained pain free and did not require analgesic medication. To our knowledge, this is the first reported case of ophthalmic division PHN successfully treated with a combination of trigeminal ganglion and retrobulbar nerve block using a local anesthetic agent and steroid for central and peripheral neural inflammatory processes. © 2016 World Institute of Pain.

  9. Distinct membrane effects of spinal nerve ligation on injured and adjacent dorsal root ganglion neurons in rats

    NARCIS (Netherlands)

    Sapunar, Damir; Ljubkovic, Marko; Lirk, Philipp; McCallum, J. Bruce; Hogan, Quinn H.

    2005-01-01

    Painful peripheral nerve injury results in disordered sensory neuron function that contributes to the pathogenesis of neuropathic pain. However, the relative roles of neurons with transected axons versus intact adjacent neurons have not been resolved. An essential first step is identification of

  10. Abdominal Pain Syndrome

    Science.gov (United States)

    ... infection) Costochondritis (inflammation of the rib cartilages) Injury (blunt trauma, muscle pulls) Nerve irritation (neuropathy) Hernias (protrusions ... of the intestine just beyond the stomach). Special tools can be passed through the tube to remove ...

  11. Comparison of percutaneous electrical nerve stimulation and ultrasound imaging for nerve localization

    NARCIS (Netherlands)

    Wegener, J. T.; Boender, Z. J.; Preckel, B.; Hollmann, M. W.; Stevens, M. F.

    2011-01-01

    Background. Percutaneous nerve stimulation (PNS) is a non-invasive technique to localize superficial nerves before performing peripheral nerve blocks, but its precision has never been evaluated by high-resolution ultrasound. This study compared stimulating points at the skin with the position of

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

    Directory of Open Access Journals (Sweden)

    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.

  13. Transient femoral nerve palsy following ilioinguinal nerve block for ...

    African Journals Online (AJOL)

    Nigerian Journal of Surgery ... Background: Elective inguinal hernia repair in young fit patients is preferably done under ilioinguinal nerve block anesthesia in the ambulatory setting to improve ... Conclusion: TFNP is a rare complication of ilioinguinal nerve block which delays patient discharge postambulatory hernioplasty.

  14. Modified protrusion arch for anterior crossbite correction - a case report.

    Science.gov (United States)

    Roy, Abhishek Singha; Singh, Gulshan Kr; Tandon, Pradeep; Chaudhary, Ramsukh

    2013-01-01

    Borderline and mild skeletal Class III relationships in adult patients are usually treated by orthodontic camouflage. Reasonably rood results have been achieved with nonsurgical teatment of anterior crossbite. Class III malocclusion may be associated with mandibular prognathism, maxillary retrognathism, or both. Class III maxillary retrognathism generally involves anterior crossbite, which must be opened if upper labial brackets are to be bonded. If multiple teeth are in crossbite, after opening the bite usual step is to ligate forward or advancement arch made of 0.018" or 0.020" stainless steel or NiTi wire main arch that must be kept separated 2 mm from the slot ofupper incisor braces. Two stops or omegas are made 1 mm mesial to the tubes of the molar bands that will impede main arch from slipping,and in this manner the arch will push the anterior teeth forward Here we have fabricated a modified multiple loop protrusion arch to correct an anterior crossbite with severe crowding that was not amenable to correct by advancement arches.

  15. Ulnar nerve damage (image)

    Science.gov (United States)

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

  16. Chondromyxoid fibroma of the mastoid facial nerve canal mimicking a facial nerve schwannoma.

    Science.gov (United States)

    Thompson, Andrew L; Bharatha, Aditya; Aviv, Richard I; Nedzelski, Julian; Chen, Joseph; Bilbao, Juan M; Wong, John; Saad, Reda; Symons, Sean P

    2009-07-01

    Chondromyxoid fibroma of the skull base is a rare entity. Involvement of the temporal bone is particularly rare. We present an unusual case of progressive facial nerve paralysis with imaging and clinical findings most suggestive of a facial nerve schwannoma. The lesion was tubular in appearance, expanded the mastoid facial nerve canal, protruded out of the stylomastoid foramen, and enhanced homogeneously. The only unusual imaging feature was minor calcification within the tumor. Surgery revealed an irregular, cystic lesion. Pathology diagnosed a chondromyxoid fibroma involving the mastoid portion of the facial nerve canal, destroying the facial nerve.

  17. Femoral nerve damage (image)

    Science.gov (United States)

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

  18. End-to-side nerve suture – a technique to repair peripheral nerve ...

    African Journals Online (AJOL)

    Lateral sprouting from an intact nerve into an attached nerve does occur, and functional recovery (sensory and motor) has been demonstrated. We have demonstrated conclusively that ETSNS in the human is a viable option in treating peripheral nerve injuries, including injuries to the brachial plexus. Among the many ...

  19. Tumors of the optic nerve

    DEFF Research Database (Denmark)

    Lindegaard, Jens; Heegaard, Steffen

    2009-01-01

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

  20. Normal and sonographic anatomy of selected peripheral nerves. Part III: Peripheral nerves of the lower limb.

    Science.gov (United States)

    Kowalska, Berta; Sudoł-Szopińska, Iwona

    2012-06-01

    The ultrasonographic examination is currently increasingly used in imaging peripheral nerves, serving to supplement the physical examination, electromyography and magnetic resonance imaging. As in the case of other USG imaging studies, the examination of peripheral nerves is non-invasive and well-tolerated by patients. The typical ultrasonographic picture of peripheral nerves as well as the examination technique have been discussed in part I of this article series, following the example of the median nerve. Part II of the series presented the normal anatomy and the technique for examining the peripheral nerves of the upper limb. This part of the article series focuses on the anatomy and technique for examining twelve normal peripheral nerves of the lower extremity: the iliohypogastric and ilioinguinal nerves, the lateral cutaneous nerve of the thigh, the pudendal, sciatic, tibial, sural, medial plantar, lateral plantar, common peroneal, deep peroneal and superficial peroneal nerves. It includes diagrams showing the proper positioning of the sonographic probe, plus USG images of the successively discussed nerves and their surrounding structures. The ultrasonographic appearance of the peripheral nerves in the lower limb is identical to the nerves in the upper limb. However, when imaging the lower extremity, convex probes are more often utilized, to capture deeply-seated nerves. The examination technique, similarly to that used in visualizing the nerves of upper extremity, consists of locating the nerve at a characteristic anatomic reference point and tracking it using the "elevator technique". All 3 parts of the article series should serve as an introduction to a discussion of peripheral nerve pathologies, which will be presented in subsequent issues of the "Journal of Ultrasonography".

  1. Effectiveness of L2 spinal nerve infiltration for selective discogenic low back pain patients

    International Nuclear Information System (INIS)

    Ohtori, Seiji; Nakamura, Shinichiro; Koshi, Takana

    2010-01-01

    It has been reported that rat L5/6 lumbar discs are innervated mainly by L2 dorsal root ganglion neurons. We previously reported that L2 spinal nerve infiltration was effective for discogenic low back pain (DLBP) patients, although the diagnosis was based only on the results of physical examination, plain films, and magnetic resonance imaging (MRI). The purpose of the current study was to evaluate L2 spinal nerve block for DLBP patients retrospectively based on MRI findings and surgical results. A total of 62 patients with only LBP and no accompanying radicular pain were investigated. Patients had only one level of disc degeneration on MRI. When pain was provoked during discography, we performed surgery at the next stage (40 patients). In all, 22 patients were excluded owing to negative discography results. Of the 40 patients, we evaluated 25 strictly selected patients suffering from DLBP. DLBP was diagnosed when the patient experienced pain relief at least 2 years after anterior lumbar interbody fusion. Fifteen patients who did not show pain relief after surgery were used for the non-DLBP group. L2 spinal nerve infiltration using 1.5 ml of lidocaine was performed in all 40 patients before surgery. The visual analogue scale (VAS) score after L2 spinal nerve infiltration was recorded, and an association of L2 spinal nerve infiltration and DLBP was explored. Low back pain scores assessed using the VAS score, the Japanese Orthopedic Association score, and the Oswestry Disability Index score in the two groups were not significantly different. L2 spinal nerve infiltration was effective for 27 patients but not effective for 13 patients; the VAS score after 15 min and 2 h improved in the DLBP group compared with that of the non-DLBP group (P<0.05). L2 spinal nerve infiltration was more effective in DLBP patients (21 patients, 84%) than in the non-DLBP group (6 patients, 40%) (P<0.05). In the current study, L2 spinal nerve infiltration was effective in 84% of selected DLBP

  2. Proteomic analysis of trans-hemispheric motor cortex reorganization following contralateral C7 nerve transfer

    Science.gov (United States)

    Yuan, Yin; Xu, Xiu-yue; Lao, Jie; Zhao, Xin

    2018-01-01

    Nerve transfer is the most common treatment for total brachial plexus avulsion injury. After nerve transfer, the movement of the injured limb may be activated by certain movements of the healthy limb at the early stage of recovery, i.e., trans-hemispheric reorganization. Previous studies have focused on functional magnetic resonance imaging and changes in brain-derived neurotrophic factor and growth associated protein 43, but there have been no proteomics studies. In this study, we designed a rat model of total brachial plexus avulsion injury involving contralateral C7 nerve transfer. Isobaric tags for relative and absolute quantitation and western blot assay were then used to screen differentially expressed proteins in bilateral motor cortices. We found that most differentially expressed proteins in both cortices of upper limb were associated with nervous system development and function (including neuron differentiation and development, axonogenesis, and guidance), microtubule and cytoskeleton organization, synapse plasticity, and transmission of nerve impulses. Two key differentially expressed proteins, neurofilament light (NFL) and Thy-1, were identified. In contralateral cortex, the NFL level was upregulated 2 weeks after transfer and downregulated at 1 and 5 months. The Thy-1 level was upregulated from 1 to 5 months. In the affected cortex, the NFL level increased gradually from 1 to 5 months. Western blot results of key differentially expressed proteins were consistent with the proteomic findings. These results indicate that NFL and Thy-1 play an important role in trans-hemispheric organization following total brachial plexus root avulsion and contralateral C7 nerve transfer. PMID:29557385

  3. Electrophysiological Assessment of a Peptide Amphiphile Nanofiber Nerve Graft for Facial Nerve Repair.

    Science.gov (United States)

    Greene, Jacqueline J; McClendon, Mark T; Stephanopoulos, Nicholas; Álvarez, Zaida; Stupp, Samuel I; Richter, Claus-Peter

    2018-04-27

    Facial nerve injury can cause severe long-term physical and psychological morbidity. There are limited repair options for an acutely transected facial nerve not amenable to primary neurorrhaphy. We hypothesize that a peptide amphiphile nanofiber neurograft may provide the nanostructure necessary to guide organized neural regeneration. Five experimental groups were compared, animals with 1) an intact nerve, 2) following resection of a nerve segment, and following resection and immediate repair with either a 3) autograft (using the resected nerve segment), 4) neurograft, or 5) empty conduit. The buccal branch of the rat facial nerve was directly stimulated with charge balanced biphasic electrical current pulses at different current amplitudes while nerve compound action potentials (nCAPs) and electromygraphic (EMG) responses were recorded. After 8 weeks, the proximal buccal branch was surgically re-exposed and electrically evoked nCAPs were recorded for groups 1-5. As expected, the intact nerves required significantly lower current amplitudes to evoke an nCAP than those repaired with the neurograft and autograft nerves. For other electrophysiologic parameters such as latency and maximum nCAP, there was no significant difference between the intact, autograft and neurograft groups. The resected group had variable responses to electrical stimulation, and the empty tube group was electrically silent. Immunohistochemical analysis and TEM confirmed myelinated neural regeneration. This study demonstrates that the neuroregenerative capability of peptide amphiphile nanofiber neurografts is similar to the current clinical gold standard method of repair and holds potential as an off-the-shelf solution for facial reanimation and potentially peripheral nerve repair. This article is protected by copyright. All rights reserved.

  4. Flare-up with associated paresthesia of a mandibular second premolar with three root canals.

    Science.gov (United States)

    Glassman, G D

    1987-07-01

    A case report is presented that deals with mental nerve paresthesia resulting from the "flare-up" of a mandibular second premolar with three root canals. A review of the literature and discussion follow, which suggest possible mechanisms that may be responsible for paresthesia as well as treatment regimens that may be used to minimize the incidence of this unexpected but occasional post-treatment endodontic sequela.

  5. Distribution of elements in rat peripheral axons and nerve cell bodies determined by x-ray microprobe analysis

    Energy Technology Data Exchange (ETDEWEB)

    LoPachin, R.M. Jr.; Lowery, J.; Eichberg, J.; Kirkpatrick, J.B.; Cartwright, J. Jr.; Saubermann, A.J.

    1988-09-01

    X-ray microprobe analysis was used to determine concentrations (millimoles of element per kilogram dry weight) of Na, P, Cl, K, and Ca in cellular compartments of frozen, unfixed sections of rat sciatic and tibial nerves and dorsal root ganglion (DRG). Five compartments were examined in peripheral nerve (axoplasm, mitochondria, myelin, extraaxonal space, and Schwann cell cytoplasm), and four were analyzed in DRG nerve cell bodies (cytoplasm, mitochondria, nucleus, and nucleolus). Each morphological compartment exhibited characteristic concentrations of elements. The extraaxonal space contained high concentrations of Na, Cl, and Ca, whereas intraaxonal compartments exhibited lower concentrations of these elements but relatively high K contents. Nerve axoplasm and axonal mitochondria had similar elemental profiles, and both compartments displayed proximodistal gradients of decreasing levels of K, Cl, and, to some extent, Na. Myelin had a selectively high P concentration with low levels of other elements. The elemental concentrations of Schwann cell cytoplasm and DRG were similar, but both were different from that of axoplasm, in that K and Cl were markedly lower whereas P was higher. DRG cell nuclei contained substantially higher K levels than cytoplasm. The subcellular distribution of elements was clearly shown by color-coded images generated by computer-directed digital x-ray imaging. The results of this study demonstrate characteristic elemental distributions for each anatomical compartment, which doubtless reflect nerve cell structure and function.

  6. Nerve growth factor receptor immunostaining suggests an extrinsic origin for hypertrophic nerves in Hirschsprung's disease.

    OpenAIRE

    Kobayashi, H; O'Briain, D S; Puri, P

    1994-01-01

    The expression of nerve growth factor receptor in colon from 20 patients with Hirshsprung's disease and 10 controls was studied immunohistochemically. The myenteric and submucous plexuses in the ganglionic bowel and hypertrophic nerve trunks in the aganglionic bowel displayed strong expression of nerve growth factor receptor. The most important finding was the identical localisation of nerve growth factor receptor immunoreactivity on the perineurium of both hypertrophic nerve trunks in Hirshs...

  7. 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.

  8. Recurrent unilateral facial nerve palsy in a child with dehiscent facial nerve canal

    Directory of Open Access Journals (Sweden)

    Christopher Liu

    2016-12-01

    Full Text Available Objective: The dehiscent facial nerve canal has been well documented in histopathological studies of temporal bones as well as in clinical setting. We describe clinical and radiologic features of a child with recurrent facial nerve palsy and dehiscent facial nerve canal. Methods: Retrospective chart review. Results: A 5-year-old male was referred to the otolaryngology clinic for evaluation of recurrent acute otitis media and hearing loss. He also developed recurrent left peripheral FN palsy associated with episodes of bilateral acute otitis media. High resolution computed tomography of the temporal bones revealed incomplete bony coverage of the tympanic segment of the left facial nerve. Conclusions: Recurrent peripheral FN palsy may occur in children with recurrent acute otitis media in the presence of a dehiscent facial nerve canal. Facial nerve canal dehiscence should be considered in the differential diagnosis of children with recurrent peripheral FN palsy.

  9. A Case Study on Idiopathic Orbital Pseudotumor: Surgery and ...

    African Journals Online (AJOL)

    This is a case study of five isolated orbital nerve inflammatory pseudotumor cases ... Optic disk edema was observed by ophthalmoscopy. ... The patients on clinical examination were found to have protrusion, reduced visual acuity of the right ...

  10. Reconstruction of the abdominal vagus nerve using sural nerve grafts in canine models.

    Science.gov (United States)

    Liu, Jingbo; Wang, Jun; Luo, Fen; Wang, Zhiming; Wang, Yin

    2013-01-01

    Recently, vagus nerve preservation or reconstruction of vagus has received increasing attention. The present study aimed to investigate the feasibility of reconstructing the severed vagal trunk using an autologous sural nerve graft. Ten adult Beagle dogs were randomly assigned to two groups of five, the nerve grafting group (TG) and the vagal resection group (VG). The gastric secretion and emptying functions in both groups were assessed using Hollander insulin and acetaminophen tests before surgery and three months after surgery. All dogs underwent laparotomy under general anesthesia. In TG group, latency and conduction velocity of the action potential in a vagal trunk were measured, and then nerves of 4 cm long were cut from the abdominal anterior and posterior vagal trunks. Two segments of autologous sural nerve were collected for performing end-to-end anastomoses with the cut ends of vagal trunk (8-0 nylon suture, 3 sutures for each anastomosis). Dogs in VG group only underwent partial resections of the anterior and posterior vagal trunks. Laparotomy was performed in dogs of TG group, and latency and conduction velocity of the action potential in their vagal trunks were measured. The grafted nerve segment was removed, and stained with anti-neurofilament protein and toluidine blue. Latency of the action potential in the vagal trunk was longer after surgery than before surgery in TG group, while the conduction velocity was lower after surgery. The gastric secretion and emptying functions were weaker after surgery in dogs of both groups, but in TG group they were significantly better than in VG group. Anti-neurofilament protein staining and toluidine blue staining showed there were nerve fibers crossing the anastomosis of the vagus and sural nerves in dogs of TG group. Reconstruction of the vagus nerve using the sural nerve is technically feasible.

  11. Reconstruction of the abdominal vagus nerve using sural nerve grafts in canine models.

    Directory of Open Access Journals (Sweden)

    Jingbo Liu

    Full Text Available BACKGROUND: Recently, vagus nerve preservation or reconstruction of vagus has received increasing attention. The present study aimed to investigate the feasibility of reconstructing the severed vagal trunk using an autologous sural nerve graft. METHODS: Ten adult Beagle dogs were randomly assigned to two groups of five, the nerve grafting group (TG and the vagal resection group (VG. The gastric secretion and emptying functions in both groups were assessed using Hollander insulin and acetaminophen tests before surgery and three months after surgery. All dogs underwent laparotomy under general anesthesia. In TG group, latency and conduction velocity of the action potential in a vagal trunk were measured, and then nerves of 4 cm long were cut from the abdominal anterior and posterior vagal trunks. Two segments of autologous sural nerve were collected for performing end-to-end anastomoses with the cut ends of vagal trunk (8-0 nylon suture, 3 sutures for each anastomosis. Dogs in VG group only underwent partial resections of the anterior and posterior vagal trunks. Laparotomy was performed in dogs of TG group, and latency and conduction velocity of the action potential in their vagal trunks were measured. The grafted nerve segment was removed, and stained with anti-neurofilament protein and toluidine blue. RESULTS: Latency of the action potential in the vagal trunk was longer after surgery than before surgery in TG group, while the conduction velocity was lower after surgery. The gastric secretion and emptying functions were weaker after surgery in dogs of both groups, but in TG group they were significantly better than in VG group. Anti-neurofilament protein staining and toluidine blue staining showed there were nerve fibers crossing the anastomosis of the vagus and sural nerves in dogs of TG group. CONCLUSION: Reconstruction of the vagus nerve using the sural nerve is technically feasible.

  12. Electrophysiology of Extraocular Cranial Nerves: Oculomotor, Trochlear, and Abducens Nerve.

    Science.gov (United States)

    Hariharan, Praveen; Balzer, Jeffery R; Anetakis, Katherine; Crammond, Donald J; Thirumala, Parthasarathy D

    2018-01-01

    The utility of extraocular cranial nerve electrophysiologic recordings lies primarily in the operating room during skull base surgeries. Surgical manipulation during skull base surgeries poses a risk of injury to multiple cranial nerves, including those innervating extraocular muscles. Because tumors distort normal anatomic relationships, it becomes particularly challenging to identify cranial nerve structures. Studies have reported the benefits of using intraoperative spontaneous electromyographic recordings and compound muscle action potentials evoked by electrical stimulation in preventing postoperative neurologic deficits. Apart from surgical applications, electromyography of extraocular muscles has also been used to guide botulinum toxin injections in patients with strabismus and as an adjuvant diagnostic test in myasthenia gravis. In this article, we briefly review the rationale, current available techniques to monitor extraocular cranial nerves, technical difficulties, clinical and surgical applications, as well as future directions for research.

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

    NARCIS (Netherlands)

    Meek, MF; Nicolai, JPA; Robinson, PH

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

  14. Nerve conduction velocity

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/003927.htm Nerve conduction velocity To use the sharing features on this page, please enable JavaScript. Nerve conduction velocity (NCV) is a test to see ...

  15. Traumatic and compressive pathology of the peripheral nerves: value of the MRI; Patologia traumatica y compresiva de los nervios perifericos: valor de la RM

    Energy Technology Data Exchange (ETDEWEB)

    Sanchez, M. L.; Romero, J.; Hernandez, L.; Miguel, E. de [Hospital General Universitario Gregorio Maranon. Madrid (Spain)

    2000-07-01

    Evaluate the usefulness of the magnetic resonance (MRI) in the diagnosis of traumatic and compressive pathology of the peripheral nerves and analyze the etiology of the lesions and their severity. 25 MRI in patients with compressive and traumatic lesions of the peripheral nerves are analyzed. They were studied with MRI (1,5T) using T1 weighted spin-echo (SE), T2 gradient echo (GE) and STIR sequences. The morphological and nerve signal alterations make it possible to locate the lesion site and to assess the course of the lesion with successive studies. In our series, the most frequent cause of compressive pathology is fibrosis. Brachial plexus root avulsion is the most frequent finding in traumatic lesions. The MTI capacity for multiplanar study and its high resolution make it possible for us to detect small lesions in the peripheral nerves and to plan the best treatment. (Author) 17 refs.

  16. [Epidural pharmacotherapy in the treatment of the pain syndrome in osteochondrosis complicated by intervertebral discs protrusion of lumbar part of the vertebral column].

    Science.gov (United States)

    Khizhniak, M V; Priĭmak, E V

    2013-03-01

    Experience of application of intralaminar epidural pharmacotherapy for the treatment of the pain syndrome in the patients, suffering osteochondrosis of lumbar portion of vertebral column, complicated by intervertebral discs protrusion, was summarized. The method introduction permits to escape the operative intervention performance for complicated osteochondrosis.

  17. Production and in vitro evaluation of macroporous, cell-encapsulating alginate fibres for nerve repair

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Sharon Chien-Yu, E-mail: sharonlin114@gmail.com [The University of Queensland, Pharmacy Australia Centre of Excellence, 20 Cornwall Street, Woolloongabba, Brisbane QLD 4102 (Australia); Wang, Yiwei, E-mail: yiweiwang@anzac.edu.au [The University of Queensland, Pharmacy Australia Centre of Excellence, 20 Cornwall Street, Woolloongabba, Brisbane QLD 4102 (Australia); Wertheim, David F., E-mail: d.wertheim@kingston.ac.uk [Faculty of Science, Engineering and Computing, Kingston University, Kingston upon Thames, Surrey KT1 2EE (United Kingdom); Coombes, Allan G.A., E-mail: allancoombes@pharmacy.psu.ac.th [Faculty of Pharmaceutical Sciences, Prince of Songkla University, Hat Yai, Songkhla 90112 (Thailand)

    2017-04-01

    The prospects for successful peripheral nerve repair using fibre guides are considered to be enhanced by the use of a scaffold material, which promotes attachment and proliferation of glial cells and axonal regeneration. Macroporous alginate fibres were produced by extraction of gelatin particle porogens from wet spun fibres produced using a suspension of gelatin particles in 1.5% w/v alginate solution. Gelatin loading of the starting suspension of 40.0, 57.0, and 62.5% w/w resulted in gelatin loading of the dried alginate fibres of 16, 21, and 24% w/w respectively. Between 45 and 60% of the gelatin content of hydrated fibres was released in 1 h in distilled water at 37 °C, leading to rapid formation of a macroporous structure. Confocal laser scanning microscopy (CLSM) and image processing provided qualitative and quantitative analysis of mean equivalent macropore diameter (48–69 μm), pore size distribution, estimates of maximum porosity (14.6%) and pore connectivity. CLSM also revealed that gelatin residues lined the macropore cavities and infiltrated into the body of the alginate scaffolds, thus, providing cell adhesion molecules, which are potentially advantageous for promoting growth of glial cells and axonal extension. Macroporous alginate fibres encapsulating nerve cells [primary rat dorsal root ganglia (DRGs)] were produced by wet spinning alginate solution containing dispersed gelatin particles and DRGs. Marked outgrowth was evident over a distance of 150 μm at day 11 in cell culture, indicating that pores and channels created within the alginate hydrogel were providing a favourable environment for neurite development. These findings indicate that macroporous alginate fibres encapsulating nerve cells may provide the basis of a useful strategy for nerve repair. - Highlights: • Nerve cells were encapsulated in macroporous alginate fibres for use in nerve repair. • Fibres were produced from alginate solution containing gelatin porogens and cells.

  18. Genipin-Cross-Linked Chitosan Nerve Conduits Containing TNF-α Inhibitors for Peripheral Nerve Repair.

    Science.gov (United States)

    Zhang, Li; Zhao, Weijia; Niu, Changmei; Zhou, Yujie; Shi, Haiyan; Wang, Yalin; Yang, Yumin; Tang, Xin

    2018-07-01

    Tissue engineered nerve grafts (TENGs) are considered a promising alternative to autologous nerve grafting, which is considered the "gold standard" clinical strategy for peripheral nerve repair. Here, we immobilized tumor necrosis factor-α (TNF-α) inhibitors onto a nerve conduit, which was introduced into a chitosan (CS) matrix scaffold utilizing genipin (GP) as the crosslinking agent, to fabricate CS-GP-TNF-α inhibitor nerve conduits. The in vitro release kinetics of TNF-α inhibitors from the CS-GP-TNF-α inhibitor nerve conduits were investigated using high-performance liquid chromatography. The in vivo continuous release profile of the TNF-α inhibitors released from the CS-GP-TNF-α inhibitor nerve conduits was measured using an enzyme-linked immunosorbent assay over 14 days. We found that the amount of TNF-α inhibitors released decreased with time after the bridging of the sciatic nerve defects in rats. Moreover, 4 and 12 weeks after surgery, histological analyses and functional evaluations were carried out to assess the influence of the TENG on regeneration. Immunochemistry performed 4 weeks after grafting to assess early regeneration outcomes revealed that the TENG strikingly promoted axonal outgrowth. Twelve weeks after grafting, the TENG accelerated myelin sheath formation, as well as functional restoration. In general, the regenerative outcomes following TENG more closely paralleled findings observed with autologous grafting than the use of the CS matrix scaffold. Collectively, our data indicate that the CS-GP-TNF-α inhibitor nerve conduits comprised an elaborate system for sustained release of TNF-α inhibitors in vitro, while studies in vivo demonstrated that the TENG could accelerate regenerating axonal outgrowth and functional restoration. The introduction of CS-GP-TNF-α-inhibitor nerve conduits into a scaffold may contribute to an efficient and adaptive immune microenvironment that can be used to facilitate peripheral nerve repair.

  19. [Does intraoperative nerve monitoring reduce the rate of recurrent nerve palsies during thyroid surgery?].

    Science.gov (United States)

    Timmermann, W; Dralle, H; Hamelmann, W; Thomusch, O; Sekulla, C; Meyer, Th; Timm, S; Thiede, A

    2002-05-01

    Two different aspects of the influence of neuromonitoring on the possible reduction of post-operative recurrent laryngeal nerve palsies require critical examination: the nerve identification and the monitoring of it's functions. Due to the additional information from the EMG signals, neuromonitoring is the best method for identifying the nerves as compared to visual identification alone. There are still no randomized studies available that compare the visual and electrophysiological recurrent laryngeal nerve detection in thyroid operations with respect to the postoperative nerve palsies. Nevertheless, comparisons with historical collectives show that a constant low nerve-palsy-rate was achieved with electrophysiological detection in comparison to visual detection. The rate of nerve identification is normally very high and amounts to 99 % in our own patients. The data obtained during the "Quality assurance of benign and malignant Goiter" study show that in hemithyreoidectomy and subtotal resection, lower nerve-palsy-rates are achieved with neuromonitoring as compared to solely visual detection. Following subtotal resection, this discrepancy becomes even statistically significant. While monitoring the nerve functions with the presently used neuromonitoring technique, it is possible to observe the EMG-signal remaining constant or decreasing in volume. Assuming that a constant neuromonitoring signal represents a normal vocal cord, our evaluation shows that there is a small percentage of false negative and positive results. Looking at the permanent recurrent nerve palsy rates, this method has a specificity of 98 %, a sensitivity of 100 %, a positive prognostic value of 10 %, and a negative prognostic value of 100 %. Although an altered neuromonitoring signal can be taken as a clear indication of eventual nerve damage, an absolutely reliable statement about the postoperative vocal cord function is presently not possible with intraoperative neuromonitoring.

  20. Fabrication of nerve guidance conduit with luminal filler as scaffold for peripheral nerve repair

    International Nuclear Information System (INIS)

    Aranilla, Charito T.; Wach, Rodoslaw; Ulanski, Piotr

    2015-01-01

    Peripheral nerve injury is a serious health concern for society, affecting trauma patients, many of whom acquire life-long disability. The gold standard of treatment for peripheral nerve injury is the use of nerve grafts, wherein nerve autograft or allograft is used to bridge the gap in the damaged nerve. Nerve guidance conduits (NGCs) are an attractive alternative to nerve autografts for aiding in the regeneration of peripheral nerve tissue. NGCs are small cylinders or tubes composed of either natural or synthetic biomaterials that are used to axon regeneration. The ends of the damaged nerve are inserted into either end of the cylinder and the NGC acts both as a connecting bridge for the severed nerve ends as well as a protective shelter for the regenerating nerve. This study aims at fabricating nerve guidance conduits with luminal structure based on synthetic biodegradable and biocompatible polymers such as poly (trimethylene carbonate ) (PTMC), poly (lactic acid) (PLA) and poly (caprolactone) (PCL). Initial base materials for fabrication were PLA acid tubes compared to PCL tubes when prepared by spray and dip-coating methods. The morphology of the tubes where examined by SEM and results showed better porosity of PLA acid tubes compared to PCL tubes when prepared by spraying technique. Poly(lactic acid) was then blended with poly(trimethylene carbonate) at a ratio of 1:4 (5% total polymer content) for further fabrication. Electron beam radiation (25 and 50 kGy) was employed for sterilization and the changes in properties induced by irradiation in comprising polymers were evaluated. The wettability, mechanical thermal properties were not significantly changed by irradiation.In a separate experiment, synthesis of carboxymethyl chitosan hydrogel crosslinked by electron beam radiation was studied to create a luminal filler for PTMC-PLA tubes. Based on proper viscosity of solution before crosslinking, sufficient gel fraction and swelling, 10% w/v concentration of