Peripheral nerve elongation by laser Doppler flowmetry controlled expansion: morphological aspects

Effect of progesterone on recovery from nerve injury during leg lengthening in rats

We investigated the effect of progesterone on the nerve during lengthening of the limb in rats. The sciatic nerves of rats were elongated by leg lengthening for ten days at 3 mm per day. On alternate days between the day after the operation and nerve dissection, the progesterone-treated group received subcutaneous injections of 1 mg progesterone in sesame oil and the control group received oil only. On the fifth, tenth and 17th day, the sciatic nerves were excised at the midpoint of the femur and the mRNA expression level of myelin protein P0 was analysed by quantitative real time polymerase chain reaction. On day 52 nodal length was examined by electron microscopy, followed by an examination of the compound muscle action potential (C-MAP) amplitude and the motor conduction velocity (MCV) of the tibial nerve on days 17 and 52. The P0 (a major myelin glycoprotein) mRNA expression level in the progesterone-treated group increased by 46.6% and 38.7% on days five and ten, respectively. On day 52, the nodal length in the progesterone-treated group was smaller than that in the control group, and the MCV of the progesterone-treated group had been restored to normal. Progesterone might accelerate the restoration of demyelination caused by nerve elongation by activating myelin synthesis.

Smart Polymeric Gels: Redefining the Limits of Biomedical Devices

This review describes recent progresses in the development and applications of smart polymeric gels, especially in the context of biomedical devices. The review has been organized into three separate sections: defining the basis of smart properties in polymeric gels; describing representative stimuli to which these gels respond; and illustrating a sample application area, namely, microfluidics. One of the major limitations in the use of hydrogels in stimuli-responsive applications is the diffusion rate limited transduction of signals. This can be obviated by engineering interconnected pores in the polymer structure to form capillary networks in the matrix and by downscaling the size of hydrogels to significantly decrease diffusion paths. Reducing the lag time in the induction of smart responses can be highly useful in biomedical devices, such as sensors and actuators. This review also describes molecular imprinting techniques to fabricate hydrogels for specific molecular recognition of target analytes. Additionally, it describes the significant advances in bottom-up nanofabrication strategies, involving supramolecular chemistry. Learning to assemble supramolecular structures from nature has led to the rapid prototyping of functional supramolecular devices. In essence, the barriers in the current performance potential of biomedical devices can be lowered or removed by the rapid convergence of interdisciplinary technologies.

Internodes can nearly double in length with gradual elongation of the adult rat sciatic nerve

Leg lengthening procedure is used increasingly to treat leg length discrepancy and some forms of dwarfism. We investigated adaptation in rat sciatic nerve to the gradual nerve elongation that occurs with leg lengthening. Indirect nerve elongation was produced by leg lengthening by a total of 15, 30, 45, or 70 mm at a rate of 1 mm/day. One day after leg lengthening completion, transverse semithin sections of sciatic nerve were prepared and examined; a teased-fiber study also was performed. Elongation decreased axon diameter, but not significantly. In teased-fiber preparations, internodal length was increased by 93%, and the longest internode measured 3000 microm after leg lengthening by 70 mm. Slopes of fiber diameter-internodal length regression lines increased with increasing elongation. Paranodal demyelination caused by nerve elongation worsened as elongation increased, stimulating remyelination (i.e., intercalation of a segment). Only 0.8% of axons showed degeneration in the group with 70 mm of elongation. We concluded that adult rat sciatic nerve can adapt itself to leg lengthening procedure with even doubling internodal length.

P0 mRNA expression increases during gradual nerve elongation in adult rats

Leg lengthening with nerve elongation is a common clinical treatment. We investigated morphological and molecular changes in peripheral nerves associated with femoral lengthening using animal models. Sciatic nerves of 13 week old male Wistar rats (n = 35) were elongated indirectly by leg lengthening for 14 days at 1 mm/day. At 3, 7, 14, 21, and 35 days following initiation of elongation, sciatic nerves on the elongated side and contralateral (control) side were excised at the midpoint of the femur. Internodal length was increased by 17%. Light and electron microscopic observation of transverse sections at 14 days showed elongated nerves appearing similar to control nerves with no degenerating axons and normal myelin thickness. We next examined changes of mRNA expression of a major myelin glycoprotein, P0, in elongated nerves using a quantitative reverse transcription-polymerase chain reaction and in situ hybridization. P0 mRNA expression in elongated nerves was increased during the first 3 weeks, with expression reaching 160% of control nerve expression at 14 days. Results of in situ hybridization were confirmatory. We concluded that myelin synthesis occurred during gradual nerve elongation. In adulthood, Schwann cells retain ability to synthesize myelin in response to nerve stretching.

Retrograde degeneration of the facial nerve after acute traction on parotid gland: an experimental investigation

The parotid gland of the cat underwent traction for 2 hours (group A) or until the facial nerve was broken (group B). The cats survived postoperatively for 1 day, 2 weeks, 1 month, and 3 months, respectively. Each cat underwent an electroneurography session before they were killed. The facial nerve was harvested and underwent histologic examination. The present study demonstrated that, in group A, the degree of facial nerve degeneration indicated with evoked electroneurography was 100% at 1 day and 2 weeks and 85% and 35%, respectively, at 1 and 3 months after damage. In group B, no electric response was recorded, epineurium of extratemporal segment was broken. This study also showed that the pronounced alteration of the facial nerve following acute traction on the parotid gland was retrograde degeneration; it involved up to its internal acoustic meatus segment. Furthermore, pronounced damage was noted in its stylomastoid foramen and extratemporal segment.

Experimental study of peripheral nerve injury during gradual limb elongation

The purpose of this study was to clarify how fast the peripheral nerve can be elongated gradually without inducing nerve conduction block, and to assess whether the damage to the peripheral nerve is reversible. Rabbit femur was gradually elongated to 30 mm at the rate of 0.8 mm/day, 2.0 mm/day, and 4.0 mm/day to stretch the sciatic nerve. Immediately after and eight weeks after elongation, each group was estimated. Elongation of the Ranvier's node, which was likely the cause of conduction block, was observed and its severity increased with elongation speed. There was no Wallerian degeneration even when conduction block was complete. There was little damage to the sciatic nerve in the group of 0.8 mm/day. Damage in the group of 2.0 mm/day immediately after elongation had a tendency to recover by eight weeks, but there was no such tendency in the group of 4.0 mm/day.

Automatic image analysis of the postnatal growth of axons and myelin sheaths in the tibial and peroneal nerves of the rabbit

The numerous morphometric studies on the myelinated fibers in the peripheral nerves have presented varying results. Only a few studies deal with the peripheral nerves from rabbits. In this work, a morphometric study was carried out on the tibial and peroneal nerves of new-born, 10-, 15-, 20-, 30-, 60-, 90- and 240-day-old rabbits. The bilateral proximal segments of both nerves were investigated. Negatives of semi-thin cross sections were used for myelinated fiber morphometric analysis, carried out by an OLYMPUS Video image analyser. Two morphometric parameters, the average axon diameter (AD) (the average length of Feret's diameters) and the specific width of the myelin sheaths (SWMS) (specifying the total width of the myelin sheath), were evaluated for every age group. In the tibial and peroneal nerves a bimodal distribution of the average AD appeared on the 20th day, and of the SWMS on the 10th day postnatum. A tight correlation was obtained when comparing mean AD (mAD) and mean SWMS (mSWMS) in new-born and 240-day-old rabbits. From birth to adulthood the mAD increased in both nerves by about 270% and the mSWMS by about 280%. The mAD/mSWMS ratio in both new-born and 8-month-old rabbits was found to be 4 in the tibial and 5 in the peroneal nerves. According to the available data, an approach to the measurement of AD as an average length of Feret's diameters and the measurement of the myelin thickness as a SWMS has not yet been employed. An extension of this methodological approach could help to understand the growth and myelinization of peripheral nerve fibers.