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Ashna M, Senthilkumar N, Sanpui P. Human Hair Keratin-Based Hydrogels in Regenerative Medicine: Current Status and Future Directions. ACS Biomater Sci Eng 2023; 9:5527-5547. [PMID: 37734053 DOI: 10.1021/acsbiomaterials.3c00883] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/23/2023]
Abstract
Regenerative medicine (RM) is a multidisciplinary field that utilizes the inherent regenerative potential of human cells to generate functionally and physiologically acceptable human cells, tissues, and organs in vivo or ex vivo. An appropriate biomaterial scaffold with desired physicochemical properties constitutes an important component of a successful RM approach. Among various forms of biomaterials explored until the present day, hydrogels have emerged as a versatile candidate for tissue engineering and regenerative medicine (TERM) applications such as scaffolds for spatial patterning and delivering therapeutic agents, or substrates to enhance cell growth, differentiation, and migration. Although hydrogels can be prepared from a variety of synthetic polymers as well as biopolymers, the latter are preferred for their inherent biocompatibility. Specifically, keratins are fibrous proteins that have been recently explored for constructing hydrogels useful for RM purposes. The present review discusses the suitability of keratin-based biomaterials in RM, with a particular focus on human hair keratin hydrogels and their use in various RM applications.
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Affiliation(s)
- Mymuna Ashna
- Department of Biotechnology, BITS Pilani Dubai Campus, Dubai International Academic City, Dubai, United Arab Emirates
| | - Neeharika Senthilkumar
- Department of Biotechnology, BITS Pilani Dubai Campus, Dubai International Academic City, Dubai, United Arab Emirates
| | - Pallab Sanpui
- Department of Biotechnology, BITS Pilani Dubai Campus, Dubai International Academic City, Dubai, United Arab Emirates
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Cavalheiro CS, Nakamoto JC, Wei TH, Sorrenti L, Wataya EY. Histological Compatibility in Distal Neurotizations: A Systematic Review. Indian J Plast Surg 2023; 56:405-412. [PMID: 38026776 PMCID: PMC10663082 DOI: 10.1055/s-0043-1774385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023] Open
Abstract
Considering the importance of defining the minimum number of axons between recipient and donor branches, that is, the definition of histological compatibility in distal neurotizations for the success of the procedure and the surgeon's freedom to choose individualized strategies for each patient, this systematic review was conducted to find out the most recent studies on the subject. The objective of this systematic review was to determine the importance of the number of axons and the relationship between axon counts in the donor and recipient nerves in the success of nerve transfer. A literature review was performed on five international databases: Web of Science, Scopus, Wiley (Cochrane Database), Embase, and PubMed. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed (2020 version), a guide designed to guide the elaboration of systematic literature reviews. One hundred and fifty-seven studies were found, and 23 were selected based on the eligibility criteria. The articles presented were conclusive in determining the importance of the number of axons in the success of nerve transfer. Still, the relationship between the number of axons in the donor and recipient nerves seems more relevant in the success of transfers and is not always explored by the authors. The review of the articles has provided compelling evidence that the number of axons is a critical determinant of the success of nerve transfer procedures. However, the relationship between the number of axons in the donor nerve and that in the recipient nerve appears to be even more crucial for successful transfers, a factor that is not always adequately explored by authors in the existing literature. Level of evidence : Level IV, therapeutic study.
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Affiliation(s)
- Cristina Schmitt Cavalheiro
- Department of Hand, Wrist and Microsurgery, Instituto Vita, São Paulo, SP, Brazil
- Institute of Orthopedic and Traumatology, Faculdade de Medicina, Universidade de Sâo Paulo, São Paulo, SP, Brazil
| | - João Carlos Nakamoto
- Department of Hand, Wrist and Microsurgery, Instituto Vita, São Paulo, SP, Brazil
| | - Teng Hsiang Wei
- Institute of Orthopedic and Traumatology, Faculdade de Medicina, Universidade de Sâo Paulo, São Paulo, SP, Brazil
| | - Luiz Sorrenti
- Department of Hand, Wrist and Microsurgery, Instituto Vita, São Paulo, SP, Brazil
| | - Erick Yoshio Wataya
- Department of Hand, Wrist and Microsurgery, Instituto Vita, São Paulo, SP, Brazil
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Zhang F, Ma B, Li Q, Zhang M, Kou Y. Chitin Conduits with Different Inner Diameters at Both Ends Combined with Dual Growth Factor Hydrogels Promote Nerve Transposition Repair in Rats. J Funct Biomater 2023; 14:442. [PMID: 37754856 PMCID: PMC10532167 DOI: 10.3390/jfb14090442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/02/2023] [Accepted: 08/15/2023] [Indexed: 09/28/2023] Open
Abstract
Severe peripheral nerve injuries, such as deficits over long distances or proximal nerve trunk injuries, pose complex reconstruction challenges that often result in unfavorable outcomes. Innovative techniques, such as nerve transposition repair with conduit suturing, can be employed to successfully treat severe peripheral nerve damage. However, cylindrical nerve guides are typically unsuitable for nerve transposition repair. Furthermore, angiogenic and neurotrophic factors are necessary to stimulate the emergence of axonal lateral sprouts, proximal growth, and the rehabilitation of neuron structures and functions. In the current study, we used chitosan to make chitin conduits with different inner diameters at both ends, combined with gelatin methacrylate hydrogels that can continuously release dual growth factors, namely, the vascular endothelial growth factor (VEGF) and the nerve growth factor (NGF), and evaluated its impact on nerve transposition repair in rats. At 16 weeks after the operation, our findings showed that the conduit combined with the dual growth factor hydrogel significantly improved the restoration of both motor and conduction functions of the nerve. In addition, histological analysis showed significant recovery of nerve fibers, target muscles, and neurons. In conclusion, the combination of chitin conduits with different inner diameters and dual growth factor hydrogels can significantly improve the effect of nerve transposition repair, which has important potential clinical value.
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Affiliation(s)
- Fengshi Zhang
- Department of Orthopedics and Trauma, Peking University People’s Hospital, Beijing 100044, China; (F.Z.); (M.Z.)
- Key Laboratory of Trauma and Neural Regeneration, Peking University, Beijing 100044, China
- National Center for Trauma Medicine, Beijing 100044, China
| | - Bo Ma
- Department of Orthopedics and Trauma, Peking University People’s Hospital, Beijing 100044, China; (F.Z.); (M.Z.)
- Key Laboratory of Trauma and Neural Regeneration, Peking University, Beijing 100044, China
- National Center for Trauma Medicine, Beijing 100044, China
| | - Qicheng Li
- Department of Orthopedics and Trauma, Peking University People’s Hospital, Beijing 100044, China; (F.Z.); (M.Z.)
- Key Laboratory of Trauma and Neural Regeneration, Peking University, Beijing 100044, China
- National Center for Trauma Medicine, Beijing 100044, China
| | - Meng Zhang
- Department of Orthopedics and Trauma, Peking University People’s Hospital, Beijing 100044, China; (F.Z.); (M.Z.)
- Key Laboratory of Trauma and Neural Regeneration, Peking University, Beijing 100044, China
- National Center for Trauma Medicine, Beijing 100044, China
| | - Yuhui Kou
- Department of Orthopedics and Trauma, Peking University People’s Hospital, Beijing 100044, China; (F.Z.); (M.Z.)
- Key Laboratory of Trauma and Neural Regeneration, Peking University, Beijing 100044, China
- National Center for Trauma Medicine, Beijing 100044, China
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Chen X, Guo J, Zhou Y, Lao J, Zhao X, Rui J. A rat model of modified contralateral C7 transfer permitting ulnar nerve recovery. J Plast Reconstr Aesthet Surg 2023; 81:122-129. [PMID: 37137193 DOI: 10.1016/j.bjps.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 02/07/2023] [Accepted: 03/15/2023] [Indexed: 05/05/2023]
Abstract
BACKGROUND Contralateral C7 transfer (cC7) is an important treatment for total brachial plexus avulsion (TBPA), which sacrifices the recovery of the ulnar nerve (UN). The present study aimed to introduce an animal model of modified cC7 that preserved the deep branch of ulnar nerve (dbUN) and verify its feasibility. METHODS Anatomical study: Lengths, diameters, and axon counts of dbUN and anterior interosseous (AIN) branches in six rats were measured. In vivo surgery: 18 rats were divided into three groups. Group A: Traditional cC7. Group B: Modified cC7 finished in one stage. Group C: Modified cC7 and AIN branch anastomosed with dbUN one month after the first stage. Electrophysiological examinations, muscle wet weight, muscle cross-sectional areas, and nerve axon counts were evaluated six months postoperatively. RESULTS Anatomical study: The distances from dbUN and AIN branches to the midpoint of the inner and outer epicondyles connection of the humerus, diameters, and axon numbers of dbUN and AIN branches were analyzed, then AIN terminal branch (tbAIN) was anastomosed with dbUN. In vivo surgery: The differences in median nerve fiber counts were not significant. There were more UN axons in group A than in groups B and C. In electrophysiological examinations, muscle wet weight and cross-sectional area of the flexor digitorum profundus showed no significant difference, but the second interosseus cross-sectional areas in groups B and C were significantly larger than in group A. CONCLUSIONS This study established an animal model of preserving dbUN in cC7 and verified its feasibility. The possibility of restoring dbUN was established.
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Affiliation(s)
- Xi Chen
- Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai 200040, PR China; NHC Key Laboratory of Hand Reconstruction (Fudan University), Shanghai 200040, PR China; Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai 200040, PR China
| | - Jinding Guo
- Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai 200040, PR China; NHC Key Laboratory of Hand Reconstruction (Fudan University), Shanghai 200040, PR China; Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai 200040, PR China
| | - Yingjie Zhou
- Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai 200040, PR China; NHC Key Laboratory of Hand Reconstruction (Fudan University), Shanghai 200040, PR China; Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai 200040, PR China
| | - Jie Lao
- Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai 200040, PR China; NHC Key Laboratory of Hand Reconstruction (Fudan University), Shanghai 200040, PR China; Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai 200040, PR China
| | - Xin Zhao
- Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai 200040, PR China; NHC Key Laboratory of Hand Reconstruction (Fudan University), Shanghai 200040, PR China; Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai 200040, PR China
| | - Jing Rui
- Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai 200040, PR China; NHC Key Laboratory of Hand Reconstruction (Fudan University), Shanghai 200040, PR China; Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai 200040, PR China.
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Ding W, Li X, Chen H, Wang X, Zhou D, Wang X. Nerve merging repair in the replantation of a severed limb with defects in multiple nerves: five cases and long-term follow-up. BMC Surg 2022; 22:222. [PMID: 35681188 PMCID: PMC9185902 DOI: 10.1186/s12893-022-01673-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 05/31/2022] [Indexed: 11/10/2022] Open
Abstract
Background Repairing all nerves is challenging in cases of upper arm avulsion combined with defects in multiple nerves because the donor area for autogenous nerve transplantation is limited and the outcomes of long-segment allogeneic nerve transplantation are poor. Based on the principle of magnified nerve regeneration, we present a method called nerve merging repair, the feasibility of which needs to be confirmed in clinical practice. Methods The nerve merging repair method relies on the use of fewer proximal nerves to innervate more distal nerves and depends mainly on whether the radial nerve (RN) can repair itself. In the case of defects in multiple nerves precluding RN self-repair, median-(median + radial) (M-(M + R)) repair is performed. If the RN can undergo self-repair, median-(median + ulnar) (M-(M + U)) or ulnar-(ulnar + median) (U-(U + M)) is used to repair the three nerves. Five cases were included in the study and involved the analysis of joint motor function, muscle strength and sensory recovery of the affected limb. Results The replanted limb survived in all 5 cases. Follow-up visits were conducted with the patients for 51–80 months, during which they experienced satisfactory recovery of skin sensation, elbow flexion and extension and partial recovery of hand muscle strength. Conclusions To a certain extent, treatment with the nerve merging repair method improved the sensory and motor function of the affected limb and limited the loss of function of the donor nerve area. This intervention provides a new approach for repairing long-segment defects in multiple nerves caused by avulsion amputation of the upper limb.
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Affiliation(s)
- Wenquan Ding
- Department of Hand Surgery, Department of Plastic Reconstructive Surgery, Ningbo No. 6 Hospital, 315040, Ningbo, China
| | - Xueyuan Li
- Department of Hand Surgery, Department of Plastic Reconstructive Surgery, Ningbo No. 6 Hospital, 315040, Ningbo, China
| | - Hong Chen
- Department of Hand Surgery, Department of Plastic Reconstructive Surgery, Ningbo No. 6 Hospital, 315040, Ningbo, China
| | - Xiaofeng Wang
- Department of Hand Surgery, Department of Plastic Reconstructive Surgery, Ningbo No. 6 Hospital, 315040, Ningbo, China
| | - Danya Zhou
- Department of Hand Surgery, Department of Plastic Reconstructive Surgery, Ningbo No. 6 Hospital, 315040, Ningbo, China
| | - Xin Wang
- Department of Hand Surgery, Department of Plastic Reconstructive Surgery, Ningbo No. 6 Hospital, 315040, Ningbo, China.
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Barham M, Streppel M, Guntinas-Lichius O, Fulgham-Scott N, Vogt J, Neiss WF. Treatment With Nimodipine or FK506 After Facial Nerve Repair Neither Improves Accuracy of Reinnervation Nor Recovery of Mimetic Function in Rats. Front Neurosci 2022; 16:895076. [PMID: 35645727 PMCID: PMC9136327 DOI: 10.3389/fnins.2022.895076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 04/25/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose Nimodipine and FK506 (Tacrolimus) are drugs that have been reported to accelerate peripheral nerve regeneration. We therefore tested these substances aiming to improve the final functional outcome of motoric reinnervation after facial nerve injury. Methods In 18 female rats, the transected facial nerve was repaired by an artificial nerve conduit. The rats were then treated with either placebo, nimodipine, or FK506, for 56 days. Facial motoneurons were pre-operatively double-labeled by Fluoro-Gold and again 56 days post-operation by Fast-Blue to measure the cytological accuracy of reinnervation. The whisking motion of the vibrissae was analyzed to assess the quality of functional recovery. Results On the non-operated side, 93–97% of those facial nerve motoneurons innervating the vibrissae were double-labeled. On the operated side, double-labeling only amounted to 38% (placebo), 40% (nimodipine), and 39% (FK506), indicating severe misdirection of reinnervation. Regardless of post-operative drug or placebo therapy, the whisking frequency reached 83–100% of the normal value (6.0 Hz), but whisking amplitude was reduced to 33–48% while whisking velocity reached 39–66% of the normal values. Compared to placebo, statistically neither nimodipine nor FK506 improved accuracy of reinnervation and function recovery. Conclusion Despite previous, positive data on the speed and quantity of axonal regeneration, nimodipine and FK506 do not improve the final functional outcome of motoric reinnervation in rats.
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Affiliation(s)
- Mohammed Barham
- Department II of Anatomy, Faculty of Medicine, University of Cologne and University Hospital of Cologne, Cologne, Germany
- *Correspondence: Mohammed Barham,
| | - Michael Streppel
- Department of Ear, Nose and Throat-Department (ENT), PAN-Clinic at Neumarkt, Cologne, Germany
| | | | - Nicole Fulgham-Scott
- Department I of Anatomy, Faculty of Medicine, University of Cologne and University Hospital of Cologne, Cologne, Germany
| | - Johannes Vogt
- Department II of Anatomy, Faculty of Medicine, University of Cologne and University Hospital of Cologne, Cologne, Germany
| | - Wolfram F. Neiss
- Department I of Anatomy, Faculty of Medicine, University of Cologne and University Hospital of Cologne, Cologne, Germany
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Saltzman EB, Krishnan K, Winston MJ, Das De S, Lee SK, Wolfe SW. A Cadaveric Study on the Utility of the Levator Scapulae Motor Nerve as a Donor for Brachial Plexus Reconstruction. J Hand Surg Am 2021; 46:812.e1-812.e5. [PMID: 33487489 DOI: 10.1016/j.jhsa.2020.11.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 09/30/2020] [Accepted: 11/23/2020] [Indexed: 02/02/2023]
Abstract
PURPOSE The purpose of the study was to evaluate the utility of the levator scapulae motor nerve (LSN) as a donor nerve for brachial plexus nerve transfer. We hypothesized that the LSN could be transferred to the suprascapular nerve (SSN) or long thoracic nerve (LTN) with a reliable tension-free coaptation and appropriate donor-to-recipient axon count ratio. METHODS Twelve brachial plexus dissections were performed on 6 adult cadavers, bilaterally. We identified the LSN, spinal accessory nerve (SAN), SSN, and LTN. Each nerve was prepared for transfer and nerve redundancies were calculated. Cross-sections of each nerve were examined histologically, and axons counted. We transferred the LSN to target first the SSN and then the LTN, in a tension-free coaptation. For reference, we transferred the distal SAN to target the SSN and LTN and compared transfer parameters. RESULTS Three cadavers demonstrated 2 LSN branches supplying the levator scapulae. The axon count ratio of donor-to-recipient nerve was 1:4.0 (LSN:SSN) and 1:2.1 (LSN:LTN) for a single LSN branch and 1:3.0 (LSN:SSN) and 1:1.6 (LSN:LTN) when 2 LSN branches were available. Comparatively, the axon count ratio of donor-to-recipient nerve was 1:2.5 and 1:1.3 for the SAN to the SSN and the LTN, respectively. The mean redundancy from the LSN to the SSN and the LTN was 1.7 cm (SD, 3.1 cm) and 2.9 cm (SD, 2.8 cm), and the redundancy from the SAN to the SSN and the LTN was 4.5 (SD, 0.7 cm) and 0.75 cm (SD, 1.0 cm). CONCLUSIONS These data support the use of the LSN as a potential donor for direct nerve transfer to the SSN and LTN, given its adequate redundancy and size match. CLINICAL RELEVANCE The LSN should be considered as an alternative nerve donor source for brachial plexus reconstruction, especially in 5-level injuries with scarce donor nerves. If used in lieu of the SAN during primary nerve reconstruction, trapezius tendon transfer for improved external rotation would be enabled.
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Affiliation(s)
- Eliana B Saltzman
- Center for Brachial Plexus and Traumatic Nerve Injury, Hospital for Special Surgery
| | - Karthik Krishnan
- Center for Brachial Plexus and Traumatic Nerve Injury, Hospital for Special Surgery; Weill Medical College of Cornell University, New York, NY
| | - Mark J Winston
- Center for Brachial Plexus and Traumatic Nerve Injury, Hospital for Special Surgery
| | - Soumen Das De
- Center for Brachial Plexus and Traumatic Nerve Injury, Hospital for Special Surgery
| | - Steve K Lee
- Center for Brachial Plexus and Traumatic Nerve Injury, Hospital for Special Surgery; Weill Medical College of Cornell University, New York, NY
| | - Scott W Wolfe
- Center for Brachial Plexus and Traumatic Nerve Injury, Hospital for Special Surgery; Weill Medical College of Cornell University, New York, NY.
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Potu BK, Ravishankar MV. Innervation Patterns of the Pronator Teres Muscle and Their Possible Role in Neurotization: A Systematic Review of Cadaveric Studies. ACTA MEDICA (HRADEC KRÁLOVÉ) 2021; 64:77-84. [PMID: 34331426 DOI: 10.14712/18059694.2021.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Contrary to the classic anatomical description, many recent studies have reported wide variations in branching patterns and location of motor branches that are supplying the pronator teres muscle. To understand these variations and their implications in surgical procedures of the nerve transfers, a systematic review was performed on the innervation of pronator teres muscle from cadaveric studies. METHODS A systematic literature search was performed in databases such as Medline, PubMed, Google Scholar, SciELO, ScienceDirect, Cochrane reviews and orthopedics textbooks using the search terms "pronator teres nerve branches"; AND "number" OR "location" OR "length" OR "diameter" yielded 545 article links. Articles were evaluated according to PRISMA guidelines. RESULTS A total of twenty cadaveric studies including 648 branches have registered 52.9% of two branch innervation pattern followed by 31.3%-single branch pattern; 13.5%-three branch pattern; 1.7%-four branch pattern, and 0.4%-five branch patterns, respectively. Of the 403 branches studied for their location in relation with the humeral intercondylar line, most branches were located distal to the line (50.3%), followed by 32.7% (proximal to it) and 16.8% at the line, respectively. The distance of branches located proximal and distal to humeral intercondylar line was in the range of 1.25-10 cm, and 1.1-7.5 cm, respectively. The mean length and diameter of nerves reported were 4.37 ± 2.43 cm, and 1.5 mm, respectively. CONCLUSIONS Our data defined the morphometrics of nerve branches and they often met the required diameter for neurotization procedures. Our findings also demonstrated that the morphometrics, branching pattern and their location vary between populations and this information is very vital for surgeons during the nerve transfers.
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Affiliation(s)
- Bhagath Kumar Potu
- Department of Anatomy, College of Medicine and Medical Sciences, Arabian Gulf University, Kingdom of Bahrain.
| | - M V Ravishankar
- Department of Anatomy, JSS Medical College, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
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Lu CF, Wang B, Zhang PX, Han S, Pi W, Kou YH, Jiang BG. Combining chitin biological conduits with small autogenous nerves and platelet-rich plasma for the repair of sciatic nerve defects in rats. CNS Neurosci Ther 2021; 27:805-819. [PMID: 33838005 PMCID: PMC8193701 DOI: 10.1111/cns.13640] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 03/03/2021] [Accepted: 03/05/2021] [Indexed: 12/16/2022] Open
Abstract
Aims Peripheral nerve defects are often difficult to recover from, and there is no optimal repair method. Therefore, it is important to explore new methods of repairing peripheral nerve defects. This study explored the efficacy of nerve grafts constructed from chitin biological conduits combined with small autogenous nerves (SANs) and platelet‐rich plasma (PRP) for repairing 10‐mm sciatic nerve defects in rats. Methods To prepare 10‐mm sciatic nerve defects, SANs were first harvested and PRP was extracted. The nerve grafts consisted of chitin biological conduits combined with SAN and PRP, and were used to repair rat sciatic nerve defects. These examinations, including measurements of axon growth efficiency, a gait analysis, electrophysiological tests, counts of regenerated myelinated fibers and observations of their morphology, histological evaluation of the gastrocnemius muscle, retrograde tracing with Fluor‐Gold (FG), and motor endplates (MEPs) distribution analysis, were conducted to evaluate the repair status. Results Two weeks after nerve transplantation, the rate and number of regenerated axons in the PRP‐SAN group improved compared with those in the PRP, SAN, and Hollow groups. The PRP‐SAN group exhibited better recovery in terms of the sciatic functional index value, composite action potential intensity, myelinated nerve fiber density, myelin sheath thickness, and gastrectomy tissue at 12 weeks after transplantation, compared with the PRP and SAN groups. The results of FG retrograde tracing and MEPs analyses showed that numbers of FG‐positive sensory neurons and motor neurons as well as MEPs distribution density were higher in the PRP‐SAN group than in the PRP or SAN group. Conclusions Nerve grafts comprising chitin biological conduits combined with SANs and PRP significantly improved the repair of 10‐mm sciatic nerve defects in rats and may have therapeutic potential for repairing peripheral nerve defects in future applications.
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Affiliation(s)
- Chang-Feng Lu
- Department of Orthopedics and Trauma, Key Laboratory of Trauma and Neural Regeneration (Ministry of Education/Peking University, Peking University People's Hospital, Beijing, 100044, China
| | - Bo Wang
- Department of Orthopedics and Trauma, Key Laboratory of Trauma and Neural Regeneration (Ministry of Education/Peking University, Peking University People's Hospital, Beijing, 100044, China
| | - Pei-Xun Zhang
- Department of Orthopedics and Trauma, Key Laboratory of Trauma and Neural Regeneration (Ministry of Education/Peking University, Peking University People's Hospital, Beijing, 100044, China
| | - Shuai Han
- Department of Orthopedics and Trauma, Key Laboratory of Trauma and Neural Regeneration (Ministry of Education/Peking University, Peking University People's Hospital, Beijing, 100044, China
| | - Wei Pi
- Department of Orthopedics and Trauma, Key Laboratory of Trauma and Neural Regeneration (Ministry of Education/Peking University, Peking University People's Hospital, Beijing, 100044, China
| | - Yu-Hui Kou
- Department of Orthopedics and Trauma, Key Laboratory of Trauma and Neural Regeneration (Ministry of Education/Peking University, Peking University People's Hospital, Beijing, 100044, China
| | - Bao-Guo Jiang
- Department of Orthopedics and Trauma, Key Laboratory of Trauma and Neural Regeneration (Ministry of Education/Peking University, Peking University People's Hospital, Beijing, 100044, China
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Ding W, Li X, Pan J, Zhang P, Yin S, Zhou X, Li J, Wang L, Wang X, Dong J. Repair Method for Complete High Ulnar Nerve Injury Based on Nerve Magnified Regeneration. Ther Clin Risk Manag 2020; 16:155-168. [PMID: 32184608 PMCID: PMC7060778 DOI: 10.2147/tcrm.s237851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 02/18/2020] [Indexed: 12/04/2022] Open
Abstract
PURPOSE Complete high ulnar nerve injury can cause serious sequelae, including residual sensation and loss of movement and especially dysfunction of the intrinsic muscles of the hand. As a solution to treat complete high ulnar nerve injury, we proposed a new repair method for ulnar nerve injury based on nerve-magnified regeneration. METHODS Twenty-two patients with complete division of the ulnar nerve at a high level who were treated from May 2013 to December 2016 were divided into two groups. The proposed repair method for complete high ulnar nerve injury was performed in group I (11 patients), while the traditional repair method, ie, repair of the original injury site of the ulnar nerve, was used in group II (11 patients). RESULTS The results showed no significant difference in the mean sensory scores assigned by the Highet-Zachary scheme (the Highet Scale) between the two groups. The mean Highet Scale score of muscle strength for the first dorsal interosseus muscle was significantly better in group I than that in group II (p=0.010). In group I, 10 of 11 patients were graded as M4 or M5. Grip strength, pinch strength, and the Disabilities of the Arm, Shoulder, and Hand (DASH) score were significantly better in group I than those in group II (p<0.01). CONCLUSION Therefore, this method for complete high ulnar nerve injury based on nerve-magnified regeneration can shorten the path of motor nerve regeneration, effectively reduce atrophy of the intrinsic muscles of the hand, and provide better hand function.
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Affiliation(s)
- Wenquan Ding
- Department of Hand Surgery, Department of Plastic Reconstructive Surgery, Ningbo No. 6 Hospital, Ningbo315040, People’s Republic of China
| | - Xueyuan Li
- Department of Hand Surgery, Department of Plastic Reconstructive Surgery, Ningbo No. 6 Hospital, Ningbo315040, People’s Republic of China
| | - Jiadong Pan
- Department of Hand Surgery, Department of Plastic Reconstructive Surgery, Ningbo No. 6 Hospital, Ningbo315040, People’s Republic of China
| | - Peixun Zhang
- Department of Trauma Orthopedics, Peking University People’s Hospital, Beijing100044, People’s Republic of China
| | - Shanqing Yin
- Department of Hand Surgery, Department of Plastic Reconstructive Surgery, Ningbo No. 6 Hospital, Ningbo315040, People’s Republic of China
| | - Xianting Zhou
- Department of Hand Surgery, Department of Plastic Reconstructive Surgery, Ningbo No. 6 Hospital, Ningbo315040, People’s Republic of China
| | - Junjie Li
- Department of Hand Surgery, Department of Plastic Reconstructive Surgery, Ningbo No. 6 Hospital, Ningbo315040, People’s Republic of China
| | - Liping Wang
- Department of Hand Surgery, Department of Plastic Reconstructive Surgery, Ningbo No. 6 Hospital, Ningbo315040, People’s Republic of China
- School of Pharmacy and Medical Sciences, and UniSA Cancer Research Institute, University of South Australia, Adelaide, SA5001, Australia
| | - Xin Wang
- Department of Hand Surgery, Department of Plastic Reconstructive Surgery, Ningbo No. 6 Hospital, Ningbo315040, People’s Republic of China
| | - Jianghui Dong
- Department of Hand Surgery, Department of Plastic Reconstructive Surgery, Ningbo No. 6 Hospital, Ningbo315040, People’s Republic of China
- School of Pharmacy and Medical Sciences, and UniSA Cancer Research Institute, University of South Australia, Adelaide, SA5001, Australia
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11
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Fang X, Deng J, Zhang W, Guo H, Yu F, Rao F, Li Q, Zhang P, Bai S, Jiang B. Conductive conduit small gap tubulization for peripheral nerve repair. RSC Adv 2020; 10:16769-16775. [PMID: 35498832 PMCID: PMC9053044 DOI: 10.1039/d0ra02143a] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Accepted: 04/01/2020] [Indexed: 11/21/2022] Open
Abstract
Despite advances in surgical techniques, functional recovery following epineurial neurorrhaphy of transected peripheral nerves often remains quite unsatisfactory. Small gap tubulisation is a promising approach that has shown potential to traditional epineurial neurorrhaphy in the treatment of peripheral nerve injury. Thus, the goal of this study is to evaluate sciatic nerve regeneration after nerve transection, followed by small gap tubulization using a reduced graphene oxide-based conductive conduit. In vitro, the electrically conductive conduit could promote Schwann cell proliferation through PI3K/Akt signaling pathway activation. In vivo, the results of electrophysiological and walking track analysis suggest that the electrically conductive conduit could promote sensory and motor nerve regeneration and functional recovery, which is based on the mechanisms of selective regeneration and multiple-bud regeneration. These promising results illustrate electrically conductive conduit small gap tubulization as an alternative approach for transected peripheral nerve repair. rGO-based conductive nerve conduit as a scaffold to bridge peripheral nerve transected injury and 2 mm gap provides a suitable microenvironment for axons selective regeneration.![]()
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12
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Matavelli Júnior FC, Gobbi L, Santos MPSD, Caetano EB, Vieira LA, Andrade RAD. TRANSFER OF THE RADIAL NERVE BRANCHES FOR THE TREATMENT OF THE ANTERIOR INTEROSSEOUS NERVE LESION: AN ANATOMICAL STUDY. ACTA ORTOPEDICA BRASILEIRA 2019; 27:298-303. [PMID: 31798319 PMCID: PMC6870542 DOI: 10.1590/1413-785220192706226097] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objective: This anatomical study aimed to analyze the possibility of transferring the radial nerve branches destined to the brachioradialis (BR), extensor carpi radialis longus (ECRL), extensor carpi radialis brevis (ECRB), and supinator (SM) muscles to innervate the AIN. Methods: Ten limbs from five male cadavers were prepared by intra-arterial injection of a solution of 10% glycerol and formalin. Results: The presence of only one branch to the BR muscle was noted in 7 limbs and two branches were noted in three limbs. In two members of a common trunk with branch to the ECRL. In eight cases, we identified one branch for the ERLC and two branches in two cases. We identified only one branch for the ECRB, while in six limbs, two branches were noted, penetrating the muscular body at two different points. We identified at least two branches innervating the supinator muscle. The AIN was detached from the median nerve distal to the intercondylar line of the humerus. In seven limbs, it originated from the nervous fascicles of the posterior region of the median nerve and from the posterolateral fascicles in three limbs. The flexor pollicis longus and flexor digitorum profundus muscles received more than one branch of the AIN in all limbs. Conclusion: The radial nerve branches for the ECRL, ECRB, and supinator muscles can be transferred directly to the AIN or to one of its branches after intraneural dissection, without tension even in elbow movements. Level of Evidence IV; Case series.
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Affiliation(s)
| | - Lucas Gobbi
- Pontifícia Universidade Católica de São Paulo, Brazil
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13
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Caetano EB, Vieira LA, Sabongi Neto JJ, Caetano MF, Sabongi RG, Cruz BAP. Anatomical Study of Innervation of the Supinator Muscle to Reinnervate the Posterior Interosseous Nerve. Rev Bras Ortop 2019; 54:253-260. [PMID: 31363278 PMCID: PMC6597431 DOI: 10.1055/s-0039-1692459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 05/15/2018] [Indexed: 11/09/2022] Open
Abstract
Objective
The purpose of this anatomical study was to analyze the possibility of transferring radial nerve branches to the supinator muscle to reinnervate the posterior interosseous nerve (PIN) originating from the C7–T1 roots.
Methods
Thirty members of 15 cadavers, all male, prepared with an intra-arterial glycerol and formaldehyde solution injection, were dissected.
Results
All dissected limbs presented at least one branch intended for the superficial and the deep heads of the supinator muscle. These branches originated from the PIN. A branch to the supinator muscle, proximal to the arcade of Frohse, was identified in six members. In addition, 2 and 3 branches to the supinator muscle were found in 11 and 4 members, respectively. In two limbs, only one branch detached from the PIN, but it duplicated itself proximal to the arcade of Frohse. Seven limbs had no branches to the supinator muscle at the region proximal to the arcade of Frohse. The branches destined for the supinator muscle were sectioned at the neuromuscular junction for connection with no tension to the PIN. The combined diameter of the branches for the supinator muscle corresponded, on average, to 53.5% of the PIN diameter.
Conclusion
The radial nerve branches intended for the supinator muscle can be transferred, with no tension, directly to the PIN to restore thumb and finger extension in patients with C7–T1 brachial plexus lesions.
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Affiliation(s)
- Edie Benedito Caetano
- Faculdade de Ciências Médicas e da Saúde, Pontifícia Universidade Católica de São Paulo, Sorocaba, SP, Brasil
| | - Luiz Angelo Vieira
- Faculdade de Ciências Médicas e da Saúde, Pontifícia Universidade Católica de São Paulo, Sorocaba, SP, Brasil
| | | | | | - Rodrigo Guerra Sabongi
- Residência Médica em Ortopedia, Universidade Federal do Estado de São Paulo (UNIFESP), São Paulo, SP, Brasil
| | - Bruno Azi Pacileo Cruz
- Faculdade de Ciências Médicas e da Saúde, Pontifícia Universidade Católica de São Paulo, Sorocaba, SP, Brasil
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14
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Caetano EB, Vieira LA, Cavalheiro CS, Arcuri MH, Sabongi RG. Anatomical study of the transfer of flexor digitorum superficialis nerve branch of median nerve to restore wrist extension and forearm pronation. EINSTEIN-SAO PAULO 2019; 17:eAO4489. [PMID: 31271607 PMCID: PMC6611088 DOI: 10.31744/einstein_journal/2019ao4489] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 11/05/2018] [Indexed: 12/05/2022] Open
Abstract
Objective To analyze the anatomical variations of the innervation of the flexor digitorum superficialis muscle and to determine if the branch of the median nerve that supply this muscle is connected to the branches to the extensor carpi radialis brevis and the pronator teres muscles, without tension, and how close to the target-muscles the transfer can be performed. Methods Fifty limbs of 25 cadavers were dissected to collect data on the anatomical variations of the branches to the flexor digitorum superficialis muscle. Results This muscle received innervation from the median nerve in the 50 limbs. In 22 it received one branch, and in 28 more than one. The proximal branch was identified in 22 limbs, and in 12 limbs it shared branches with other muscles. The distal branch was present in all, and originated from the median nerve as an isolated branch, or a common trunk with the anterior interosseous nerve in 3 limbs, and from a common trunk with the flexor carpi radialis muscle and anterior interosseous nerve in another. It originated distally to the anterior interosseous nerve at 38, in 5 on the same level, and in 3 proximal to the anterior interosseous nerve. In four limbs, innervation came from the anterior interosseous nerve, as well as from the median nerve. Accessory branches of the median nerve for the distal portion of the flexor digitorum superficialis muscle were present in eight limbs. Conclusion In 28 limbs with two or more branches, one of them could be connected to the branches to the extensor carpi radialis brevis and pronator teres muscles without tension, even during the pronation and supination movements of the forearm and flexion-extension of the elbow.
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15
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Biological activity of laminin/polylaminin-coated poly-ℇ-caprolactone filaments on the regeneration and tissue replacement of the rat sciatic nerve. Mater Today Bio 2019; 3:100026. [PMID: 32159152 PMCID: PMC7061579 DOI: 10.1016/j.mtbio.2019.100026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 08/07/2019] [Accepted: 08/12/2019] [Indexed: 01/13/2023] Open
Abstract
Unlike the central nervous system, peripheral nerves can regenerate after injury. However, depending on the size of the lesion, the endogenous regenerative potential is not enough to replace the lost nerve tissue. Many strategies have been used to generate biomaterials capable of restoring nerve functions. Here, we set out to investigate whether adsorbing the extracellular matrix protein, laminin (LM), to poly-ℇ-caprolactone (PCL) filaments would enhance functional nerve regeneration. Initial in vitro studies showed that explants of dorsal root ganglia (DRGs) of P1 neonate mice exhibited stronger neuritogenesis on a substrate of LM that had been previously polymerized (polylaminin [polyLM]) than on ordinary LM. On the other hand, when silicone tubes filled with PCL filaments were used to bridge a 10-mm sciatic nerve gap in rats, only filaments coated with LM improved tissue replacement beyond that obtained with empty tubes. Motor function recovery correlated with tissue replacement as only LM-coated filaments consistently improved motor skills. Finally, analysis of the lateral gastrocnemius muscle revealed that the LM group presented twice the amount of α-bungarotixin–labeled motor plates. In conclusion, although polyLM was more effective in stimulating growth of sensory fibers out of DRGs in vitro, LM adsorbed to PCL filaments exhibited the best regenerative properties in inducing functional motor recovery after peripheral injury in vivo.
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16
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Frank K, Englbrecht M, Koban KC, Cotofana SC, Stewart JK, Giunta RE, Schenck TL. Nerve transfer of the anterior interosseous nerve to the thenar branch of the median nerve – an anatomical and histological analysis. J Plast Reconstr Aesthet Surg 2019; 72:751-758. [DOI: 10.1016/j.bjps.2018.12.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 11/22/2018] [Accepted: 12/02/2018] [Indexed: 10/27/2022]
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17
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Li L, Li Y, Fan Z, Wang X, Li Z, Wen J, Deng J, Tan D, Pan M, Hu X, Zhang H, Lai M, Guo J. Ascorbic Acid Facilitates Neural Regeneration After Sciatic Nerve Crush Injury. Front Cell Neurosci 2019; 13:108. [PMID: 30949031 PMCID: PMC6437112 DOI: 10.3389/fncel.2019.00108] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Accepted: 03/05/2019] [Indexed: 12/14/2022] Open
Abstract
Ascorbic acid (AA) is an essential micronutrient that has been safely used in the clinic for many years. The present study indicates that AA has an unexpected function in facilitating nerve regeneration. Using a mouse model of sciatic nerve crush injury, we found that AA can significantly accelerate axonal regrowth in the early stage [3 days post-injury (dpi)], a finding that was revealed by immunostaining and Western blotting for antibodies against GAP-43 and SCG10. On day 28 post-injury, histomorphometric assessments demonstrated that AA treatment increased the density, size, and remyelination of regenerated axons in the injured nerve and alleviated myoatrophy in the gastrocnemius. Moreover, the results from various behavioral tests and electrophysiological assays revealed that nerve injury-derived functional defects in motor and sensory behavior as well as in nerve conduction were significantly attenuated by treatment with AA. The potential mechanisms of AA in nerve regeneration were further explored by investigating the effects of AA on three types of cells involved in this process [neurons, Schwann cells (SCs) and macrophages] through a series of experiments. Overall, the data illustrated that AA treatment in cultured dorsal root ganglionic neurons resulted in increased neurite growth and lower expression of RhoA, which is an important inhibitory factor in neural regeneration. In SCs, proliferation, phagocytosis, and neurotrophin expression were all enhanced by AA. Meanwhile, AA treatment also improved proliferation, migration, phagocytosis, and anti-inflammatory polarization in macrophages. In conclusion, this study demonstrated that treatment with AA can promote the morphological and functional recovery of injured peripheral nerves and that this effect is potentially due to AA’s bioeffects on neurons, SCs and macrophages, three of most important types of cells involved in nerve injury and regeneration.
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Affiliation(s)
- Lixia Li
- Guangdong Provincial Key Laboratory of Construction and Detection in Tissue Engineering, Southern Medical University, Guangzhou, China.,Department of Histology and Embryology, Southern Medical University, Guangzhou, China.,Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, China
| | - Yuanyuan Li
- Guangdong Provincial Key Laboratory of Construction and Detection in Tissue Engineering, Southern Medical University, Guangzhou, China.,Department of Histology and Embryology, Southern Medical University, Guangzhou, China
| | - Zhihao Fan
- Guangdong Provincial Key Laboratory of Construction and Detection in Tissue Engineering, Southern Medical University, Guangzhou, China.,Department of Histology and Embryology, Southern Medical University, Guangzhou, China
| | - Xianghai Wang
- Guangdong Provincial Key Laboratory of Construction and Detection in Tissue Engineering, Southern Medical University, Guangzhou, China.,Department of Histology and Embryology, Southern Medical University, Guangzhou, China.,Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, China.,Key Laboratory of Mental Health of the Ministry of Education, Southern Medical University, Guangzhou, China
| | - Zhenlin Li
- Guangdong Provincial Key Laboratory of Construction and Detection in Tissue Engineering, Southern Medical University, Guangzhou, China.,Department of Histology and Embryology, Southern Medical University, Guangzhou, China
| | - Jinkun Wen
- Guangdong Provincial Key Laboratory of Construction and Detection in Tissue Engineering, Southern Medical University, Guangzhou, China.,Department of Histology and Embryology, Southern Medical University, Guangzhou, China
| | - Junyao Deng
- Guangdong Provincial Key Laboratory of Construction and Detection in Tissue Engineering, Southern Medical University, Guangzhou, China.,Department of Histology and Embryology, Southern Medical University, Guangzhou, China
| | - Dandan Tan
- Guangdong Provincial Key Laboratory of Construction and Detection in Tissue Engineering, Southern Medical University, Guangzhou, China.,Department of Histology and Embryology, Southern Medical University, Guangzhou, China
| | - Mengjie Pan
- Guangdong Provincial Key Laboratory of Construction and Detection in Tissue Engineering, Southern Medical University, Guangzhou, China.,Department of Histology and Embryology, Southern Medical University, Guangzhou, China
| | - Xiaofang Hu
- Guangdong Provincial Key Laboratory of Construction and Detection in Tissue Engineering, Southern Medical University, Guangzhou, China.,Department of Histology and Embryology, Southern Medical University, Guangzhou, China.,Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, China
| | - Haowen Zhang
- Guangdong Provincial Key Laboratory of Construction and Detection in Tissue Engineering, Southern Medical University, Guangzhou, China.,Department of Histology and Embryology, Southern Medical University, Guangzhou, China
| | - Muhua Lai
- Guangdong Provincial Key Laboratory of Construction and Detection in Tissue Engineering, Southern Medical University, Guangzhou, China.,Department of Histology and Embryology, Southern Medical University, Guangzhou, China
| | - Jiasong Guo
- Guangdong Provincial Key Laboratory of Construction and Detection in Tissue Engineering, Southern Medical University, Guangzhou, China.,Department of Histology and Embryology, Southern Medical University, Guangzhou, China.,Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, China.,Key Laboratory of Mental Health of the Ministry of Education, Southern Medical University, Guangzhou, China
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18
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Wang ZY, Qin LH, Zhang WG, Zhang PX, Jiang BG. Qian-Zheng-San promotes regeneration after sciatic nerve crush injury in rats. Neural Regen Res 2019; 14:683-691. [PMID: 30632509 PMCID: PMC6352607 DOI: 10.4103/1673-5374.247472] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Qian-Zheng-San, a traditional Chinese prescription consisting of Typhonii Rhizoma, Bombyx Batryticatus, Scorpio, has been found to play an active therapeutic role in central nervous system diseases. However, it is unclear whether Qian-Zheng-San has therapeutic value for peripheral nerve injury. Therefore, we used Sprague-Dawley rats to investigate this. A sciatic nerve crush injury model was induced by clamping the right sciatic nerve. Subsequently, rats in the treatment group were administered 2 mL Qian-Zheng-San (1.75 g/mL) daily as systemic therapy for 1, 2, 4, or 8 weeks. Rats in the control group were not administered Qian-Zheng-San. Rats in sham group did not undergo surgery and systemic therapy. Footprint analysis was used to assess nerve motor function. Electrophysiological experiments were used to detect nerve conduction function. Immunofluorescence staining was used to assess axon counts and morphological analysis. Immunohistochemical staining was used to observe myelin regeneration of the sciatic nerve and the number of motoneurons in the anterior horn of the spinal cord. At 2 and 4 weeks postoperatively, the sciatic nerve function index, nerve conduction velocity, the number of distant regenerated axons and the axon diameter of the sciatic nerve increased in the Qian-Zheng-San treatment group compared with the control group. At 2 weeks postoperatively, nerve fiber diameter, myelin thickness, and the number of motor neurons in the lumbar spinal cord anterior horn increased in the Qian-Zheng-San treatment group compared with the control group. These results indicate that Qian-Zheng-San has a positive effect on peripheral nerve regeneration.
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Affiliation(s)
- Zhi-Yong Wang
- Department of Anatomy and Histo-embryology, School of Basic Medical Sciences, Peking University, Beijing, China
| | - Li-Hua Qin
- Department of Anatomy and Histo-embryology, School of Basic Medical Sciences, Peking University, Beijing, China
| | - Wei-Guang Zhang
- Department of Anatomy and Histo-embryology, School of Basic Medical Sciences, Peking University, Beijing, China
| | - Pei-Xun Zhang
- Department of Trauma and Orthopedics, Peking University People's Hospital, Beijing, China
| | - Bao-Guo Jiang
- Department of Trauma and Orthopedics, Peking University People's Hospital, Beijing, China
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19
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Kou YH, Jiang BG, Yu F, Yu YL, Niu SP, Zhang PX, Yin XF, Han N, Zhang YJ, Zhang DY. Repair of long segmental ulnar nerve defects in rats by several different kinds of nerve transposition. Neural Regen Res 2019; 14:692-698. [PMID: 30632510 PMCID: PMC6352591 DOI: 10.4103/1673-5374.247473] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Multiple regeneration of axonal buds has been shown to exist during the repair of peripheral nerve injury, which confirms a certain repair potential of the injured peripheral nerve. Therefore, a systematic nerve transposition repair technique has been proposed to treat severe peripheral nerve injury. During nerve transposition repair, the regenerated nerve fibers of motor neurons in the anterior horn of the spinal cord can effectively grow into the repaired distal nerve and target muscle tissues, which is conducive to the recovery of motor function. The aim of this study was to explore regeneration and nerve functional recovery after repairing a long-segment peripheral nerve defect by transposition of different donor nerves. A long-segment (2 mm) ulnar nerve defect in Sprague-Dawley rats was repaired by transposition of the musculocutaneous nerve, medial pectoral nerve, muscular branches of the radial nerve and anterior interosseous nerve (pronator quadratus muscle branch). In situ repair of the ulnar nerve was considered as a control. Three months later, wrist flexion function, nerve regeneration and innervation muscle recovery in rats were assessed using neuroelectrophysiological testing, osmic acid staining and hematoxylin-eosin staining, respectively. Our findings indicate that repair of a long-segment ulnar nerve defect with different donor nerve transpositions can reinnervate axonal function of motor neurons in the anterior horn of spinal cord and restore the function of affected limbs to a certain extent.
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20
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Jiang BG, Han N, Rao F, Wang YL, Kou YH, Zhang PX. Advance of Peripheral Nerve Injury Repair and Reconstruction. Chin Med J (Engl) 2018; 130:2996-2998. [PMID: 29237933 PMCID: PMC5742928 DOI: 10.4103/0366-6999.220299] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Bao-Guo Jiang
- Department Trauma and Orthopedics, Peking University People's Hospital, Beijing 100044, China
| | - Na Han
- Center Laboratory, Peking University People's Hospital, Beijing 100044, China
| | - Feng Rao
- Department Trauma and Orthopedics, Peking University People's Hospital, Beijing 100044, China
| | - Yi-Lin Wang
- Department Trauma and Orthopedics, Peking University People's Hospital, Beijing 100044, China
| | - Yu-Hui Kou
- Department Trauma and Orthopedics, Peking University People's Hospital, Beijing 100044, China
| | - Pei-Xun Zhang
- Department Trauma and Orthopedics, Peking University People's Hospital, Beijing 100044, China
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21
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Caetano EB, Vieira LA, Sabongi RG, Correio LM, Ogata KK, Boni EBDS. TRANSFER OF NERVE BRANCHES OF THE FLEXOR CARPI RADIALIS TO THE POSTERIOR INTEROSSEOUS NERVE. ACTA ORTOPEDICA BRASILEIRA 2018; 26:222-226. [PMID: 30210248 PMCID: PMC6131275 DOI: 10.1590/1413-785220182604191853] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objective: The objective of this paper was to study the anatomical variations of the flexor carpi radialis muscle (FCR) and determine in cadaver limbs whether the FCR nervous branch can be connected to the posterior interosseous nerve (PIN) without tension and how close to the target muscles the transfer can be performed. Method: Thirty cadaveric upper limbs were dissected. Results: The FCR received exclusive innervation of the median nerve, distally to the intercondylar line of the humerus. In 5 limbs, an isolated branch was found and in 25, a common trunk with other nervous branches occurred. We investigated whether the branch for the FCR was long enough to be transferred to the PIN. The diameter of the nerve branch for the FCR corresponded on average to 50% of the PIN. Conclusion: In 12 limbs, the branch destined to the FCR could be connected to the PIN, distally to the nerve branches to the supinator muscle even during the movements of the forearm and the elbow. In 18 specimens, it was necessary to mobilize the PIN for this innervation. Level of Evidence IV, Case Series.
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22
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Wen J, Han Y, Guo S, Yang M, Li L, Sun G, Wang J, Hu F, Liang J, Wei L, Zhou Q, Zhang W, Tan J. Recovery of respiratory function and autonomic diaphragm movement following unilateral recurrent laryngeal nerve to phrenic nerve anastomosis in rabbits. J Neurosurg Spine 2018; 29:470-480. [PMID: 29979142 DOI: 10.3171/2017.12.spine17849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The authors studied restoration of respiratory function in rabbits, using the recurrent laryngeal nerve to restore function after the phrenic nerve had been severed. The results of this animal study are encouraging and suggest that a similar technique could possibly be used to help patients with severe cervical spinal cord injuries.
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Affiliation(s)
- Junxiang Wen
- 1Department of Orthopaedics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine.,Departments of3Spine Surgery and
| | | | - Song Guo
- Departments of3Spine Surgery and
| | | | - Lijun Li
- Departments of3Spine Surgery and
| | - Guixin Sun
- 4Traumatology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jun Wang
- 2Shanghai Key Laboratory for Bone and Joint Diseases, Shanghai Institute of Orthopedics and Traumatology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine; and
| | - Fangqiong Hu
- 2Shanghai Key Laboratory for Bone and Joint Diseases, Shanghai Institute of Orthopedics and Traumatology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine; and
| | - Jing Liang
- 2Shanghai Key Laboratory for Bone and Joint Diseases, Shanghai Institute of Orthopedics and Traumatology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine; and
| | - Li Wei
- 2Shanghai Key Laboratory for Bone and Joint Diseases, Shanghai Institute of Orthopedics and Traumatology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine; and
| | - Qi Zhou
- 2Shanghai Key Laboratory for Bone and Joint Diseases, Shanghai Institute of Orthopedics and Traumatology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine; and
| | - Weibin Zhang
- 1Department of Orthopaedics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine.,2Shanghai Key Laboratory for Bone and Joint Diseases, Shanghai Institute of Orthopedics and Traumatology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine; and
| | - Jun Tan
- Departments of3Spine Surgery and
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Jiang BG, Yin XF, Deng JX, Weng J, Kou YH, Zhang PX, Wang YH, Han N. Territory maximization hypothesis during peripheral nerve regeneration. Neural Regen Res 2018; 13:230-231. [PMID: 29557367 PMCID: PMC5879889 DOI: 10.4103/1673-5374.226393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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24
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Peixun Z, Na H, Kou Y, Xiaofeng Y, Jiang B. Peripheral nerve intersectional repair by bi-directional induction and systematic remodelling: biodegradable conduit tubulization from basic research to clinical application. ARTIFICIAL CELLS NANOMEDICINE AND BIOTECHNOLOGY 2017; 45:1464-1466. [PMID: 28884592 DOI: 10.1080/21691401.2017.1373658] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
In terms of the clinical effect of peripheral nerve injury repair, the biological degradable conduit 2 mm small gap tubulization is far better than the traditional epineurial or perineurium neurorrhaphy. The assumption of the bi-directional induction between the central system and the terminal effector during peripheral nerve regeneration is purposed and proved in clinical by our group. The surgical approach of transferring a portion of or the whole contralateral C7 nerve to repair a part of or the whole ipsilateral brachial plexus injury is clinically promoted, in which the most important idea and practice is to use the cone conduit designed by the group to repair thick nerves with fine nerves. Some of the patients suffering from cerebral palsy or cerebral haemorrhage and those who got cerebral infarction yet have not reached recovery after 3-6 months could regain some functions of the ipsilateral upper limb and improve the life quality by transfer of a portion of or the whole contralateral C7 nerve and connection by cone conduit.
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Affiliation(s)
- Zhang Peixun
- a Trauma & Orthopaedics Department , Peking University People's Hospital , Beijing , China
| | - Han Na
- b Center Laboratory, Peking University People's Hospital , Beijing , China
| | - Yuhui Kou
- a Trauma & Orthopaedics Department , Peking University People's Hospital , Beijing , China
| | - Yin Xiaofeng
- a Trauma & Orthopaedics Department , Peking University People's Hospital , Beijing , China
| | - Baoguo Jiang
- a Trauma & Orthopaedics Department , Peking University People's Hospital , Beijing , China
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Deng JX, Zhang DY, Li M, Weng J, Kou YH, Zhang PX, Han N, Chen B, Yin XF, Jiang BG. Autologous transplantation with fewer fibers repairs large peripheral nerve defects. Neural Regen Res 2017; 12:2077-2083. [PMID: 29323049 PMCID: PMC5784358 DOI: 10.4103/1673-5374.221167] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Peripheral nerve injury is a serious disease and its repair is challenging. A cable-style autologous graft is the gold standard for repairing long peripheral nerve defects; however, ensuring that the minimum number of transplanted nerve attains maximum therapeutic effect remains poorly understood. In this study, a rat model of common peroneal nerve defect was established by resecting a 10-mm long right common peroneal nerve. Rats receiving transplantation of the common peroneal nerve in situ were designated as the in situ graft group. Ipsilateral sural nerves (10–30 mm long) were resected to establish the one sural nerve graft group, two sural nerves cable-style nerve graft group and three sural nerves cable-style nerve graft group. Each bundle of the peroneal nerve was 10 mm long. To reduce the barrier effect due to invasion by surrounding tissue and connective-tissue overgrowth between neural stumps, small gap sleeve suture was used in both proximal and distal terminals to allow repair of the injured common peroneal nerve. At three months postoperatively, recovery of nerve function and morphology was observed using osmium tetroxide staining and functional detection. The results showed that the number of regenerated nerve fibers, common peroneal nerve function index, motor nerve conduction velocity, recovery of myodynamia, and wet weight ratios of tibialis anterior muscle were not significantly different among the one sural nerve graft group, two sural nerves cable-style nerve graft group, and three sural nerves cable-style nerve graft group. These data suggest that the repair effect achieved using one sural nerve graft with a lower number of nerve fibers is the same as that achieved using the two sural nerves cable-style nerve graft and three sural nerves cable-style nerve graft. This indicates that according to the ‘multiple amplification’ phenomenon, one small nerve graft can provide a good therapeutic effect for a large peripheral nerve defect.
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Affiliation(s)
- Jiu-Xu Deng
- Department of Orthopedics and Trauma, Peking University People's Hospital, Beijing, China
| | - Dian-Yin Zhang
- Department of Orthopedics and Trauma, Peking University People's Hospital, Beijing, China
| | - Ming Li
- Department of Orthopedics and Trauma, Peking University People's Hospital, Beijing, China
| | - Jian Weng
- Department of Orthopedics and Trauma, Peking University People's Hospital, Beijing, China
| | - Yu-Hui Kou
- Department of Orthopedics and Trauma, Peking University People's Hospital, Beijing, China
| | - Pei-Xun Zhang
- Department of Orthopedics and Trauma, Peking University People's Hospital, Beijing, China
| | - Na Han
- Department of Orthopedics and Trauma, Peking University People's Hospital, Beijing, China
| | - Bo Chen
- Department of Orthopedics and Trauma, Peking University People's Hospital, Beijing, China
| | - Xiao-Feng Yin
- Department of Orthopedics and Trauma, Peking University People's Hospital, Beijing, China
| | - Bao-Guo Jiang
- Department of Orthopedics and Trauma, Peking University People's Hospital, Beijing, China
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Schenck TL, Lin S, Stewart JK, Koban KC, Aichler M, Rezaeian F, Giunta RE. Sensory reanimation of the hand by transfer of the superficial branch of the radial nerve to the median and ulnar nerve. Brain Behav 2016; 6:e00578. [PMID: 28032001 PMCID: PMC5166995 DOI: 10.1002/brb3.578] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Revised: 07/17/2016] [Accepted: 08/10/2016] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND It remains a surgical challenge to treat high-grade nerve injuries of the upper extremity. Extra-anatomic reconstructions through the transfer of peripheral nerves have gained clinical importance over the past decades. This contribution outlines the anatomic and histomorphometric basis for the transfer of the superficial branch of the radial nerve (SBRN) to the median nerve (MN) and the superficial branch of the ulnar nerve (SBUN). METHODS The SBRN, MN, and SBUN were identified in 15 specimens and the nerve transfer performed. A favorable site for coaptation was chosen and its location described using relevant anatomical landmarks. Histomorphometric characteristics of donor and target were compared to evaluate the chances of a clinical success. RESULTS A suitable location for dissecting the SBRN was identified prior to its first bifurcation. Coaptations were possible near the pronator quadratus muscle, approximately 22 cm distal to the lateral epicondyle of the humerus. The MN and SBUN had to be dissected interfasciculary over 82 ± 5.7 mm and 49 ± 5.5 mm, respectively. Histomorphometric analysis revealed sufficient donor-to-recipient axon ratios for both transfers and identified the SBRN as a suitable donor with high axon density. CONCLUSION Our anatomic and histomorphometric results indicate that the SBRN is a suitable donor for the MN and SBUN at wrist level. The measurements show feasibility of this procedure and shall help in planning this sensory nerve transfer. High axon density in the SBRN identifies it or its branches an ideal candidate for sensory reanimation of fingers and thumbs.
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Affiliation(s)
- Thilo L Schenck
- Hand Surgery, Plastic Surgery and Aesthetic Surgery Ludwig-Maximilians-University Munich Munich Germany
| | - Shenyu Lin
- Hand Surgery, Plastic Surgery and Aesthetic Surgery Ludwig-Maximilians-University Munich Munich Germany
| | - Jessica K Stewart
- Department of Obstetrics and Gynecology University Hospital rechts der Isar Technical University Munich Munich Germany
| | - Konstantin C Koban
- Hand Surgery, Plastic Surgery and Aesthetic Surgery Ludwig-Maximilians-University Munich Munich Germany
| | - Michaela Aichler
- Research Unit Analytical Pathology Helmholtzzentrum München German Research Center for Environmental Health Munich Germany
| | - Farid Rezaeian
- Department of Plastic Surgery and Hand Surgery University Hospital Zurich Zurich Switzerland
| | - Riccardo E Giunta
- Hand Surgery, Plastic Surgery and Aesthetic Surgery Ludwig-Maximilians-University Munich Munich Germany
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Restoration of ulnar nerve motor function by pronator quadratus motor branch: an anatomical study. Acta Neurochir (Wien) 2016; 158:755-759. [PMID: 26860598 DOI: 10.1007/s00701-016-2728-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Accepted: 01/27/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND The traditional surgical approach to repair of brachial plexus lesions involves use of whole segment ulnar nerve graft for contralateral seventh cervical (cC7) nerve root transfer, which sabotages the possibility of ulnar nerve recovery. We assessed the anatomical feasibility of a new approach that involves preservation of the motor branch of ulnar nerve (MBUN), for a later stage repair using the recovered pronator quadratus motor branch (PQMB), subsequent to the cC7 transfer procedure. METHODS Twenty-seven adult cadaver arms and one side of fresh adult cadaver were used in this study. The anterior interosseous nerve and its PQMB, as well as the motor and sensory branches of the ulnar nerve were dissected. The distances from the end of PQMB to the mid-point of a line joining the radial styloid and ulnar styloid, as well as to the point of divergence of the ulnar nerve, were measured. The MBUN was dissected from distal to proximal and the maximum length was measured. The diameter and number of axons of the nerve branches were also recorded. RESULTS The distance from the end of the PQMB to the midpoint of the radial styloid and ulnar styloid was 6.04 ± 0.52 cm, and that to the point of divergence of the ulnar nerve was 8.02 ± 0.63 cm. The maximum length of the MBUN after its dissociation was 9.70 ± 1.38 cm. The mean diameters of axons of the MBUN and PQMB were 0.09 ± 0.02 cm and 0.05 ± 0.01 cm, respectively. The corresponding mean numbers of axons were 2913 ± 624 and 757 ± 183, respectively. CONCLUSIONS The results indicate that the PQMB is suitable for transferring to the MBUN without nerve graft. This anatomical study paves the way for further testing of this new procedure after cC7 transfer in clinical settings.
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Krarup C, Boeckstyns M, Ibsen A, Moldovan M, Archibald S. Remodeling of motor units after nerve regeneration studied by quantitative electromyography. Clin Neurophysiol 2016; 127:1675-1682. [DOI: 10.1016/j.clinph.2015.08.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Revised: 07/16/2015] [Accepted: 08/13/2015] [Indexed: 10/23/2022]
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Sukegawa K, Suzuki T, Ogawa Y, Kobayashi T, Matsuura Y, Kuniyoshi K. A Cadaver Study of Median-to-Radial Nerve Transfer for Radial Nerve Injuries. J Hand Surg Am 2016; 41:20-6. [PMID: 26710730 DOI: 10.1016/j.jhsa.2015.10.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 10/15/2015] [Accepted: 10/15/2015] [Indexed: 02/02/2023]
Abstract
PURPOSE To assess the anatomic feasibility of a median-to-radial nerve transfer in cadaver limbs and to quantify the number of axons present in the cut ends of the involved donor and recipient nerves. METHODS Ten fresh frozen cadaveric upper limbs were dissected. We investigated whether the flexor carpi radialis (FCR) branch/flexor digitorum superficialis (FDS) branch (donor nerve) reached the posterior interosseous nerve (PIN)/extensor carpi radialis brevis (ECRB) branch (recipient nerve) without tension. We also investigated the length of the transected supinator fascia for FCR-posterior interosseous nerve transfer and the FDS-ECRB positional relationship using the epicondyle line and the midline of the forearm as axes. The findings were used for these 2 types of nerve transfer with evaluation closer to the target muscles. The distance between the point at which the FDS and ECRB branches met and the point at which the ECRB branch entered the muscle was measured. After nerve coaptation, the axon number was determined by histological evaluation. RESULTS In all limbs, the FCR and FDS branches reached the PIN and the ECRB branch without tension. The transected supinator fascia was 17 (3-25) mm long. The point at which the FDS branch reached the ECRB branch [corrected] was 48 (23-65) mm distal to the epicondyle line and approximately 23 (18-27) mm radial to the midline of the forearm. The distance between the point at which the FDS and ECRB branches met and the point at which the ECRB branch entered the muscle was 27 (17-40) mm. The mean axon numbers were FCR, 1501 (932-3022); PIN, 5162 (4325-7732); FDS, 885 (558-962); and ECRB, 548 (433-723). CONCLUSIONS The FCR branch could be transferred to the PIN [corrected] and the FDS to the ECRB branch in all limbs without tension. CLINICAL RELEVANCE We provide anatomical and histological information for median-to-radial nerve transfer.
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Affiliation(s)
- Koji Sukegawa
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan.
| | - Takane Suzuki
- Department of Bioenvironmental Medicine, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan
| | - Yasufumi Ogawa
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan
| | - Tomoko Kobayashi
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan
| | - Yusuke Matsuura
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan
| | - Kazuki Kuniyoshi
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan
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Hosseinian MA, Gharibi Loron A, Nemati B, Khandaghy M. Comparison of a distal end-to-side neurorrhaphy with a proximal–distal end-to-side neurorrhaphy: in a rat model. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY 2015; 25:1261-4. [DOI: 10.1007/s00590-015-1699-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 08/24/2015] [Indexed: 10/23/2022]
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Schenck TL, Stewart J, Lin S, Aichler M, Machens HG, Giunta RE. Anatomical and histomorphometric observations on the transfer of the anterior interosseous nerve to the deep branch of the ulnar nerve. J Hand Surg Eur Vol 2015; 40:591-6. [PMID: 25261412 DOI: 10.1177/1753193414551909] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
This study focuses on the anatomical and histomorphometric features of the transfer of the anterior interosseous nerve to the deep motor branch of the ulnar nerve. The transfer was carried out in 15 cadaver specimens and is described using relevant anatomical landmarks. Nerve samples of donor and target nerves were histomorphometrically analysed and compared. The superficial and the deep ulnar branches had to be separated from each other for a length of 67 mm (SD 12; range 50-85) to reach the site of coaptation. We identified a suitable site for coaptation lying proximal to the pronator quadratus muscle, 202 mm (SD 15; range 185-230) distal to the medial epicondyle of the humerus. The features of the anterior interosseous nerve included a smaller nerve diameter, smaller cross-sectional area of fascicles, fewer fascicles and axons, but a similar axon density. The histomorphometric inferiority of the anterior interosseous nerve raises a question about whether it should be transferred only to selected parts of the deep motor branch of the ulnar nerve.Level III.
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Affiliation(s)
- T L Schenck
- Department of Plastic Surgery and Hand Surgery, University Hospital rechts der Isar, Technical University Munich, Germany
| | - J Stewart
- Hand Surgery, Plastic Surgery and Aesthetic Surgery, Ludwig Maximilians University Munich, Germany
| | - S Lin
- Hand Surgery, Plastic Surgery and Aesthetic Surgery, Ludwig Maximilians University Munich, Germany
| | - M Aichler
- Research Unit Analytical Pathology, Helmholtzzentrum München, German Research Center for Environmental Health, Munich, Germany
| | - H-G Machens
- Department of Plastic Surgery and Hand Surgery, University Hospital rechts der Isar, Technical University Munich, Germany
| | - R E Giunta
- Hand Surgery, Plastic Surgery and Aesthetic Surgery, Ludwig Maximilians University Munich, Germany
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Kou YH, Zhang PX, Wang YH, Chen B, Han N, Xue F, Zhang HB, Yin XF, Jiang BG. Sleeve bridging of the rhesus monkey ulnar nerve with muscular branches of the pronator teres: multiple amplification of axonal regeneration. Neural Regen Res 2015; 10:53-9. [PMID: 25788920 PMCID: PMC4357117 DOI: 10.4103/1673-5374.150706] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2014] [Indexed: 01/09/2023] Open
Abstract
Multiple-bud regeneration, i.e., multiple amplification, has been shown to exist in peripheral nerve regeneration. Multiple buds grow towards the distal nerve stump during proximal nerve fiber regeneration. Our previous studies have verified the limit and validity of multiple amplification of peripheral nerve regeneration using small gap sleeve bridging of small donor nerves to repair large receptor nerves in rodents. The present study sought to observe multiple amplification of myelinated nerve fiber regeneration in the primate peripheral nerve. Rhesus monkey models of distal ulnar nerve defects were established and repaired using muscular branches of the right forearm pronator teres. Proximal muscular branches of the pronator teres were sutured into the distal ulnar nerve using the small gap sleeve bridging method. At 6 months after suture, two-finger flexion and mild wrist flexion were restored in the ulnar-sided injured limbs of rhesus monkey. Neurophysiological examination showed that motor nerve conduction velocity reached 22.63 ± 6.34 m/s on the affected side of rhesus monkey. Osmium tetroxide staining demonstrated that the number of myelinated nerve fibers was 1,657 ± 652 in the branches of pronator teres of donor, and 2,661 ± 843 in the repaired ulnar nerve. The rate of multiple amplification of regenerating myelinated nerve fibers was 1.61. These data showed that when muscular branches of the pronator teres were used to repair ulnar nerve in primates, effective regeneration was observed in regenerating nerve fibers, and functions of the injured ulnar nerve were restored to a certain extent. Moreover, multiple amplification was subsequently detected in ulnar nerve axons.
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Affiliation(s)
- Yu-Hui Kou
- Department of Trauma and Orthopedics, Peking University People's Hospital, Beijing, China
| | - Pei-Xun Zhang
- Department of Trauma and Orthopedics, Peking University People's Hospital, Beijing, China
| | - Yan-Hua Wang
- Department of Trauma and Orthopedics, Peking University People's Hospital, Beijing, China
| | - Bo Chen
- Department of Trauma and Orthopedics, Peking University People's Hospital, Beijing, China
| | - Na Han
- Department of Trauma and Orthopedics, Peking University People's Hospital, Beijing, China
| | - Feng Xue
- Department of Trauma and Orthopedics, Peking University People's Hospital, Beijing, China
| | - Hong-Bo Zhang
- Department of Trauma and Orthopedics, Peking University People's Hospital, Beijing, China
| | - Xiao-Feng Yin
- Department of Trauma and Orthopedics, Peking University People's Hospital, Beijing, China
| | - Bao-Guo Jiang
- Department of Trauma and Orthopedics, Peking University People's Hospital, Beijing, China
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Zhang PX, Li-Ya A, Kou YH, Yin XF, Xue F, Han N, Wang TB, Jiang BG. Biological conduit small gap sleeve bridging method for peripheral nerve injury: regeneration law of nerve fibers in the conduit. Neural Regen Res 2015; 10:71-8. [PMID: 25788923 PMCID: PMC4357121 DOI: 10.4103/1673-5374.150709] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2014] [Indexed: 11/04/2022] Open
Abstract
The clinical effects of 2-mm small gap sleeve bridging of the biological conduit to repair peripheral nerve injury are better than in the traditional epineurium suture, so it is possible to replace the epineurium suture in the treatment of peripheral nerve injury. This study sought to identify the regeneration law of nerve fibers in the biological conduit. A nerve regeneration chamber was constructed in models of sciatic nerve injury using 2-mm small gap sleeve bridging of a biodegradable biological conduit. The results showed that the biological conduit had good histocompatibility. Tissue and cell apoptosis in the conduit apparently lessened, and regenerating nerve fibers were common. The degeneration regeneration law of Schwann cells and axons in the conduit was quite different from that in traditional epineurium suture. During the prime period for nerve fiber regeneration (2-8 weeks), the number of Schwann cells and nerve fibers was higher in both proximal and distal ends, and the effects of the small gap sleeve bridging method were better than those of the traditional epineurium suture. The above results provide an objective and reliable theoretical basis for the clinical application of the biological conduit small gap sleeve bridging method to repair peripheral nerve injury.
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Affiliation(s)
- Pei-Xun Zhang
- Department of Trauma and Orthopedics, Peking University People's Hospital, Beijing, China
| | - A Li-Ya
- Department of Trauma and Orthopedics, Peking University People's Hospital, Beijing, China
| | - Yu-Hui Kou
- Department of Trauma and Orthopedics, Peking University People's Hospital, Beijing, China
| | - Xiao-Feng Yin
- Department of Trauma and Orthopedics, Peking University People's Hospital, Beijing, China
| | - Feng Xue
- Department of Trauma and Orthopedics, Peking University People's Hospital, Beijing, China
| | - Na Han
- Department of Trauma and Orthopedics, Peking University People's Hospital, Beijing, China
| | - Tian-Bing Wang
- Department of Trauma and Orthopedics, Peking University People's Hospital, Beijing, China
| | - Bao-Guo Jiang
- Department of Trauma and Orthopedics, Peking University People's Hospital, Beijing, China
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Zhang PX, Yin XF, Kou YH, Xue F, Han N, Jiang BG. Neural regeneration after peripheral nerve injury repair is a system remodelling process of interaction between nerves and terminal effector. Neural Regen Res 2015; 10:52. [PMID: 25788919 PMCID: PMC4357116 DOI: 10.4103/1673-5374.150705] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2014] [Indexed: 12/03/2022] Open
Affiliation(s)
- Pei-Xun Zhang
- Department of Trauma and Orthopedics, Peking University People's Hospital, Beijing, China
| | - Xiao-Feng Yin
- Department of Trauma and Orthopedics, Peking University People's Hospital, Beijing, China
| | - Yu-Hui Kou
- Department of Trauma and Orthopedics, Peking University People's Hospital, Beijing, China
| | - Feng Xue
- Department of Trauma and Orthopedics, Peking University People's Hospital, Beijing, China
| | - Na Han
- Department of Trauma and Orthopedics, Peking University People's Hospital, Beijing, China
| | - Bao-Guo Jiang
- Department of Trauma and Orthopedics, Peking University People's Hospital, Beijing, China
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An S, Zhang P, Peng J, Deng L, Wang Z, Wang Z, Wang Y, Yin X, Kou Y, Ha N, Jiang B. Motor function recovery during peripheral nerve multiple regeneration. J Tissue Eng Regen Med 2013; 9:415-23. [PMID: 24323657 DOI: 10.1002/term.1833] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Revised: 04/19/2013] [Accepted: 09/02/2013] [Indexed: 11/11/2022]
Affiliation(s)
- Shuai An
- Peking University People's Hospital Beijing China
| | - Peixun Zhang
- Peking University People's Hospital Beijing China
| | | | - Lei Deng
- Peking University People's Hospital Beijing China
| | - Zhenwei Wang
- Peking University People's Hospital Beijing China
| | - Zhiyong Wang
- Peking University People's Hospital Beijing China
| | - Yanhua Wang
- Peking University People's Hospital Beijing China
| | - Xiaofeng Yin
- Peking University People's Hospital Beijing China
| | - Yuhui Kou
- Peking University People's Hospital Beijing China
| | - Na Ha
- Peking University People's Hospital Beijing China
| | - Baoguo Jiang
- Peking University People's Hospital Beijing China
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Wen J, Yang M, Li L, Sun G, Tan J. Partial recovery of respiratory function and diaphragm reinnervation following unilateral vagus nerve to phrenic nerve anastomosis in rabbits. PLoS One 2013; 8:e79552. [PMID: 24265777 PMCID: PMC3827148 DOI: 10.1371/journal.pone.0079552] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2012] [Accepted: 09/24/2013] [Indexed: 12/01/2022] Open
Abstract
Respiratory dysfunction is the leading cause of mortality following upper cervical spinal cord injury (SCI). Reinnervation of the paralyzed diaphragm via an anastomosis between phrenic nerve and a donor nerve is a potential strategy to mitigate ventilatory deficits. In this study, anastomosis of vagus nerve (VN) to phrenic nerve (PN) in rabbits was performed to assess the potential capacity of the VN to compensate for lost PN inputs. At first, we compared spontaneous discharge pattern, nerve thickness and number of motor fibers between these nerves. The PN exhibited a highly rhythmic discharge while the VN exhibited a variable frequency discharge pattern. The rabbit VN had fewer motor axons (105.3±12.1 vs. 268.1±15.4). Nerve conduction and respiratory function were measured 20 weeks after left PN transection with or without left VN-PN anastomosis. Compared to rabbits subjected to unilateral phrenicotomy without VN-PN anastomosis, diaphragm muscle action potential (AP) amplitude was improved by 292%, distal latency by 695%, peak inspiratory flow (PIF) by 22.6%, peak expiratory flow (PRF) by 36.4%, and tidal volume by 21.8% in the anastomosis group. However, PIF recovery was only 28.0%, PEF 28.2%, and tidal volume 31.2% of Control. Our results suggested that VN-PN anastomosis is a promising therapeutic strategy for partial restoration of diaphragm reinnervation, but further modification and improvements are necessary to realize the full potential of this technique.
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Affiliation(s)
- Junxiang Wen
- Department of Orthopaedics, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
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Wang Z, Zhang P, Kou Y, Yin X, Han N, Jiang B. Hedysari extract improves regeneration after peripheral nerve injury by enhancing the amplification effect. PLoS One 2013; 8:e67921. [PMID: 23844128 PMCID: PMC3700897 DOI: 10.1371/journal.pone.0067921] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Accepted: 05/22/2013] [Indexed: 11/18/2022] Open
Abstract
Radix Hedysari is an herbal preparation frequently used in traditional Chinese medicine. It can promote regeneration after peripheral nerve injury, but its effect on the amplification ratio (the ratio of distal to proximal fibers) during peripheral nerve regeneration has not yet been examined. In this study, we explored the effect of Hedysari extract on the amplification ratio in the peripheral nerve. Male Sprague-Dawley rats were separated into three groups at random: normal group (without surgery), model group (given sleeve nerve bridging surgery, but without adjuvant treatment) and treatment group (given sleeve nerve bridging surgery and then given Hedysari extract as adjuvant treatment). Twelve weeks after surgery, general observations, electrophysiological examination, histological analysis, morphometric measurements, and amplification ratio calculations were made. The results showed that nerve conduction velocity, the fiber and axon diameter, the g-ratio, the number of regenerating nerve fibers and the amplification ratio were better in the treatment group than in the model group, suggesting that Hedysari extract can effectively promote the growth of lateral buds in the proximal nerve stump and substantially improve the amplification effect during peripheral nerve regeneration.
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Affiliation(s)
- Zhiyong Wang
- Department of Trauma and Orthopedics, Peking University People's Hospital, Beijing, China
| | - Peixun Zhang
- Department of Trauma and Orthopedics, Peking University People's Hospital, Beijing, China
- * E-mail: (PZ); (BJ)
| | - Yuhui Kou
- Department of Trauma and Orthopedics, Peking University People's Hospital, Beijing, China
| | - Xiaofeng Yin
- Department of Trauma and Orthopedics, Peking University People's Hospital, Beijing, China
| | - Na Han
- Department of Trauma and Orthopedics, Peking University People's Hospital, Beijing, China
| | - Baoguo Jiang
- Department of Trauma and Orthopedics, Peking University People's Hospital, Beijing, China
- * E-mail: (PZ); (BJ)
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Yin XF, Kou YH, Wang YH, Zhang PX, Zhang DY, Fu ZG, Zhang HB, Jiang BG. Morphological study on the collaterals developed by one axon during peripheral nerve regeneration. ARTIFICIAL CELLS NANOMEDICINE AND BIOTECHNOLOGY 2013; 42:217-21. [DOI: 10.3109/21691401.2013.800082] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Jiang BG, Feng Yin X, Xun Zhang P, Han N, Kou YH. Hypothesis of peripheral nerve regeneration induced by terminal effectors. ARTIFICIAL CELLS NANOMEDICINE AND BIOTECHNOLOGY 2013; 42:92-4. [PMID: 23638790 DOI: 10.3109/21691401.2013.785955] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Peripheral nerve injury (PNI) is a common trauma in clinical practice. A number of techniques to deal with PNI repair have been designed in clinics. From these methods for nerve repairing shown to be effective in clinics, as well as related experiments, we formulated a hypothesis that PNI regeneration and functional repair are induced by terminal effectors. Regeneration of peripheral nerves is the process whereby the nerve fibers regenerated by the induction of terminal effectors establish connections with effector organs and induce the spinal cord and upper centers to recognize effector organs and to re-model them for effective innervations. The hypothesis has two major components: (1) after surgical repairing of the injured nerves, the functional localization of regenerated nerves is determined by the connected effector organs and (2) the upper nervous system enables structural remodeling and functional changes according to the functions of the effector organs.
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Affiliation(s)
- Bao Guo Jiang
- Department of Orthopaedics and Trauma, Peking University People's Hospital , Beijing , P. R. China
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40
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Effect of Modified Formula Radix Hedysari on the Amplification Effect during Peripheral Nerve Regeneration. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 2013:647982. [PMID: 23533510 PMCID: PMC3595679 DOI: 10.1155/2013/647982] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Accepted: 01/23/2013] [Indexed: 01/09/2023]
Abstract
Many studies have demonstrated a compensatory amplification phenomenon during nerve regeneration. When a relatively fine nerve is used as a donor to connect to a distal nerve after transection, the donor nerve regenerates more collaterals than its own fibers, which extend to the distal stump, grow into distal endoneurial tubes, and finally reach and dominate the target organs. This is known as the amplification phenomenon. In this study, we investigated the amplification phenomenon in rats treated with Modified Formula Radix Hedysari (MFRH) as adjuvant therapy for 12 weeks. The rats were divided into three groups at random (six animals in each group). In the model group and the treatment group, the proximal common peroneal nerve was used as a donor nerve to connect to the distal tibial nerve. Rats in the normal group did not undergo surgery. After surgery, the treatment group was administered MFRH as systemic therapy, while the model group and the normal group were not given treatment. The results demonstrated that the nerve conduction velocity, the fiber diameter, the axon diameter, the number of regenerating nerve fibers, and the amplification ratio were better in the treatment group than in the model group, suggesting that MFRH promoted the nerve amplification effect.
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Zhang Z, Kou Y, Yin X, Wang Y, Zhang P, Jiang B. The effect of a small gap sleeve suture at the distal anastomosis of a nerve graft on promoting nerve regeneration and functional recovery. ARTIFICIAL CELLS NANOMEDICINE AND BIOTECHNOLOGY 2013; 41:282-8. [PMID: 23316870 DOI: 10.3109/21691401.2012.742097] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The effect of a small gap sleeve suture at the distal anastomosis of a nerve graft on promoting nerve regeneration and functional recovery was investigated by experimental observation. The model of common peroneal nerve defect in Sprague-Dawley (SD) rats was established, and an autologous sural nerve graft repair was performed. The small gap sleeve suture was applied at the distal anastomosis in the first stage for the experimental group. The results showed that the number of regenerated nerve fibers and the recovery of nerve function for the rats in the experimental group were superior to those in the control group.
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Affiliation(s)
- Zhenjun Zhang
- Department of Orthopedics and Trauma, Peking University People's Hospital, Beijing 100044, P.R. China
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42
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Wang C, Liu J, Yuan W, Zhou X, Wang X, Xu P, Chen J, Wu G, Shi S. Anatomical feasibility of vagus nerve esophageal branch transfer to the phrenic nerve. Neural Regen Res 2012; 7:703-7. [PMID: 25745467 PMCID: PMC4347012 DOI: 10.3969/j.issn.1673-5374.2012.09.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2011] [Accepted: 02/03/2012] [Indexed: 11/18/2022] Open
Abstract
This study measured the vagus and phrenic nerves from 12 adult cadavers. We found that the width and thickness of the vagus and phrenic nerves were different in the chest. The distance from the point of the vagus nerve and phrenic nerve on the plane of the inferior border of portal pulmonary arteries (T point) was approximately 7 cm to the diaphragm and was approximately 10 cm to the clavicle level. The number of motor fibers in the vagus nerves was 1 716 ± 362, and the number of nerve fibers was 4 473 ± 653. The number of motor fibers in the phrenic nerves ranged from 3 078 ± 684 to 4 794 ± 638, and the number of nerve fibers ranged from 3 437 ± 642 to 5 071 ± 723. No significant difference was found in the total number of nerve fibers. The results suggest that width, thickness, and total number of nerve fibers are similar between the vagus and phrenic nerves, but the number of motor fibers is different between them.
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Affiliation(s)
- Ce Wang
- Department of Orthopedics, Changzheng Hospital, Second Military Medical University, Shanghai 210000, China
| | - Jun Liu
- Department of Orthopedics, General Hospital of Shenyang Military Area Command of Chinese PLA, Shenyang 110016, Liaoning Province, China
| | - Wen Yuan
- Department of Orthopedics, Changzheng Hospital, Second Military Medical University, Shanghai 210000, China
| | - Xuhui Zhou
- Department of Orthopedics, Changzheng Hospital, Second Military Medical University, Shanghai 210000, China
| | - Xinwei Wang
- Department of Orthopedics, Changzheng Hospital, Second Military Medical University, Shanghai 210000, China
| | - Peng Xu
- Department of Orthopedics, Changzheng Hospital, Second Military Medical University, Shanghai 210000, China
| | - Jian Chen
- Department of Orthopedics, Changzheng Hospital, Second Military Medical University, Shanghai 210000, China
| | - Guoxin Wu
- Department of Orthopedics, Changzheng Hospital, Second Military Medical University, Shanghai 210000, China
| | - Sheng Shi
- Department of Orthopedics, Changzheng Hospital, Second Military Medical University, Shanghai 210000, China
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Jianping P, Xiaofeng Y, Yanhua W, Zhenwei W, Yuhui K, Chungui X, Peixun Z, Baoguo J. Different multiple regeneration capacities of motor and sensory axons in peripheral nerve. ACTA ACUST UNITED AC 2012; 40:309-16. [PMID: 22409279 DOI: 10.3109/10731199.2012.657205] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
After peripheral nerve injury, axons often project sprouts from the node of Ranvier proximal to the damage site. It is well known that one parent axon can sprout and maintain several regenerating axons. If enough endoneurial tubes in the distal stump are present for the regenerating axons to grow along, then the number of mature myelinated nerve fibers in the distal stump will be greater than the number in the proximal stump. "Multiple regeneration" is used to describe this phenomenon in the peripheral nerve. According to previous studies, a prominent nerve containing many axons can be repaired by the multiple regenerating axons sprouting from another nerve that contains fewer axons. Most peripheral nerves contain a mixture of myelinated motor and sensory axons as well as unmyelinated sensory and autonomic axons. In this study, a multiple regeneration animal model was developed by bridging the proximal common peroneal nerve with the distal common peroneal nerve and the tibial nerve. Differences in the multiple regeneration ratio of motor and sensory nerves were evaluated using histomorphometry one month after ablating the dorsal root ganglion (DRGs) and ventral roots, respectively. The results suggest that the motor nerves have a significantly larger multiple regeneration ratio than the sensory nerves at two different time points.
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Wang Y, Zhang P, Yin X, Peng J, Kou Y, Zhang Z, Zhang D, Jiang B. Characteristics of peripheral nerve regeneration following a second nerve injury and repair. ACTA ACUST UNITED AC 2012; 40:296-302. [PMID: 22384852 DOI: 10.3109/10731199.2011.652259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
During the process of peripheral nerve regeneration, a single neuron can regenerate and maintain more than one collateral in a regenerative distal stump. Furthermore, some of the new shoots can mature gradually through remyelination and grow into the remote target organ to play a physiological function. Our study found that when neonatal nerve fibers are subjected to a second injury, the regenerative distal stump can regenerate and maintain more than one collateral in the second regenerative distal stump. The neonatal nerve contributed to the functional recovery of the nerve, but the restoration of nerve function was not complete.
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Affiliation(s)
- Yanhua Wang
- Peking University People's Hospital, Beijing, China
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Yin XF, Kou YH, Wang YH, Zhang P, Zhang HB, Jiang BG. Portion of a Nerve Trunk can be Used as a Donor Nerve to Reconstruct the Injured Nerve and Donor Site Simultaneously. ACTA ACUST UNITED AC 2011; 39:304-9. [DOI: 10.3109/10731199.2011.574636] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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46
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Hill PS, Apel PJ, Barnwell J, Smith T, Koman LA, Atala A, Van Dyke M. Repair of peripheral nerve defects in rabbits using keratin hydrogel scaffolds. Tissue Eng Part A 2011; 17:1499-505. [PMID: 21275820 DOI: 10.1089/ten.tea.2010.0184] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Entubulation of transected nerves using bioabsorbable conduits is a promising alternative to sural nerve autografting, but full functional recovery is rarely achieved. Numerous studies have suggested that scaffold-based conduit fillers may promote axon regeneration, but no neuroinductive biomaterial filler has been identified. We previously showed that a nerve guide filled with keratin hydrogel actively stimulates regeneration in a mouse model, and results in functional outcomes superior to empty conduits at early time points. The goal of the present study was to develop a peripheral nerve defect model in a rabbit and assess the effectiveness of a keratin hydrogel filler. Although repairs with keratin-filled conduits were not as consistently successful as autograft overall, the use of keratin resulted in a significant improvement in conduction delay compared to both empty conduits and autograft, as well as a significant improvement in amplitude recovery compared to empty conduits when measurable regeneration did occur. Taking into account all study animals (i.e., regenerated and nonregenerated), histological assessment showed that keratin-treated nerves had significantly greater myelin thickness than empty conduits. These data support the findings of our earlier study and suggest that keratin hydrogel fillers have the potential to be used clinically to improve conduit repair.
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Affiliation(s)
- Paulina S Hill
- Wake Forest Institute for Regenerative Medicine, Wake Forest University School of Medicine, Winston Salem, North Carolina 27157, USA
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47
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Yin XF, Kou YH, Wang YH, Zhang P, Zhang DY, Fu ZG, Zhang HB, Jiang BG. Can “Dor to Dor+Rec Neurorrhaphy” by Biodegradable Chitin Conduit Be A New Method for Peripheral Nerve Injury? ACTA ACUST UNITED AC 2011; 39:110-5. [DOI: 10.3109/10731199.2010.506851] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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48
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Kou Y, Zhang P, Yin X, Wei S, Wang Y, Zhang H, Jiang B. Influence of different distal nerve degeneration period on peripheral nerve collateral sprouts regeneration. ACTA ACUST UNITED AC 2010; 39:223-7. [PMID: 21117869 DOI: 10.3109/10731199.2010.533127] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The effects of the distal nerve degeneration on the regeneration of the collateral sprouts from the proximal nerve stump have been examined. The delayed cross-suture anastomosis technique was used in which the tibial nerve was denervated for 0-8 weeks before cross-suture of the freshly axotomized common peroneal and chronically denervated TIB nerve stumps. There was a remarkable decreasing of the regenerated myelinated axons number after the distal nerve suffered 8 weeks deterioration, suggesting that short-term denervation did not affect the collateral sprouts regeneration but more prolonged denervation profoundly reduced collateral sprouts regenerated in the distal nerve stump.
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Affiliation(s)
- Yuhui Kou
- Peking University People's Hospital, Beijing, China
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Ding F, Wu J, Yang Y, Hu W, Zhu Q, Tang X, Liu J, Gu X. Use of tissue-engineered nerve grafts consisting of a chitosan/poly(lactic-co-glycolic acid)-based scaffold included with bone marrow mesenchymal cells for bridging 50-mm dog sciatic nerve gaps. Tissue Eng Part A 2010; 16:3779-90. [PMID: 20666610 DOI: 10.1089/ten.tea.2010.0299] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Bone marrow mesenchymal cells (MSCs) have attracted increasing research interest due to their possible use as support cells for nerve tissue-engineering approaches. We developed a novel design of tissue-engineered nerve grafts consisting of a chitosan/poly(lactic-co-glycolic acid) (PLGA)-based neural scaffold included with autologous MSCs. The graft was used as an alternative to nerve autografts for bridging 50-mm-long gaps in dog sciatic nerve, and the repair outcome at 6 months after nerve grafting was evaluated by a combination of electrophysiological assessment, FluoroGold retrograde tracing, and histological investigation to regenerated nerve tissue and reinnervated target muscle. The experimental results indicated that introduction of autologous MSCs to the chitosan/PLGA-based neural scaffold promoted sciatic nerve regeneration and functional recovery, demonstrating significant efficacy that was, to a certain degree, close to that by nerve autografting, a gold standard for treating large peripheral nerve gaps, and better than that by grafting with the chitosan/PLGA-based scaffold alone.
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Affiliation(s)
- Fei Ding
- Jiangsu Key Laboratory of Neuroregeneration, Nantong University, Nantong, P. R. China
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50
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Zhang P, Kou Y, Yin X, Wang Y, Zhang H, Jiang B. The experimental research of nerve fibers compensation amplification innervation of ulnar nerve and musculocutaneous nerve in rhesus monkeys. ACTA ACUST UNITED AC 2010; 39:39-43. [PMID: 20677901 DOI: 10.3109/10731199.2010.494583] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This experiment intended to authenticate the compensation and amplification effect of regenerated nerve fibers after nerve injury in primate. The Rhesus Monkeys right ulnar nerves and musculocutaneous nerves were chosed. The proximal impaired ulnar nerve as the proximal end and the distal impaired ulnar nerve musculocutaneous nerve as the distal ends. The ulnar nerve proximal stump fibers can grow into both the ulnar nerve distal stump and the musculocutaneus nerve at the same time and established two different electrophysiological conduction passageway. There exist nerve fibers compensation amplification effect after peripheral nerve injury on Rhesus Monkeys.
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Affiliation(s)
- Peixun Zhang
- Department of Trauma Orthopeadics, Peking University People's Hospital, Beijing, China.
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