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Kita A, Kedeshian K, Hong M, Hoffman L. An in vitro model for postoperative cranial nerve dysfunction and a proposed method of rehabilitation with N-acetylcysteine microparticles. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08622-z. [PMID: 38649541 DOI: 10.1007/s00405-024-08622-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 03/16/2024] [Indexed: 04/25/2024]
Abstract
PURPOSE When operating near cranial motor nerves, transient postoperative weakness of target muscles lasting weeks to months is often observed. As nerves are typically intact at a procedure's completion, paresis is hypothesized to result from a combination of neurapraxia and axonotmesis. As both neurapraxia and axonotmesis involve Schwann cell injury and require remyelination, we developed an in vitro RSC96 Schwann cell model of injury using hydrogen peroxide (H2O2) to induce oxidative stress and investigated the efficacy of candidate therapeutic agents to promote RSC96 viability. As a first step in developing a long-term local administration strategy, the most promising of these agents was incorporated into sustained-release microparticles and investigated for bioactivity using this assay. METHODS The concentration of H2O2 which reduced viability by 50% was determined to establish a standard for inducing oxidative stress in RSC96 cultures. Fresh cultures were then co-dosed with H2O2 and the potential therapeutics melatonin, N-acetylcysteine, resveratrol, and 4-aminopyridine. Schwann cell viability was evaluated and the most efficacious agent, N-acetylcysteine, was encapsulated into microparticles. Eluted samples of N-acetylcysteine from microparticles was evaluated for retained bioactivity. RESULTS 100 µM N-acetylcysteine improved the viability of Schwann cells dosed with H2O2. 100 µM Microparticle-eluted N-acetylcysteine also enhanced Schwann cell viability. CONCLUSION We developed a Schwann cell culture model of iatrogenic nerve injury and used this to identify N-acetylcysteine as an agent to promote recovery. N-acetylcysteine was packaged into microparticles and demonstrated promise as a locally administrable agent to reduce oxidative stress in Schwann cells.
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Affiliation(s)
- Ashley Kita
- Department of Head and Neck Surgery, David Geffen School of Medicine at University of California Los Angeles, 10883 Le Conte Avenue, CHS 63-170, Los Angeles, CA, 90095, USA.
| | - Katherine Kedeshian
- Department of Head and Neck Surgery, David Geffen School of Medicine at University of California Los Angeles, 10883 Le Conte Avenue, CHS 63-170, Los Angeles, CA, 90095, USA
| | - Michelle Hong
- Department of Head and Neck Surgery, David Geffen School of Medicine at University of California Los Angeles, 10883 Le Conte Avenue, CHS 63-170, Los Angeles, CA, 90095, USA
| | - Larry Hoffman
- Department of Head and Neck Surgery, David Geffen School of Medicine at University of California Los Angeles, 10883 Le Conte Avenue, CHS 63-170, Los Angeles, CA, 90095, USA
- Vestibular Neuroscience Laboratory, Brain Research Institute, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA
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Corrêa DG, Júnior AL, Pacheco FT. Oculomotor nerve trauma: the intensity matters in imaging interpretation. Acta Neurol Belg 2023:10.1007/s13760-023-02347-2. [PMID: 37515702 DOI: 10.1007/s13760-023-02347-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 07/20/2023] [Indexed: 07/31/2023]
Affiliation(s)
- Diogo Goulart Corrêa
- Clínica de Diagnóstico por Imagem (CDPI), Avenida das Américas, 4666, 302A, 303, 307, 325, 326, Barra da Tijuca, Rio de Janeiro, RJ, 2640-102, Brazil.
- Rio de Janeiro State University, Boulevard 28 de Setembro, 77, Vila Isabel, Rio de Janeiro, RJ, 20551-030, Brazil.
| | | | - Felipe Torres Pacheco
- Department of Neuroradiology, Irmandade da Santa Casa de Misericórdia de São Paulo, Rua Dr. Cesário Mota Júnior, 112, Vila Buarque, São Paulo, SP, 01221-010, Brazil
- Department of Radiology, DASA, São Paulo, SP, Brazil
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Öztürk K, Kuzu TE, Gürgan CA, Önder GÖ, Yay A. The effect of different treatment protocols with diode laser on regeneration in axonetmesis ınjuries of the ınferior alveolar nerve: an animal study. Lasers Med Sci 2023; 38:169. [PMID: 37515606 DOI: 10.1007/s10103-023-03834-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 07/19/2023] [Indexed: 07/31/2023]
Abstract
The inferior alveolar nerve can be damaged during dental procedures, leading to symptoms, such as tingling, numbness, and reduced quality of life. Recovery depends on factors such as medications, surgery, and photobiomodulation therapy. Photobiomodulation therapy has shown the potential to improve nerve function and reduce regeneration time; however, there is no standard treatment protocol yet. This study aimed to examine the effect of diode lasers on nerve regeneration in patients with axonetmesis injuries. In this experiment on animals, Wistar rats' damaged sensory systems were treated with lasers to restore them. Animals were randomly divided into six groups: a sham group, a control group, and four laser treatment groups(1st group: performed every day, 10 sessions; 2nd group: performed every 2 days, 10 sessions; 3rd group: performed every day, 20 sessions; and 4th group: performed every 2 days, 20 sessions). Sensory function was determined using the Semmes-Weinstein monofilament test, which was repeated after the surgical procedure. The results showed that the 20-session group had the best improvement, most closely resembling the group without sensory test damage. The histomorphometric results showed that the number of axons was significantly lower in the group that received 10 daily sessions and in the control group than in the undamaged nerve. Axon diameter was lower in all groups than in the sham group. In conclusion, the remarkable aspect of this study is that consecutive-day 20-session laser treatment showed better improvement than the over-the-day 20-session treatment protocol.
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Affiliation(s)
- Kübra Öztürk
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Nuh Naci Yazgan University, Kayseri, Turkey.
| | - Turan Emre Kuzu
- Department of Periodontology, Faculty of Dentistry, Nuh Naci Yazgan University, Kayseri, Turkey
| | - Cem A Gürgan
- Department of Periodontology, Faculty of Dentistry, Nuh Naci Yazgan University, Kayseri, Turkey
| | - Gözde Özge Önder
- Department of Histology and Embryology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Arzu Yay
- Department of Histology and Embryology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
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Sivanarayanan TB, Bhat IA, Sharun K, Palakkara S, Singh R, Remya, Parmar MS, Bhardwaj R, Chandra V, Munuswamy P, Kinjavdekar P, Pawde AM, Amarpal, Sharma GT. Allogenic bone marrow-derived mesenchymal stem cells and its conditioned media for repairing acute and sub-acute peripheral nerve injuries in a rabbit model. Tissue Cell 2023; 82:102053. [PMID: 36907044 DOI: 10.1016/j.tice.2023.102053] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 02/28/2023] [Accepted: 03/01/2023] [Indexed: 03/06/2023]
Abstract
The present study evaluated healing potential of bone marrow-derived mesenchymal stem cells (BM-MSCs) and BM-MSCs-conditioned medium (BM-MSCs-CM) for acute and subacute injuries in the rabbit peripheral nerve injury model. The regenerative capacity of MSCs was evaluated in 40 rabbits divided into eight groups, four groups each for acute and subacute injury models. BM-MSCs and BM-MSCS-CM were prepared by isolating allogenic bone marrow from the iliac crest. After inducing sciatic nerve crush injury, different treatments consisting of PBS, Laminin, BM-MSCs + laminin, and BM-MSCS-CM + laminin were used on the day of injury in the acute injury model and after ten days of crush injury in the subacute groups. The parameters studied included: pain, total neurological score, gastrocnemius muscle weight and volume ratio, histopathology of the sciatic nerve and gastrocnemius muscle, and scanning electron microscopy (SEM). Findings indicate that BM-MSCs and BM-MSCS-CM have augmented the regenerative capacity in acute and subacute injury groups with a slightly better improvement in the subacute groups than the animals in acute injury groups. Histopathology data revealed different levels of regenerative process undergoing in the nerve. Neurological observations, gastrocnemius muscle evaluation, muscle histopathology, and the SEM results depicted better healing in animals treated with BM-MSCs and BM-MSCS-CM. With this data, it could be concluded that BM-MSCs support the healing of injured peripheral nerves, and the BM-MSCS-CM does accelerate the healing of acute and subacute peripheral nerve injuries in rabbits. However, stem cell therapy may be indicated during the subacute phase for better results.
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Affiliation(s)
- T B Sivanarayanan
- Division of Surgery, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, India
| | - Irfan Ahmad Bhat
- Division of Physiology and Climatology, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, India
| | - Khan Sharun
- Division of Surgery, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, India
| | - Sangeetha Palakkara
- Division of Surgery, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, India
| | - Rashmi Singh
- Division of Surgery, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, India
| | - Remya
- Division of Surgery, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, India
| | - Mehtab Singh Parmar
- Division of Physiology and Climatology, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, India
| | - Rahul Bhardwaj
- Division of Physiology and Climatology, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, India
| | - Vikash Chandra
- Division of Physiology and Climatology, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, India
| | - Palanivelu Munuswamy
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, India
| | - Prakash Kinjavdekar
- Division of Surgery, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, India
| | - A M Pawde
- Division of Surgery, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, India
| | - Amarpal
- Division of Surgery, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, India.
| | - G Taru Sharma
- National Institute of Animal Biotechnology, Hyderabad 500032, India.
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Veloza MJ, Useche JN, Muñoz SB, Vásquez R, Cardona Ortegón JD. Preganglionic injury of C8 nerve root secondary to shoulder dislocation: Diagnosis based on MRI findings. Curr Med Imaging 2023:CMIR-EPUB-129307. [PMID: 36744690 DOI: 10.2174/1573405619666230206122521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 12/22/2022] [Accepted: 12/27/2022] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Traumatic spinal root injury caused by shoulder dislocation may involve the brachial plexus or, in some cases, a single nerve. The degree of severity of the injury depends on many patient-specific factors as well as the mechanism of injury. It is essential to suspect this type of lesion by means of a thorough physical examination in order to have better patient outcomes. CASE PRESENTATION We presented the subtle magnetic resonance imaging (MRI) findings in a 35-year-old male with left shoulder trauma and dislocation after falling off a bicycle. He complained of decreased muscle strength and sensitivity in the C8 dermatome. Atrophy of the hypothenar region and flexion deformity of the 4th and 5th digits were noted. Magnetic resonance imaging findings were consistent with a partial preganglionic C8 motor root lesion. We found T2 increased signal intensity and thinning of the intradural segment of the C8 motor nerve root and low signal in the sequence of a multi-echo gradient recalled echo (GRE). CONCLUSION MRI is a noninvasive tool that allows a detailed anatomical characterization of the nerves. In brachial plexus injuries, the use of the GRE sequence is useful to identify the lesions, even if they are subtle; however, some lesions may go unnoticed. It is important to note that these patients require an interdisciplinary group to reach a correct diagnosis, which is vital to establish the appropriate treatment and follow-up.
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Affiliation(s)
- María José Veloza
- Department of diagnostic imaging, Fundación Santa Fe de Bogotá. Bogotá, Colombia
| | - Juan Nicolás Useche
- Department of diagnostic imaging, Fundación Santa Fe de Bogotá. Bogotá, Colombia
| | - Sonia Bermúdez Muñoz
- Department of diagnostic imaging, Fundación Santa Fe de Bogotá. Bogotá, Colombia
| | - Ricardo Vásquez
- Department of diagnostic imaging, Fundación Santa Fe de Bogotá. Bogotá, Colombia
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de Almeida Melo Maciel Mangueira M, Caparelli-Dáquer E, Filho OPG, de Assis DSFR, Sousa JKC, Lima WL, Pinheiro ALB, Silveira L Jr, Mangueira NM. Raman spectroscopy and sciatic functional index (SFI) after low-level laser therapy (LLLT) in a rat sciatic nerve crush injury model. Lasers Med Sci 2022. [PMID: 35503388 DOI: 10.1007/s10103-022-03565-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 04/23/2022] [Indexed: 10/18/2022]
Abstract
Axonotmesis causes sensorimotor and neurofunctional deficits, and its regeneration can occur slowly or not occur if not treated appropriately. Low-level laser therapy (LLLT) promotes nerve regeneration with the proliferation of myelinating Schwann cells to recover the myelin sheath and the production of glycoproteins for endoneurium reconstruction. This study aimed to evaluate the effects of LLLT on sciatic nerve regeneration after compression injury by means of the sciatic functional index (SFI) and Raman spectroscopy (RS). For this, 64 Wistar rats were divided into two groups according to the length of treatment: 14 days (n = 32) and 21 days (n = 32). These two groups were subdivided into four sub-groups of eight animals each (control 1; control 2; laser 660 nm; laser 808 nm). All animals had surgical exposure to the sciatic nerve, and only control 1 did not suffer nerve damage. To cause the lesion in the sciatic nerve, compression was applied with a Kelly clamp for 6 s. The evaluation of sensory deficit was performed by the painful exteroceptive sensitivity (PES) and neuromotor tests by the SFI. Laser 660 nm and laser 808 nm sub-groups were irradiated daily (100 mW, 40 s, energy density of 133 J/cm2). The sciatic nerve segment was removed for RS analysis. The animals showed accentuated sensory and neurofunctional deficit after injury and their rehabilitation occurred more effectively in the sub-groups treated with 660 nm laser. Control 2 sub-group did not obtain functional recovery of gait. The RS identified sphingolipids (718, 1065, and 1440 cm-1) and collagen (700, 852, 1004, 1270, and 1660 cm-1) as biomolecular characteristics of sciatic nerves. Principal component analysis revealed important differences among sub-groups and a directly proportional correlation with SFI, mainly in the sub-group laser 660 nm treated for 21 days. In the axonotmesis-type lesion model presented herein, the 660 nm laser was more efficient in neurofunctional recovery, and the Raman spectra of lipid and protein properties were attributed to the basic biochemical composition of the sciatic nerve.
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Abstract
Peripheral nerve injuries are a heterogeneous and distinct group of disorders that are secondary to various causes commonly including motor vehicle accidents, falls, industrial accidents, household accidents, and penetrating trauma. The earliest classification of nerve injuries was given by Seddon and Sunderland, which holds true till date and is commonly used. Neuropraxia, axonotmesis, and neurotmesis are the three main types of nerve injuries. The electrophysiological studies including nerve conduction studies (NCS) and electromyography (EMG) play a key role and are now considered an extension of the clinical examination in patients with peripheral nerve injuries. The electrophysiological results should be interpreted in the light of clinical examination. These studies help in localizing the site of lesion, determine the type and severity of lesion, and help in prognosticating. In neuropraxia, the compound muscle action potential (CMAP) and sensory nerve action potential (SNAP) are elicitable on stimulating the nerve distal to the site of the lesion but demonstrate conduction block on proximal stimulation. The electrodiagnostic findings in axonotmesis and neurotmesis are similar. After few days of injury, Wallerian degeneration sets in with failure to record CMAP and SNAP. Intraoperative technique involves recording from the peripheral nerves during the intraoperative period and has proved useful in the surgical management of nerve injuries and helps in identifying the injured nerve, to determine whether the nerve is in continuity and in localizing the site of lesion. Intraoperative monitoring also helps in identifying the nerve close to an ongoing surgery so that surgical damage to the nerve can be prevented.
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Affiliation(s)
- Nitish Kamble
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Dhaval Shukla
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Dhananjay Bhat
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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Marquez Neto OR, Leite MS, Freitas T, Mendelovitz P, Villela EA, Kessler IM. The role of magnetic resonance imaging in the evaluation of peripheral nerves following traumatic lesion: where do we stand? Acta Neurochir (Wien) 2017; 159:281-290. [PMID: 27999953 DOI: 10.1007/s00701-016-3055-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 12/12/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Peripheral nerve injury is a common and important cause of morbidity and disability in patients who have suffered a traumatic injury, particularly younger people. Various different injuries can result in damage to specific nerves. In patients with multiple trauma, the prevalence of peripheral nerve injury is estimated at 2.8%, but can reach 5% with the inclusion of brachial plexus involvement. Physical examination, as well as the origin and location of the trauma, can indicate the nerve involved and the type of nerve damage. However, the depth and severity of damage, and the structures involved often cannot be determined initially, but depend on longer periods of observation to reach a definitive and accurate diagnosis for which treatment can be proposed. Current approaches to locate and assess the severity of traumatic nerve injury involve clinical and electrodiagnostic studies. From a clinical and neurophysiological point of view, nerve injuries are classified in an attempt to correlate the degree of injury with symptoms, type of pathology, and prognosis, as well as to determine the therapy to be adopted. OBJECTIVES MRI in the diagnosis of traumatic peripheral nerve injury has increasingly been used by surgeons in clinical practice. In this article, we analyze the use of magnetic resonance (MR) for the evaluation of traumatic peripheral nerve diseases that are surgically treatable. We also consider basic concepts in the evaluation of technical and MR signs of peripheral nerve injuries. MATERIALS AND METHODS Studies were identified following a computerized search of MEDLINE (1950 to present), EMBASE (1980 to present), and the Cochrane database. The MEDLINE search was conducted on PUBMED, the EMBASE search was conducted on OVID, and the Cochrane database was conducted using their online library. A set was created using the terms: 'traumatic', 'nerve', and 'resonance'. RESULTS The included articles were identified using a computerized search and the resulting databases were then sorted according to the inclusion and exclusion criteria. This yielded 10,340 articles (MEDLINE, n = 758; EMBASE, n = 9564; and Cochrane, n = 18). A search strategy was then built by excluding articles that only concern plexus injury and adding the terms 'neuropathies', 'DTI' and 'neurotmesis'. In total, seven studies were included in the review effectively addressing the role of MRI in the evaluation of traumatic peripheral nerve injury. We extracted all relevant information on the imaging findings and the use of magnetic resonance in trauma. We did not include technical or specific radiological aspects of the imaging techniques. CONCLUSIONS These seven articles were subsequently evaluated by analyzing their results, methodological approach, and conclusions presented.
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Affiliation(s)
- Oswaldo Ribeiro Marquez Neto
- Department of Neurosurgery, University Hospital of Brasilia, UnB, Secretaria de Clínica Cirurgica SGAN 605, Av. L2 Norte, Brasilia, DF, CEP: 70.830200, Brazil.
| | - Matheus Silva Leite
- Department of Neurosurgery, Hospital de Base do Distrito Federal, SMHS - Área Especial- Q. 101, Brasília, DF, CEP :70330-150, Brazil
| | - Tiago Freitas
- Department of Neurosurgery, Hospital de Base do Distrito Federal, SMHS - Área Especial- Q. 101, Brasília, DF, CEP :70330-150, Brazil
| | - Paulo Mendelovitz
- Department of Radiology, University Hospital of Brasilia, UnB, Radiologia SGAN 605, Av. L2 Norte, Brasilia, DF, CEP: 70.830200, Brazil
| | - Eric Arruda Villela
- Department of Hand Surgery, Hospital de Base do Distrito Federal, SMHS - Área Especial- Q. 101, Brasília, DF, CEP :70330-150, Brazil
| | - Iruena Moraes Kessler
- Department of Neurosurgery, University Hospital of Brasilia, UnB, Secretaria de Clínica Cirurgica SGAN 605, Av. L2 Norte, Brasilia, DF, CEP: 70.830200, Brazil
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Barbosa RA, Nunes TLGM, Nunes TLGM, da Paixão AO, Belo Neto R, Moura S, Albuquerque Junior RLC, Cândido EAF, Padilha FF, Quintans-Júnior LJ, Gomes MZ, Cardoso JC. Hydroalcoholic extract of red propolis promotes functional recovery and axon repair after sciatic nerve injury in rats. Pharm Biol 2015; 54:993-1004. [PMID: 26511070 DOI: 10.3109/13880209.2015.1091844] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
CONTEXT Peripheral axon injury and degeneration are often mediated by oxidative stress and inflammation. The hydroalcoholic extract of the red propolis (HERP) has attracted great attention because of its antioxidant and anti-inflammatory activities. OBJECTIVE The objective of this work is to study the effect of HERP on nerve repair and functional recovery after sciatic nerve injury (SNI) in rats. MATERIALS AND METHODS The chemical markers in HERP were identified using high-resolution mass spectroscopy. After axonotmesis of sciatic nerve, ibuprofen (IBP) and HERP treatments were orally administered for 28 d. Behavioural tests were performed weekly after SNI. The myelinated axon number was counted using morphometric analysis. RESULTS The compounds found in HERP were pinocembrin, formononetin, vestitol, and biochanin A. The animals that underwent SNI showed a significant decrease in motor function based on the Basso, Beattie and Bresnahan scale and sciatic functional index compared with sham animals until 7 d after the surgery (p < 0.05). After 14 and 21 d, the SNI groups treated with either HERP or IBP showed significant improvement (p < 0.01), and the SNI group treated with HERP 10 mg/kg showed accelerated motor recovery compared with the other groups (p < 0.01). SNI caused also a reduction in the myelinated axon counts, and treatment with HERP 10 mg/kg induced a significant increase in the number of myelinated fibres compared with all other groups. CONCLUSION HERP promoted regenerative responses and accelerated functional recovery after sciatic nerve crush. Thus, it can be considered to be a new strategy or complementary therapy for treating nerve injuries.
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Affiliation(s)
| | | | | | | | - Reinaldo Belo Neto
- a Department of Healthy and Environment, Tiradentes University , Aracaju , Brazil
| | - Sidnei Moura
- b Department of Technology, University of Caxias Do Sul , Caxias Do Sul , Brazil
| | - Ricardo Luiz Cavalcanti Albuquerque Junior
- a Department of Healthy and Environment, Tiradentes University , Aracaju , Brazil
- c Department of Biomaterials, Morphology and Experimental Pathology, Research and Technology Institute (ITP) , Aracaju , Brazil
| | - Edna Aragão Farias Cândido
- a Department of Healthy and Environment, Tiradentes University , Aracaju , Brazil
- c Department of Biomaterials, Morphology and Experimental Pathology, Research and Technology Institute (ITP) , Aracaju , Brazil
| | - Francine Ferreira Padilha
- a Department of Healthy and Environment, Tiradentes University , Aracaju , Brazil
- c Department of Biomaterials, Morphology and Experimental Pathology, Research and Technology Institute (ITP) , Aracaju , Brazil
| | | | - Margarete Zanardo Gomes
- a Department of Healthy and Environment, Tiradentes University , Aracaju , Brazil
- c Department of Biomaterials, Morphology and Experimental Pathology, Research and Technology Institute (ITP) , Aracaju , Brazil
| | - Juliana Cordeiro Cardoso
- a Department of Healthy and Environment, Tiradentes University , Aracaju , Brazil
- c Department of Biomaterials, Morphology and Experimental Pathology, Research and Technology Institute (ITP) , Aracaju , Brazil
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Chhabra A, Ahlawat S, Belzberg A, Andreseik G. Peripheral nerve injury grading simplified on MR neurography: As referenced to Seddon and Sunderland classifications. Indian J Radiol Imaging 2014. [PMID: 25114384 DOI: 10.4103/0971-3026.137025.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The Seddon and Sunderland classifications have been used by physicians for peripheral nerve injury grading and treatment. While Seddon classification is simpler to follow and more relevant to electrophysiologists, the Sunderland grading is more often used by surgeons to decide when and how to intervene. With increasing availability of high-resolution and high soft-tissue contrast imaging provided by MR neurography, the surgical treatment can be guided following the above-described grading systems. The article discusses peripheral nerve anatomy, pathophysiology of nerve injury, traditional grading systems for classifying the severity of nerve injury, and the role of MR neurography in this domain, with respective clinical and surgical correlations, as one follows the anatomic paths of various nerve injury grading systems.
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Affiliation(s)
- Avneesh Chhabra
- Department of Radiology and Orthopaedic Surgery, University of Texas Southwestern Medical Center, Baltimore, MD, USA
| | - Shivani Ahlawat
- Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Allan Belzberg
- Department of Neurosurgery, The Johns Hopkins Hospital, Baltimore, MD, USA
| | - Gustav Andreseik
- Department of Radiology, University Hospital Zürich, Zürich, Switzerland
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Chhabra A, Ahlawat S, Belzberg A, Andreseik G. Peripheral nerve injury grading simplified on MR neurography: As referenced to Seddon and Sunderland classifications. Indian J Radiol Imaging 2014; 24:217-24. [PMID: 25114384 PMCID: PMC4126136 DOI: 10.4103/0971-3026.137025] [Citation(s) in RCA: 93] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
The Seddon and Sunderland classifications have been used by physicians for peripheral nerve injury grading and treatment. While Seddon classification is simpler to follow and more relevant to electrophysiologists, the Sunderland grading is more often used by surgeons to decide when and how to intervene. With increasing availability of high-resolution and high soft-tissue contrast imaging provided by MR neurography, the surgical treatment can be guided following the above-described grading systems. The article discusses peripheral nerve anatomy, pathophysiology of nerve injury, traditional grading systems for classifying the severity of nerve injury, and the role of MR neurography in this domain, with respective clinical and surgical correlations, as one follows the anatomic paths of various nerve injury grading systems.
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Affiliation(s)
- Avneesh Chhabra
- Department of Radiology and Orthopaedic Surgery, University of Texas Southwestern Medical Center, Baltimore, MD, USA
| | - Shivani Ahlawat
- Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Allan Belzberg
- Department of Neurosurgery, The Johns Hopkins Hospital, Baltimore, MD, USA
| | - Gustav Andreseik
- Department of Radiology, University Hospital Zürich, Zürich, Switzerland
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Ribeiro J, Gartner A, Pereira T, Gomes R, Lopes MA, Gonçalves C, Varejão A, Luís AL, Maurício AC. Perspectives of employing mesenchymal stem cells from the Wharton's jelly of the umbilical cord for peripheral nerve repair. Int Rev Neurobiol 2014; 108:79-120. [PMID: 24083432 DOI: 10.1016/b978-0-12-410499-0.00004-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Mesenchymal stem cells (MSCs) from Wharton's jelly present high plasticity and low immunogenicity, turning them into a desirable form of cell therapy for the injured nervous system. Their isolation, expansion, and characterization have been performed from cryopreserved umbilical cord tissue. Great concern has been dedicated to the collection, preservation, and transport protocols of the umbilical cord after the parturition to the laboratory in order to obtain samples with higher number of viable MSCs without microbiological contamination. Different biomaterials like chitosan-silicate hybrid, collagen, PLGA90:10, poly(DL-lactide-ɛ-caprolactone), and poly(vinyl alcohol) loaded with electrical conductive materials, associated to MSCs have also been tested in the rat sciatic nerve in axonotmesis and neurotmesis lesions. The in vitro studies of the scaffolds included citocompatibility evaluation of the biomaterials used and cell characterization by imunocytochemistry, karyotype analysis, differentiation capacity into neuroglial-like cells, and flow cytometry. The regeneration process follow-up has been performed by functional analysis and the repaired nerves processed for stereological studies permitted the morphologic regeneration evaluation. The MSCs from Wharton's jelly delivered through tested biomaterials should be regarded a potentially valuable tool to improve clinical outcome especially after trauma to sensory nerves. In addition, these cells represent a noncontroversial source of primitive mesenchymal progenitor cells, which can be harvested after birth, cryogenically stored, thawed, and expanded for therapeutic uses. The importance of a longitudinal study concerning tissue engineering of the peripheral nerve, which includes a multidisciplinary team able to develop biomaterials associated to cell therapies, to perform preclinical trials concerning animal welfare and the appropriate animal model is here enhanced.
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Affiliation(s)
- Jorge Ribeiro
- Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Universidade do Porto (UP), Porto, Portugal; Centro de Estudos de Ciência Animal (CECA), Instituto de Ciências e Tecnologias Agrárias e Agro-Alimentares (ICETA), Universidade do Porto (UP), Porto, Portugal
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Waldinger MD, de Lint GJ, van Gils APG, Masir F, Lakke E, van Coevorden RS, Schweitzer DH. Foot orgasm syndrome: a case report in a woman. J Sex Med 2013; 10:1926-34. [PMID: 23782523 DOI: 10.1111/jsm.12217] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Spontaneous orgasm triggered from inside the foot has so far not been reported in medical literature. AIMS The study aims to report orgasmic feelings in the left foot of a woman. METHODS A woman presented with complaints of undesired orgasmic sensations originating in her left foot. In-depth interview, physical examination, sensory testing, magnetic resonance imaging (MRI-scan), electromyography (EMG), transcutaneous electrical nerve stimulation (TENS), and blockade of the left S1 dorsal root ganglion were performed. MAIN OUTCOME MEASURES The main outcomes are description of this clinical syndrome, results of TENS application, and S1 dorsal root ganglion blockade. RESULTS Subtle attenuation of sensory amplitudes of the left suralis, and the left medial and lateral plantar nerve tracts was found at EMG. MRI-scan disclosed no foot abnormalities. TENS at the left metatarso-phalangeal joint-III of the left foot elicited an instant orgasmic sensation that radiated from plantar toward the vagina. TENS applied to the left side of the vagina elicited an orgasm that radiated to the left foot. Diagnostic blockade of the left S1 dorsal root ganglion with 0.8 mL bupivacaine 0.25 mg attenuated the frequency and intensity of orgasmic sensation in the left foot with 50% and 80%, respectively. Additional therapeutic blockade of the same ganglion with 0.8 mL bupivacaine 0.50 mg combined with pulsed radiofrequency treatment resulted in a complete disappearance of the foot-induced orgasmic sensations. CONCLUSION Foot orgasm syndrome (FOS) is descibed in a woman. Blockade of the left S1 dorsal root ganglion alleviated FOS. It is hypothesized that FOS, occurring 1.5 years after an intensive care emergency, was caused by partial nerve regeneration (axonotmesis), after which afferent (C-fiber) information from a small reinnervated skin area of the left foot and afferent somatic and autonomous (visceral) information from the vagina on at least S1 spinal level is misinterpreted by the brain as being solely information originating from the vagina.
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Affiliation(s)
- Marcel D Waldinger
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of BetaSciences, Utrecht University, Utrecht, The Netherlands.
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