[Surgical treatment of nerve lesions]. / Operatieve behandeling van zenuwletsels.

A peripheral nerve lesion may result in loss of motor and sensory function and pain. Nerve surgery may lead to function recovery or contribute to pain reduction. Different surgical techniques are used depending on the specific type of lesion. Common techniques consist of coapting, grafting, moving or burying the nerve. The outcome depends on the interval between the time the lesion occurred and the time of repair as well as the patient's age. Here we present three case studies of patients with a different type of nerve lesion and its consequences. We describe the specific surgical intervention performed to treat the nerve lesion. Immediate repair of the nerve should be performed when the patient has an open wound. In closed lesions, the decision to repair a damaged nerve depends on the severity of the trauma, the nerve(s) involved, the location and the age of the patient. In general, repair should be performed as soon as possible.

[DoNTRuN a neurosurgical trainee network; network for the advancement of clinical research]. / DoNTRuN, een neurochirurgisch assistentennetwerk.

There is a lot of research into the effectiveness of interventions, but good evidence for many interventions is missing. This is very true of simple and frequently performed treatments. These interventions are often done by trainees in the course of their specialist training, and for this reason they are in a unique position to carry out research into them. There are far fewer high-quality, multicentre clinical trials in the surgical specialisations than in any other specialisation. As trainee neurosurgeons, we are of the opinion that this can be improved upon. With the establishment of the Dutch Neurosurgical Trainee Research Network (DoNTRuN), a national network, we are aiming to initiate and carry out new clinical trials. This initiative, which is currently unique in the Netherlands, will not only enable us to set up multicentre clinical trials relatively simply, but will also educate trainees in the carrying out of thorough clinical research, an area neglected in the current training program.

SGCZ mutations are unlikely to be associated with myoclonus dystonia.

BACKGROUND: Myoclonus dystonia syndrome (MDS) is a hyperkinetic movement disorder caused, in a proportion of cases, by mutations of the maternally imprinted epsilon-sarcoglycan gene (SGCE). SGCE mutation rates vary between cohorts, suggesting genetic heterogeneity. E- and ζ-sarcoglycan are both expressed in brain tissue. In this study we tested whether zeta-sarcoglycan gene (SGCZ) mutations also contribute to this disorder. METHODS: Patients with clinically suspected MDS and no SGCE mutation were recruited and classified, according to previously published criteria, as to their likelihood of the movement disorder. All SGCZ exons and intron/exon boundaries were screened by direct sequencing. RESULTS: Fifty-four SGCE mutation-negative patients were recruited from the UK and the Netherlands. Subdivided according to the likelihood of the movement disorder resulted in 17 'definite', 16 'probable' and 21 'possible' cases. No pathogenic SGCZ mutations were identified. CONCLUSIONS: SGCZ mutations are unlikely to contribute to the genetic heterogeneity in MDS.

Differentiation of neurons and radial glia in the spinal cord of the teleost Brachydanio rerio (the zebrafish): An immunocytochemical study.

The differentiation of neurons and glial cells in the spinal cord of the zebrafish was studied by means of immunohistochemistry, using antisera against the 68 kD subunit of neurofilament (anti-NFP68) and against glial fibrillary acidic protein (anti-GFAP), both isolated from the bovine brain. Anti-NFP68 and anti-GFAP reactivity appear in the spinal cord at about 60 h after fertilization. At that time the anti-NFP68 reactivity is detectable in the dorsal Rohon-Beard neurons. About 12 h later, NFP68 positive neurons appear in the prospective motor column. In this respect the differentiation of the primary sensory system precedes that of the spinal motor system. During development the configuration of the glial cell processes changes from a horizontal arrangement in embryos to a radial frame work in larvae and in adults. From these observations together with data on the organization of the adult spinal motor column(28) we conclude that the motoneurons of the white and those of the red myotomal muscle fibers may have different origins in the neuroepithelial germinal layer. The anti-NFP68 serum recognizes a 120 and a 94 kD component of fish neurofilaments. Thus the subunit composition of neurofilament in fishes differs from that in mammals.