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1.
Sci Rep ; 10(1): 4108, 2020 03 05.
Article in English | MEDLINE | ID: mdl-32139771

ABSTRACT

Susceptibility to root-knot nematodes (Meloidogyne spp.) is one of the major factors limiting mungbean production in South and South-East Asia. Host-pest-environment interaction in mungbean and root-knot nematode (M. incognita) was investigated in multi-location field evaluation using 38 promising mungbean genotypes extracted from initial evaluation of 250 genotypes under sick plots considering second stage freshly hatched juvenile as inoculants. The extent of environmental and genotype-by-environment interactions (GGE) was assessed to comprehend the dynamism of resistance and identification of durable resistant mungbean genotypes. Among environmental factors, nematode activity was highly influenced by rainfall and minimum temperature. The GGE biplot and multiple comparison tests detected a higher proportion of genotype × environment (GE) interaction followed by genotype and environment on number of nematode galls, gall index and reproduction factor. The first two principal components (PCs) explained 64.33% and 66.99% of the total variation of the environment-centered gall scoring and reproduction factor data, respectively. The high GE variation indicated the presence of non-cross over interactions which justify the necessities of multi-location testing. Detection of non-redundant testing locations would expedite optimum resource utilization in future. The GGE biplot analysis identified genotypes such as PM-10-12, IPM-410-3 and NVL-641 as the outperforming and desirable genotypes with durable resistance against M. incognita which can be exploited in mungbean breeding programmes globally. On the contrary, the highest gall scoring and reproduction factor were recorded in genotype IPM-9901-8. Computation of confidence interval (CI) at 95% level through bootstrapping increased precision of GGE biplot towards genotype recommendation. Furthermore, total phenol content, ascorbic acid, phenlylalanine ammonia lyase (PAL) and polyphenol oxidase (PPO) activities were also higher in identified resistant genotypes and this information would be useful for devising mungbean breeding strategies in future for resistance against root-knot nematodes.


Subject(s)
Gene-Environment Interaction , Plant Diseases/parasitology , Tylenchoidea , Vigna/parasitology , Animals , Disease Resistance , Genotype , Plant Diseases/genetics , Vigna/genetics , Vigna/immunology
2.
Curr Med Chem ; 19(32): 5572-9, 2012.
Article in English | MEDLINE | ID: mdl-22834817

ABSTRACT

Genetic engineering of stem cells and their derivatives has the potential to enhance their regenerative capabilities. Here, dendrimer- and lipofection-based approaches were used for non-viral neurotrophin-3 (NT-3) over-expression in Schwann cells differentiated from skin precursors (SKP-SCs). A variety of dendrimers were first tested for transfection efficiency on HEK 293T cells, with PAMAMNH2 G4 found most effective and used subsequently for SKP-SCs transfection. Plasmid-based expression resulted in increased NT-3 release from SKP-SCs in both adherent and microcarrier-based culture. In a proof-of-concept study, the microcarrier/SKP-SCs were implanted into the injured nerve, and transfected cells were shown to detach, integrate into the nerve tissue and associate with regenerating axons. Virus-free systems for transient neurotrophin expression are a feasible and biologically safe option to increase the therapeutic value of stem cells and stem cell-derived cells in nerve repair strategies. Further work to develop bioprocesses for expansion of SKP-SCs on microcarriers in bioreactors is still needed.


Subject(s)
Neurotrophin 3/metabolism , Schwann Cells/metabolism , Transfection/methods , Animals , Cells, Cultured , Dendrimers , Female , HEK293 Cells , Humans , Nerve Regeneration , Polypropylenes , Rats , Rats, Inbred Lew , Sciatic Nerve/injuries , Sciatic Nerve/physiology , Skin/cytology , Stem Cell Transplantation
3.
Oncogene ; 30(29): 3234-47, 2011 Jul 21.
Article in English | MEDLINE | ID: mdl-21383692

ABSTRACT

Claudin-2 is a unique member of the claudin family of transmembrane proteins, as its expression is restricted to the leaky epithelium in vivo and correlates with epithelial leakiness in vitro. However, recent evidence suggests potential functions of claudin-2 that are relevant to neoplastic transformation and growth. In accordance, here we report, on the basis of analysis of mRNA and protein expression using a total of 309 patient samples that claudin-2 expression is significantly increased in colorectal cancer and correlates with cancer progression. We also report similar increases in claudin-2 expression in inflammatory bowel disease-associated colorectal cancer. Most importantly, we demonstrate that the increased claudin-2 expression in colorectal cancer is causally associated with tumor growth as forced claudin-2 expression in colon cancer cells that do not express claudin-2 resulted in significant increases in cell proliferation, anchorage-independent growth and tumor growth in vivo. We further show that the colonic microenvironment regulates claudin-2 expression in a manner dependent on signaling through the EGF receptor (EGFR), a key regulator of colon tumorigenesis. In addition, claudin-2 expression is specifically decreased in the colon of waved-2 mice, naturally deficient in EGFR activation. Furthermore, genetic silencing of claudin-2 expression in Caco-2, a colon cancer cell line, prevents the EGF-induced increase in cell proliferation. Taken together, these results uncover a novel role for claudin-2 in promoting colon cancer, potentially via EGFR transactivation.


Subject(s)
Colonic Neoplasms/genetics , ErbB Receptors/genetics , Membrane Proteins/metabolism , Transcriptional Activation , Animals , Caco-2 Cells , Cell Division/genetics , Claudins , Colonic Neoplasms/etiology , Colonic Neoplasms/pathology , Epidermal Growth Factor/pharmacology , Fluorouracil/pharmacology , Gene Expression Regulation, Neoplastic/drug effects , Gene Silencing , Humans , Inflammatory Bowel Diseases/etiology , Inflammatory Bowel Diseases/genetics , Inflammatory Bowel Diseases/pathology , Membrane Proteins/genetics , Mice , Mice, Nude , Protein Kinases/metabolism , RNA, Messenger/genetics , Up-Regulation
5.
Neuroscience ; 164(3): 1097-107, 2009 Dec 15.
Article in English | MEDLINE | ID: mdl-19737602

ABSTRACT

Introduction of autologous stem cells into the site of a nerve injury presents a promising therapy to promote axonal regeneration and remyelination following peripheral nerve damage. Given their documented ability to differentiate into Schwann cells (SCs) in vitro, we hypothesized that skin-derived precursor cells (SKPs) could represent a clinically-relevant source of transplantable cells that would enhance nerve regeneration following peripheral nerve injury. In this study, we examined the potential for SKP-derived Schwann cells (SKP-SCs) or nerve-derived SCs to improve nerve regeneration across a 12 mm gap created in the sciatic nerve of Lewis rats bridged by a freeze-thawed nerve graft. Immunohistology after 4 weeks showed survival of both cell types and early regeneration in SKP seeded grafts was comparable to those seeded with SCs. Histomorphometrical and electrophysiological measurements of cell-treated nerve segments after 8 weeks survival all showed significant improvement as compared to diluent controls. A possible mechanistic explanation for the observed results of improved regenerative outcomes lies in SKP-SCs' ability to secrete bioactive neurotrophins. We therefore conclude that SKPs represent an easily accessible, autologous source of stem cells for transplantation therapies which act as functional Schwann cells and show great promise in improving regeneration following nerve injury.


Subject(s)
Nerve Regeneration/physiology , Peripheral Nerves/transplantation , Schwann Cells/metabolism , Skin Transplantation/methods , Skin/cytology , Stem Cell Transplantation/methods , Stem Cells/physiology , Animals , Animals, Newborn , Cell Differentiation/physiology , Cells, Cultured , Graft Survival/physiology , Nerve Growth Factors/metabolism , Neurogenesis/physiology , Peripheral Nerve Injuries , Peripheral Nerves/physiology , Rats , Rats, Inbred Lew , Schwann Cells/cytology , Sciatic Neuropathy/physiopathology , Sciatic Neuropathy/surgery , Stem Cells/cytology , Transplantation, Autologous , Treatment Outcome
6.
Neuroscience ; 152(4): 877-87, 2008 Apr 09.
Article in English | MEDLINE | ID: mdl-18358630

ABSTRACT

During regeneration of injured peripheral nerves, local conditions may influence how regenerative axon sprouts emerge from parent axons. More extensive lesions might be expected to disrupt such growth. In this work, we discovered instead that long segmental crush injuries facilitate the growth and maturation of substantially more axon sprouts than do classical short crush injuries (20 mm length vs. 2 mm). At identical distances from the proximal site of axon interruption there was a 45% rise in the numbers of neurofilament labeled axons extending through a long segmental crush zone by 1 week. By 2 weeks, there was a 35% greater density of regenerating myelinated axons in long compared with short crush injuries just beyond (5 mm) the proximal injury site. Moreover, despite the larger numbers of axons, their maturity was identical and they were regular, parallel, associated with Schwann cells (SCs) and essentially indistinguishable between the injuries. Backlabeling with Fluorogold indicated that despite these differences, the axons arose from similar numbers of parent motor and sensory neurons. Neither injury was associated with ischemia. Both injuries were associated with rises in GFAP (glial acidic fibrillary protein) and p75 mRNAs, markers of SC plasticity but p75, GFAP and brain-derived neurotrophic factor mRNAs did not differ between the injuries. There was a higher local mRNA level of GAP43/B50 at 7 days following injury and a higher sonic hedgehog protein (Shh) mRNA at 24 h in long crush zones. GAP43/B50 protein and SHH protein both had prominent localization within regenerating axons. Long segmental nerve trunk crush injuries do not impair regeneration but instead generate greater axon plasticity that results in larger numbers of mature myelinated axons. The changes occur without apparent change in SC activation, overall nerve architecture or nerve blood flow. While the mechanism is uncertain, the findings indicate that manipulation of the nerve microenvironment can induce substantial changes in regenerative sprouting.


Subject(s)
Axons/physiology , Nerve Regeneration/physiology , Sciatic Neuropathy/pathology , Sciatic Neuropathy/physiopathology , Analysis of Variance , Animals , Axons/metabolism , Disease Models, Animal , Gene Expression Regulation , Glial Fibrillary Acidic Protein/metabolism , Hedgehog Proteins/metabolism , Laser-Doppler Flowmetry/methods , Male , Nerve Fibers, Myelinated/pathology , Nerve Fibers, Myelinated/physiology , Neurofilament Proteins/metabolism , Neurons/metabolism , Neurons/pathology , Nitric Oxide Synthase Type II/metabolism , Rats , Rats, Sprague-Dawley , Receptor, Nerve Growth Factor/metabolism , Regional Blood Flow/physiology , Sciatic Neuropathy/metabolism , Stilbamidines/metabolism , Time Factors
7.
Eur J Clin Invest ; 36(8): 544-51, 2006 Aug.
Article in English | MEDLINE | ID: mdl-16893376

ABSTRACT

BACKGROUND: Cardiovascular (CV) disease is associated with increased levels of glucose, but the prevalence of dysglycaemia in CV diseases is not fully known. The study examined the prevalence of unknown dysglycaemia and its association with inflammation in Caucasian patients with ischaemic vascular complications, i.e. coronary artery disease (CAD), cerebrovascular disease (CVD) and peripheral artery disease (PAD). MATERIALS AND METHODS: This case-controlled study involved 149 patients (mean age 68 years) hospitalized for CAD, PAD or CVD and 59 control-subjects (CTR) free from CV-disease. The prevalence of dysglycaemia according to WHO/ADA criteria (impaired fasting glycaemia, impaired glucose tolerance or diabetes mellitus) was assessed by a 75-g oral glucose tolerance test. Inflammatory parameters were analyzed in fasting samples. RESULTS: Dysglycaemia was found in 49%, 55% and 57% of patients with CAD, CVD and PAD, respectively; all were significantly higher than among the controls (29%). The odds ratio (95% CI) for being dysglycaemic were 1.7 (1.04-2.77), 1.9 (1.19-3.06) and 2.0 (1.25-3.19) for CAD, CVD and PAD, respectively. Inflammatory markers (the total leucocyte count, soluble tumour necrosis factor-receptor type I, C-reactive protein) were elevated in patient groups and tended to increase with increasing blood glucose levels in all groups. The levels of the anti-inflammatory cytokine transforming growth factor-beta1 and insulin-like growth factor binding protein 3 were lowered in patients with CAD and, in patients with PAD, the former was inversely related to the levels of the blood glucose. CONCLUSIONS: Undiagnosed dysglycaemia was common in patients with ischaemic CV manifestations regardless of vascular bed involved. Inflammation was associated in a dosage-related manner to glucose levels.


Subject(s)
Cardiovascular Diseases/complications , Glucose Metabolism Disorders/diagnosis , Adult , Biomarkers/blood , Cardiovascular Diseases/metabolism , Cerebrovascular Disorders/complications , Cerebrovascular Disorders/metabolism , Cholesterol/blood , Coronary Artery Disease/complications , Coronary Artery Disease/metabolism , Female , Glucose/metabolism , Glucose Metabolism Disorders/etiology , Glucose Metabolism Disorders/metabolism , Glucose Tolerance Test , Humans , Hyperglycemia/diagnosis , Hyperglycemia/etiology , Hyperglycemia/metabolism , Inflammation/metabolism , Male , Peripheral Vascular Diseases/complications , Peripheral Vascular Diseases/metabolism
8.
Neuropathol Appl Neurobiol ; 29(6): 563-73, 2003 Dec.
Article in English | MEDLINE | ID: mdl-14636163

ABSTRACT

There is mounting evidence that a significant portion of cerebrospinal fluid drainage is associated with transport along cranial and spinal nerves with absorption taking place into lymphatic vessels external to the central nervous system. To characterize these pathways further, yellow Microfil was infused into the cisterna magna of 2-7-day-old lambs post mortem to perfuse either the cranial or spinal subarachnoid compartments. In some animals, blue Microfil was perfused into the carotid arteries simultaneously. Microfil was observed in lymphatic networks in the nasal mucosa, covering the hard and soft palate, conchae, nasal septum, the ethmoid labyrinth and the lateral walls of the nasal cavity. Many of these lymphatics drained into vessels located on the lateroposterior wall of the nasopharynx and from this location drained to the retropharyngeal lymph nodes. Additionally, lymphatics containing Microfil penetrated the lateral wall of the nasal cavity and joined with superficial lymphatic ducts travelling towards the submandibular and preauricular lymph nodes. In two cases, lymphatic vessels were observed anastomosing with deep veins in the retropharyngeal area. Microfil was also distributed within the nerve trunks of cranial and spinal nerves. The contrast agent was located in longitudinal channels within the endoneurial space and lymphatics containing Microfil were observed emerging from the mesoneurium. In summary, Microfil distribution patterns in neonatal lambs illustrated the important role that cranial and spinal nerves play in linking the subarachnoid compartment with extracranial lymphatics.


Subject(s)
Brain/metabolism , Cerebrospinal Fluid/physiology , Lymphatic System/anatomy & histology , Absorption , Animals , Animals, Newborn , Injections, Intraventricular , Sheep , Silicone Elastomers/administration & dosage , Subarachnoid Space
9.
Am J Physiol Regul Integr Comp Physiol ; 281(4): R1215-23, 2001 Oct.
Article in English | MEDLINE | ID: mdl-11557630

ABSTRACT

We quantified cerebrospinal fluid (CSF) transport (conductance) and CSF outflow resistance in late-gestation fetal and adult sheep using two methods, a constant pressure infusion method and a bolus injection technique into the lateral ventricles. No significant differences in CSF conductance (fetus 0.013 +/- 0.002, adult 0.014 +/- 0.003 ml x min(-1) x cm H(2)O(-1)) or CSF outflow resistance (fetus 83.7 +/- 9.8, adult 84.7 +/- 19.7 cm H(2)O x ml(-1) x min) were observed. To confirm CSF transport to plasma in fetal animals, (125)I- or (131)I-labeled human serum albumin (HSA) was injected into the lateral ventricles. The tracer entered fetal plasma with an average mass transport rate of 1.91 +/- 0.47% injected/h (n = 9). In two fetuses, we monitored the tracer appearance in plasma and cervical and thoracic duct lymph after injection of radioactive HSA into the ventricular CSF. As was the case in adult animals, fetal tracer concentrations increased in all three compartments over time, with the highest concentrations measured in lymph collected from the cervical lymphatics. These results 1) indicate that global CSF transport parameters in the late-gestation fetus and adult sheep are similar and 2) suggest an important role for extracranial lymphatic vessels in CSF transport before birth.


Subject(s)
Cerebrospinal Fluid/physiology , Fetus/physiology , Animals , Biological Transport/physiology , Cerebrospinal Fluid Pressure/physiology , Female , Injections, Intraventricular , Intracranial Pressure/physiology , Pregnancy , Serum Albumin, Radio-Iodinated/blood , Serum Albumin, Radio-Iodinated/cerebrospinal fluid , Serum Albumin, Radio-Iodinated/pharmacokinetics , Solutions/administration & dosage , Solutions/pharmacokinetics
10.
Can J Neurol Sci ; 28(3): 239-44, 2001 Aug.
Article in English | MEDLINE | ID: mdl-11513343

ABSTRACT

BACKGROUND: We undertook a prospective study to investigate relationships between outcome measures of ulnar neuropathy at the elbow. METHODS: Thirty-one patients (mean age 52.6, range 20-80), with clinically and electrically verified ulnar neuropathy at the elbow, were seen independently by a neurosurgeon and a physiotherapist. All tests were administered to all patients on each visit. Data collected included measures of sensory (monofilament, two-point discrimination, vibration) and motor function (grip, key-pinch, muscle atrophy), pain (visual analogue scale (VAS)) and impact on lifestyle (Levine's questionnaires (function status score--FSS, symptom severity score--SSS)), disability of the arm, shoulder and hand module (DASH) and patient-specific measures (PSM). Parametric and non-parametric correlation and factor analysis were done. RESULTS: Outcome analysis was available for 63 patient visits, with follow-up obtained for 20 patients (mean 8.5 months). Lifestyle and pain instruments (FSS, SSS, DASH, PSM and VAS) all correlated well with each other (r > 0.6, p < .01). DASH was moderately to highly correlated to nine of the 11 measures. Some tests correlated poorly, for example, Semmes-Weinstein monofilament with other sensory measures and muscle atrophy with almost all measures. Factor analysis revealed that there are two principal factors, accounting for 77% of the variance. Factor 1 relates to impact on lifestyle and pain while Factor 2 relates to strength and function. DISCUSSION/CONCLUSIONS: Intraclass measures, particularly ones assessing lifestyle and pain instruments are strongly correlated. Factor analysis revealed two principal factors that account for the majority of the variance; future studies with a larger sample size are needed to validate this analysis.


Subject(s)
Elbow/pathology , Peripheral Nervous System Diseases/therapy , Ulnar Nerve , Adult , Aged , Aged, 80 and over , Elbow/innervation , Female , Follow-Up Studies , Hand Strength/physiology , Humans , Male , Middle Aged , Pain Measurement , Peripheral Nervous System Diseases/pathology , Prospective Studies , Treatment Outcome
11.
Can J Neurol Sci ; 28(2): 155-8, 2001 May.
Article in English | MEDLINE | ID: mdl-11383942

ABSTRACT

BACKGROUND: Traumatic retroperitoneal hematoma in the iliacus muscle is an unusual but potentially serious cause of femoral compression neuropathy. CASE REPORT: We describe the clinical, imaging, and management features of a case of traumatic iliacus retroperitoneal hematoma with delayed manifestation of femoral neuropathy. DISCUSSION: The anatomical substrate for hematoma formation with subacute compression of the femoral nerve is emphasized. A subacute compartment syndrome with progressive edema, swelling and ischemia of iliacus compartment is suggested as the underlying cause. Early fasciotomy with or without hematoma evacuation should be considered in order to provide rapid decompression and to minimize the chance of permanent nerve injury.


Subject(s)
Femoral Nerve , Hematoma/complications , Nerve Compression Syndromes/etiology , Adolescent , Athletic Injuries/complications , Athletic Injuries/diagnostic imaging , Hematoma/diagnostic imaging , Humans , Ilium , Male , Nerve Compression Syndromes/diagnostic imaging , Retroperitoneal Space , Tomography, X-Ray Computed
12.
Neurosurgery ; 48(5): 1166-9, 2001 May.
Article in English | MEDLINE | ID: mdl-11334287

ABSTRACT

OBJECTIVE AND IMPORTANCE: We report the first case in the literature of cervical myelopathy caused by progressive cord compression as a result of epithelioid hemangioendothelioma of the cervical vertebra. CLINICAL PRESENTATION: A 58-year-old man presented with progressive cervical myelopathy. Imaging revealed a vascular, expansile lesion of contiguous cervical vertebrae causing cord compression. The surgical pathology revealed epithelioid hemangioendothelioma, a rare tumor not previously reported to present in such a fashion. INTERVENTION: Preoperative embolization and a two-stage anterior and posterior surgical decompression and fusion procedure were performed. The high vascularity of this lesion makes surgery a formidable surgical challenge. Adjuvant radiotherapy was administered to the residual tumor because of its potential for low-grade malignancy. CONCLUSION: The diagnosis relied on accurate histopathological assessment. The general principles of achieving cord decompression and tumor control are important. The literature on epithelioid hemangioendothelioma involving the spine is reviewed, and the tumor biology and the role of adjuvant therapy are discussed.


Subject(s)
Hemangioendothelioma/complications , Spinal Cord Compression/etiology , Spinal Cord Diseases/etiology , Spinal Neoplasms/complications , Angiography, Digital Subtraction , Cervical Vertebrae , Decompression, Surgical , Embolization, Therapeutic , Hemangioendothelioma/diagnosis , Hemangioendothelioma/pathology , Hemangioendothelioma/surgery , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Preoperative Care , Spinal Cord Compression/complications , Spinal Cord Compression/surgery , Spinal Fusion , Spinal Neoplasms/diagnosis , Spinal Neoplasms/pathology , Spinal Neoplasms/surgery , Tomography, X-Ray Computed
13.
Am J Physiol Regul Integr Comp Physiol ; 280(5): R1573-81, 2001 May.
Article in English | MEDLINE | ID: mdl-11294783

ABSTRACT

Tracer studies indicate that cerebrospinal fluid (CSF) transport can occur through the cribriform plate into the nasal submucosa, where it is absorbed by cervical lymphatics. We tested the hypothesis that sealing the cribriform plate extracranially would impair the ability of the CSF pressure-regulating systems to compensate for volume infusions. Sheep were challenged with constant flow or constant pressure infusions of artificial CSF into the CSF compartment before and after the nasal mucosal side of the cribriform plate was sealed. With both infusion protocols, the intracranial pressure (ICP) vs. flow rate relationships were shifted significantly to the left when the cribriform plate was blocked. This indicated that obstruction of the cribriform plate reduced CSF clearance. Sham surgical procedures had no significant effects. Estimates of the proportional flow through cribriform and noncribriform routes suggested that cranial CSF absorption occurred primarily through the cribriform plate at low ICPs. Additional drainage sites (arachnoid villi or other lymphatic pathways) appeared to be recruited only when intracranial pressures were elevated. These data challenge the conventional view that CSF is absorbed principally via arachnoid villi and provide further support for the existence of several anatomically distinct cranial CSF transport pathways.


Subject(s)
Intracranial Pressure/physiology , Lymphatic System/physiology , Animals , Cerebrospinal Fluid/physiology , Female , Homeostasis , Hydrocephalus/physiopathology , Models, Animal , Nasal Mucosa/physiology , Sheep
15.
Magn Reson Med ; 45(3): 415-20, 2001 Mar.
Article in English | MEDLINE | ID: mdl-11241698

ABSTRACT

T(1) and T(2) relaxation times, magnetization transfer (MT), and diffusion anisotropy of rat sciatic nerve were measured at different time intervals following trauma. The nerve injury was induced by either cutting (irreversible nerve degeneration) or crushing (degeneration followed by regeneration). The MR properties were measured for proximal and distal portions of the injured nerve. The portions of the nerve proximal to the induced injury exhibited MR characteristics similar to those of normal nerves, whereas the distal portions showed significant differences in all MR parameters. These differences diminished in the regenerating nerves within approximately 4 weeks post injury. In the case of irreversible nerve damage, the differences in the distal nerves were slightly larger and did not resolve even 6 weeks after induced trauma. The MR measurements were correlated with histopathology exams. Observed changes in tissue microstructure, such as demyelination, inflammation, and axonal loss, can result in a significant increase in the average T(1) and T(2) relaxation times, reduction in the MT effect, and decrease in diffusion anisotropy. MR parameters, therefore, are very good indicators of nerve damage and may be useful in monitoring therapies that assist nerve regeneration. Magn Reson Med 45:415-420, 2001.


Subject(s)
Magnetic Resonance Imaging , Sciatic Nerve/injuries , Sciatic Neuropathy/diagnosis , Animals , Male , Nerve Regeneration/physiology , Rats , Rats, Inbred Lew , Sciatic Nerve/pathology , Sciatic Neuropathy/pathology , Sensitivity and Specificity
16.
J Neurosurg ; 94(1): 102-10, 2001 Jan.
Article in English | MEDLINE | ID: mdl-11147877

ABSTRACT

OBJECT: Rejection of nerve allografts and loss of regenerated host axons after withdrawal of immunosuppressive therapy poses an ongoing challenge in peripheral nerve repair. The present report is of a blinded prospective controlled study in which an established rat model of nerve allotransplantation is used to examine the effect of fiber type on survival and degeneration of nerve allografts after discontinuation of immunosuppression. The authors hypothesized that sensory axons will selectively resist a rejection response, whereas motor axons will degenerate. METHODS: Four-centimeter nerve segments from ACI rats were grafted into peroneal and sural (mixed) or saphenous (sensory) nerve gaps in Lewis rats. In some rats, L4-6 dorsal root ganglia were ablated before grafting, creating pure motor sural and peroneal nerves. All rats received 12 weeks of immunosuppressive therapy to support nerve regeneration into allografts. Immunosuppression with cyclosporin was then withdrawn. At planned death (12-18 weeks postsurgery), graft tissue was subjected to histomorphometric analysis for evaluation of axon survival and loss. Graft rejection led to loss of all axons in approximately 60% of the allograft segments. The mixed nerve group was most prone to complete rejection, with significantly lowered axon counts at Weeks 16 and 18 compared with the Week 12 baseline. Axons from the sensory nerve were least likely to degenerate. The pure motor nerve group axons demonstrated intermediate sensitivity, with a selective loss of larger axons at Week 16 and a significant decrease in axon counts from the Week 12 baseline at Week 18. CONCLUSIONS: Whereas the majority of axons are lost after withdrawal of immunosuppressive therapy from nerve allografts, there is a selective survival of axons from cutaneous sensory nerves and smaller-diameter motor fibers. The biological and molecular mechanisms that make some axons impervious to injury remain to be determined.


Subject(s)
Axons/physiology , Cyclosporine/administration & dosage , Immunosuppressive Agents/administration & dosage , Motor Neurons/physiology , Nerve Tissue/transplantation , Neurons, Afferent/physiology , Animals , Axons/drug effects , Cell Survival , Cyclosporine/pharmacology , Ganglia, Spinal/surgery , Immunosuppressive Agents/pharmacology , Male , Motor Neurons/drug effects , Nerve Tissue/drug effects , Nerve Tissue/pathology , Neurons, Afferent/drug effects , Rats , Rats, Inbred ACI , Rats, Inbred Lew , Skin/innervation , Time Factors , Transplantation, Homologous
17.
Spine (Phila Pa 1976) ; 25(17): 2269-71, 2000 Sep 01.
Article in English | MEDLINE | ID: mdl-10973414

ABSTRACT

STUDY DESIGN: This is a report of a rare presentation of a split cord malformation with diastometamyelia. OBJECTIVES: This report draws attention to the fact that the only manifestation of diastmetamyelia in the adult patient may be neurogenic claudication. SUMMARY OF BACKGROUND DATA: Patients with split cord malformations and diastometamyelia rarely have symptomatic onset in adulthood. When present, a traumatic event leading to an acute neurologic change is the usual presentation. METHODS: An adult patient presented with symptoms of neurogenic claudication in the left leg. Magnetic resonance imaging examination showed a split cord malformation and diastometamylia at L3-L4 with spinal stenosis of the left hemicord. Decompressive laminectomy and subtotal resection of the bony spur were performed. RESULTS: Two years after decompression, the patient has complete resolution of his leg symptoms and is back to work. CONCLUSIONS: Neurogenic claudication without any objective neurologic deficit or neurocutaneous stigmas of an underlying spinal cord abnormality may be the only presentation in the adult with diastometamyelia. Decompression to relieve both clinical and radiologic evidence of spinal stenosis obtained excellent outcome.


Subject(s)
Intermittent Claudication/etiology , Neural Tube Defects/complications , Spinal Cord/abnormalities , Spinal Dysraphism/complications , Adult , Humans , Intermittent Claudication/pathology , Intermittent Claudication/surgery , Magnetic Resonance Imaging , Male , Neural Tube Defects/pathology , Neural Tube Defects/surgery , Spinal Cord/pathology , Spinal Cord/surgery , Spinal Dysraphism/pathology , Spinal Dysraphism/surgery , Tomography, X-Ray Computed , Treatment Outcome
18.
Pediatr Neurosurg ; 32(5): 226-9, 2000 May.
Article in English | MEDLINE | ID: mdl-10965267

ABSTRACT

Isolated axillary nerve injury is uncommon, particularly in children. The motor deficit of shoulder abduction may not recover spontaneously and can be a substantial handicap. Detection may be difficult initially, as the injury is masked by trauma such as head injury, and concomitant shoulder injury requiring immobilization. After mobilization, patients learn to partially compensate by using alternate muscles. There are few reports of surgical management of this nerve injury. Most concern predominantly adults, and the results are mixed with on average slightly greater than half having a good recovery (defined as grade 4-5 Medical Research Council muscle power). We present our experience with 4 pediatric patients who had axillary nerve injury. Three patients had an interposition nerve graft, and 1 patient underwent neurolysis. All patients recovered to grade 4-5 deltoid muscle power. Children with an axillary nerve injury which fails to recover spontaneously by 4-6 months should strongly be considered for surgical exploration.


Subject(s)
Axilla/innervation , Brachial Plexus Neuropathies/surgery , Muscle, Skeletal/pathology , Neuroma/surgery , Adolescent , Brachial Plexus Neuropathies/etiology , Brachial Plexus Neuropathies/pathology , Brachial Plexus Neuropathies/physiopathology , Child , Electromyography , Female , Humans , Male , Muscle, Skeletal/innervation , Muscle, Skeletal/physiopathology , Nerve Transfer , Neuroma/etiology , Neurosurgical Procedures , Paresis , Recovery of Function , Shoulder Dislocation/complications , Shoulder Fractures/complications
19.
Neurol Med Chir (Tokyo) ; 40(4): 187-99, 2000 Apr.
Article in English | MEDLINE | ID: mdl-10853317

ABSTRACT

In this review, various conventional nerve repair techniques including direct epineurial repair, grouped fascicular repair, fascicular repair, and nerve grafting are described. The indications for use, as well as the relative advantage and disadvantage, of each technique are discussed. The experimental and clinical evidence from a review of the pertinent literature does not demonstrate a significant difference in outcome of one method over the others. Surgical decisions should be made by a thorough evaluation of all aspects of the nerve injury and surgical methods. All nerve injuries cannot be repaired using only one type of nerve repair method. The surgeon should be familiar with all the techniques described and be prepared to use them under appropriate circumstances.


Subject(s)
Nerve Regeneration , Nerve Transfer/methods , Peripheral Nerve Injuries , Peripheral Nerves/surgery , Humans , Peripheral Nerves/physiopathology , Tissue Transplantation/methods , Transplantation, Autologous/methods
20.
J Reconstr Microsurg ; 16(3): 219-25, 2000 Apr.
Article in English | MEDLINE | ID: mdl-10803627

ABSTRACT

Rodent studies of nerve allografts are limited by a relatively short length of graft segment. The authors attempted to establish an outbred sheep model that would allow the study of longer, more clinically relevant nerve gaps. Using outbred ewes, two 8-cm long radial sensory nerves were grafted into gaps (5 cm) in the median nerve. Sheep received an autograft and an allograft. Four sheep were immunosuppressed with Cyclosporin A (CsA) and four were controls. Blood CsA levels greater than 1000 microg/L were obtained. Systemic immunosuppression resulted in severe opportunistic infections, and the sheep were sacrificed between 35 and 47 days following surgery. Histologically, in the autografts and CsA-treated allografts, evidence of nerve regeneration was seen. Non-immunosuppressed allografts were clearly rejected. While clear differences in the histology of experimental and control grafted nerve tissues were seen, the sheep allograft model presents considerable challenges due to immunosuppression-related infectious complications.


Subject(s)
Cyclosporine/administration & dosage , Immunosuppressive Agents/administration & dosage , Median Nerve/transplantation , Nerve Regeneration/immunology , Radial Nerve/transplantation , Transplantation Immunology , Animals , Disease Models, Animal , Graft Survival , Immunosuppression Therapy/methods , Nerve Regeneration/physiology , Reference Values , Sheep , Transplantation, Autologous , Transplantation, Homologous
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