Immunophilin ligands in peripheral nerve regeneration.

Immunophilins are a family of receptors for immunosuppressive drugs like cyclo-sporin A, FK506, rapamycin and their non-immunosuppressive analogues, which are collectively referred to as immunophilin ligands. The present study aimed to review neuroprotective and neuroregenerative actions of immunophilin ligands on peripheral nerve injuries. The special emphasis was given to well-known immunosuppressive drug FK506. Its historical background, administration routes, dosages, neuroregenerative, neuroprotective actions, therapeutic time window in administration, action mechanism and side effects of FK506 were reviewed.

Melatonin and its therapeutic actions on peripheral nerve regeneration.

Melatonin has many different roles in the human body, including its importance in circadian rhythms, sleep physiology, mental status, reproduction, tumour development, ageing, and many other physiologic processes. Although there are more than hundreds of studies on effects of melatonin in several tissues, its effects on peripheral nerve has been documented in a limited number of studies. This paper focused to review the available literature in terms of several actions and effects of melatonin (beneficial or toxic effects) on well-known peripheral nerve injury models.

Reactions of the rat musculoskeletal system to compressive spinal cord injury (SCI) and whole body vibration (WBV) therapy.

Traumatic spinal cord injury (SCI) causes a loss of locomotor function with associated compromise of the musculo-skeletal system. Whole body vibration (WBV) is a potential therapy following SCI, but little is known about its effects on the musculo-skeletal system. Here, we examined locomotor recovery and the musculo-skeletal system after thoracic (T7-9) compression SCI in adult rats. Daily WBV was started at 1, 7, 14 and 28 days after injury (WBV1-WBV28 respectively) and continued over a 12-week post-injury period. Intact rats, rats with SCI but no WBV (sham-treated) and a group that received passive flexion and extension (PFE) of their hind limbs served as controls. Compared to sham-treated rats, neither WBV nor PFE improved motor function. Only WBV14 and PFE improved body support. In line with earlier studies we failed to detect signs of soleus muscle atrophy (weight, cross sectional diameter, total amount of fibers, mean fiber diameter) or bone loss in the femur (length, weight, bone mineral density). One possible explanation is that, despite of injury extent, the preservation of some axons in the white matter, in combination with quadripedal locomotion, may provide sufficient trophic and neuronal support for the musculoskeletal system.

Functional deficits and morphological changes in the neurogenic bladder match the severity of spinal cord compression.

UNLABELLED: Following spinal cord injury (SCI), loss of spinal and supraspinal control results in desynchronisation of detrusor vesicae (parasympathicus) and external urethral sphincter (sympathicus) activity. Despite recovery of lower urinary tract function being a high priority in patients with SCI, effective treatment options are unavailable largely because mechanisms are poorly understood. PURPOSE AND METHODS: We used a clinically relevant model of thoracic SCI compression injury in adult female Wistar rats and confirmed that lesion volumes following severe injuries were significantly greater compared to moderate injuries (p < 0.05). Between 1-9 weeks, we assessed recovery of bladder function as well as return of locomotor function using the Basso, Beattie and Bresnahan (BBB) score. Bladder morphometrics and overall intramural innervation patterns, as assessed with ß-III tubulin immunohistochemistry, were also examined. RESULTS: Despite variability, bladder function was significantly worse following severe compared to moderate compression injury (p < 0.05); furthermore, the degree of bladder and locomotor dysfunction were significantly correlated (r = 0.59; p < 0.05). In addition, at 9 weeks after SCI we saw significantly greater increases in bladder dry weight (p < 0.05) and wall thickness following severe compared to moderate injury as well as increases in intramural axon density (moderate: 3× normal values; severe 5×; both p < 0.05) that also correlated with injury severity (r = 0.89). CONCLUSION: The moderate and severe compression models show consistent and correlated deficits in bladder and locomotor function, as well as in gross anatomical and histopathological changes. Increased intramural innervation may contribute to neurogenic detrusor overactivity and suggests the use of therapeutic agents which block visceromotoric efferents.

Does FK506 reduce the size of the watershed area after vascular injury of the sciatic nerve?

AIM: FK506 (also known Tacrolimus, Prograf) is an immunosuppressant drug which is used to prevent rejection after organ transplantation. Although there are several studies on neuroprotective effect of FK506 on brain ischemia, few reports on effects of FK506 after peripheral nerve ischemia have been reported. In the present study, we examined the size of watershed area after stripping of the epineurial vessels and studied the effect of FK506 on reduction of the size of watershed area. MATERIALS AND METHODS: Forty-eight adult female rats were used and randomly divided into four groups as control, sham, FK506-treated and vehicle-treated. In FK506-treated and vehicle-treated groups epineurial vessels around the sciatic nerve (vasa nervorum) were stripped. Additionally, FK506-treated group were received subcutaneous injection of 5 mg/kg FK506. Percent of watershed area (100 × total watershed areas / total nerve area) after stripping and FK506 treatment was calculated. RESULTS: We found no significant difference in comparison of the total size of watershed areas in FK506 and vehicle-treated groups or even the percent of the watershed area in both groups. CONCLUSIONS: We think that this study will be helpful to understand neuroprotective effect of FK506 and will give an insight into sparing of the nerve fibers from vascular injuries of the peripheral nerve.

A unique case with splitting of the median nerve by the ulnar artery.

Variations of the median nerve and ulnar artery have been well documented in the literature. In the present case, splitting of the median nerve by the ulnar artery is presented. Our literature searches revealed that there was no article, to our knowledge, describing such splitting. We think that this variation should be kept in mind during surgical and diagnostic procedures.

Walking track analysis: an assessment method for functional recovery after sciatic nerve injury in the rat.

Walking track analysis was first described by de Medinaceli et al. This technique has been significantly modified to provide methods of indexing nerve function that are more valid. Moreover, it has been questioned by several authors. The aim of the present review is to offer a combined knowledge about walking track analysis for scientists who deal with neuroscience.

Co-existence of the pectoralis quartus and pectoralis intermedius muscles.

During the routine dissection studies on the right side of a 56-year-old female cadaver we encountered co-existence of the pectoralis quartus and pectoralis intermedius muscles. The pectoralis quartus originated from the costochondral junction of the fifth and sixth ribs, and then extended laterally under the border of pectoralis major muscle, but it was entirely separate from it. The pectoralis quartus formed a long flat band with an average width of 1.5 cm. It then inserted as an aponeurosis to the both of lateral lip of the intertubercular groove of the humerus and tendon of the short head of the biceps brachii muscle. Furthermore, the pectoralis intermedius muscle was a fleshy slip between the pectoralis minor and pectoralis quartus muscles and arose from the third and fourth ribs. It then united to the tendon of the short head of the biceps brachii muscle two cm below the coracoid process.

Arterial, neural and muscular variations in the upper limb.

During our routine dissection studies we observed arterial, neural and muscular variations in the upper limbs of an adult male cadaver. In this case we observed the superficial brachial artery origination from the third part of the axillary artery, communications between the musculocutaneous and median nerves, variant formation of the brachial plexus, origination of the profunda brachii artery from the posterior circumflex humeral artery and supernumerary tendons of the abductor pollicis longus muscle. We think that such variations should be kept in mind during surgical and diagnostic procedures.

Bilateral abductor pollicis longus muscle variation. Case report and review of the literature.

An abnormal abductor pollicis longus muscle was encountered bilaterally during the dissection of the upper limb of a 26-year-old male cadaver. In the left side, the abductor pollicis longus had seven tendon slips. The medial two inserted into the abductor pollicis brevis, the other five inserted into the base of the first metacarpal bone. In the right side of the case, the abductor pollicis longus was consisted of three bellies. The lateral belly's tendon was the main abductor pollicis longus tendon and inserted into the base of the first metacarpal bone. The medial belly inserted into the abductor pollicis brevis. Between these muscle bellies, there was an intermediate belly. Its tendon was split into two thin slips and inserted into both the abductor pollicis brevis and the opponens pollicis muscles. The number of such accessory tendons has a functional significance in the development of de Quervain's stenosing tendovaginitis and possibly also has a practical significance. This paper is the first to describe seven tendons of the abductor pollicis longus and extensor pollicis brevis in the same compartment.

High origin of the radial artery accompanied by muscular and neural anomalies.

A high origin of the radial artery accompanied by muscular and neural abnormalities (three-headed biceps brachii, absence of the palmaris longus muscle, and communication between median and musculocutaneous nerves) were encountered during the dissection of a 25-year-old male cadaver. Co-existence of these variations has not, to our knowledge, been reported in the available literature.

A variant of the Cannieu-Riche communication: case report.

A variant of Cannieu-Riche communication was encountered during the dissection studies. The communication was between the digital branch to the index finger and branch to the adductor pollicis muscle. Terminal communications between motor nerves may provide muscles with double motor innervation, and are important for the motor innervation of the hand, in particular the thenar muscles. This variant should be kept in mind during surgical operations, electrophysiological examinations of the hand.

Exercise training and axonal regeneration after sciatic nerve injury.

In the present study, we aimed to investigate the relationship between exercise training and peripheral nerve regeneration after crush injury. For this purpose, HRP neurohistochemistry and modified Pal-Weigert methods were used to assess the axonal regeneration. In the 2nd and 3rd regeneration week groups, myelin debris was observed, and there was no significant difference between exercise trained and sedentary groups. In the 4th regeneration week group, it was seen that myelin debris was removed, and some myelinated fibers were observed in the exercise trained group. On the other hand, there was no myelinated fiber in the sedentary group, and there was a significant difference between exercise trained and sedentary groups. Consequently, we think that exercise is effective in the 4th regeneration week.

A case with subclavius posticus muscle.

During routine dissection studies, we encountered an aberrant muscle in the neck region of a 50 year-old female cadaver. The accessory muscle was on the left side. It arose from the superior angle of the scapula and lay over the brachial plexus and brachial artery then inserted to the first rib's cartilage. According to its origin and insertion, the aberrant muscle was considered to be the subclavius posticus. The accessory muscle was innervated by a branch coming from the suprascapular nerve.

A case with multiple anomalies in the upper limb.

During routine educational dissection studies, we encountered multiple nervous and arterial anomalies in a 60-year-old embalmed male cadaver. The arterial anomalies were observed on the right side. The superficial brachial artery originated from the axillary artery under the pectoralis minor muscle. There was an arch between the superficial brachial and brachial arteries in the cubital fossa. Additionally, a communication was observed between the musculocutaneous and median nerves. Moreover, the coracobrachialis muscle was innervated by an accessory nerve branch originating from the lateral cord of the brachial plexus. All of the nervous anomalies were on the left side. A combination of these variations in the same case has not, to our knowledge, been previously described in the available literature.

The importance of the anatomy of the splenic artery and its branches in splenic artery embolisation.

Splenic artery embolisation can be performed preoperatively in an attempt to decrease thrombocyte destruction, or as an alternative to surgery, to obtain partial or total organ ablation. During this procedure, it is very important to deliver embolising agents distal to the origin to pancreatic branches to avoid the risk of pancreatitis. Therefore, a detailed knowledge of the anatomy of the splenic artery and its branches is required to achieve safe embolisation. The purpose of our study is to measure the average distance between the origin of the last pancreatic branch and the splenic hilum in digital angiograms and cadaver specimens.