Low back pain due to superior cluneal nerve entrapment: A clinicopathologic study.

INTRODUCTION: We studied the clinical and nerve pathologic features in 6 patients whose low back pain (LBP) was relieved by superior cluneal nerve (SCN) neurectomy to determine whether nerve compression was the mechanism underlying this type of LBP. METHODS: All 6 patients (7 nerves) underwent SCN neurectomy for intractable LBP. Their clinical outcomes and the pathologic features of 7 nerves were reviewed. RESULTS: All patients reported LBP relief immediately after SCN neurectomy. Pathologic study of the 7 resected nerves showed marked enlargement, decreased myelinated fiber density, an increase in thinly myelinated fibers (n = 2), perineurial thickening (n = 5), subperineurial edema (n = 4), and Renaut bodies (n = 4). At the distal end of 1 enlarged nerve, we observed a moderate reduction in the density and marked reduction in the number of large myelinated fibers. DISCUSSION: The pathologic findings and effectiveness of neurectomy suggest that, in our patients, SCN neuropathy likely elicited LBP via nerve compression. Muscle Nerve 57: 777-783, 2018.

Perineural cysts resembling complex cystic adnexal masses on transvaginal sonography.

Perineural cysts may be discovered incidentally on pelvic sonography and can easily mimic more common gynecologic masses. We report the complex cystic adnexal mass like appearance of these incidentally noted cysts which mimicked malignancy on sonography in a postmenopausal female, with stage I breast cancer and vaginal spotting.

Multiple perineuriomas in chicken (Gallus gallus domesticus).

Intraneural perineurioma is an extremely rare condition characterized by perineurial cell proliferation within peripheral nerve (PN) sheaths. In the veterinary field, this entity has been reported only in a dog. We examined multiple enlargements of PNs in 11 chickens (Gallus gallus domesticus) (9 Japanese bantams and 2 specific pathogen-free White Leghorn), which were inoculated with an avian leukosis virus (ALV) causing so-called fowl glioma. All chickens clinically exhibited progressive leg paralysis. Lumbosacral plexus, brachial plexus, and/or spinal ganglion were commonly affected, and these nerves contained a diffuse proliferation of spindle cells arranged concentrically in characteristic onion bulb-like structures surrounded by residual axons and myelin sheaths. The spindle cells were immunohistochemically negative for S-100alpha/beta protein. Electron microscopy revealed that these cells were characterized by short bipolar cytoplasmic processes, occasional cytoplasmic pinocytotic vesicles, and discontinuous basal laminae. These features are consistent with those of intraneural perineurioma. Furthermore, the specific sequence of the ALV was detected in the PN lesions of 8/11 (73%) birds by polymerase chain reaction. These results indicate that the multiple intraneural perineuriomas of chicken may be associated with the ALV-A causing fowl glioma.

Synaptogenesis in the brachial and lumbosacral enlargements of the spinal cord in the postnatal opossum, Monodelphis domestica.

Synaptic proteins were localized in light microscopy on sections of the brachial and lumbosacral enlargements of the spinal cord of postnatal opossums, Monodelphis domestica, to determine whether their expression correlates with the development of major motor pathways and simple motor behaviors. The tissues were fixed, cryoprotected, frozen, cut in 15-micrometer sections, and processed immunohistochemically using antibodies against synaptophysin, synaptotagmin-I, or SNAP-25. Immunolabeling was observed in the presumptive white matter before the presumptive gray matter, suggesting that the proteins are evidenced in growing axons before the onset of synaptogenesis, and it was observed in presumed propriospinal axons before most presumed descending axons of supraspinal origin. In the newborn opossum, the immunolabeling was scant in the gray matter and was limited to the periphery of the ventral horn, and indeed few synapses were seen in electron microscopy in nonexperimental material. Labeling increased in intensity and spread throughout the gray matter until 5-7 weeks, when it was no longer found in the white matter and resembled the adult pattern of labeling. Considering the location and relative intensity of the immunolabeling for the three proteins over time in the two enlargements, synaptogenesis occurs according to three general gradients: rostrocaudal, ventrodorsal, and lateromedial. These gradients match those of spinal cord and limb development, and of the growth of descending axons into the cord. Synaptogenesis is most intense when the spinal sensorimotor reflexes begin to be expressed.

Paraneoplastic demyelinating neuropathy, subacute sensory neuropathy, and anti-Hu antibodies: clinicopathological study of an autopsy case.

A patient with anti-Hu antibodies, small-cell lung carcinoma, and autopsy-proven subacute sensory neuropathy had early slowing of motor and sensory conduction velocities. In the peripheral nerves, chronic demyelinating and remyelinating lesions with axonal degeneration were associated with an inflammatory reaction consisting of CD8+ T cells and CD68+ macrophages. On immunohistochemical testing, the patient's serum did not react with normal nerve, suggesting that the Hu proteins were not the target of the inflammatory reaction in the nerve.

Características anatómicas generales macroscópicas y microscópicas de la cadena ganglionar simpática laterovertebral lumbar (pars abdominalis systematis autonomici): (en fetos humanos de término) / General macroscopic and microscopic anatomical characteristics of the lumbar laterovertebral sympathic ganglionar chain

Se hace un estudio anatómico detallado de 182 cadenas ganglionares simpáticas láterovertebrales lumbares pertenecientes a fetos humanos de término de ambos sexos, teniendo como base la observación directa con el microscopio de operaciones (Carl ZEISS) de disecciones anatómicas especializadas, planificadas y ejecutadas al efecto. Se dan detalles referentes a: 1) Cantidad de ganglios que la constituyen y la individualidad morfológica de ellos; 2) Longitud total que posee; 3) Sus límites; 4) Ubicación (general respecto al músculo iliopsoas y la fascia ilíaca) 5) Relaciones (de sus caras) 6) Trayecto. Se determinan las características del cordón interganglionar, los ramos que emanan de los ganglios y la vascularización que presentan. Se establece la estructura macroscópica y microscópica de los ganglios catenarios. Se insiste sobre la importancia de la sistematización de la cadena ganglionar como elemento constitutivo periférico del simpático

Growth cone morphology and trajectory in the lumbosacral region of the chick embryo.

We quantitatively analyzed several features of orthogradely labeled peripheral growth cones in the lumbosacral region of the chick embryo. We compared motoneuron growth cones in regions where they appear to express specific directional preferences (the plexus region and regions where muscle nerves diverge from main nerve trunks), which we operationally defined as "decision regions," to motoneuron growth cones in other pathway regions (the spinal nerve, nerve trunk, and muscle nerve pathways) which we termed, for contrast, "non-decision region." We found that motoneuron growth cones are larger, more lamellepodial, and have more complex trajectories in decision regions. Sensory growth cone populations, which are thought to be dependent upon motoneurons for outgrowth (Landmesser, L., and M. Honig (1982) Soc. Neurosci. Abstr. 8: 929), do not enlarge or become more lamellepodial in motoneuron decision regions, suggesting that this local environment does not affect all species of growth cones equally and that the alterations in motoneuron growth cones in these regions may be relevant to their specific guidance. In addition, the resemblance between the sensory population and other closely fasciculating growth cones lends support to the suggestion that sensory neurons utilize motoneuron neurites as a substratum. We suggest that the convoluted trajectories, enlarged size, and more lamellepodial morphology of motoneuron growth cones in decision regions is either related directly to the presence of specific cues that guide motoneurons or to some aspect of this environment that allows them to respond to specific cues.

[Functional morphology of neural elements in interorganic adhesions and in coalesced organs]. / Funktsional'naia morfologiia nervnykh élementov mezhorgannykh srashchenii i srashchennykh organov.

The results of investigations concerning the problem on reinnervation of organs and vessels are summarized. Under the conditions of organo- and neuropexy, regenerating neural fibers pass through two stages of development. The first stage--formation and growth of neural fibers, the second--a more prolonged period of successive quantitative and qualitative morpho-functional transformations of these elements into mature structures. Judging from the histochemical characteristics, the latter become functionally competent by the 5th month after implantation of neural trunks into the arterial walls (the common, carotid and femoral arteries). The organopexies affect the neural cells structure in the denervated urinary organs. The reparative processes occurring, to some extent, protect them from destruction and stimulate their partial restoration. When the vegetative ganglia (the cranial cervical, caudal mesenteric ganglia) are transposed on the organs, some neurocytes are preserved. Their composition and histochemical structure correspond to an intact ganglion. A suggestion is made that the partly preserved ganglion could be used to form a new center of local regulation. An observation has been made according to which under the inductive effect of the donor-organ in the organ-recipient numerous newly formed neural fibers appear. They are capable to participate in reinnervation of the injured organ and, hence, in restoration of its function.

Distribution of lumbar and sacral afferent axons in submucosa of cat urinary bladder.

Lumbar and sacral afferent axons in the submucosa of the urinary bladder were recognized by degeneration in seven cats subjected to spinal ganglionectomies. Of 2,935 observed terminating axon profiles, 145 were found degenerating. Lumber afferent axons were 3.7 times more numerous than sacral afferent axons in the submucosa, a reversal of the ratio reported for the muscle coat of the bladder. Sacral afferent axons were evenly distributed to different regions of the bladder, but lumbar afferents were concentrated in the bladder neck. Apparent afferent endings in the submucosa of the urinary bladder were principally free nerve endings. Synaptic vesicles were found in 57% of observed terminating axon profiles. The bladder neck had more terminating axon profiles of all kinds than other regions of the urinary bladder.