ISSN:0148-639X    

DOI:10.1002/mus.880130902

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY

摘要:

AbstractNerves have a structure of considerable complexity with features of special relevance to nerve injury and nerve regeneration. These include variations in the cross‐sectional areas devoted to fascicular and epineurial tissue, the fascicular redistribution and mixing of different branch fibers brought about by fascicular plexuses, and the numbers of nerve fibers representing individual branches. The elasticity and tensile strength of nerve trunks and their capacity to resist traction deformation reside in the fascicular tissue, while the epineurium provides a protective cushion against compression. The microstructure of nerve trunks provides the basis for a classification of nerve injuries into five degrees of severity with partial and mixed types—each with a clearly defined pathology and distinguishing clinical features. Following a transection injury, changes occur in the severed axons, endoneurial tubes, fasciculi, and nerve trunk. The type of injury and the nature of these changes determine the outcome of axon regenerat

ISSN:0148-639X    

DOI:10.1002/mus.880130903

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY

摘要:

AbstractNumerous factors eternal to the nerve cell can support and enhance nerve regeneration after injury. The definition of these factors and the elucidation of their mechanisms of action are the central goals of much contemporary neurobiologic research. This research will hopefully lead to the discovery of factors that will prove to be therapeutically beneficial for patients with either peripheral nervous system (PNS) injury or central nervous system (CNS) injury. This article reviews the biology of the regeneration response of the nerve to injury and discusses many of the factors that enhance nerve growth. Finally, the nerve guide or nerve regeneration chamber model for the evaluation of putative nerve regeneration enhancing agents in vivo is also discussed.

ISSN:0148-639X    

DOI:10.1002/mus.880130904

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY

摘要:

AbstractAlthough great empasis is placed on providing a satisfactory conduit for regeneration of peripheral axons after nerve repair, the quality of functional restoration is influenced as much by thequalityas thequantityof axonal regeneration. Misdirected regeneration is so commonly encountered that motor axons appear to enter and regenerate to muscles in an almost random manner. Thus, when there are several choices, as usually is the case with more proximal nerve or plexus repairs, misdirected reinnervation accounts in many incidences for a poor quality of functional restoration. The regenerative capacities of type I and type II motor axons appear to differ. Proprioceptors and other sensory axons have been shown to reinnervate inappropriate end organs. Consequently, deranged central reflex modulation and disturbed orderly recruitment of motor units according to the size principle also contributes to this problem. Central re‐education or adaptation to misdirected regeneration does not occur to any appreciable exten

ISSN:0148-639X    

DOI:10.1002/mus.880130905

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY

摘要:

AbstractThe use of single iber EMG and macro EMG in studies of reinnervation is discussed. SFEMG gives information about changes in the topography of the motor unit and in function of transmission in terminal nerve, motor endplate and muscle fiber. Dynamics of reinnervation may be studied with this technique. The amount of reinnervation is obtained from macro EMG studies. The capacity for reinnervation is discussed for a few conditions as well as factors that limit the reinnervation process.

ISSN:0148-639X    

DOI:10.1002/mus.880130906

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY

摘要:

AbstractMaximum peak‐to‐pek fibrillation potential amplitude was measured in 69 subjects between 7 days and 10½ years post complete or partial peripheral nerve injury. Mean amplitude during the first 2 months was 612 μV; third and fourth months 512 μV, fifth and sixth months 320 μV. After the first year, no population of fibrillation potentials greater than 100 μV was recorded. The sciatic nerve was sectioned in 13 guinea pigs and animals studied up to 17 weeks. Fibrillation potential amplitude in gastrocnemius muscles declined paralleling that in humans. By the end of the study, type l fibers had lost almost half of their initial diameter and type II fibers had atrophied more than twice this amount. Fibrillation potential amplitude may be useful in estimating the time post nerve injury and appears to correlate with the surface area and fiber diameter of a type I musc

ISSN:0148-639X    

DOI:10.1002/mus.880130907

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY

摘要:

AbstractNeuromuscular elecrophysiological techniques can provide clinically important information about the localization, severity, and pathophysiology of peripheral nerve injuries, and about the progress of reinnervation. The relevant variables for study are compound nerve and muscle action potentials, motor unit action potentials, and denervation potentials. Available methods do not permit meaningful quantitation of regeneration. Newer methods under development attempt to estimate the number of motor units in a muscle and the number of axons in a nerve.

ISSN:0148-639X    

DOI:10.1002/mus.880130908

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY

摘要:

AbstractSFEMG can be used o follow the course of reinnervation. The parameters of fiber density, mean jitter and percent blocking must each be followed and related to the type of injury to determine the stage of reinnervation. The few reported cases in the literature of SFEMG recordings followed over time after nerve compromise are reviewed and an additional case is presented by the author. Mean jitter values can return to normal approximately 1½ years postonset of reinnervation. Some individual recordings may remain abnormal permanently

ISSN:0148-639X    

DOI:10.1002/mus.880130909

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY

摘要:

AbstractThe lack of effectve therapy for many of the chronic neuromuscular diseases such as amyotrophic lateral sclerosis, hereditary motor sensory neuropathy (Charcot—Marie–Tooth disease), spinocerebellar degenerations and idiopathic polyneuropathy has led to a search for substances that may stimulate peripheral nerve regeneration. Two such agents that have been proposed are gangliosides (mixed purified bovine brain gangliosides, Cronassial) and thyrotropin releasing factor (TRH). Studies on both of these agents were initially reported with enthusiasm to be successful, but later double‐blind controlled studies have failed to confirm these findings. This review provides critical analysis of the designs of studies of potentially effective agents in chronic neuromuscular diseases, and emphasizes the power of the placebo response, and the importance of designing placebos which are indistinguishable from the trial medication other than in the active e

ISSN:0148-639X    

DOI:10.1002/mus.880130910

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY

摘要:

AbstractMagnification, useof fine interfascicular grafts for repair, and development of intraoperative electrophysiologic measurements of function have had a substantial impact on this field in the last 10 to 20 years. Basic surgical principles established during and since World War II remain the foundation for surgical repair of peripheral nerve injury but have been complemented nicely by these more recent advances. Selection of patients for surgery, as well as the timing of such, has been reviewed with emphasis on the differences between suspected transections and lesions in continuity, as well as comments on serious peripheral enterpments and tumors affecting nerve. The importance of not only preoperative electromyographic studies but also the intraoperative use of stimulation and stimulation and recording of nerve action potentials (NAPs) for lesions in continuity has been stressed. Operative techniques such as neurolysis, NAP recordings, suture, split repair, and interfascicular graft repair have been reviewed and some commentary on results provided. There has been a gradual evolution of centers in this country and abroad for care of the more serious surgical nerve problems. It is anticipated that in the future, such centers will be able to provide improved data concerning results with civilian nerve injuries.

ISSN:0148-639X    

DOI:10.1002/mus.880130911

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY