Dissertation/ Thesis
An investigation of the recovery following end-to-end and end-to-side neurorrhaphy in rat brachial plexus injury
| العنوان: | An investigation of the recovery following end-to-end and end-to-side neurorrhaphy in rat brachial plexus injury |
|---|---|
| Alternate Title: | 神經接合術於大鼠臂神經叢損傷修補之研究 |
| المؤلفون: | Wen-Chieh Liao, 廖文潔 |
| Thesis Advisors: | 曾國藩 |
| سنة النشر: | 2010 |
| المجموعة: | National Digital Library of Theses and Dissertations in Taiwan |
| الوصف: | 99 Injury to peripheral nerves often resorts to nerve transfer for restoring function. Here we evaluated the efficacy of end-to-end (EEN) and end-to-side neurorrhaphy (ESN) of rat musculocutaneous nerve, the recipient, to ulnar nerve, the donor. The donor was transected for EEN and exposed an epineurial window for ESN of the recipient. In EEN, regenerating axons started thick and regained control diameters in 3–4 months while ESN induced slow sprouting of mostly thin collaterals that barely approached control diameters by 6 months. Motor end plates regained control density 4 months following EEN but remained low by 6 months after ESN. The short-latency compound muscle action potential typical of control was quickly restored at 3 months following nerve reconnection. On the other hand, the responses of the ESN started with low amplitude and variable latencies and failed to regain control sizes even by 6 months after surgery Grooming test scores, nevertheless, recovered successfully in both the 3 month-EEN and the 6 month-ESN groups. In short, both neurorrhaphies resulted in functional recovery but EEN appeared quicker and better at the expense of donor function. Since the distance that the regenerating axons have to travel remains as the key determinant, we then explored whether regeneration/myelination-enhancing agent- methylcobalamin, anti-inflammatory drug- methylprednisolone, and neurite growth-enhancing and angiogenic factor- pleiotrophin accelerated the recovery following neurorrhaphy. We explored the administration of PBS, methylcobalamin, methylprednisolone and pleiotrophin alone and combined administration methylcobalamin and pleiotrophin on the same rat ulno-musculocutaneous nerve EEN model that we described above. None of the three drugs applied affected the expression of the neurite-growth associated protein GAP-43 demonstrating that they did not interfere with the regenerating attempt of the injured cell bodies. As expected, methylprednisolone suppressed the perineuronal microglial reaction, periaxonal ED-1 expression and resulted in transiently suppression of the enumeration of regenerated axons and pleiotrophin increased the blood vessel density and nerve fiber densities in the reconnected nerve. Interestingly, methylcobalamin was found to enhance the recovery of compound muscle action potentials and augmented the diameters and myelin thicknesses of the regenerated axons and enhance the expression of S100(+) in Schwann cells 1 month following EEN. Simultaneous methylcobalamin and pleiotrophin treatment resulted in quick and persistent supernumerary reinnervation but failed to enhance the recovery over that of the former alone. In conclusion, methylcobalamin may be preferred over methylprednisolone to facilitate the recovery of peripheral nerves following end-to-end neurorrhaphy. |
| Original Identifier: | 099NTU05391005 |
| نوع الوثيقة: | 學位論文 ; thesis |
| وصف الملف: | 139 |
| الاتاحة: | http://ndltd.ncl.edu.tw/handle/13036978525118485835 |
| رقم الانضمام: | edsndl.TW.099NTU05391005 |
| قاعدة البيانات: | Networked Digital Library of Theses & Dissertations |
| الوصف غير متاح. |