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Peripheral Nerve Injury

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6561. Cyclooxygenase-1 in the spinal cord is altered after peripheral nerve injury. (PubMed)

Cyclooxygenase-1 in the spinal cord is altered after peripheral nerve injury. The mechanisms underlying neuropathic pain are incompletely understood and its treatment is often unsatisfactory. Spinal cyclooxygenase-2 (COX-2) expression is upregulated after peripheral inflammation, associated with spinal prostaglandin production leading to central sensitization, but the role of COX isoenzymes in sensitization after nerve injury is less well characterized. The current study was undertaken (...) in the superficial laminae, but decreased in the rest of the ipsilateral spinal cord 4 weeks after PSNT and 2 weeks after SNL. These changes in immunostaining were greatest at the L5 level.These data suggest that COX-1 expression in the spinal cord is not static, but changes in a time- and laminar-dependent manner after nerve injury. These anatomic data are consistent with observations by others that spinally administered specific COX-1 inhibitors may be useful to prevent and treat neuropathic pain.

2003 Anesthesiology

6562. Painful peripheral nerve injury decreases calcium current in axotomized sensory neurons. (PubMed)

Painful peripheral nerve injury decreases calcium current in axotomized sensory neurons. Reports of Ca(2+) current I(Ca) loss after injury to peripheral sensory neurons do not discriminate between axotomized and spared neurons. The spinal nerve ligation model separates axotomized from spared neurons innervating the same site. The authors hypothesized that I(Ca) loss is a result of neuronal injury, so they compared axotomized L5 dorsal root ganglion neurons to spared L4 neurons, as well (...) as neurons from rats undergoing skin incision alone.After behavioral testing, dissociated neurons from L4 and L5 dorsal root ganglia were studied in both current and voltage patch clamp modes. The biophysical consequence of I(Ca) loss on the action potential was confirmed using selective I(Ca) antagonists. Data were grouped into small, medium, and large cells for comparison.Reduced I(Ca) was predominantly a consequence of axotomy (L5 after spinal nerve ligation) and was most evident in small and medium

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2006 Anesthesiology

6563. Effect of knock down of spinal cord PSD-93/chapsin-110 on persistent pain induced by complete Freund's adjuvant and peripheral nerve injury. (PubMed)

Effect of knock down of spinal cord PSD-93/chapsin-110 on persistent pain induced by complete Freund's adjuvant and peripheral nerve injury. PSD-93/chapsin-110 is a neuronal PDZ domain-containing protein that binds to and clusters the N-methyl-D-aspartate receptor (NMDAR) at synapses in the central nervous system. It also assembles a specific set of signaling proteins around the NMDAR and mediates downstream signaling by the NMDAR. Thus, PSD-93/chapsin-110 might be involved in many (...) and mechanical stimuli during complete Freund's adjuvant-induced inflammatory pain and peripheral nerve injury-induced neuropathic pain. In contrast, the rats injected intrathecally with PSD-93/chapsin-110 missense oligodeoxynucleotide did not exhibit these changes. We also found that pretreatment with PSD-93/chapsin-110 antisense oligodeoxynucleotide did not change the locomotor activity or the responses to acute noxious thermal and mechanical stimuli in intact rats. The present results indicate

2003 Pain

6564. Anti-hyperalgesic and morphine-sparing actions of propentofylline following peripheral nerve injury in rats: mechanistic implications of spinal glia and proinflammatory cytokines. (PubMed)

Anti-hyperalgesic and morphine-sparing actions of propentofylline following peripheral nerve injury in rats: mechanistic implications of spinal glia and proinflammatory cytokines. Injury to peripheral nerves often produces non-physiological, long-lasting spontaneous pain, hyperalgesia and allodynia that are refractory to standard treatment and often insensitive to opioids, such as morphine. Recent studies demonstrate spinal glial activation and increased proinflammatory cytokines in animal (...) -polymerase chain reaction, RNase protection assay, enzyme-linked immunosorbent assay, and immunocytochemistry in rats. The results show that chronic propentofylline treatment attenuated the development of hyperalgesia and restored the analgesic activity of acute morphine in neuropathic rats. These findings directly correlated with the ability of propentofylline to inhibit glial activation and enhanced spinal proinflammatory cytokines following peripheral nerve injury. These findings along with our

2003 Pain

6565. Redox modulation of peripheral T-type Ca2+ channels in vivo: alteration of nerve injury-induced thermal hyperalgesia. (PubMed)

Redox modulation of peripheral T-type Ca2+ channels in vivo: alteration of nerve injury-induced thermal hyperalgesia. We reported recently that redox agents, including the endogenous amino acid L-cysteine, modulate T-type Ca2+ currents in primary sensory neurons in vitro, and alter mechanical and thermal nociception in peripheral nociceptors in vivo in intact animals [Neuron 31 (2001) 75]. Here, we studied the effects of locally applied redox agents (L-cysteine and 5,5'-dithio-bis-(2 (...) -nitrobenzoic acid) (DTNB) on thermal hyperalgesia in animals with neuropathic pain due to chronic constrictive injury (CCI) of the sciatic nerve. We found that, following injection into the peripheral receptive fields, the endogenous reducing agent L-cysteine increased thermal hyperalgesia in a dose-dependent manner in rats with CCI of the sciatic nerve as well as in sham-operated rats. However, the magnitude of the increase was smaller and duration of effect was shorter in rats with CCI of the sciatic

2004 Pain

6566. Peripheral nerve injury evaluation and management. (PubMed)

Peripheral nerve injury evaluation and management. 16125601 2006 01 05 2006 11 15 0149-7944 62 5 2005 Sep-Oct Current surgery Curr Surg Peripheral nerve injury evaluation and management. 469-76 Winfree Christopher J CJ Department of Neurological Surgery, Columbia University Medical Center, New York, NY, USA. eng Comparative Study Journal Article Meta-Analysis Review United States Curr Surg 7802123 0149-7944 IM Adult Birth Injuries diagnosis surgery Brachial Plexus injuries Brachial Plexus (...) Neuropathies diagnosis epidemiology surgery Case-Control Studies Electromyography Female Humans Infant, Newborn Injury Severity Score Male Middle Aged Nerve Regeneration physiology Nerve Transfer methods Neurosurgical Procedures methods Prognosis Recovery of Function Retrospective Studies Risk Assessment Treatment Outcome 20 2005 8 30 9 0 2006 1 6 9 0 2005 8 30 9 0 ppublish 16125601 S0149-7944(05)00026-7 10.1016/j.cursur.2005.03.008

2005 Current surgery

6567. Editorial on participating in the Journal of Brachial Plexus and Peripheral Nerve Injury (PubMed)

Editorial on participating in the Journal of Brachial Plexus and Peripheral Nerve Injury 17374160 2007 07 26 2008 11 20 1749-7221 2 2007 Mar 20 Journal of brachial plexus and peripheral nerve injury J Brachial Plex Peripher Nerve Inj Editorial on participating in the Journal of Brachial Plexus and Peripheral Nerve Injury. 8 Bahm Jörg J eng Editorial 2007 03 20 United States J Brachial Plex Peripher Nerve Inj 101265114 1749-7221 2007 03 15 2007 03 20 2007 3 22 9 0 2007 3 22 9 1 2007 3 22 9 0

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2007 Journal of brachial plexus and peripheral nerve injury

6568. End-to-side neurorrhaphies in a rodent model of peripheral nerve injury: a preliminary report of a novel technique. (PubMed)

End-to-side neurorrhaphies in a rodent model of peripheral nerve injury: a preliminary report of a novel technique. The standard techniques for repair of peripheral nerve injuries with neuroma formation are typically suboptimal. To begin to explore alternative techniques, the authors used an established model in rodents by using end-to-side "terminolateral" neurorrhaphies (TLNs) to study alternative grafting techniques. The TLN "jump grafts" bypass a neuromain-continuity, hypothetically (...) maintaining functional units within the neuroma to facilitate functional regeneration. Evaluation of the extent and origin of the regenerating fibers within the grafts was also undertaken.The right tibial nerve in four adult Sprague-Dawley rats was injured using either a crush or transection technique and compared with four uninjured controls. The contralateral peroneal nerve was immediately harvested for microsurgical repair by using TLN jump grafts in all animals. Following a 3-month recovery

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2004 Journal of Neurosurgery

6569. Surgical repair of brachial plexus injury: a multinational survey of experienced peripheral nerve surgeons. (PubMed)

Surgical repair of brachial plexus injury: a multinational survey of experienced peripheral nerve surgeons. Brachial plexus injuries (BPIs) are often devastating events that lead to upper-extremity paralysis, rendering the limb a painful extraneous appendage. Fortunately, there are several nerve repair techniques that provide restoration of some function. Although there is general agreement in the medical community concerning which patients may benefit from surgical intervention, the actual (...) repair technique for a given lesion is less clear. The authors sought to identify and better define areas of agreement and disagreement among experienced peripheral nerve surgeons as to the management of BPIs.The authors developed a detailed survey in two parts: one part addressing general issues related to BPI and the other presenting four clinical cases. The survey was mailed to 126 experienced peripheral nerve physicians and 49 (39%) participated in the study. The respondents represent 22

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2004 Journal of Neurosurgery

6570. Reduction of neural adhesions by biodegradable autocrosslinked hyaluronic acid gel after injury of peripheral nerves: an experimental study. (PubMed)

Reduction of neural adhesions by biodegradable autocrosslinked hyaluronic acid gel after injury of peripheral nerves: an experimental study. Adhesion formation is a serious problem in peripheral nerve surgery, frequently causing dysfunction and pain. The authors aimed to develop an objective biomechanical method of quantifying nerve adhesions and to use this technique for the evaluation of the efficacy of an autocrosslinked hyaluronic acid (HA) gel as an antiadhesion therapy.Thirty-three female (...) Wistar rats underwent dissection, crush injury, or transection plus repair of the sciatic nerve. The nerves were or were not treated with the HA gel. Six weeks after surgery, the adhesions formed were assessed by measuring the peak force required to break the adhesions over a standardized area. Results of biomechanical measurements demonstrated that the peak force significantly increased as the severity of the injury increased. After using the HA gel to treat the nerve, the peak force

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2004 Journal of Neurosurgery

6571. Use of a static magnetic field to promote recovery after peripheral nerve injury. (PubMed)

Use of a static magnetic field to promote recovery after peripheral nerve injury. While pulsed electromagnetic stimulation has been shown to enhance peripheral nerve regeneration, the effect of a static magnetic field on nerve repair is less clear. The aim of this study was to establish what effect an imposed exogenous static magnetic field has on peripheral nerve regeneration after transection and repair.Three groups of six adult sheep were used. The first group acted as normal controls (...) ), electrophysiological (determinations of stimulated jitter, maximum conduction velocity, refractory period, and F waves), and isometric tension (isometric twitch and tetanic tension) assessments.Exogenously applied static electromagnetic fields do not enhance peripheral nerve regeneration.

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2006 Journal of Neurosurgery

6572. Systemic lidocaine in pain due to peripheral nerve injury and predictors of response. (PubMed)

Systemic lidocaine in pain due to peripheral nerve injury and predictors of response. To investigate the effects of IV lidocaine on spontaneous and evoked pain (allodynia and hyperalgesia) due to peripheral nerve injury (postherpetic neuralgia or nerve trauma) using quantitative sensory testing.The authors randomized 22 patients to receive lidocaine 5 mg/kg IV during 30 minutes or placebo in a double-blind crossover design and 16 patients subsequently received mexiletine on an open basis (...) without allodynia.These data indicate modality-specific antihyperalgesic effects of IV lidocaine in patients with peripheral nerve injury. Patients with mechanical allodynia may be good candidates for treatment with local anesthetic-like drugs and possibly with other sodium-channel blockers.

2004 Neurology Controlled trial quality: uncertain

6573. [Observation on therapeutic effect of electroacupuncture combined with functional training for treatment of peripheral nerve incomplete injury of upper limbs]. (PubMed)

[Observation on therapeutic effect of electroacupuncture combined with functional training for treatment of peripheral nerve incomplete injury of upper limbs]. To search for the best program for treatment of peripheral nerve incomplete injury.Ninety cases were randomly divided into a treatment group, a control group I and a control group II, 30 cases in each group. The treatment group were treated with electroacupuncture at Jianyu (LI 15), Hegu (LI 4), Quchi (LI 11), etc. plus functional (...) training, and the control group I with electroacupuncture and the control group H with functional training. After treatment for 3 months, basic function, practical function, EMG, nerve conduction velocity were compared among the 3 groups.The good rate of basic function of 50.0%, the curemarkedly effective rate of practical function of 50.0% and the total effective rate of neurophysiology of 64.3% in the treatment group were better than 20.7%, 17.2%, 41.4% in the control group I (P < 0.05) and 23.3

2007 Zhongguo zhen jiu = Chinese acupuncture & moxibustion Controlled trial quality: uncertain

6574. Laser phototherapy (780 nm), a new modality in treatment of long-term incomplete peripheral nerve injury: a randomized double-blind placebo-controlled study. (PubMed)

Laser phototherapy (780 nm), a new modality in treatment of long-term incomplete peripheral nerve injury: a randomized double-blind placebo-controlled study. The authors conducted this pilot study to prospectively investigate the effectiveness of low-power laser irradiation (780 nm) in the treatment of patients suffering from incomplete peripheral nerve and brachial plexus injuries for 6 months up to several years.Injury of a major nerve trunk frequently results in considerable disability (...) associated with loss of sensory and motor functions. Spontaneous recovery of long-term severe incomplete peripheral nerve injury is often unsatisfactory.A randomized, double-blind, placebo-controlled trial was performed on 18 patients who were randomly assigned placebo (non-active light: diffused LED lamp) or low-power laser irradiation (wavelength, 780 nm; power, 250 mW). Twenty-one consecutive daily sessions of laser or placebo irradiation were applied transcutaneously for 3 h to the injured peripheral

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2007 Photomedicine and laser surgery Controlled trial quality: predicted high

6575. The potential of electrical stimulation to promote functional recovery after peripheral nerve injury--comparisons between rats and humans. (PubMed)

The potential of electrical stimulation to promote functional recovery after peripheral nerve injury--comparisons between rats and humans. The declining capacity for injured peripheral nerves to regenerate their axons with time and distance is accounted for, at least in part, by the chronic axotomy of the neurons and Schwann cell denervation prior to target reinnervation. A largely unrecognized site of delay is the surgical suture site where, in rats, 4 weeks is required for all neurons (...) to regenerate their axons across the site. Low frequency stimulation for just 1 h after surgery accelerates this axon crossing in association with upregulation of neurotrophic factors in the neurons. We translated these findings to human patients by examining the number of reinnervated motor units in the median nerve-innervated thenar muscles before and after carpel tunnel release surgery in a randomized controlled trial. Motor unit number estimates (MUNE) in patients with moderate and severe carpal tunnel

2007 Acta neurochirurgica. Supplement Controlled trial quality: uncertain

6576. Role of macrophage migration inhibitory factor (MIF) in peripheral nerve regeneration: anti-MIF antibody induces delay of nerve regeneration and the apoptosis of Schwann cells. (PubMed)

Role of macrophage migration inhibitory factor (MIF) in peripheral nerve regeneration: anti-MIF antibody induces delay of nerve regeneration and the apoptosis of Schwann cells. Macrophage migration inhibitory factor (MIF) is a pluripotent cytokine involved in inflammation and immune responses as well as in cell growth. Although we previously demonstrated the presence of MIF in peripheral nerves, and MIF mRNA expression was up-regulated after axotomy, the role of MIF in nerve injury (...) surgery by the anti-MIF antibody treatment. Consistent with these results, Ki-67-positive cells were significantly decreased by the anti-MIF antibody treatment. Immunohistochemical analyses revealed that p53 and, to a lesser extent, Fas were more up-regulated in the anti-MIF antibody-treated nerves than in the controls.Taken together, these results suggest that MIF plays an important role in acceleration of peripheral nerve regeneration and in prevention of Schwann cell apoptosis, mainly through

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2002 Molecular Medicine

6577. An uncommon peripheral nerve injury after penetrating injury of the forearm: the importance of clinical examination. (PubMed)

An uncommon peripheral nerve injury after penetrating injury of the forearm: the importance of clinical examination. A 22 year old woman presented to the accident and emergency department with a self inflicted stab wound to the radial side of the volar aspect of the left forearm caused by a pen knife. Her wounds were sutured on the day of injury. Over the course of next three weeks her wounds healed well but she noticed difficulty in using the hand. She therefore attended her general (...) of the PIN in the supinator canal was found and repaired with good functional outcome. This case reflects the importance of clinical examination in uncommon peripheral nerve injuries and appropriate referral to a specialist department in case of doubtful penetrating wound that pose a threat to an underlying important structure.

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2003 Emergency Medicine Journal

6578. Development of neuropathic pain in the rat spared nerve injury model is not prevented by a peripheral nerve block. (PubMed)

Development of neuropathic pain in the rat spared nerve injury model is not prevented by a peripheral nerve block. The mechanisms responsible for initiation of persistent neuropathic pain after peripheral nerve injury are unclear. One hypothesis is that injury discharge and early ectopic discharges in injured nerves produce activity-dependent irreversible changes in the central nervous system. The aim of this study was to determine whether blockade of peripheral discharge by blocking nerve (...) conduction before and 1 week after nerve injury could prevent the development and persistence of neuropathic pain-like behavior in the spared nerve injury model.Bupivacaine-loaded biodegradable microspheres embedded in fibrin glue were placed in a silicone tube around the sciatic nerve to produce a conduction block. After sensory-motor testing of block efficacy, a spared nerve injury procedure was performed. Development of neuropathic pain behavior was assessed for 4 weeks by withdrawal responses

2003 Anesthesiology

6579. Peripheral nerve injury during anesthesia. (PubMed)

Peripheral nerve injury during anesthesia. A case is presented where a peripheral nerve injury occurred due to the pressure of a restraint buckle causing a postoperative motor and sensory deficit. Because these are iatrogenic injuries it is useful to review the mechanism of injury and means of prevention.

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1990 Anesthesia progress

6580. Expression of α2-adrenergic receptors in rat primary afferent neurones after peripheral nerve injury or inflammation (PubMed)

Expression of α2-adrenergic receptors in rat primary afferent neurones after peripheral nerve injury or inflammation 1. Immunocytochemistry with polyclonal antibodies directed against specific fragments of intracellular loops of alpha2A- and alpha2C-adrenergic receptors (alpha2A-AR, alpha2C-AR) was used to explore the possibility that expression of these receptors in dorsal root ganglion (DRG) neurones of rat alters as a result of peripheral nerve injury or localized inflammation. 2. Small (...) injury, double labelling with Fluoro-Gold, a marker of retrograde transport from transected fibres, or by immunoreactivity for c-jun protein, an indicator of injury and regeneration, suggested that many of the neurones expressing alpha2A-AR-IR were uninjured by the sciatic lesions. 4. In general the largest proportionate increase in numbers of neurones labelled by alpha2A-AR-IR after nerve lesions appeared in the medium-large diameter range (31-40 microm), a group principally composed of cell bodies

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1999 The Journal of physiology

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