Author/Editor     Kovačič, Uroš
Title     Obnova občutljivosti v področju prerezanega živca, od strani prišitega na nepoškodovan živec
Translated title     Recovery of cutaneus pain sensitivity after end-to-side anastomosis of a transected peripheral nerve in the rat
Type     članek
Source     Med Razgl
Vol. and No.     Letnik 38, št. 2
Publication year     1999
Volume     str. 207-22
Language     slo
Abstract     If the proximal nerve stump is not available after a peripheral nerve injury, end-to-side anastomosis of its distal stump remains the only treatment modality promising potential recovery of the injured nerve's function. Sensory return after end-to-side anastomosis has been investigated in only one study in which the donor nerve was interrupted distally to the anastomosis. There have been no reports on the use of an uninjured donor nerve to date. The present study was undertaken to test the hypothesis that recovery of sensory function of a transected nerve can be induced by using end-to-side anastomosis to an uninjured nerve. The distal stump of the transected peroneal nerve was approximated end to side to the intact sural nerve using epineural sutures. Sprouting of sensory axons into the anastomosed peroneal nerve was assessed by the nerve pinch test, and the number of myelinated axons was determined on a tissue cross-section stained with Azur II. The myelinated axons were counted and their cross-section areas were determined for the sural nerves of both the operated and control animals. Pain sensitivity of the foot instep skin was assessed by the skin pinch test. Over the period of 18 weeks after end-to-side anastomosis of the transected peroneal nerve to the intact sural nerve, the axons sprouted into the peroneal nerve in all the 11 animals operated. The pinch test in the anastomosed distal stump of the peroneal was positive in all animals as far as it was possible to test. There were 277+-119 myelinated axons in the anastomosed peroneal nerve, their cross section area being mostly smaller than 10 microm2. (Abstract truncated at 2000 characters.)
Summary     Če po poškodbi perifernega živca njegovega proksimalnega krna ni na voljo, potem je prišitje njegovega distalnega krna na nepoškodovani sosednji živec edina možnost za morebitno obnovo njegove funkcije. Znana je samo ena raziskava, v kateri so proučevali obnovo senzorične funkcije po anastomozi end to side in pri tem uporabili model s prekinjenim donorskim živcem distalno od anastomoze. Obnove senzorične funkcije po anastomozi end to sida, pri kateri donorski živec ni bil poškodovan, še niso razlskovali. Preverili bomo hipotezo, da je obnova senzorične funkcije poškodovanega perifernega živca prek anastomoze end to side z nepoškodovanim živcem mogoča. V raziskavi smo pri podganah na nepoškodovani suralni živec od strani z epinevrijskimi šivi prišili prerezani distalni krn peronealnega živca. Vraščanje senzoričnih aksonov v distalne krne živcev, od strani prišitih na suralni živec, smo ugotavljali s testom vščipa živca in s štetjem mieliniziranih aksonov na prečnih rezih od strani prišitega peronealnega živca, ki smo jih obarvali z barvilom Azur II. Mielinizirana vlakna smo šteli in določali površino njihovih presekov tudi v suralnem živcu tako poskusnih kot tudi kontrolnih neoperiranih živali. Obnovo občutljivosti za bolečino na koži narta smo ugotavljali s testom vščipa kože. V obdobju 18 tednov po prišitju prerezanega peronealnega živca od strani na nepoškodovan suralni živec so aksoni iz tega živca pri enajstih poskusnih živalih vedno brsteli v prišiti peronealni živec, ki je bil občutljiv na vščip, kolikor daleč je bilo mogoče testirati, in v katerem smo našli 277+-119 (srednja vrednost+-standardni odklon) mieliniziranih aksonov, katerih prečni presek je bil večinoma manjši od 10 microm2. (Izvleček prekinjen pri 2000 znakih.)
Descriptors     PERONEAL NERVE
SURAL NERVE
NERVE REGENERATION
AXONS
RATS
ANASTOMOSIS, SURGICAL
PAIN MEASUREMENT