Adrenergic nerve fibers in the human fetal sciatic nerve.

The adrenergic innervation was studied in the human sciatic nerve at the gestational age of 16, 17, 18 and 21 weeks. Formaldehyde-induced catecholamine fluorescence, tyrosine hydroxylase (TH) and neuropeptide Y (NPY) peroxidase-antiperoxidase immunohistochemistry methods were used. At the gestational age of 16, 17 and 18 weeks no adrenergic or NPY-positive nerve fibers were seen. At 21 weeks both fluorescence microscopy and TH immunohistochemistry showed adrenergic nerve fibers around arterioles in the epiperineurium and single nerve fibers in the endoneurium not related to blood vessels. The number of adrenergic nerve fibers appeared to be higher in the sciatic than in the tibial segment of the nerve. At this age, as at earlier stages of gestation, no NPY-positive nerve fibers were seen either in the epiperineurium or in the endoneurium. The results suggest that adrenergic nerve fibers may be associated with the epiperineurial blood vessels in the human sciatic nerve, and that the innervation starts to develop between 18 and 21 weeks of gestational age.     

Experimental study of results of nerve suture under tension vs. nerve grafting.

Evoked electromyograms and myelinated fiber caliber histograms were used to compare the results of end-to-end nerve suture and nerve grafting, performed with an operating microscope. The best results were achieved after direct suture without tension. Direct suture under a tension of 25 grams produced results sometimes comparable the that of the zero tension group, but mostly quite inferior to those and even to the grafted group. The regeneration of axons in the nerve graft group was delayed more than in the sutured groups, but by the tenth month the number of regenerating fibers had increased with stable and comparatively good results. After a nerve suture under a tension of 25 grams, there is impairment of the blood flow at the suture site, and the results are not as good. In such situations I believe nerve grafting should be performed. This amount of tension also seems to be the limit which will allow accurate coaptation of a nerve by microsurgical techniques.     

Macrophages and nerve regeneration.

Macrophages are not only phagocytic cells but also secrete a plethora of growth factors that are potentially important for regeneration. This review will examine the emerging evidence of a likely contribution by macrophages to axonal regeneration.     

Pleiotrophin cellular localization in nerve regeneration after peripheral nerve injury.

Pleiotrophin (PTN) is a member of the family of heparin-binding growth factors that displays mitogenic activities and promotes neurite outgrowth in vitro. In vivo, PTN is widely expressed along pathways of developing axons during the late embryonic and early postnatal period. Although the level of PTN gene expression is very low during adulthood, activation of the gene may occur during recovery from injury and seems to play an important role in tissue regeneration processes. In this study, we investigated whether PTN was involved in the regenerative process of injured peripheral nerves. To refer localization of the fluorescent markers to myelinated axons, we developed a specific computer tool for colocalization of fluorescence images with phase contrast images. Immunohistochemical analysis showed PTN in different types of nonneural cells in distal nerve segments, including Schwann cells, macrophages, and endothelial cells, but not in axons. Schwann cells exhibited PTN immunoreactivity as early as 2 days after injury, whereas PTN-positive macrophages were found 1 week later. Strong PTN immunoreactivity was noted in endothelial cells at all time points. These findings support the idea that PTN participates in the adaptive response to peripheral nerve injury. A better understanding of its contribution may suggest new strategies for enhancing peripheral nerve regeneration.     

Embryogenesis of peripheral nerve pathways in grasshopper legs. II. The major nerve routes

In the preceding paper (H. Keshishian and D. Bentley, 1983a, Dev. Biol. 96, 89-102) the events leading to the morphogenesis of nerve 5B1 in the grasshopper embryonic metathoracic leg were presented. Here the role of later differentiating peripheral neurons in establishing the other major nerves of the leg is examined. In addition to the (tibial 1) (Ti1) pioneer neuron cell pairs that establish nerve 5B1 in the tibia femur, and coxa-trochanter, six later differentiating cells and/or cell pairs were identified and examined with respect to their role in peripheral nerve ontogeny. Nerve path pioneering was observed in two cell pairs of the distal tarsus (Ta1 and Ta2), by neurons of the posterior proximal tibia (Ti2), the posterior midfemur (neurons F3 and F4), and by an additional cell pair in the anterior coxal-trochanteral region of the limb bud (cell pair, CT2). In addition, efferent projections onto limb and epithelia played an important role in establishing nerve branches. In two nerves the axonal trajectory from the periphery to the CNS is established by afferent and efferent pathfinding axons meeting halfway and overgrowing each other's established projections. For each nerve branch examined it was found that axons projected initially to the cell bodies of previously arising neurons along the trajectory. The location along the limb bud ectoderm where neurons arise, and hence their ultimate cell body positions, played an important role in organizing the fasciculation of follower axons and establishing branch points.     

Inferior alveolar nerve reconstruction with a polyglycolic acid bioabsorbable nerve conduit.

A custom-designed polyglycolic acid (PGA) bioabsorbable nerve conduit was used to reconstruct a 25-mm defect in the right inferior alveolar nerve. The initial nerve injury, following a dental extraction, resulted in loss of lower lip sensation and severe facial pain. Sixteen months after tooth extraction, with no improvement in symptomatology, the alveolar canal was enlarged in diameter by means of mandibular osteotomy to accommodate a 2-mm-diameter polyglycolic acid tube. The proximal end of the inferior alveolar nerve was sutured into the polyglycolic acid tube. The mental nerve was sutured into the distal end of the tube. Pain of neural origin was relieved in the early postoperative period. Two years following nerve reconstruction, pain relief remains excellent and perception of pressure and vibration is similar to the thresholds for these perceptions on the contralateral lip.     

Molecular approaches to nerve regeneration.

Current research into regeneration of the nervous system has focused on defining the molecular events that occur during regeneration. One well-characterized system for studying nerve regeneration is the sciatic nerve of rat. Numerous studies have characterized the sequence of events that occur after a crush injury to the sciatic nerve (Cajal 1928; Hall 1989). These events include axon and myelin breakdown, changes in the permeability of the blood vessels, proliferation of Schwann cells, invasion of macrophages, and the phagocytosis of myelin fragments by Schwann cells and macrophages. The distal segment of the injured sciatic nerve provides a supportive environment for the regeneration of the nerve fibres (Cajal 1928; David & Aguayo 1981). Within a period of weeks, the injured sciatic nerve is able to regrow and successfully reinnervate the appropriate targets. Some of the molecules that provide trophic support for the regrowing nerve fibres have been identified, including nerve growth factor (NGF) (Heumann et al. 1987) and glial maturation factor beta (Bosch et al. 1989). Another class of molecules show changes in their rates of synthesis during regeneration, including both proteins (Skene & Shooter 1983; Muller et al. 1986) and mRNA species (Trapp et al. 1988; Meier et al. 1989). To better understand nerve regeneration, we have taken two, parallel molecular approaches to study the events associated with regeneration. The first of these is to study in detail the mechanism of action of a molecule that has been implicated in the regeneration process, nerve growth factor. The second approach is to identify novel gene sequences which are regulated during regeneration.(ABSTRACT TRUNCATED AT 250 WORDS)     

The suprascapular nerve as re-interpreted by its communication with the phrenic nerve.

A particular nerve bundle which may be called phrenicosuprascapular communication is, although only rarely, met with in various forms in man. By teasing, fibres of this communication are revealed to belong to the most anterior components of the brachial plexus, being closely associated with anterior nerves such as the phrenic, accessory phrenic, subclavius and even pectoralis. It is, therefore, obvious that the nervus suprascapularis conveys anterior fibres. It may be interpreted that the anteriormost nerve fibres may be separated from the main cord(s) and form an irregular network or plexus for themselves. It should be stressed that the n. suprascapularis consists of all the anterior components of the brachial plexus and that this is an anterior nerve.