The Experts below are selected from a list of 186 Experts worldwide ranked by ideXlab platform
Pietro Giovanoli - One of the best experts on this subject based on the ideXlab platform.
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Direct Nerve Suture and knee immobilization in 90° flexion as a technique for treatment of common peroneal, tibial and sural Nerve injuries in complex knee trauma.
Journal of surgical case reports, 2012Co-Authors: Robert Döring, Bernhard Ciritsis, Thomas Giesen, Hans-peter Simmen, Pietro GiovanoliAbstract:There are different ways to treat peripheral Nerve injuries with concomitant defects in the lower extremity. One option is a direct Nerve Suture followed by immobilization of the knee in flexion as it is described for gunshot wounds that lead to lesions of the sciatic Nerve and its terminal branches as well as isolated Nerve lesions. We used this technique to treat a case of multiple Nerve injuries of the lower extremity combined with a complex knee trauma including a lesion of both bones and the posterior capsule. To our knowledge, this technique has not yet been described for such a combined injury in literature.
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direct Nerve Suture and knee immobilization in 90 flexion as a technique for treatment of common peroneal tibial and sural Nerve injuries in complex knee trauma
Journal of Surgical Case Reports, 2012Co-Authors: Robert Döring, Bernhard Ciritsis, Thomas Giesen, Hans-peter Simmen, Pietro GiovanoliAbstract:There are different ways to treat peripheral Nerve injuries with concomitant defects in the lower extremity. One option is a direct Nerve Suture followed by immobilization of the knee in flexion as it is described for gunshot wounds that lead to lesions of the sciatic Nerve and its terminal branches as well as isolated Nerve lesions. We used this technique to treat a case of multiple Nerve injuries of the lower extremity combined with a complex knee trauma including a lesion of both bones and the posterior capsule. To our knowledge, this technique has not yet been described for such a combined injury in literature.
Robert Döring - One of the best experts on this subject based on the ideXlab platform.
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Direct Nerve Suture and knee immobilization in 90° flexion as a technique for treatment of common peroneal, tibial and sural Nerve injuries in complex knee trauma.
Journal of surgical case reports, 2012Co-Authors: Robert Döring, Bernhard Ciritsis, Thomas Giesen, Hans-peter Simmen, Pietro GiovanoliAbstract:There are different ways to treat peripheral Nerve injuries with concomitant defects in the lower extremity. One option is a direct Nerve Suture followed by immobilization of the knee in flexion as it is described for gunshot wounds that lead to lesions of the sciatic Nerve and its terminal branches as well as isolated Nerve lesions. We used this technique to treat a case of multiple Nerve injuries of the lower extremity combined with a complex knee trauma including a lesion of both bones and the posterior capsule. To our knowledge, this technique has not yet been described for such a combined injury in literature.
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direct Nerve Suture and knee immobilization in 90 flexion as a technique for treatment of common peroneal tibial and sural Nerve injuries in complex knee trauma
Journal of Surgical Case Reports, 2012Co-Authors: Robert Döring, Bernhard Ciritsis, Thomas Giesen, Hans-peter Simmen, Pietro GiovanoliAbstract:There are different ways to treat peripheral Nerve injuries with concomitant defects in the lower extremity. One option is a direct Nerve Suture followed by immobilization of the knee in flexion as it is described for gunshot wounds that lead to lesions of the sciatic Nerve and its terminal branches as well as isolated Nerve lesions. We used this technique to treat a case of multiple Nerve injuries of the lower extremity combined with a complex knee trauma including a lesion of both bones and the posterior capsule. To our knowledge, this technique has not yet been described for such a combined injury in literature.
Hiroshi Kiyama - One of the best experts on this subject based on the ideXlab platform.
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Suture of transected Nerve suppresses expression of bh3 only protein noxa in Nerve transected motor neurons of c57bl 6j mouse
Journal of Neurotrauma, 2007Co-Authors: Kazushige Gamo, Hideki Yoshikawa, Sumiko Kiryuseo, Hiroshi KiyamaAbstract:Disrupted peripheral Nerves are typically Sutured as spontaneous recovery does not always occur. However, the molecular mechanisms involved in Nerve regeneration following end-to-end Nerve Suture are obscure. Here, we investigated effects of end-to-end Nerve Suture after peripheral Nerve transection on motor neurons, using the C57BL/6J mouse hypoglossal Nerve injury model. In this animal model, 60-80% of injured motor neurons gradually progress to neuronal death, while the remaining injured neurons survive and regenerate. Mice were divided into the Cut and Suture groups. In the Cut group, the right hypoglossal Nerve was transected. In the Suture group, the right hypoglossal Nerve was transected and then was repaired using end-to-end Nerve Suture. We assessed differences between the Cut and Suture groups by analyzing the neuronal survival rate by thionine staining and the Nerve terminal regeneration rate by vesicular acetylcholine transporter (VAChT) immunohistochemistry, which is a marker for cholinergic presynaptic terminal. We found that 82.9% of motor neurons survived in the Suture group, whereas only 39.2% of motor neurons did in the Cut group 56 days after surgery. At that time point, 86% of presynaptic terminals compared to controls were regenerated in the Suture group, and 21% were regenerated in the Cut group. These results demonstrate that peripheral Nerve Suture prevented death of Nerve-transected motor neurons and promoted Nerve regeneration. We also examined expression profiles of major survival and death signal-associated genes in hypoglossal nuclei using in situ hybridization and real-time polymerase chain reaction (PCR). Although most of the survival- and death-associated genes were regulated in a similar manner in both groups, expression of BH3-only protein Noxa mRNA was significantly lower in the Suture than in the Cut group. A significant suppression of Noxa expression by the Suture may be a major reason why Nerve Suture induces survival and regeneration of Nerve-injured motor neurons.
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Suture of transected Nerve suppresses expression of BH3-only protein Noxa in Nerve-transected motor neurons of C57BL/6J mouse.
Journal of neurotrauma, 2007Co-Authors: Kazushige Gamo, Sumiko Kiryu-seo, Hideki Yoshikawa, Hiroshi KiyamaAbstract:Disrupted peripheral Nerves are typically Sutured as spontaneous recovery does not always occur. However, the molecular mechanisms involved in Nerve regeneration following end-to-end Nerve Suture are obscure. Here, we investigated effects of end-to-end Nerve Suture after peripheral Nerve transection on motor neurons, using the C57BL/6J mouse hypoglossal Nerve injury model. In this animal model, 60-80% of injured motor neurons gradually progress to neuronal death, while the remaining injured neurons survive and regenerate. Mice were divided into the Cut and Suture groups. In the Cut group, the right hypoglossal Nerve was transected. In the Suture group, the right hypoglossal Nerve was transected and then was repaired using end-to-end Nerve Suture. We assessed differences between the Cut and Suture groups by analyzing the neuronal survival rate by thionine staining and the Nerve terminal regeneration rate by vesicular acetylcholine transporter (VAChT) immunohistochemistry, which is a marker for cholinergic presynaptic terminal. We found that 82.9% of motor neurons survived in the Suture group, whereas only 39.2% of motor neurons did in the Cut group 56 days after surgery. At that time point, 86% of presynaptic terminals compared to controls were regenerated in the Suture group, and 21% were regenerated in the Cut group. These results demonstrate that peripheral Nerve Suture prevented death of Nerve-transected motor neurons and promoted Nerve regeneration. We also examined expression profiles of major survival and death signal-associated genes in hypoglossal nuclei using in situ hybridization and real-time polymerase chain reaction (PCR). Although most of the survival- and death-associated genes were regulated in a similar manner in both groups, expression of BH3-only protein Noxa mRNA was significantly lower in the Suture than in the Cut group. A significant suppression of Noxa expression by the Suture may be a major reason why Nerve Suture induces survival and regeneration of Nerve-injured motor neurons.
Heinz Redl - One of the best experts on this subject based on the ideXlab platform.
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Effects of alleviated tension at the Nerve repair site using biodegradable tubular conduits: Histological, electrophysiological and functional results in a rat model
European Surgery, 2005Co-Authors: Robert Schmidhammer, Shahin Zandieh, Raoul Hopf, T. Hausner, L. E. Pelinka, A. Kroepfl, Heinz RedlAbstract:BACKGROUND: The effect of mobilization on the functional regeneration of peripheral Nerves remains controversial. Functional efficacy of alleviated tension at the Nerve repair site in a full range of motion model in the rat was recently published elsewhere. This study sought to determine the effect of alleviated tension at the Nerve repair site using biodegradable tubular conduits for segmental Nerve splinting to block, thereby blocking variable tension. METHODS: In 60 rats, the right sciatic Nerve was transected midthigh and coapted immediately microsurgically. The animals were divided into four groups. Group N, epineural Nerve repair (control). For the groups listed below, segmental tubular Nerve splinting with alleviated in situ tension at the Nerve Suture site was performed using tubular conduits of different biodegradable materials. Polyurethane group, biodegradable polyurethane tubular conduits. Neuragen group, collagen I tubular conduits. Neurolac group: DL-lactide-ε-caprolactone tubular conduits. Full range of motion of lower limbs was ensured by passive motion of hind limbs once a week after functional testing. Histological and electrophysiological assessment and 12 postoperative weekly function tests (toe spread test and BBB Locomotor Rating Scale) were carried out. RESULTS: Functional results were significantly better in all groups using segmental biodegradable tubular Nerve splinting for alleviated in situ tension at the Nerve repair site, mainly because of less endoneural scar formation at the Nerve Suture segment. However, this effect was attenuated when polyurethane tubular conduits were used. Electrophysiologic results showed increased amplitude and compound Nerve action potential area in the alleviated tension groups. Nerve conduction velocity was fastest in the Neuragen group. CONCLUSIONS: Complete alleviation of in situ tension at the Nerve Suture site with biodegradable tubular conduits seems to improve functional peripheral Nerve regeneration by significant decrease of endoneural collagenization in the Nerve Suture segment. Additionally, our findings suggest that alleviated tension in the Nerve Suture segment using biodegradable conduits depends upon which material is used. GRUNDLAGEN: Der Einfluss der Mobilisierung auf die funktionelle Regeneration peripherer Nerven wird nach wie vor kontroversiell diskutiert. Eine funktionelle Effektivität von völlig aufgehobener Spannung im Bereich des Nervenrekonstruktionssegmentes in einem Vollbewegungsmodell der Ratte wurde bereits publiziert. Das Ziel dieser Studie war es, den Effekt einer vollständig aufgehobenen Spannung im Bereich der Nervenrekonstruktion durch segmentale Nervenschienung mittels bioresorbierbarer Tuben zu untersuchen. METHODIK: An 60 Ratten wurde der rechte Nervus ischiadicus auf Höhe der Oberschenkelmitte durchtrennt und anschließend mikrochirurgisch koaptiert. 4 Gruppen wurden gebildet. Gruppe N, epineurale Koaptation (Kontrollgruppe). Bei allen weiteren Gruppen wurde eine segmentale Nervenschienung mit aufgehobener Spannung am Nervennahtbereich durchgeführt. Es wurden verschiedene bioresorbierbare tubuläre Materialien verwendet. Polyurethan-Gruppe, bioresorbierbare Polyurethan-Tuben. Neuragen-Gruppe, Kollagen-I-Tuben. Neurolac-Gruppe, DL-Lactide-ε-caprolactone-Tuben. Eine vollständige Bewegung der unteren Extremität wurde durch eine wöchentliche passive Bewegungsbehandlung der Tiere gewährleistet. Histologische und elektrophysiologische Untersuchungen sowie wöchentliche funktionelle Tests (Zehenspreiz-Test und BBB-Locomotor Rating Scale) wurden durchgeführt. ERGEBNISSE: Die funktionellen Ergebnisse waren in allen Gruppen besser, in denen eine segmentale Schienung des Koaptationsbereiches mit aufgehobener Spannung erfolgte. Bei diesen Tieren konnte eine Verringerung des neuralen Bindegewebes im Bereich des Nervennahtsegmentes nachgewiesen werden. Dieser Effekt wurde bei der Verwendung von Polyurethan-Tuben vermindert. Die Ergebnisse der elektrophysiologischen Untersuchung zeigten bei den Gruppen mit aufgehobener Spannung am Nervennahtbereich eine Erhöhung der Amplitude und der CNAP-(compound Nerve action potential-)Fläche. Die Nervenleitgeschwindigkeit (NCV) war in der Neuragen-Gruppe am schnellsten. SCHLUSSFOLGERUNGEN: Eine vollständig aufgehobene Spannung im Bereich der Nervenkoaptation durch segmentale Schienung mittels bioresorbierbarer Tuben kann das funktionelle Ergebnis am Modell der Ratte verbessern. Diese Verbesserung scheint insbesondere durch eine Verringerung des neuralen Narbengewebes im Bereich des Koaptationssegmentes bedingt. Zusätzlich sind die Ergebnisse von der Art des verwendeten Materials abhängig.
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Effects of alleviated tension at the Nerve repair site using biodegradable tubular conduits: Histological, electrophysiological and functional results in a rat model
European Surgery, 2005Co-Authors: Robert Schmidhammer, Shahin Zandieh, Raoul Hopf, T. Hausner, L. E. Pelinka, A. Kroepfl, Heinz RedlAbstract:BACKGROUND: The effect of mobilization on the functional regeneration of peripheral Nerves remains controversial. Functional efficacy of alleviated tension at the Nerve repair site in a full range of motion model in the rat was recently published elsewhere. This study sought to determine the effect of alleviated tension at the Nerve repair site using biodegradable tubular conduits for segmental Nerve splinting to block, thereby blocking variable tension. METHODS: In 60 rats, the right sciatic Nerve was transected midthigh and coapted immediately microsurgically. The animals were divided into four groups. Group N, epineural Nerve repair (control). For the groups listed below, segmental tubular Nerve splinting with alleviated in situ tension at the Nerve Suture site was performed using tubular conduits of different biodegradable materials. Polyurethane group, biodegradable polyurethane tubular conduits. Neuragen group, collagen I tubular conduits. Neurolac group: DL-lactide-ε-caprolactone tubular conduits. Full range of motion of lower limbs was ensured by passive motion of hind limbs once a week after functional testing. Histological and electrophysiological assessment and 12 postoperative weekly function tests (toe spread test and BBB Locomotor Rating Scale) were carried out. RESULTS: Functional results were significantly better in all groups using segmental biodegradable tubular Nerve splinting for alleviated in situ tension at the Nerve repair site, mainly because of less endoneural scar formation at the Nerve Suture segment. However, this effect was attenuated when polyurethane tubular conduits were used. Electrophysiologic results showed increased amplitude and compound Nerve action potential area in the alleviated tension groups. Nerve conduction velocity was fastest in the Neuragen group. CONCLUSIONS: Complete alleviation of in situ tension at the Nerve Suture site with biodegradable tubular conduits seems to improve functional peripheral Nerve regeneration by significant decrease of endoneural collagenization in the Nerve Suture segment. Additionally, our findings suggest that alleviated tension in the Nerve Suture segment using biodegradable conduits depends upon which material is used. GRUNDLAGEN: Der Einfluss der Mobilisierung auf die funktionelle Regeneration peripherer Nerven wird nach wie vor kontroversiell diskutiert. Eine funktionelle Effektivität von völlig aufgehobener Spannung im Bereich des Nervenrekonstruktionssegmentes in einem Vollbewegungsmodell der Ratte wurde bereits publiziert. Das Ziel dieser Studie war es, den Effekt einer vollständig aufgehobenen Spannung im Bereich der Nervenrekonstruktion durch segmentale Nervenschienung mittels bioresorbierbarer Tuben zu untersuchen. METHODIK: An 60 Ratten wurde der rechte Nervus ischiadicus auf Höhe der Oberschenkelmitte durchtrennt und anschließend mikrochirurgisch koaptiert. 4 Gruppen wurden gebildet. Gruppe N, epineurale Koaptation (Kontrollgruppe). Bei allen weiteren Gruppen wurde eine segmentale Nervenschienung mit aufgehobener Spannung am Nervennahtbereich durchgeführt. Es wurden verschiedene bioresorbierbare tubuläre Materialien verwendet. Polyurethan-Gruppe, bioresorbierbare Polyurethan-Tuben. Neuragen-Gruppe, Kollagen-I-Tuben. Neurolac-Gruppe, DL-Lactide-ε-caprolactone-Tuben. Eine vollständige Bewegung der unteren Extremität wurde durch eine wöchentliche passive Bewegungsbehandlung der Tiere gewährleistet. Histologische und elektrophysiologische Untersuchungen sowie wöchentliche funktionelle Tests (Zehenspreiz-Test und BBB-Locomotor Rating Scale) wurden durchgeführt. ERGEBNISSE: Die funktionellen Ergebnisse waren in allen Gruppen besser, in denen eine segmentale Schienung des Koaptationsbereiches mit aufgehobener Spannung erfolgte. Bei diesen Tieren konnte eine Verringerung des neuralen Bindegewebes im Bereich des Nervennahtsegmentes nachgewiesen werden. Dieser Effekt wurde bei der Verwendung von Polyurethan-Tuben vermindert. Die Ergebnisse der elektrophysiologischen Untersuchung zeigten bei den Gruppen mit aufgehobener Spannung am Nervennahtbereich eine Erhöhung der Amplitude und der CNAP-(compound Nerve action potential-)Fläche. Die Nervenleitgeschwindigkeit (NCV) war in der Neuragen-Gruppe am schnellsten. SCHLUSSFOLGERUNGEN: Eine vollständig aufgehobene Spannung im Bereich der Nervenkoaptation durch segmentale Schienung mittels bioresorbierbarer Tuben kann das funktionelle Ergebnis am Modell der Ratte verbessern. Diese Verbesserung scheint insbesondere durch eine Verringerung des neuralen Narbengewebes im Bereich des Koaptationssegmentes bedingt. Zusätzlich sind die Ergebnisse von der Art des verwendeten Materials abhängig.
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Effects of alleviated tension at the Nerve repair site using biodegradable tubular conduits: Histological, electrophysiological and functional results in a rat model
European Surgery, 2005Co-Authors: Robert Schmidhammer, Shahin Zandieh, T. Hausner, L. E. Pelinka, A. Kroepfl, Rudolf Hopf, Heinz RedlAbstract:BACKGROUND: The effect of mobilization on the functional regeneration of peripheral Nerves remains controversial. Functional efficacy of alleviated tension at the Nerve repair site in a full range of motion model in the rat was recently published elsewhere. This study sought to determine the effect of alleviated tension at the Nerve repair site using biodegradable tubular conduits for segmental Nerve splinting to block, thereby blocking variable tension. METHODS: In 60 rats, the right sciatic Nerve was transected midthigh and coapted immediately microsurgically. The animals were divided into four groups. Group N, epineural Nerve repair (control). For the groups listed below, segmental tubular Nerve splinting with alleviated in situ tension at the Nerve Suture site was performed using tubular conduits of different biodegradable materials. Polyurethane group, biodegradable polyurethane tubular conduits. Neuragen group, collagen I tubular conduits. Neurolac group: DL-lactide-e-caprolactone tubular conduits. Full range of motion of lower limbs was ensured by passive motion of hind limbs once a week after functional testing. Histological and electrophysiological assessment and 12 postoperative weekly function tests (toe spread test and BBB Locomotor Rating Scale) were carried out. RESULTS: Functional results were significantly better in all groups using segmental biodegradable tubular Nerve splinting for alleviated in situ tension at the Nerve repair site, mainly because of less endoneural scar formation at the Nerve Suture segment. However, this effect was attenuated when polyurethane tubular conduits were used. Electrophysiologic results showed increased amplitude and compound Nerve action potential area in the alleviated tension groups. Nerve conduction velocity was fastest in the Neuragen group. CONCLUSIONS: Complete alleviation of in situ tension at the Nerve Suture site with biodegradable tubular conduits seems to improve functional peripheral Nerve regeneration by significant decrease of endoneural collagenization in the Nerve Suture segment. Additionally, our findings suggest that alleviated tension in the Nerve Suture segment using biodegradable conduits depends upon which material is used.
Hans-peter Simmen - One of the best experts on this subject based on the ideXlab platform.
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Direct Nerve Suture and knee immobilization in 90° flexion as a technique for treatment of common peroneal, tibial and sural Nerve injuries in complex knee trauma.
Journal of surgical case reports, 2012Co-Authors: Robert Döring, Bernhard Ciritsis, Thomas Giesen, Hans-peter Simmen, Pietro GiovanoliAbstract:There are different ways to treat peripheral Nerve injuries with concomitant defects in the lower extremity. One option is a direct Nerve Suture followed by immobilization of the knee in flexion as it is described for gunshot wounds that lead to lesions of the sciatic Nerve and its terminal branches as well as isolated Nerve lesions. We used this technique to treat a case of multiple Nerve injuries of the lower extremity combined with a complex knee trauma including a lesion of both bones and the posterior capsule. To our knowledge, this technique has not yet been described for such a combined injury in literature.
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direct Nerve Suture and knee immobilization in 90 flexion as a technique for treatment of common peroneal tibial and sural Nerve injuries in complex knee trauma
Journal of Surgical Case Reports, 2012Co-Authors: Robert Döring, Bernhard Ciritsis, Thomas Giesen, Hans-peter Simmen, Pietro GiovanoliAbstract:There are different ways to treat peripheral Nerve injuries with concomitant defects in the lower extremity. One option is a direct Nerve Suture followed by immobilization of the knee in flexion as it is described for gunshot wounds that lead to lesions of the sciatic Nerve and its terminal branches as well as isolated Nerve lesions. We used this technique to treat a case of multiple Nerve injuries of the lower extremity combined with a complex knee trauma including a lesion of both bones and the posterior capsule. To our knowledge, this technique has not yet been described for such a combined injury in literature.