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J P Fossion - One of the best experts on this subject based on the ideXlab platform.

  • activity of the helix in ear acupuncture corresponding to the Segmental Innervation of the human body part i clinical observations
    Enzyme and Microbial Technology, 2010
    Co-Authors: J P Fossion
    Abstract:

    Abstract Background In the eighties of the last century Rene Bourdiol established two postulations in his cartography of the ear described and illustrated in the booklet on auriculotherapy of Raphael Nogier: First the longitudinal strip on the helix represented influence on the Segmental Innervation of the body. He situated this Segmental action between the bulbar cauda and the tubercle of Darwin. Second the anterior side on a transverse cross section of the helix, represented cutaneous Segmental afference and the posterior side represented motor responses. Aim The aim is to present the elaboration of a chart of the helix border with its Segmental motivation for clinical indications. Method In a series of two articles we present a clinical body of evidence for the elaboration of the Segmental chart of the helix border. Detection is done with a palpator. We use semipermanent needles as standard therapy in series of five sessions per person. Results We find very intense activity on the helix border over its entire length, going from the bulbar tail to point Zero on the root. The Segmental representation follows a proportional and logical distribution in the succession of the segments. The cervical level is situated on its bulbar “tail” and the sacral level ends on point Zero in its “root”. Although this study is qualitative in nature, needling is so influential therapeutically that a statistical study would be highly recommended. Conclusion On the basis of clinical evidence, we propose to extend the influence on Segmental Innervation of the body to the entire border of the helix. The tubercle of Darwin is in no way closing the Segmental sequence. The sacral level ends on point Zero in its root instead. We found clinical evidence to propose a complementary third point in each transverse cross section of the helix, in every level investigated. To the sensory nature of the anterior border and the motor nature of the posterior border, we thus add a vascular influence of the cornice. These three transversal points on cross section of the helix, cutaneous, motor and vascular, are representations of the sensory, motor and vascular Innervation of the same Segmental level.

  • activity of the helix in ear acupuncture corresponding to the Segmental Innervation of the human body
    Enzyme and Microbial Technology, 2010
    Co-Authors: J P Fossion
    Abstract:

    Abstract Background Intrigued by the two postulations of Rene Bourdiol, the one on the influence of the helix border on the Segmental Innervation of the body and the other on the differentiation into an anterior sensory side and a posterior motor side, we looked for further clinical evidence. Aim The aim is to present the elaboration of a chart of the helix border with its Segmental indications. Method In a series of two articles we present a clinical body of evidence for the elaboration of the Segmental chart of the helix border. This evidence was found by detection of painful points in the ear of patients with different diagnoses. Results We find very intense activity on the helix border over its entire length, going from the bulbar tail to point Zero on the root. The Segmental representation follows a proportional and logical distribution in the succession of the segments. Although this study is qualitative in nature, needling is so influential therapeutically that a statistical study would be highly recommended. Conclusion On the basis of clinical evidence, we confirm the postulation of Rene Bourdiol on Segmental influence of the helix but propose to extend this action to the entire border of the helix. We find also confirmation for the second postulation of Rene Bourdiol, on the sensory nature of the anterior border and the motor nature of the posterior border. During our investigation however we found also a vascular influence of the cornice (internal hidden border of the helix). On cross section of the helix therefore, we situate three transversal points, cutaneous, motor and vascular, representing the sensory, motor and vascular Innervation of the same Segmental level. The bulbar thickening of the tail contributes perhaps to a cervical enlargement for the plexus brachialis, but the bulbar tail is much more convincingly identifiable with the medulla oblongata containing the therapeutically interesting spinal trigeminal nucleus and the accessory cuneate nucleus. The localization of the tubercle of Darwin is only present in 10 % of the population. Even when present, the localization of this Segmental landmark is too variable and does in my view not represent a lumbosacral enlargement for the Innervation of the lower limb as suggested by Bourdiol.

Gregory A. Dumanian - One of the best experts on this subject based on the ideXlab platform.

  • The Effects of Targeted Muscle ReInnervation on Neuromas in a Rabbit Rectus Abdominis Flap Model
    The Journal of hand surgery, 2012
    Co-Authors: Peter Kim, Kristina K. O'shaughnessy, Todd A. Kuiken, Eric A. Pohlmeyer, Gregory A. Dumanian
    Abstract:

    Purpose A targeted muscle reInnervation (TMR) model was created using a pedicled rabbit rectus abdominis (RA) flap to receive the input from previously amputated forelimb neuromas. We hypothesize that a Segmental muscle flap can undergo TMR and that it is possible to differentiate the signal from 3 independent nerves. In addition, by virtue of the nerve coaptation, the morphology of the previous amputation neuroma would become more like that of an in-continuity neuroma. Methods Five New Zealand white rabbits had a forelimb amputation. In a second-stage surgery, an RA flap was transposed onto the chest wall. After neuroma excision, 3 neurorrhaphies were made between the median nerve, radial nerve, and ulnar nerves, and 3 motor nerves of the RA. After 10 weeks, the electrophysiologic properties of the reinnervated flap were tested. Nerve specimens from the median, radial, and ulnar nerves were harvested before and after TMR to quantify the histomorphometric changes effected by TMR on the mixed nerve neuromas. Results Of the 12 nerve coaptations performed in the 4 viable flaps, all 12 were grossly successful. Muscle surface EMG data demonstrated that the RA retained its Segmental Innervation pattern after TMR. Similarly, prolonged stimulation of 1 nerve reinnervating the RA resulted in the depletion of glycogen specific to the territory of the muscle stimulated by that nerve. TMR was found to favorably alter the histomorphometric characteristics of the neuroma by decreasing myelinated fiber counts and increasing fascicle diameter in the transferred nerves. Conclusions This study demonstrates that 1 segmented muscle having TMR by multiple nerve ingrowth and in turn generate discrete EMG signals. During this process, the previous amputation neuroma undergoes favorable morphologic alteration. Clinical relevance Based on these preclinical results, this technique might be useful in upper extremity amputees to recruit target muscles to have reInnervation to drive myoelectric prostheses and to treat symptomatic neuromas.

Werner Trojaborg - One of the best experts on this subject based on the ideXlab platform.

  • determination of the Segmental sensory and motor Innervation of the lumbosacral spinal nerves an electrophysiological study
    Brain, 1992
    Co-Authors: Rocco Liguori, Christian Krarup, Werner Trojaborg
    Abstract:

    The knowledge of the Segmental Innervation of the skin and muscles of the lower limb in man is inadequate. For this reason, sensory and motor Segmental Innervation of the lower extremities was examined by electro-physiological methods in 27 normal subjects, one patient with possible L5 radiculopathy and one with possible lumbosacral plexus affection. Needle electrodes were placed at root levels from L3 to S2 using bony landmarks. The electrode was then placed close to the spinal nerve as indicated by a low (⩽ 1 mA) threshold necessary to stimulate motor fibres. The position was controlled by X-ray in 10 subjects. Sensory Innervation was determined by recording the sensory action potential evoked by stimulating the saphenous nerve at the medial epicondyle (mainly L3 and L4) and at the medial malleolus (mainly L4 and in some L3), the medial plantar nerve at the first plantar interstice (mainly S1, some L5 and S2), the deep personeal nerve at the first dorsal interstice (mainly L5, some S1), the sural nerve at the dorsolateral aspect of the foot (mainly S1, some L5 and S2) and at the lateral malleolus (mainly S1, some L5 and S2), and the superficial peroneal nerve at the superior extensor retinaculum (mainly L5, S1). The motor Innervation was determined by stimulating the spinal nerves supramaximally and recording the evoked responses from the medial and lateral vastus (mainly L3, L4), the anterior tibial (mainly L5), the peroneus longus (L5, S1), the extensor digitorum brevis (mainly S1), the gastrocnemius (mainly S1), the abductor hallucis (mainly S2) and the biceps femoris (mainly L5, S1). Sensory and motor conduction velocity measurements along the leg and across the lumbosacral plexus indicated that there was no difference in a disto-proximal direction, except for a 10% reduction along the most distal part of the sural nerve which, however, might be explained by utilization time. There was therefore no evidence of gradual tapering of nerve fibres in a distal direction. The proximal motor conduction velocity to the most distally placed muscle (abductor hallucis) was about 20% lower than to the proximally placed muscles (gastrocnemius and biceps femoris) suggesting a general difference in fibre calibre.

William C. Lineaweaver - One of the best experts on this subject based on the ideXlab platform.

  • Use of intercostal nerves as nerve grafts in hand reconstruction with rectus abdominis flaps
    The Journal of hand surgery, 1994
    Co-Authors: Kenneth K. Yim, Kenneth Hui, Douglas Ramos, William C. Lineaweaver
    Abstract:

    Following complex crush and avulsion hand injuries with significant tissue loss and exposed vital structures, microvascular tissue transplantation can reliably provide soft tissue coverage in one setting. Rectus abdominis muscle free flaps are frequently used in hand reconstruction because of the ease of dissection, low donor site morbidity, reliable, large diameter vessels for anastomosis, and supine positioning of the patient, allowing two teams of surgeons to work simultaneously reducing the operative time.’ Because of the Segmental Innervation of the rectus muscle, it is not used for functional transplantation, and the innervating intercostal nerves are routinely sacrificed during harvesting of muscle. We propose that the intercostal nerves within the rectus sheath can be used for primary nerve grafting in complicated hand injuries when soft tissue loss requires rectus muscle free flaps for coverage and nerve grafting is attempted within the injury.

Bing Zhu - One of the best experts on this subject based on the ideXlab platform.

  • inhibition of electroacupuncture on nociceptive responses of dorsal horn neurons evoked by noxious colorectal distention in an intensity dependent manner
    Journal of Pain Research, 2019
    Co-Authors: Wei Wang, Peijing Rong, Qingguang Qin, Kun Liu, Yufeng Zhao, Bing Zhu
    Abstract:

    Background The transmission of visceral nociception can be inhibited by electroacupuncture (EA) at the spinal level. However, relationships between current intensity and EA-induced analgesia are still lacking. This study compares the effects of different intensities of EA at local acupoints and heterotopic acupoints on nociceptive responses of spinal wide dynamic range (WDR) neurons induced by noxious colorectal distension (CRD). Materials and methods Experiments were conducted on 40 Sprague Dawley rats anesthetized with 10% urethane. Discharges of WDR neurons in the L1-L3 segments of the dorsal horn of the spinal cord were recorded extracellularly by glass micropipettes. Different intensities of EA (0.5, 1, 2, 4, 6, and 8 mA, 0.5 ms, 2 Hz) were applied to contralateral "Zusanli" (ST 36) or "Neiguan" (PC 6), with either the same or different Segmental Innervation of the colon. Results In local acupoints, the increased discharges of WDR neurons evoked by CRD were significantly inhibited by EA at 0.5-8 mA. A positive relationship between current intensity and the inhibiting rate was observed within 0.5-4 mA, but the inhibiting rate reached a plateau when EA exceeded 4 mA. In heterotopic acupoints, the increased discharges of WDR neurons evoked by CRD were significantly inhibited by EA at 2-8 mA. A positive relationship between current intensity and the inhibiting rate was observed within 2-6 mA. Further increase in the current beyond 6 mA also resulted in a plateau effect. Conclusion Within a certain range, the nociceptive responses of dorsal horn neurons induced by CRD could be inhibited by EA in an intensity-dependent manner.

  • RESEARCH ARTICLE Open Access Acupuncture at homotopic acupoints exerts dual effects on bladder motility in anesthetized rats
    2016
    Co-Authors: Qingguang Qin, Kun Liu, Xinyan Gao, Bing Zhu
    Abstract:

    Background: In Chinese medicine, dual effects on target organs are considered a primary characteristic of acupoint. Acupoints may be classified as heterotopic or homotopic in terms of spinal Segmental Innervation: homotopic acupoints contain afferent Innervation in the same segment from which efferent fibers innervate target visceral organs, and heterotopic acupoints utilize different spinal segments to innervate target visceral organs than the segment receiving the afferent signal. It is well-known that dual effects of acupuncture on the bladder can be generated based on different states of the bladder, however, the dual effects of single acupoint stimulation and acupoint site-specificity (homotopic acupoints and heterotopic acupoints) on the bladder have yet to be investigated. Methods: Twenty Sprague-Dawley rats were anesthetized and the intravesical pressure was measured via a manometric balloon inserted into the bladder. The acupuncture needle was separately inserted to a depth of 4 mm at the acupoints RN1 (Huiyin), RN3 (Zhongji), BL28 (Pangguangshu), BL32 (Ciliao), RN2 (Qugu) or BL23 (Shenshu), and manually rotated right then left with a frequency of 2 Hz for 1 min. Following acupuncture stimulation, bladder pressure was recorded and compared against the pre-stimulation measurements. Results: During the bladder’s active state, manual acupuncture (MA) at RN1, RN3, BL28, BL32 or RN2 inhibited bladder motility (P < 0.01). In the static bladder, MA at RN1, RN3, BL28, BL32, RN2 or BL23 increased bladder motility (P < 0.01). Conclusions: MA at homotopic acupoints may produce dual effects on bladder motility: inhibiting bladder motility when in an active state and enhancing bladder motility when in a static state