BACKGROUND: The concept of "double crush syndrome (DCS)"-a proximal compressive lesion making the distal nerve more vulnerable to injury-is an intriguing hypothesis. However, recent studies did not show unitary results. This study was preliminarily undertaken in order to clarify the causal relationship of proximal compressive lesion and carpal tunnel syndrome (CTS) in an electrophysiologic aspect. METHODS: In the period between June 1998 and June 1999 there were 24 patients with CTS(33 limbs with CTS). With these CTS patients, thorough electrodiagnostic studies were performed to discover coexisting proximal compressive lesions along the median nerve and its corresponding cervical root lesions. RESULTS: In 10 of these limbs (30%), there was a electrodiagnostically-proven coexisting proximal compressive lesion(all cervical radiculopathies). But only 1 limb (3%) had an anatomically responsible association. Finally only 1 limb (3%) with CTS had a possibility of DCS. CONCLUSIONS: CTS and cervical radiculopathy are common disorders, so there is a high possibility of coexisting as a double primary lesion without a pathophysiological relationship. Our results do not support the double crush hypothesis. However, the possibility of a reversed double crush syndrome is suggested.
Carpal Tunnel Syndrome* ; Crush Syndrome* ; Extremities ; Humans ; Median Nerve ; Radiculopathy

Double compression of the ulnar nerve, including Guyon's canal syndrome associated with cubital tunnel syndrome caused by the anconeus epitrochlearis muscle, is a very rare condition. We present a case of double crush syndrome of the ulnar nerve at the wrist and elbow in a 55-year-old man, as well as a brief review of the literature. Although electrodiagnostic findings were consistent with an ulnar nerve lesion only at the elbow, ultrasonography revealed a ganglion compressing the ulnar nerve at the hypothenar area and the anconeus epitrochlearis muscle lying in the cubital tunnel. Careful physical examination and ultrasound assessment of the elbow and wrist confirmed the clinical diagnosis prior to surgery.
Crush Syndrome* ; Cubital Tunnel Syndrome ; Deception ; Diagnosis* ; Elbow ; Ganglion Cysts* ; Humans ; Middle Aged ; Physical Examination ; Ulnar Nerve* ; Ultrasonography* ; Wrist

AIMTo explore the effect of Simvastatin on the regeneration of sciatic nerve with crush injury in rats.

METHODSAnimals were randomized into the following experimental groups: Simvastatin-treated, vehicle and sham-operated groups. Sciatic nerves with crush injury were performed. After surgery, the functional evaluation of nerve recovery, electrophysiologic assessment, histological assessment, serum IL-6 and lipid were performed.

RESULTSThe toe spread index of Simvastatin-treated rats after operation was higher significantly than vehicle rats at 5 d and 8 d (P<0.05). CMAP was higher and NCV was faster (P < 0.05). The serum IL-6 at 5 d of post-operation was significant lower (P < 0.05). Total serum cholesterol of Simvastatin-treated animals was higher than that of other animals (P < 0.05) at 2 weeks of post-operation. The histological analysis showed that the numbers of myelinated axons and the thickness of myelin sheath of Simvastatin-treated crush injury animals at 4 weeks of post-operation were more than that of vehicle animals.

CONCLUSIONThe present study showed that Simvastatin could promote the regeneration of the sciatic nerve after crush injury in rats, partly through inhibiting immune and inflammatory responses and making the balance of serum cholesterol during these processes.

Animals ; Female ; Nerve Crush ; Nerve Regeneration ; drug effects ; physiology ; Rats ; Rats, Sprague-Dawley ; Sciatic Nerve ; drug effects ; injuries ; physiology ; Simvastatin ; pharmacology

Time-dependent translocational changes of Synapsin I (SyI), a synaptic vesicle-associated phosphoprotein and its involvement in the axonal transport were investigated in the regenerating axonal sprouts. A weak SyI immunoreactivity (IR) was found in the axoplasm of normal axons. Rat sciatic nerves were crush-injured by ligating with 1-0 silk thread at the mid-thigh level and released from the ligation 24 h later. At various times after release, immunocytochemistry was performed. SyI was translocated from the proximal to the distal site of ligation and also involved in the sprouting of regenerating axons. The distribution patterns of SyI IR were changed in the crush-injured nerves. SyI immunoreactive thin processes were strongly appeared in the proximal region from 1 h after release. After 3 h, a very strong IR was expressed. The intense SyI immunoreactive thin processes were elongated distally and were changed the distribution pattern by time-lapse. After 12 h, strong immunoreactive processes were extended to the ligation crush site. At 1 day, a very intense IR was expressed. At 2 days, immunoreactive thin processes extended into the distal region over the ligation crush site and strong IR was observed after 3 days. SyI was accumulated in the proximal region at the early phases after release. These results suggest that SyI may be related to the translocation of vesicles to the elongated membranes by a fast axonal transport in the regenerating sprouts.
Animals ; Axonal Transport ; Axons/*physiology/ultrastructure ; Immunohistochemistry ; Male ; Nerve Crush ; Nerve Regeneration/*physiology ; Protein Transport ; Rats ; Rats, Sprague-Dawley ; Sciatic Nerve/physiology ; Synapsins/*metabolism ; Time Factors

Degenerative and regnerative changes are occurred in the dorsal root ganglion (DRG) cells after the peripheral nerve injury. This experiment aimed to study the changes of neurotrophic factors and their receptors mRNA expressions in the regenerating sensory neurons after nerve crush injury. To study the regenration process of DRG neurons, the peripheral nerve was crushed rather than transection. mRNA expression was examined by in situ hybridization with oligonucleotide probes to nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), neurotrophin 3 (NT-3), nerve growth factor receptor (NGFR), trkA, trkB and trkC. The results are as following: 1. After the peripheral nerve crush injury, the number of NGF and BDNF mRNA containing neurons are increased for 5 weeks with peak at 1 day and 3 days, respectively. NGFR mRNA containing neurons are transiently decreased during several days after the lesion but return to normal within 1 week. 2. The number of trkA and trkB mRNA containing neurons are not altered by nerve crush. 3. NT-3 and trkC mRNA containing neurons are not observed in the control and lesioned DRG. This study provides the morphological evidences of neurotrophins and their receptors mRNAs changes in the DRG neurons in response to crush nerve injury.
Animals ; Brain-Derived Neurotrophic Factor ; Diagnosis-Related Groups ; Ganglia, Spinal* ; In Situ Hybridization ; Nerve Crush ; Nerve Growth Factor ; Nerve Growth Factors* ; Neurons ; Neurotrophin 3 ; Oligonucleotide Probes ; Peripheral Nerve Injuries* ; Peripheral Nerves* ; Rats* ; RNA, Messenger* ; Sensory Receptor Cells ; Spinal Nerve Roots*

Sciatic nerve injury is a common disease of peripheral nerve in clinic. After nerve injury, there are many dysfunctions in motoneurons and muscles following regeneration. Previous studies mostly investigated the aspects related to the injured nerve, and the effect on the recurrent inhibition (RI) pathway of spine following regeneration was not fully understood. Following reinnervation after temporary sciatic nerve crush, the functional alteration of RI was studied. In adult rats, RI between lateral gastrocnemius-soleus (LG-S) and medial gastrocnemius (MG) motor pools was assessed by conditioning monosynaptic reflexes (MSRs) elicited from the cut dorsal roots and recorded from either the LG-S or MG nerves by antidromic stimulation of the synergist muscle nerve. The following results were obtained. (1) The RI of MSRs in rats was almost lost (<5 weeks) after sciatic nerve crush. Although the RI partially recovered following reinnervation (6 weeks), it remained permanently depressed (up to 14 weeks). (2) Sciatic nerve crush on one side did not affect the contralateral RI. (3) Sciatic nerve crush did not induce any motoneuron loss revealed by immunohistochemistry. Peripheral nerve temporary disconnection causes long term alterations in RI pathway which make up motoneuron's function enhance for the alteration of muscle power and suggests that peripheral nerve injury induces long term plastic changes in the spinal motoneuron circuitry.
Animals ; Long-Term Synaptic Depression ; physiology ; Male ; Motor Neurons ; physiology ; Nerve Crush ; Nerve Regeneration ; physiology ; Neuronal Plasticity ; physiology ; Neurons, Afferent ; physiology ; Rats ; Rats, Wistar ; Reflex, Monosynaptic ; physiology ; Sciatic Nerve ; injuries ; physiopathology ; Spinal Cord ; physiopathology ; Spinal Nerve Roots ; physiopathology

PURPOSE: The intermediate filament proteins, desmin and vimentin, are specific components of the cytoskeleton of striated muscle fibers and of mononuclear cells of mesenchymal origin including myoblasts, respectively. Desmin has also been found in presumptive myoblasts of mammals. The aim of this experiment was attempted to observe the phenotypic changes of intermediate filaments in skeletal muscle fibers during early stages of sciatic nerve crushing injury. MATERIALS AND METHODS: The sciatic nerves of rats were surgically crushed by hemostat and serial cryosections of soleus and extensor digitorum longus(EDL) muscles were prepared at 2, 4, 6, 8, 10, 15, 20 and 27 days after nerve injury. Serial cryosections were immunolabelled with desmin, vimentin and laminin and were histochemically reacted with NADH-TR. RESULTS: 1) Firstly, desmin positive fibers were appeared in fast-twitch type C fibers of both muscles at 6 days after nerve crushing, but were not reacted for vimentin. 2) Co-expressions of desmin and vimentin were firstly detected in fast-twitch type A fibers of EDL muscles at 8 days after nerve injury. In soleus muscles, co-expressions of desmin and vimentin were firstly seen in slow-twitch type B fibers at 10 days after nerve injury. Many atrophic fibers, that contained several central nuclei like myotubes and co-expressed desmin and vimentin, were appeared in EDL muscles at 10 days after nerve injury. Although whole regions of fibers were regenerated in EDL muscles, only peripheral regions of fibers were regenerated in soleus muscles at 15 days after nerve injury. Many atrophic fibers, co-expressed of desmin and vimentin, were appeared in EDL muscles at 20 days after nerve injury. These whole fibers represented various degrees of regenerating stages. Most of mature fibers containing several central nuclei, only expressed vimentin slightly, were seen in soleus muscles at 20 days after nerve injury. Most fibers of both muscles were matured at 27 days after nerve injury, but some fibers in EDL muscles were still in processing of degeneration and regeneration. No expressions of desmin and vimentin indicated that muscle fibers were almostly matured in soleus muscles at 27 days after nerve injury. 3) Targetoid or target fibers which informed reinnervation, were appeared firstly in soleus muscles at 20 days and were seen in both muscles at 27 days after nerve injury. All targetoid and target fibers were type B fibers. CONCLUSION: Desmin was revealed in processes of degeneration and regeneration and vimentin was appealed in regeneration process. At the same time, positive immunoreactivity of desmin and vimentin showed specific differences in degree of degeneration and regeneration according to different muscles and muscle fibers.
Animals ; Cytoskeleton ; Desmin ; Intermediate Filament Proteins* ; Intermediate Filaments* ; Laminin ; Leg* ; Mammals ; Muscle Fibers, Skeletal ; Muscle, Striated ; Muscles* ; Myoblasts ; Nerve Crush ; Nerve Fibers, Myelinated ; Nerve Fibers, Unmyelinated ; Rats* ; Regeneration* ; Sciatic Nerve* ; Vimentin

PURPOSE: The intermediate filament proteins, desmin and vimentin, are specific components of the cytoskeleton of striated muscle fibers and of mononuclear cells of mesenchymal origin including myoblasts, respectively. Desmin has also been found in presumptive myoblasts of mammals. The aim of this experiment was attempted to observe the phenotypic changes of intermediate filaments in skeletal muscle fibers during early stages of sciatic nerve crushing injury. MATERIALS AND METHODS: The sciatic nerves of rats were surgically crushed by hemostat and serial cryosections of soleus and extensor digitorum longus(EDL) muscles were prepared at 2, 4, 6, 8, 10, 15, 20 and 27 days after nerve injury. Serial cryosections were immunolabelled with desmin, vimentin and laminin and were histochemically reacted with NADH-TR. RESULTS: 1) Firstly, desmin positive fibers were appeared in fast-twitch type C fibers of both muscles at 6 days after nerve crushing, but were not reacted for vimentin. 2) Co-expressions of desmin and vimentin were firstly detected in fast-twitch type A fibers of EDL muscles at 8 days after nerve injury. In soleus muscles, co-expressions of desmin and vimentin were firstly seen in slow-twitch type B fibers at 10 days after nerve injury. Many atrophic fibers, that contained several central nuclei like myotubes and co-expressed desmin and vimentin, were appeared in EDL muscles at 10 days after nerve injury. Although whole regions of fibers were regenerated in EDL muscles, only peripheral regions of fibers were regenerated in soleus muscles at 15 days after nerve injury. Many atrophic fibers, co-expressed of desmin and vimentin, were appeared in EDL muscles at 20 days after nerve injury. These whole fibers represented various degrees of regenerating stages. Most of mature fibers containing several central nuclei, only expressed vimentin slightly, were seen in soleus muscles at 20 days after nerve injury. Most fibers of both muscles were matured at 27 days after nerve injury, but some fibers in EDL muscles were still in processing of degeneration and regeneration. No expressions of desmin and vimentin indicated that muscle fibers were almostly matured in soleus muscles at 27 days after nerve injury. 3) Targetoid or target fibers which informed reinnervation, were appeared firstly in soleus muscles at 20 days and were seen in both muscles at 27 days after nerve injury. All targetoid and target fibers were type B fibers. CONCLUSION: Desmin was revealed in processes of degeneration and regeneration and vimentin was appealed in regeneration process. At the same time, positive immunoreactivity of desmin and vimentin showed specific differences in degree of degeneration and regeneration according to different muscles and muscle fibers.
Animals ; Cytoskeleton ; Desmin ; Intermediate Filament Proteins* ; Intermediate Filaments* ; Laminin ; Leg* ; Mammals ; Muscle Fibers, Skeletal ; Muscle, Striated ; Muscles* ; Myoblasts ; Nerve Crush ; Nerve Fibers, Myelinated ; Nerve Fibers, Unmyelinated ; Rats* ; Regeneration* ; Sciatic Nerve* ; Vimentin

OBJECTIVETo establish a rat model mimicking erectile dysfunction following radical prostatectomy by crush injury or reaction of the cavernous nerve (CN).

METHODSThirty rats were randomized into CN crush group, CN resection group and sham-operated group. Four weeks after surgery, the rat models were evaluated by apomorphine test and ICP/MAP measurement. Fluorogold (FG) retrograde tracer was used to assess the CN injury. The penile tissues were then harvested for immunohistochemical detection of the nNOS-positive fibers to evaluate the CN injury.

RESULTSThe rats in CN crush group and CN resection group exhibited erectile dysfunction in apomorphine test or in response to electrical stimulation of the ganglion stellatum (MPG). In the sham-operated group, the rats showed normal erectile function with increased ICP/MAP following electrical stimulation (P<0.05). Immunohistochemistry revealed reduced nNOS-positive fibers in both CN crush group and CN resection group as compared with those in the sham-operated group (P<0.05), showing no significant difference between the former two groups (P>0.05). The FG-positive MPG cells in CN crush group and CN resection group were significantly less than that in the sham-operated group (P<0.05), and the positive cells were even less in CN resection group (P<0.05).

CONCLUSIONThe rat CN is structurally similar to human CN, and crush injury and resection of the CN are both reliable methods for establishing rat models of erectile dysfunction following radical prostatectomy.

Animals ; Disease Models, Animal ; Erectile Dysfunction ; etiology ; Male ; Nerve Crush ; Penis ; innervation ; Postoperative Period ; Prostatectomy ; adverse effects ; Rats ; Rats, Sprague-Dawley

PURPOSE: To find out the effect of transplanted umbilical cord blood derived human mesenchymal stem cells (hUCB- MSCs) in the rat model of bilateral cavernosal nerve injury (BCNX) MATERIALS AND METHODS: Male Sprague Dawley rats were divided into three groups: Group I (7 rats, Control, Sham operation) had only bilateral cavernosal nerve crushing injury. PKH-26 fluorescent cell linker was labeled to hUCB- MSCs Group II (7 rats) had transplantation of hUCB- MSCs (3x10(5)cells/50microliter PBS) into MPG after BCNX. Group III (7 rats) had transplantation of hUCB- MSCs (3x10(5)cells/50microliter PBS) into the CC after BCNX. We detected the PKH-26 labeled MSCs in Group II, and III at four weeks after transplantation. Peak intracavernosal pressure (ICP) and ICP/mean arterial pressure (MAP) were recorded after pelvic nerve stimulation at 12 weeks after transplantation. RESULTS: PKH-26 labeled hUCB-MSCs were detected in MPG and CC of group II and III at four weeks after transplantation. The peak ICP was significantly higher in the Group II (69.6+/-5.9mmHg) and Group III (59.7+/-7.6mmHg) compared to Group I40.6+/-10.5mmHg) at 12 weeks after transplantation. The rates of ICP/MAP were significantly higher in Group II (32.2+/-6.4%) and Group III (57.8+/-4.9%) compared to Group I (49.5+/-2.9%) at 12 weeks after transplantation. CONCLUSIONS: The intracavernosal and major pelvic ganglion transplantation of hUCB- MSCs improve erectile function in a rat model of neurogenic impotence.
Animals ; Arterial Pressure ; Fetal Blood ; Ganglion Cysts ; Humans ; Male ; Mesenchymal Stromal Cells ; Nerve Crush ; Organic Chemicals ; Rats ; Rats, Sprague-Dawley ; Salicylamides ; Transplants ; Umbilical Cord