Remote ischemic preconditioning (RIPC) is an intrinsic phenomenon whereby 3~4 consecutive ischemia-reperfusion cycles to a remote tissue (noncardiac) increases the tolerance of the myocardium to sustained ischemiareperfusion induced injury. Remote ischemic preconditioning induces the local release of chemical mediators which activate the sensory nerve endings to convey signals to the brain. The latter consequently stimulates the efferent nerve endings innervating the myocardium to induce cardioprotection. Indeed, RIPC-induced cardioprotective effects are reliant on the presence of intact neuronal pathways, which has been confirmed using nerve resection of nerves including femoral nerve, vagus nerve, and sciatic nerve. The involvement of neurogenic signaling has been further substantiated using various pharmacological modulators including hexamethonium and trimetaphan. The present review focuses on the potential involvement of neurogenic pathways in mediating remote ischemic preconditioning-induced cardioprotection.
Brain ; Femoral Nerve ; Hexamethonium ; Ischemic Preconditioning* ; Myocardium ; Negotiating ; Nerve Endings ; Neurons ; Sciatic Nerve ; Sensory Receptor Cells ; Trimethaphan ; Vagus Nerve

Sensorineural hearing loss (SNHL) does not recover and only few exceptions exist. It is mostly due to the reason that hair cells in the cochlea cannot regenerate once damaged. Therefore, clinical approaches for SNHL mostly rely on the implantable or external device to deliver sound to brain. Despite the advance of technology, current strategy does not replicate the sound perception of naïve inner ear. To overcome this issue, novel trials to protect or rescue hair cells from the ototoxic insults are investigated. One of these is gene therapy. Protective gene therapy has been applied to several ototoxic insults, but some trials have shown negative effect. Gene therapy using neurotrophin, one of the growth factor, has been expected to show protective effect against acoustic overexposure. But unregulated and untargeted expression of Ntf3 revealed adverse effect showing deterioration of nerve ending and synapse. Meanwhile, gene therapies have been adopted and tried for cisplatin ototoxicity. Most of the studies has been shown promising outcome. Also several studies have shown protective effect of gene therapy for aminoglycoside ototoxicity. Recent publication showed that heat-shock protein 70 was effective in preventing aminoglycoside ototoxicity. Furthermore, use of gene therapy expands to the field of cochlear implant, in which it can be used as an enhancer of treatment outcome. Application of neurotrophins resulted in increase of spiral ganglion densities as well as migration of peripheral nervous fibers to the location which would be closer to the electrode when implanted.
Acoustics ; Brain ; Cisplatin ; Cochlea ; Cochlear Implants ; Ear, Inner ; Electrodes ; Genetic Therapy* ; Hair ; Hearing Loss, Sensorineural ; Hearing* ; HSP70 Heat-Shock Proteins ; Nerve Endings ; Nerve Growth Factors ; Publications ; Spiral Ganglion ; Synapses ; Treatment Outcome

The mental foramen is a bilateral opening in the vestibular portion of the mandible through which nerve endings, such as the mental nerve, emerge. In general, the mental foramen is located between the lower premolars. This region is a common area for the placement of dental implants. It is very important to identify anatomical variations in presurgical imaging exams since damage to neurovascular bundles may have a direct influence on treatment success. In the hemimandible, the mental foramen normally appears as a single structure, but there are some rare reports on the presence and number of anatomical variations; these variations may include accessory foramina. The present report describes the presence of accessory mental foramina in the right mandible, as detected by cone-beam computed tomography before dental implant placement.
Anatomic Variation ; Bicuspid ; Cone-Beam Computed Tomography* ; Dental Implants ; Mandible ; Nerve Endings

OBJECTIVETo investigate the density and distribution of nerve endings and neuropeptide Y (NPY) in lumbar facet joints of patients with low back pain.

METHODSFifteen patients without low back pain were selected as control group (group A). Facet joint samples in group A were obtained during the operation or lumbar spinal canal tumor they suffered from. Those patients with low back pain were divided into three groups according to their different origins of pain, such as not from facet joint (group B, 15 patients) ,from facet joint only (group C, 20 patients), or from facet joint partially (group D, 20 patients). Different origins were determined by VAS after facet joint block. The density and distribution of nerve ending and neuropeptide in the capsular tissues were analyzed by a modified gold chloride staining and immunochemistry respectively.

RESULTSCompared with the ones in group A and B, the fact joints in group C and D were more inclined to be degenerated and got more nerve endings. NPY was expressed mainly in the facet joint of patients with low back pain in group C and D. In addition, there was a significant relationship between the distribution of nerve endings and NPY expression,while none of them were related with MRI Fujiwara grade of facet joint.

CONCLUSIONThese results suggest that the number of mechanoreceptors, neural sprouting and secreted peptides in the facet joint capsules vary with the change of mechanical or nociceptive stimulation, which may promote the development of low back pain in return.

Adult ; Aged ; Case-Control Studies ; Chronic Pain ; etiology ; metabolism ; pathology ; Female ; Humans ; Low Back Pain ; etiology ; metabolism ; pathology ; Male ; Mechanoreceptors ; physiology ; Middle Aged ; Nerve Endings ; pathology ; Neuropeptide Y ; analysis

Muscle pain is one of the most common, as well as elusive, clinical complaints. Pain can be experienced in muscles by any dysfunction of the muscle itself, peripheral nerves, or central nervous system. Persistent inflammation of the muscle increases nerve endings of the nociceptors and can develop allodynia or hyperalgesia. Myofascial trigger points are formed by perpetuating contraction of the sarcomeres and local ischemia and can result in regional pain. Disorders of the peripheral nervous system can entail muscle pain in the innervated territory. The central nervous system can also modulate or generate muscle pain. Gate-control theory provides an explanation as to how pain can be affected by the nervous system. Fibromyalgia is believed to be related to a lowered pain threshold in the central nervous system. Clinicians, during their diagnostic approach, should not unduly attribute muscle pain to pathology confined to the muscle merely because pain is perceived and evoked from the muscle. Even in cases where abnormalities are confirmed in the muscle, such as myofascial trigger points, clinicians should seek the underlying etiology. In particular, diagnosis of myofascial pain syndrome does not rule out primary musculoskeletal disorders. Rather, arthropathies or radiculopathies are known to frequently involve myofascial pain syndrome, which would not improve unless they are resolved. After accurate diagnosis of muscle pain is obtained, appropriate treatment should be implemented. A multi-disciplinary, individualized approach, including physiotherapy, exercise, education, and behavioral modification, is recommended.
Central Nervous System ; Contracts ; Fibromyalgia ; Hyperalgesia ; Inflammation ; Ischemia ; Muscles ; Myofascial Pain Syndromes ; Nerve Endings ; Nervous System ; Nociceptors ; Pain Threshold ; Peripheral Nerves ; Peripheral Nervous System ; Radiculopathy ; Sarcomeres ; Trigger Points

Recently, rising curiosity on remnant preservation technique of anterior cruciate ligament (ACL) reconstruction, there is much interested in being and distribution of the mechanoreceptor of ACL. So, we performed histologic analyzing and mapping of sensory nerve fiber of the human ACL in this study. Total of 20 anterior cruciate ligaments were obtained from total knee replacement. Each ACL samples was divided into seven specimens; tibial insertion site, mid transitional site, femoral insertion site, and in between the sites, and total of 140 tissue samples were stained with hematoxylin-eosin and immunohistochemical, and observed with light microscope. Five hundred thirty-four fine neuroparticle structures, Ruffini corpuscles, and free nerve endings were observed in 20 ACL samples. The mean of fibers observed were 1.88, 1.71, 1.15, 1.08, 1.15, 1.55, and 1.82, respectively from tibial insertional site to femoral insertional site. With immunohistochemical stain, S-100 protein was strong positive at nerve cells, but was weak positive or negative at neurofilament. Mapping of sensory nerve distribution were done based on the results. We identified the mechanoreceptor of the human ACL using optical and immunohistochemical methods and mapped the histologic distribution of that.
Anterior Cruciate Ligament ; Arthroplasty, Replacement, Knee ; Exploratory Behavior ; Humans ; Light ; Mechanoreceptors ; Nerve Endings ; Nerve Fibers ; Neurons ; Proprioception ; S100 Proteins

OBJECTIVETo determine the effect of tension relaxation by small needle knife on the muscle tension and morphology changes of nerve terminals when sustained pressure was applied to muscular tissue.

METHODSRat gracilis muscles were exposed to pressure in vivo at 70 kPa for 2 hours. Sixty rats were divided into three groups: normal, control and experiment group respectively. In all rats except the six normal ones, the lower legs were considered as the control group, and the right left as experiment group. At day 1, 2 and 3, 9 rats from the two groups were randomly selected and sacrificed in order to determine the muscle tension change. At the same time, muscle histology and morphology changes of nerve terminals were observed.

RESULTSAbnormal tension increased in muscles under compression of 70 kPa. At the 1st and 2nd days, there were no significant differences between the two groups. Compared with control group, the tension was lower in experiment group, and there was statistically significant difference (P < 0.01) between the two groups. Exposure of striated muscle tissue to intensive and prolonged compression may pathologically alter its microstructure. Histological evaluation showed that this stiffening accompanied extensive necrotic damage. The changes could not be found in the nerve terminals.

CONCLUSIONDeep muscle tissue that undergoes prolonged compression may significantly increase its stiffness during acute injury. Tension relaxation applied by small needle knife can effectively reduce the mechanical load which is harmful to the whole tissue.

Animals ; Biomechanical Phenomena ; Female ; Male ; Medicine, Chinese Traditional ; Muscle Tonus ; Muscle, Skeletal ; innervation ; pathology ; physiology ; Nerve Endings ; pathology ; Pain Management ; Rats ; Rats, Sprague-Dawley

PURPOSE: Hands are the chief organs for physically manipulating the environment, using anywhere from the roughest motor skills to the finest, and since the fingertips contain some of the densest areas of nerve endings on the human body, they are continuously used organ with complex functions, and therefore, often gets injured. To prevent any functional loss, a detailed anatomical knowledge is required to have a perfect surgical treatment. Also it is necessary to have a thorough understanding of arrangements of the human extensor tendons and intertendinous connections when tenoplasty or tendon transfer is required. We performed a study of the arrangements of the human extensor tendons and the configuration of the intertendinous connections over the dorsum of the wrist and hand. METHODS: A total of 58 hands from Korean cadavers were dissected. The arrangements of extensor indicis proprius, extensor digitorum communis, and extensor digiti minimi tendons and intertendinous connections were studied. RESULTS: The most common distribution patterns of the extensor tendons of the fingers were as follows: a single extensor indicis proprius(EIP) tendon which inserted ulnar to the extensor digitorum-index(EDC-index); a single EDC-index; a single EDC-middle; a double EDC-ring; an absent EDC-little; a double extensor digiti minimi(EDM), a single EDC-index(98.3%), a single EDC-middle(62%), a double EDC-ring(50%), and an absent(65.5%) or a single (32.8%) EDC-little. A double(70.6%) EDM tendons were seen. Intertendinous connections were classified into 3 types: type 1 with thin filamentous type, type 2 with a thick filamentous type, and type 3 with a tendinous type subdivided to r shaped 3r type and y shaped 3y type. The most common patterns were type 1 in the 2nd intermetacarpal space, type 2 in the 3rd intermetacarpal space, and type 3r in the 4th intermetacarpal space. And in the present study, we observed one case of the extensor digitorum brevis manus(EDBM) on the boht side. CONCLUSION: A knowledge of both the usual and possible variations of the extensor tendon and the intertendinous connection is useful in the identification and repair of these structures.
Cadaver ; Fingers ; Hand ; Human Body ; Humans ; Motor Skills ; Nerve Endings ; Tendon Transfer ; Tendons ; Wrist

PURPOSE: Ketamine may decrease core-to-peripheral redistribution of heat through direct central sympathetic stimulation and inhibition of norepinephrine uptake into postganglionic sympathetic nerve endings. The purpose of this study was to evaluate the efficacy of epidural ketamine in preventing shivering during transurethral resection of the prostate (TURP) under epidural anesthesia. MATERIALS AND METHODS: Ninety-three male patients scheduled for TURP under epidural anesthesia were enrolled in this study. Patients were randomized into one of three groups. Group 1 consisted of 31 patients who received epidural 0.75% ropivacaine, group 2 consisted of 32 patients who received epidural ketamine (0.2 mg/kg) in addition to 0.75% ropivacaine, and group 3 consisted of 30 patients who received epidural ketamine (0.4 mg/kg) in addition to 0.75% ropivacaine. Shivering and side effects such as hypotension, bradycardia, nausea, and hallucination were recorded during the anesthesia and for 2 hours while in the postanesthetic recovery room. RESULTS: Shivering was statistically more frequent in group 1 than in the other groups. The incidence of sedation was significantly higher in group 3 than in the other groups. The incidences of side effects such as hypotension, bradycardia, and nausea were significantly higher in group 1 than in the other groups. CONCLUSIONS: In this study, epidural ketamine 0.2 mg/kg and 0.4 mg/kg was shown to have a lower incidence of shivering and other side effects except sedation. In patients who undergo TURP under epidural anesthesia, the prophylactic use of low-dose epidural ketamine would be helpful in preventing any adverse effects, including shivering.
Amides ; Anesthesia ; Anesthesia, Epidural ; Bradycardia ; Hallucinations ; Hot Temperature ; Humans ; Hypotension ; Incidence ; Ketamine ; Male ; Nausea ; Nerve Endings ; Norepinephrine ; Prostate ; Recovery Room ; Shivering ; Transurethral Resection of Prostate

The main transmitter substance mediating erection is the nitric oxide released from the vascular endothelial cells of corpus cavernosum and from the nonadrenergic, noncholinergic nerve endings. In addition, some neurotransmitters, such as acetylcholine or vasoactive intestinal polypeptide (VIP), have been reported to play an important role in mediating the erection. Thus, autonomic neuropathy may cause erectile dysfunction, and in reality, it occurs frequently in individuals with diabetes mellitus (DM), in which polyneuropathy, including both peripheral somatic sensorimotor neuropathy and autonomic neuropathy, develops usually. Thiazolidinedione (TZD) is an insulin-sensitizing agent used for the treatment of type 2 DM with insulin resistance, and has been reported to ameliorate nephropathy, decrease plasma glucose level and reduce blood pressure. However, the effect of this drug on the neuropathy related to erectile dysfunction has never been proved. In the present study, to evaluate the effect of TZDs on the neuropathy concerned with erectile dysfunction, we examined neurochemical changes of major pelvic ganglion (MPG) neurons in Otsuka Long Evans Tokushima Fatty (OLETF) rats, genetic models with non-insulin-dependent DM, after TZDs (pioglitazone and rosiglitazone) treatment. Age-matched nondiabetic Long Evans Tokushima Otsuka (LETO) rats were used as controls. Nitric oxide synthase (NOS), tyrosine hydroxylase (TH), VIP, and neuropeptide Y (NPY) contents were measured in MPG neurons of LETO, OLETF and pioglitazone- or rosiglitazone-treated OLETF rats by morphometry. Compared to the corresponding LETO group, number of TH-, NOS- and VIP-immunoreactive (ir) neurons decreased, while that of NPY-ir neurons, which modulate noradrenergic vasoconstriction of penile arteries, increased in the MPG of the OLETF group. After administration of pioglitazone- or rosiglitazone to OLETF rats for 23 weeks, these neurochemical changes were recovered to the control levels of the LETO group, although some variations were accompanied. These results suggest that TZDs treatment may be helpful for the treatment of autonomic neuropathy concerned with erectile dysfunction.
Acetylcholine ; Animals ; Arteries ; Blood Pressure ; Diabetes Mellitus ; Endothelial Cells ; Erectile Dysfunction ; Ganglion Cysts ; Glucose ; Insulin Resistance ; Male ; Models, Genetic ; Negotiating ; Nerve Endings ; Neurons ; Neuropeptide Y ; Neurotransmitter Agents ; Nitric Oxide ; Nitric Oxide Synthase ; Plasma ; Polyneuropathies ; Rats ; Rats, Inbred OLETF ; Thiazolidinediones ; Tyrosine 3-Monooxygenase ; Vasoactive Intestinal Peptide ; Vasoconstriction