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Biomedical subjects

A Gunkel

Publications and source records attributed to A Gunkel.

25 records · Page 2Linked to original sources

Differences in glial, synaptic and motoneuron responses in the facial nucleus of the rat brainstem following facial nerve resection and nerve suture reanastomosis.

Transection and reanastomosis of the facial nerve with microsurgical sutures in rats (facial-facial anastomosis) results in the complete regeneration of the facial nucleus, whereas resection of a 10 mm length of the peripheral facial nerve leads to degeneration and loss of neurons in the nucleus. Nerve sutures or resections were performed in 84 female Wistar rats, and the time course and differences between regenerative and degenerative reactions in the facial nuclei were compared after survival times of 4-112 days. The volume of the facial nucleus, number of facial motoneurons and motoneuron density were estimated stereologically by the physical dissector method. Synaptic plasticity, activation of astroglia and microglia were studied cytochemically with anti-synaptophysin, anti-glial fibrillary acidic protein and the isolectin Griffonia simplicifolia I-B4 (GSA I-B4). After facial-facial anastomosis the volume of the facial nucleus and its number of motoneurons remained constant, whereas resection of the facial nerve caused shrinkage of the facial nucleus and loss of one-third of facial motoneurons within 112 days post-operation. Synaptic stripping, activation of microglia and astroglia occurred in the same sequence and were reversible after both operations, but these reactions were more severe and prolonged after resection, i.e. without suture of the facial nerve. It appears to be most important clinically that differences between de- and regeneration become clear within 7 days post-axotomy. Our results strongly support reconstruction of the facial nerve as early as possible after a nerve lesion.

Anastomosis, Surgical↗

Axotomy induces intranuclear immunolocalization of neuron-specific enolase in facial and hypoglossal neurons of the rat.

Neuron-specific enolase as an enzyme of the glycolytic pathway is localized in the cytoplasm of nerve cells, but not in the cell nucleus. We have applied immunocytochemistry with 1:64,000 polyclonal anti-rat neuron-specific enolase to the brainstem of male and female adult Wistar rats following: (a) transection of the facial nerve with immediate microsurgical nerve suture (facial-facial anastomosis), (b) transection of the hypoglossal nerve with immediate suture (hypoglossal-hypoglossal anastomosis) and (c) transection of the facial and hypoglossal nerve with immediate suture of the proximal hypoglossal to the distal facial nerve stump (hypoglossal-facial anastomosis). Studying the intracellular immunolocalization of neuron-specific enolase in neurons of the facial and hypoglossal nucleus we detected that (1) in normal rats about 20% of all facial and hypoglossal neurons display not only cytoplasmic, but also intranuclear neuron-specific enolase-like immunoreactivity and (2) following any axotomy of the facial or hypoglossal peripheral nerve, the perikarya of all injured motoneurons react by an outstanding increase of neuron-specific enolase-like immunoreactivity in the karyoplasm. Similar findings were obtained in experiments on non-fixed cultured Neuro-2a cells that had been lesioned with hydrogen peroxide. Counting the absolute numbers of normal and reactive neurons at 1-365 days post axotomy revealed that the increase of neuron-specific enolase in neuronal cell nuclei is temporary and reversible. It is first detected at 2 days post axotomy, reaches its maximum at 10-18 days post axotomy and is no longer evident 56 days following surgery.(ABSTRACT TRUNCATED AT 250 WORDS)

Anastomosis, Surgical↗

Recovery of original nerve supply after hypoglossal-facial anastomosis causes permanent motor hyperinnervation of the whisker-pad muscles in the rat.

Hypoglossal-facial anastomosis (HFA), used in humans for the treatment of facial palsy, was experimentally performed in adult female Wistar rats. The time course of facial reinnervation and the extent of the new motor nerve supply of the vibrissal muscles that develops after HFA were estimated by counting all motoneurons in the brainstem labeled by injection of horseradish peroxidase (HRP) into the whisker pad; muscle innervation by motor endplates was not studied. In untreated animals, HRP injection labels 1,254 +/- 54 (mean +/- S.D.; n = 6) motoneurons, localized exclusively in the lateral subdivision of the facial nucleus. Immediately following HFA, this number drops to zero. The first HRP-labeled motoneurons appear in the hypoglossal nucleus at 28 days postoperation (dpo) and at 56 dpo their number reaches 1,096 +/- 48. Unexpectedly, the facial nerve, whose proximal stump has been left as blind end during surgery, additionally sends axons to the facial periphery. This resprouting is first detected at 42 dpo with HRP-marked neurons throughout the facial nucleus lacking somatotopic organization. The number of these labeled neurons also rises with time, and at 56 dpo, a total of 1,797 +/- 142 facial and hypoglossal motoneurons, that is, 43% more motoneurons than in normal animals, supplies the whisker pad. This hyperinnervation, that is, the projection of more motoneurons into the target muscle than under normal conditions--further increases to 1,978 +/- 92 motoneurons at 224 dpo and may provide a new animal model for studying the competitive relationships between motoneurons in their search for peripheral targets.

Anastomosis, Surgical↗

The hypoglossal-facial anastomosis as model of neuronal plasticity in the rat.

Hypoglossal-facial cross anastomosis (HFA) causes regeneration with change of function, as the axotomized hypoglossal motoneurons sprout into the facial plexus and reinnervate the mimic musculature. Following HFA, hypoglossal-hypoglossal single anastomosis (HHA) and resection of 8-10 mm peripheral hypoglossal nerve in 190 female adult Wistar rats, we compared the axon reactions in the hypoglossal nucleus during 1) regeneration with change of function, 2) regeneration with restoration of original function and 3) degeneration of the nucleus. Following postoperative survival times of 1-16 weeks we estimated the volume of the hypoglossal nucleus and counted the number of hypoglossal neurons with the physical disector on both sides of the brainstem. Additional sections of the same animals were reacted with anti-synaptophysin, anti-GFAP and the isolectin Griffonia simplicifolia I-B4 (GSA I-B4) as cytochemical markers for presynaptic boutons, activated astroglia and microglia. After HHA and HFA all hypoglossal neurons survive and the volume of the hypoglossal nucleus remains constant. Resection of the hypoglossal nerve leads to the loss of one third of the hypoglossal neurons and of one third of the volume of the hypoglossal nucleus within 16 weeks post operation. Hypoglossal-facial anastomosis and hypoglossal-hypoglossal anastomosis differ in postoperative swelling of the hypoglossal nucleus, microglia and astroglia activation and the duration of synaptic stripping. All differences are limited to the acute growth phase during regeneration. It is concluded that hypoglossal-facial anastomosis provides more stimulation and facilitates faster recovery of the hypoglossal nucleus than does hypoglossal-hypoglossal anastomosis.

Anastomosis, Surgical↗

[Comparative studies of the stability of nerve anastomoses using CO2 laser adaptation compared with conventional technics].

Despite sophisticated microsurgical techniques for nerve repair, neural anastomoses often dehisce, especially under pronounced traction on the nerve endings. We investigated the resistance to traction of several neural anastomoses made by different techniques, including the laser. Neural anastomoses constructed or fixed by a CO2 laser beam were considered with special interest. The forces required to disrupt the different anastomoses were monitored by a dynamometer, and the whole procedure was recorded in slow motion on video. Improved results cannot be achieved with the laser techniques available today: indeed neural anastomoses were less resistant to traction after CO2 laser coagulation. Anastomoses constructed by means of epineural sutures showed much the best resistance to traction.

Anastomosis, Surgical↗

Ciliary beat frequency, olfaction and endoscopic sinus surgery.

We assessed prospectively changes in olfaction and ciliary beat frequency (CBF) after functional endoscopic sinus surgery (FESS) in 70 patients with chronic sinusitis. CBF was measured by the microscopic-photometry technique 2, 4 and 6 months after FESS. Olfaction was evaluated by the Erlangener Smell Identification Test. Preoperative CBF was markedly reduced due to the infectious process. CBF was significantly improved (p < 0.001), reaching normal values 6 months postoperatively despite the endoscopic examination revealing normal nasal mucosa at around 3 months. The pattern of improvement of CBF was linear being more rapid between months 4 and 6. After operation olfactory-impaired patients were improved subjectively and objectively (p < 0.001 and p = 0.003). We conclude that impaired olfactory ability and CBF are significantly improved after FESS, and FESS demands longer postoperative follow-up periods for at least 6 months even if the clinical evaluations were normal.

Adolescent↗

Comparison of the TEMPO+ ear-level speech processor and the cis pro+ body-worn processor in adult MED-EL cochlear implant users.

A study was conducted to compare the new MED-EL TEMPO+ ear-level speech processor with the CIS PRO+ body-worn processor in the COMBI 40/COMBI 40+ implant system. Speech tests were performed in 46 experienced subjects in two test sessions approximately 4 weeks apart. Subjects were switched over from the CIS PRO+ to the TEMPO+ in the first session and used only the TEMPO+ in the time between the two sessions. Speech tests included monosyllabic word tests and sentence tests via the telephone. An adaptive noise method was used to adjust each subject's scores to approximately 50%. Additionally, subjects had to complete a questionnaire based on their 4 weeks of experience with the TEMPO+. The speech test results showed a statistically significant improvement in the monosyllabic word scores with the TEMPO+. In addition, in the second session, subjects showed a significant improvement when using the telephone with the TEMPO+, indicating some learning in this task. In the questionnaire, the vast majority of subjects found that the TEMPO+ allows equal or better speech understanding and rated the sound quality of the TEMPO+ higher. All these objective and subjective results indicate the superiority of the TEMPO+ and are mainly attributed to a new coding strategy called CIS+ and its implementation in the TEMPO+. In other words, based on the results of this study, it appears that after switching over from the CIS PRO+ to the TEMPO+, subjects are able to maintain or even improve their own speech understanding capability.

Adult↗