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Biomedical subjects

A Hazari

Publications and source records attributed to A Hazari.

5 recordsLinked to original sources

Nerve fibre and sensory end organ density in the epidermis and papillary dermis of the human hand.

Quantification of sensory recovery after peripheral nerve surgery is difficult and no accurate techniques are available at present. Quantification of reinnervated skin has been used experimentally, and in some clinical studies, but the lack of knowledge about the normal sensory distribution has been a problem. The purpose of this study was, therefore, to map the density of sensory end organs, nerve fibres and free nerve endings in the glabrous skin of the human hand. Skin biopsies were taken from patients undergoing acute and elective hand surgery. Nerve fibres were stained in the epidermis and papillary dermis and quantified in five sites on the palm of the hand, using protein gene product 9.5 immunoreactivity-a panneuronal marker. The finger tip skin was found to have more than twice the nerve fibre density in the papillary dermis than the skin of the palm, and the number of Meissner corpuscles in the finger tip was also higher than in the palm. We found a reduction in innervation density with increasing age in the dermis, however, that was not the case for the epidermis. The innervation of the epidermis showed high interindividual variability and unlike the papillary dermis did not display any pattern of distribution in the hand.

Adult↗

Treatment of end-neuromas, neuromas-in-continuity and scarred nerves of the digits by proximal relocation.

This paper reports the results of treatment by proximal relocation of 104 painful nerves in 57 digits in 48 patients. These included 86 digital nerves and 18 terminal branches of the superficial radial nerve and the dorsal branch of the ulnar nerve. Eighty-three were end-neuromas and 14 were neuromas-in-continuity, of which nine followed nerve repair and five occurred following a closed crush injury. Seven were painful as a result of tethering in scarred tissue. Eighty nerves (77%) required a single relocation and 24 (23%) required more than one operation. Ninety-eight per cent of nerve relocations achieved complete pain relief at the primary site. One patient had mild pain on pressure at the primary site after relocation of two nerves from this site. Over 90% of the nerves had no spontaneous pain, pain on movement or hypersensitivity of the overlying skin at the final site of relocation. However, the incidence of mild or no pain on direct pressure at the site of nerve relocation was lower at 83% as relocated nerves, although traumatized less often at the sites chosen for relocation, can still be painful on direct pressure.

Adult↗

A resorbable nerve conduit as an alternative to nerve autograft in nerve gap repair.

Poly-3-hydroxybutyrate (PHB) occurs within bacterial cytoplasm as granules and is available as bioabsorbable sheets. Previously, the advantage of PHB in primary repair has been investigated while in this study the same material has been used to bridge an irreducible gap. The aim was to assess the level of regeneration in PHB conduits compared to nerve autografts. The rat sciatic nerve was exposed, a 10 mm nerve segment was resected and bridged with either an autologous nerve graft or a PHB conduit. The grafted segments were harvested up to 30 days. Immunohistochemical staining was performed and computerised quantification of penetration distance and volume of axonal regeneration was estimated by protein gene product (PGP) immunostaining and calcitonin gene-related peptide (CGRP) positive fibres. Penetration and proliferation density of Schwann cells into the conduit was measured by quantifying S-100 staining. The inflammatory response was quantified with ED-1 staining for macrophages. Antibodies to vWf provided an assessment of angiogenesis and capillary infiltration. Percentage immunostaining for PGP in autograft and PHB groups showed a progressive increase up to 30 days with a significant linear trend with time and an increase in the volume of axonal regeneration. A similar pattern of progressive increase with time was observed with CGRP immunostaining for both groups and with S-100 in the PHB group. Good angiogenesis was present at the nerve ends and through the walls of the conduit. The results demonstrate good nerve regeneration in PHB conduits in comparison with nerve grafts.

Animals↗

A new resorbable wrap-around implant as an alternative nerve repair technique.

Poly-3-hydroxybutyrate (PHB), a bacterial storage product, is available as bioabsorbable sheets and has been used in this study for primary nerve repair. The aim was to assess axonal regeneration following such repair and determine the inflammatory response to PHB. In 20 adult cats, the transected superficial radial nerve was wrapped in PHB sheets, while primary epineural repair was carried out in the contralateral limb. At 6 and 12 months, the repair sites were assessed immunohistochemically for macrophage infiltration and myelinated axons were counted in the distal nerve. Mean macrophage counts across the whole width of the nerve in both groups at 6 and 12 months showed no statistically significant difference. Nor was there any significant difference between the two groups at both time-points in axon counts, axon diameter, myelin thickness and g-ratio. There was a statistically significant increase in fibre diameters at 12 months, indicating that fibres were undergoing continuous maturation.

Animals↗

Superior sternal cleft: construction with a titanium plate.

Sternal cleft is a rare congenital deformity, with a superior cleft being the most common. Although sternal clefting is known to be associated with vascular dysplasia, to our knowledge, we report the first case of superior sternal cleft with cervicofacial hemangiomata and cardiac defects in the absence of true ectopia cordis in a neonate. Early surgery in all cases of sternal clefting is advocated, preferably within the first 4 weeks of life. However, if the child is unfit for operation at this stage, repair should be carried out as soon as the child is stable and fit. The method of choice is primary approximation with the intraoperative precaution of confirming cardiorespiratory stability. We suggest reinforcing the primary approximation with a titanium plate to achieve rigid internal fixation and to reduce the tension at the approximation site. Because titanium osseointegrates well, this procedure results in a solid bony sternum.

Bone Plates↗