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At least 595 records · Page 33Linked to original sources
PubMed2005

Effects of reduction mammoplasty on upper-limb nerve conduction across the thoracic outlet in women with macromastia: a prospective randomized study.

UNLABELLED: Macromastia is a common problem. The physical complaints include upper body pain and aches. There have been anecdotal reports of neurologic deficits in the nerves emanating from the lower trunk of the brachial plexus. This is thought to be due to pressure on the lower trunk from both the first rib and tilting forward of the coracoid process. Other anecdotal reports have centered on the correction of neuropraxia of the ulnar nerve following bilateral breast reduction (BBR). We investigate the effect of BBR on the electrophysiological function of the nerve supply to the upper limbs in women with macromastia. METHODOLOGY: Consecutive patients undergoing BBR were randomized into 2 groups, depending on time of surgery. None had any prior neurologic disorder. Each patient had a comprehensive neurologic assessment and 2 electrodiagnostic neurophysiologic tests. Group 1 had 2 tests, one before surgery and a second 3 months postsurgery, while Group 2 had 2 sets of tests, one initially and a second test 4 months later (control). The outcome measures include somatosensory evoked potential (SSEP) (median and ulnar), F-wave median and ulnar latencies. The F waves measure the integrity of neural conduction time from the anterior horn cells to the hypothenar and thenar muscles reflecting lower trunk function. The SSEP of the median nerve measure the integrity of the nerve fibers traversing the upper trunk of the brachial plexus and the ulnar nerve SSEP that of the lower trunk. There was no statistical difference in the conduction times. BBR does not have any effect on the upper limb nerve conduction times.

Adolescent↗
PubMed1979

Intercostal nerve block with thoracoabdominal incision.

A double-blind study was done on 30 patients undergoing thoracoabdominal incisions for retroperitoneal lymphadenectomy in testicular carcinoma to determine the effect of intraoperative intercostal nerve block with bupivacaine. The postoperative pain, day of ambulation and day of oral fluid intake were analyzed. In this homogeneous group we found a significant reduction in the amount of postoperative analgesia required but no difference in the day of ambulation or fluid intake.

Abdomen↗
PubMed1978

The great potential of the intercostal flap for torso reconstruction.

The intercostal flap has many uses for torso reconstruction, whether employed as an island flap or a free flap. With modifications, it can be used as a sensory skin flap, or as a compound osteocutaneous flap to restore stability in a chest wall construction, or as a skin flap with a permanent blood supply to provide stable cover after excision of radiation ulcers.

Adult↗
PubMed2003

Isolated compression of the pectoral nerve resulting in atrophy of the major pectoral muscle.

We report on two cases of isolated damage to a muscle branch of the lateral pectoral nerve. Diagnosis was established by the clinical presentation and electromyographic examination. In the few reported cases of such injuries, the cause was trauma to this region. However, in both of our patients, focal muscle atrophy gradually developed after initiation of training schedules to increase the cross-section of the major pectoral muscle; we therefore assume that compression injury to the nerve by repetitive muscle contractions may be of pathogenic relevance. Anatomical studies of this region showed that the nerve branches of the lateral pectoral nerve, having to pierce through a connective tissue septum that is thicker here by a few millimeters, may be subjected to additional risk of compression. Early recognition and treatment are vital to prevent associated morbidity of these rare but serious injuries.

Adult↗
PubMed1987

Excitation of upper cervical inspiratory neurons by inspiratory neurons of the nucleus tractus solitarius in the cat.

Experiments were conducted to investigate the connection from inspiratory neurons in the ventrolateral region of the nucleus tractus solitarius to the inspiratory neurons in the contralateral upper cervical (C1-C2) spinal cord. Microstimulation within the region usually produced long-latency (10 to 30 ms) synaptic activation of the upper cervical inspiratory neurons. Antidromic mapping of axons of the ventrolateral nucleus tractus solitarius in C1 demonstrated the existence of collateral arbors in the region of the upper cervical inspiratory neurons (7 of 15). Cross-correlation histograms showed the existence of short-term synchronization of firing for 12 of 74 pairs of ventrolateral nucleus tractus solitarius and upper cervical inspiratory neurons. Cross-correlation combined with antidromic activation showed that the short-term synchronization was due to a direct connection in two cases and a common input in one case. It was concluded that at least some ventrolateral nucleus tractus solitarius inspiratory neurons may directly excite upper cervical inspiratory neurons, probably via monosynaptic connections. Both groups of neurons may also share common inputs.

Afferent Pathways↗
PubMed1984

Relations between axon length and axon caliber. "Is maximum conduction velocity the factor controlling the evolution of nerve structure"?

A search was made for any existent relationship between the length of a nerve fiber and the caliber of its axon. This was done in the hope of defining morphological parameters useful for assessing conduction time. Four fiber populations were examined: (1) phrenic fibers in rat and rabbit during different phases of body growth; (2) phrenic fibers of mature animals of greatly different body size including mouse and cow; (3) rat intercostal nerves which vary in length by a factor exceeding 5 due to the funnel-shape of the thorax; and (4) ventral root fibers of the cow. In all of these fiber populations, there was no evidence for a direct relationship between the length of a fiber and its caliber. Rather, a tendency was noted for fiber caliber to approach certain ceilings independent of length. These data, seen in conjunction with other information on fiber structure, cast serious doubt on the widely accepted concept that maximum conduction velocity is the factor controlling nerve structure. A much more likely factor controlling the structure of myelinated nerve fibers is the capacity to modulate information by frequency coding of impulses.

Aging↗
PubMed1983

Baroreceptor modulation of inspiratory termination by intercostal nerve stimulation.

The influence of carotid sinus baroreceptor activity on the termination of inspiration by intercostal nerve stimulation was assessed in decerebrate cats which were paralyzed, artificially ventilated and bilaterally vagotomized. The carotid sinus was vascularly isolated bilaterally so that carotid sinus pressure could be precisely controlled independent of the systemic arterial pressure. Inspiratory activity was monitored by a phrenic neurogram. The threshold current at which electrical stimulation of the T6 intercostal nerve terminated phrenic neural activity was determined by stimulating the T6 intercostal nerve at 10 different delays from the onset of phrenic discharge. An increase in mean carotid sinus pressure from 100 to 150 mm Hg decreased the threshold current required to terminate inspiration at each delay. Similarly, a decrease in mean carotid sinus pressure from 100 to 50 mm Hg increased the threshold current. Alteration of the systemic arterial pressure (independent of the carotid sinus pressure) by norepinephrine administration did not alter the threshold current. These results demonstrate that alterations in carotid sinus baroreceptor activity have a distinct effect on the mechanisms governing inspiratory termination.

Animals↗
PubMed1985

Excitatory and inhibitory effects of morphine on the intercostal-to-phrenic respiratory reflex.

The purpose of this study was to determine the effect of intravenously administered morphine on the intercostal-to-phrenic reflex in spinal (C1) cats. The carotid and vertebral arteries were ligated. In addition a metal clamp was placed around the neck and tightened in order to occlude all blood flow to the brain. The animals were vagotomized, paralyzed and ventilated artificially. End-tidal PCO2 and body temperature were kept constant by means of servocontrollers. The intercostal-to-phrenic reflex was activated by rhythmic tapping of the lower thorax anteriorly with a metal bar. Three different doses of morphine were used. The smallest dose (1 mg/kg) caused a marked stimulation of phrenic activity that lasted for more than 5 min. A larger dose (10 mg/kg) had only a mild excitatory effect. A much larger dose (50 mg/kg), on the other hand, caused inhibition of evoked phrenic activity. Possible mechanisms involved in mediating the dose dependent effects of morphine on the intercostal-to-phrenic reflex are discussed.

Animals↗
PubMed1980

Somatosplanchnic reflex discharges in rats.

Splanchnic efferent reflex discharges caused by electrical stimulation of limb afferent nerves or intercostal afferent nerves were studied in chloralose-urethane anesthetized rats. Stimulation of the limb afferent nerve produced late supraspinal reflex discharges via group II and III afferent excitation. Stimulation of the intercostal afferent nerve produced early spinal reflex discharges via group II and III afferent excitation and also late spinal reflex discharges via group IV afferent excitation. Intercostal afferent nerve stimulation seemed to strongly depress the splanchnic late supraspinal reflex discharges.

Afferent Pathways↗
PubMed1979

Prospective randomized evaluation of intrathoracic intercostal nerve block with bupivacaine on postoperative ventilatory function.

This prospective and randomized study demonstrates the beneficial effect of intrathoracic intercostal block with bupivacaine on the recovery of pulmonary function after thoracotomy. A significantly (p less than 0.05) better forced expiratory volume was seen in the treated group in the early post-operative period. Similar findings were observed in forced vital capacity. Also, the requirements for analgesics were decreased in the treated group. We believe that intrathoracic intercostal block with bupivacaine when properly utilized can be a good adjuvant in the improvement of pulmonary function after thoracotomy.

Adult↗