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At least 847 records · Page 47Linked to original sources
PubMed2004

Bridge over troubled waters.

Spinal cord injury interrupts connections between the brain and spinal cord, rather than producing large-scale damage. Reconnecting severed axons with their prior targets is a primary objective of spinal cord repair. Despite progress, this goal will probably not be attained soon because many problems remain to be solved. We discuss an alternative for promoting motor function after spinal damage by bridging the injury. We highlight a novel spinal injury bridge that we have developed to reconnect spinal motor circuits below the injury with the brain. A spinal nerve that exits above the injury is disconnected and inserted into the cord caudal to injury. Motor axons in the inserted nerve regenerate into the cord and synapse on neurons producing a novel circuit to bypass the injury.

Animals↗
PubMed1993

Percutaneous facet denervation in chronic thoracic spinal pain.

In 40 patients with chronic thoracic spinal pain of more than 12 months duration which failed to respond to conservative treatment and with a previous evaluation by specialists, mainly neurologists and orthopaedic surgeons, the diagnosis of facet syndrome was made. This diagnosis was based on clinical criteria and a transient positive response to a prognostic blockade of the medial branch of the dorsal ramus of the thoracic spinal nerve. They were selected to undergo percutaneous radiofrequency denervation of the facet joints. The short and long-term results of 51 percutaneous thoracic facet denervations in 40 patients are described. After 2 months, 19 patients (47.5%) were pain-free, 14 patients (35%) had more than 50% pain-relief, and 7 patients (17.5%) had no relief. After a follow-up of 18-54 (average 31) months in 36 cases (3 patients had died because of malignancy, and 1 had undergone a spinal fusion), 16 patients (44%) were pain-free, 14 patients (39%) had more than 50% pain-relief and in 6 cases (17%) the result was poor. Adverse effects consisted of postoperative pain in 5 patients (12.5%). When conservative treatment fails, percutaneous thoracic facet denervation can be a safe and beneficial therapy in chronic thoracic spinal pain originating from the facet joints.

Adult↗
PubMedDate not supplied

Medial antebrachial cutaneous nerve conduction in true neurogenic thoracic outlet syndrome.

Thoracic outlet syndrome (TOS) and its diagnosis have been topics of controversy, fueled in part by the lack of an objective test for early diagnosis. True neurogenic TOS results in diagnostic EMG findings only in its later stages. We describe a series of patients in whom the diagnosis is supported by changes in the medial antebrachial cutaneous (MAC) nerve at or before the development of these typical EMG findings in median and ulnar nerves.

Action Potentials↗
PubMed1994

Involvement of the autonomic nervous system in the in vivo memory to glucose of pancreatic beta cell in rats.

The fact that the potentiating effect of prolonged hyperglycemia on the subsequent insulin secretion is observed in vivo but not in vitro suggests the involvement of extrapancreatic factors in the in vivo memory of pancreatic beta cells to glucose. We have investigated the possible role of the autonomic nervous system. Rats were made hyperglycemic by a 48-h infusion with glucose (HG rats). At the end of glucose infusion as well as 6 h postinfusion, both parasympathetic and sympathetic nerve activities were profoundly altered: parasympathetic and sympathetic activities, assessed by the firing rate either of the thoracic vagus nerve or the superior cervical ganglion, were dramatically increased and decreased, respectively. Moreover, 6 h after the end of glucose infusion, insulin secretion in response to a glucose load was dramatically increased in HG rats compared to controls. To determine whether these changes could be responsible for the increased sensitivity of the beta cell to glucose, insulin release in response to glucose was measured in HG and control rats, either under subdiaphragmatic vagotomy or after administration of the alpha 2A-adrenergic agonist oxymetazoline. Both treatments partially abolished the hyperresponsiveness of the beta cell to glucose in HG rats. Therefore chronic hyperglycemia brings about changes in the activity of the autonomic nervous system, which in turn are responsible, at least in part, for the generation of enhanced beta cell responsiveness to glucose in vivo.

Action Potentials↗
PubMedDate not supplied

Thoracic paravertebral block in chronic postoperative pain.

BACKGROUND AND OBJECTIVES: Chronic postoperative pain in thoracic dermatomes is common. The most frequently used methods of pain relief in this area are posterior multidermatomal intercostal nerve or thoracic epidural blocks. Compared with these methods, thoracic paravertebral block may have some advantages. Usually only one injection is needed, and the use of larger volumes of local anesthetic (up to 25 ml) results in widespread unilateral analgesia including sympathetic block without the potential risk of hypotension and motor block associated with epidural block. METHODS: We retrospectively analyzed 281 thoracic paravertebral blocks performed for chronic postoperative pain (post-thoracotomy and postmastectomy) from 1986 to 1990 in our pain clinic. RESULTS: In post-thoracotomy group, patients were without pain for at least a month after 58% of the blocks; in 30%, the effect lasted for at least two months; in 8%, more than four months and, in 3%, more than five months. In 88% of patients with postmastectomy pain, the achieved pain relief with thoracic paravertebral block was less than a month. No severe complications occurred. CONCLUSIONS: Thoracic paravertebral block proved to be a reliable and safe technique for unilateral pain relief in chronic post-thoracotomy pain.

Adult↗
PubMed1987

Continuous intercostal blockade after cardiac surgery.

The provision of analgesia using continuous bilateral intercostal blockade was compared with that provided by conventional i.v. narcotics for the first 48 h after cardiac surgery. The subjective quality of analgesia was significantly superior with the regional technique. However, pulmonary function tests, gas exchange, lung volume, and radiological and clinical evidence of pulmonary complications were not improved. The failure to reduce morbidity and the potential for complications such as pneumothorax, makes it difficult to recommend the regional analgesia technique in this situation.

Cardiac Surgical Procedures↗