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The loss of continuity of the nerve structure interrupts the transmission of nerve impulses and leads to the disorganization of functional activities. Many methods, as the use of neurogenic factors, aid in the process of neural regeneration by accelerating or improving peripheral nerves neoformation. The adipose tissue is abundant in the human body, and it has presented promising results in the regeneration of peripheral nerves. We carried out a randomized controlled study in 9 months, using 45 male Wistar rats, 80 days old, and the sciatic nerve was chosen for analysis. The control animals were divided into three groups – Initial group (IG), Final group (FG), and denervated group (DG) – with seven animals each. The experimental groups, with twelve animals each, were polyethylene tube filled with fat (EGF) and polyethylene tube without filling (EGwf). All groups, except IG, were submitted to 10 sessions of hyperbaric oxygen treatment of 1h 45 min in alternating days. Functional evaluation by walking-track was assessed using the Catwalk XT® software and tissues were harvested and stained with 1% toluidine blue for histological analysis. Quantitative data were first analyzed with the Kolmogorov Smirnov normality test. Comparison between the four groups was analyzed by ANOVA followed by Tukey Test. We concluded that hyperbaric oxygen therapy had positive results on morphometric and functional parameters. However, no significant differences were found regarding the use of autologous fat graft.

Introduction: Different studies have evaluated the effects of electrophysical agents on regeneration after peripheral nerve injury. Among them, the most used in clinical and experimental research is photobiomodulation therapy (PBMT). Objective: To analyze the effect of standard energy (16.8 J) of PBMT on peripheral nerve regeneration, applied at different periods after sciatic nerve injury in mice. Methods: Thirty male Swiss mice were divided into six groups: naive; sham; control; LLLT-01 (660 nm, 16.8 J of total energy emitted in 1 day); LLLT-04 (660 nm, 4.2 J per day, 16.8 J of total energy emitted in 4 days); LLLT-28, (660 nm, 0.6 J per day, 16.8 J of total energy emitted over 28 days). The animals were evaluated using thermal hyperalgesia, Sciatic Functional Index (SFI), and Static Sciatic Index (SSI). Data were obtained at baseline and after 7, 14, 21, and 28 days after surgery. Results: For the SFI and SSI, all groups showed significant differences compared to the control group, and the LLLT-04 group presented the best results among those receiving PBMT. In the assessment of thermal hyperalgesia, there was a significant difference in the 14th day of evaluation in the LLLT-04 group. Conclusion: The application of 16.8 J was useful in sciatic nerve regeneration with an improvement of hyperalgesia, with higher efficacy when applied in four days (4.2 J/day).

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES A medula espinal (ME) é afetada em casos de traumas diretos ou indiretos e alguns estudos apontam que os nervos periféricos induzem um ambiente propício para regeneração. Além disso, várias plantas medicinais possuem metabólitos secundários com atividades no Sistema Nervoso Central. Este estudo objetivou analisar o efeito regenerativo na ME in vitro e in vivo na presença de fragmentos do nervo isquiático (FGNI) com adição dos óleos essenciais (OES) de Hyptis suaveolens (HS) e Croton blanchetianus (CB). As plantas de HS e CB foram submetidas ao processo de hidrodestilação e a análise da composição química foi feita por cromatografia gasosa e espectrometria de massas. Para a avaliação da plasticidade na ME in vitro, células foram coletadas de ratos neonatos Wistar e cultivadas em 6 grupos: um controle (D-10) e os demais grupos com diferentes combinações de meio condicionado do nervo isquiático (MCNI) e os OES de HS e CB. A morfometria celular foi avaliada após 96 horas por microscopia de contraste de fases, sendo em seguida realizada a imunocitoquímica para GFAP, GAP-43, NeuN e a plasticidade analisada por Microscopia Eletronica de Varredura. Os grupos foram comparados estatisticamente através do teste de Tukey e Bonferroni (p

This study aims to investigate morphological alterations caused by partial sciatic nerve ligation (PNL) and the efficacy of a moderate-intensity swimming training as therapeutic strategy for nerve regeneration.A number of 30 male adult mice were equally divided in control, 14 days after PNL (PNL 14 days), 42 days after PNL (PNL 42 days), 70 days after PNL (PNL 70 days) and 5-week exercise training after 7 days post-lesion (PNL trained 35 days) groups. PNL trained 35 days group began with a 10-min session for 3 days and this time was gradually increased by 10 min every three sessions until the animals had swum for 50 min per session. Morphoquantitative analysis was carried out to assess nerve regeneration in each group.PNL 14 days group exhibited less degenerating signs than PNL 42 days group, where most post-lesion alterations were visualized. Nerve area and minimum diameter were significantly lower (p 0.05) than control group. PNL 70 days group showed a greater degree of regenerating fibers and similar morphometric parameters to control group. PNL trained 35 days demonstrated signs of regeneration, reaching control group values in the morphometric analysis.PNL promotes great histopathological changes, which became more visible at 42 post-injury days. A natural nerve-regeneration tendency was observed throughout time, as observed in PNL 70 days group; nevertheless, moderate swimming training was found to be a therapeutic resource for nerve regeneration, accelerating such process from a morphoquantitative perspective.ANOVA: One-way analysis of variance; BDNF: Brain-derived neurotrophic factor; FGF-2: Fibroblast growth factor 2; GDNF: Glial cell line derived neurotrophic factor; IGF: Insulin-link growth factor; IL-1β: Interleukin-1β; NGF: Neural growth factor; PBS: Phosphate-buffered saline; PNL: Partial sciatic nerve ligation.

Submitted by DIEGO NOE RODRIGUEZ SANCHEZ null (dnr_51@hotmail.com) on 2016-06-22T16:49:29Z No. of bitstreams: 1 Dissertação_Diego_Final.pdf: 62116504 bytes, checksum: c5a01fb03474d162a65b0ca8041e5d46 (MD5) Approved for entry into archive by Ana Paula Grisoto (grisotoana@reitoria.unesp.br) on 2016-06-23T19:11:05Z (GMT) No. of bitstreams: 1 sanchez_dnr_me_bot.pdf: 62116504 bytes, checksum: c5a01fb03474d162a65b0ca8041e5d46 (MD5) Made available in DSpace on 2016-06-23T19:11:05Z (GMT). No. of bitstreams: 1 sanchez_dnr_me_bot.pdf: 62116504 bytes, checksum: c5a01fb03474d162a65b0ca8041e5d46 (MD5) Previous issue date: 2016-05-12 As lesões de nervos periféricos por neurotmese apresentam resultados paradoxais na recuperação pela ausência na regeneração. Assim, manter o ambiente permissivo de crescimento no coto distal após a lesão é essencial, sendo as células de Schwann chaves neste processo. A terapia celular apresenta potencial para a regeneração nervosa, baseado na substituição celular e promoção do crescimento axonal. As células tronco mesenquimais multipotentes de tecido adiposo (CTMM-TA) são uma fonte promissora pela fácil obtenção, expansão in vitro e por apresentarem propriedades imunomoduladoras e antinflamatórias. Neste sentido, o objetivo deste estudo foi comparar os efeitos do transplante de CTMM caninas e murinas em combinação com a técnica de tubulação com veia descelularizada, na regerenaração do nervo ciático em modelo experimental de neurotmese em ratos. Ratos Wistar submetidos a neurotmese do nervo ciático foram divididos em 5 grupos: Grupo controle (GC), Grupo denervado (GD), Grupo Transplante de Veia descelularizada (GV), Grupo Veia + células tronco mesenquimais multipotentes caninas (GCTMMc), Grupo Veia + células tronco mesenquimais multipotentes murinas (GCTMMm). Após a marcação com nanocristais fluorescentes e viabilidade celular, 1 x 106 CTMM caninas e murinas foram injetadas depois da realização da lesão experimental por neurotmese com 10mm por tubulação com veia descelularizada nos grupos GCTMMc e GCTMMm, e solução tampão salina de Hank's (HBSS) no grupo veia (GV). Durante o período de 35 dias, o índice de funcionalidade do nervo ciático (IFNC) e a eletroneuromiografia (ENMG) foram realizadas para avaliar a recuperação funcional. Análises histológicas e imunohistoquímicas foram efetuadas para revelar a mielinização, a produção de fatores neurtróficos e a persistencia das CTMM. Observaram-se resultados positivos funcionais nos dias 27 e 35 no grupo tratado com GCTMMm. Os resultados eletrofisiológicos de latência (m/s) e amplitude (mV) no nervo ciático foram superiores nos grupos GCTMMc e GCTMMm. Na avaliação do número e a densidade de fibras nervosas, os grupos GCTMMm e GCTMMc, mostraram melhores resultados. Foi observado uma expressão significativamente alta de BDNF no grupo GCTMMc, associado com o incremento na expressão da proteína S-100 nos grupos GCTMMc e GCTMMm, comparado com o GD. Demonstrou-se, também, que as CTMM derivadas do tecido adiposo canino e murino apresentaram efeitos positivos na regeneração do nervo ciático após neurotmese em ratos. The peripheral nerves injury by neurotmesis presents confusing results in the recovery by the lack of regeneration. Thus, it is essential to maintain a growth permissive microenvironment in the distal stump following injury for Schwann cells. The cell therapy has therapeutic potential for nerve regenertion, based on cell replacement and promotion of axonal growth. Adipose-derived multipotent mesenchymal stem cells (AdMSC) are a promising source for easy retrieval and expansion in vitro and have immunomodulatory and anti-inflammatory properties. The objective of this study was to compare the effects of canine and murine MSC transplantation in combination with the tubulization of decellularized vein in sciatic nerve regeneration. Wistar rats were divided into 5 groups: control group (CG), denervated group (DG), decellularized vein transplantation group (VG), vein + canine MSC group (cMSC) and vein + murine MSC group (mMSC). After labeling with fluorescent nanocrystals and cell viability, 1 x 106 canine and murine MSC were injected after experimental injury for neurotmesis with 10mm and tubulization with decellularized vein in the cMSC and mMSC groups. During a period of 35 days the sciatic nerve functional index (SFI) and electroneuromyography (EMG) were performed to access functional recovery. Histological analysis and immunohistochemistry were performed to evaluate myelination, neurotrophic factor production and persistence of MSC. It was observed functional postive results at 27th and 35th days in the group treated with mMSC. The electrophysiologycal results of latency (m/s) and amplitude (mV) in the sciatic nerve, they were higher in groups cMSC and mMSC. In assessing the number and density of nerve fibers, mMSC and cMSC groups showed better results. It was observed a significantly higher BDNF expression than the cMSC group, associated with increased xvi expression of S-100 protein in the cMSC and mMSC groups compared to the GD. Also, it has been shown that MSC canine and murine derived of adipose tissue (AdMSC) showed positive effects on the sciatic nerve regeneration in the rat model neurotmesis.

Os nervos periféricos sofrem constantes lesões de origem traumática, o que resulta em perdas funcionais. A terapia com laser de baixa potência vem sendo utilizada para minimizar os efeitos maléficos da inflamação e acelerar o processo de cicatrização dos tecidos lesados. Este estudo teve como objetivo verificar o efeito da irradiação do laser 830 nm no comportamento do nervo isquiático de ratos submetido a esmagamento. Foram utilizados 20 ratos, todos tendo tido o nervo isquiático esmagado, divididos em 4 grupos (n=5): P7 e P14, tratamento placebo por 7 e 14 dias; L7 e L14, tratamento por laser (dosagem de 4 J/cm²) por 7 e 14 dias. Os animais dos grupos P7 e P14 foram submetidos aos mesmos procedimentos, mas com o laser desligado. Os parâmetros analisados foram presença de infiltrado inflamatório e fibroblastos, destruição da bainha de mielina e degeneração axonal. Na análise estatística foi observada diferença estatística com relação a três parâmetros: os animais do grupo L14 apresentaram maior quantidade de fibroblastos (p=0,0001), menor degeneração da bainha de mielina (p=0,007) e menor quantidade de infiltrado inflamatório (p=0,001). A aplicação do laser de baixa potência contribuiu para a redução do processo inflamatório decorrente da lesão do nervo isquiático de ratos.Peripheral nerves are commonly subject to traumatic injuries, leading to functional loss. Low-power laser therapy has been used in order to minimize harmful effects of inflammation and to accelerate healing of injured tissues. The purpose of this study was to assess the effect of 830 nm-laser irradiation on rat sciatic nerves submitted to crush. Twenty male Wistar rats had their sciatic nerve crushed and were divided into 4 groups (n=5): Sham7 and Sham14, placebo-treated for 7 and 14 days; L7 and L14, laser-treated (at 4 J/cm²) for 7 and 14 days. Sham group animals were submitted to the same procedures, but with the laser turned off. Assessed parameters were inflammatory infiltrates, fibroblasts, myelin sheath destruction, and axonal degeneration. The statistical analysis showed significant differences in three parameters: L14 animals showed more fibroblasts (p=0.0001), lesser myelin sheath degeneration (p=0.007), and lesser inflammatory infiltrates (p=0.001). Low-power laser therapy hence contributed to reduce the inflammatory process due to rat sciatic nerve injury.

OBJECTIVES: We investigated the effects of treadmill training (10 weeks) on hindlimb motor function and nerve morphometric parameters in diabetic rats submitted to sciatic nerve crush. MATERIALS AND METHOD: Wistar rats (n = 64) were divided into the following groups: non-diabetic; trained non-diabetic; non-diabetic with sciatic nerve crush; trained non-diabetic with sciatic nerve crush; diabetic; trained diabetic; diabetic with sciatic nerve crush or trained diabetic with sciatic nerve crush. Diabetes was induced by streptozotocin injection (50 mg/kg, iv). Hindlimb motor function was evaluated weekly by assessing sciatic functional indices, and the proximal and distal portions of the sciatic nerve were used for morphometric analysis. RESULTS: At 13 weeks post-injury, the distal nerve portion of all injured groups and the proximal nerve portion of the diabetic with sciatic nerve crush group presented altered morphometric parameters such as decreased myelinated fiber diameter (~7.4 + 0.3μm vs ~4.8 + 0.2μm), axonal diameter (~5 + 0.2μm vs ~3.5 + 0.1μm) and myelin sheath thickness (~1.2 + 0.07μm vs ~0.65 + 0.07μm) and an increase in the percentage of area occupied by endoneurium (~28 + 3% vs ~60 + 3%). In addition, in the non-diabetic with sciatic nerve crush group the proximal nerve portion showed a decreased myelinated fiber diameter (7.4+0.3μm vs 5.8 + 0.3μm) and myelin sheath thickness (1.29 + 0.08μm vs 0.92 + 0.08μm). The non-diabetic with sciatic nerve crush, trained non-diabetic with sciatic nerve crush, diabetic with sciatic nerve crush and trained diabetic with sciatic nerve crush groups showed normal sciatic functional index from the 4th,4th,9th and 7th week post-injury, respectively. Morphometric alterations in the proximal nerve portion of the diabetic with sciatic nerve crush and non-diabetic with sciatic nerve crush groups were either prevented or reverted to values similar to the non-diabetic group by treadmill training. CONCLUSION: Diabetic condition promoted delay in sciatic nerve regeneration. Treadmill training is able to accelerate hindlimb motor function recovery in diabetic injured rats and prevent or revert morphometric alterations in proximal nerve portions in non-diabetic and diabetic injured rats.

CONTEXTUALIZAÇÃO: As lesões nervosas periféricas podem comprometer atividades diárias de um indivíduo e resultam em perda da sensibilidade e motricidade do território inervado. OBJETIVO: Com o intuito de acelerar os processos regenerativos, objetivou-se analisar a influência da aplicação do laser de arsenieto de gálio e alumínio (AsGaAl, 660Nm) sobre a recuperação funcional do nervo ciático de ratos. MATERIAIS E MÉTODOS: O nervo ciático de 12 ratos Wistar foi submetido à lesão por neurotmese e anastomose epineural e divididos em dois grupos: controle e laserterapia. Após a lesão, utilizou-se o laser de GaAlAs, 660Nm, 4J/cm², 26,3mW, feixe de 0,63cm², em três pontos eqüidistantes sobre a lesão, por 20 dias. As impressões das pegadas dos animais foram obtidas antes e após (sete, 14 e 21 dias pós-operatórios) o procedimento cirúrgico e calculou-se o índice funcional do ciático (IFC). RESULTADOS: A comparação do IFC não resultou em diferença significante (p>0,05) entre os grupos. CONCLUSÕES: Conclui-se que os parâmetros e métodos empregados na laserterapia demonstram resultados nulos sobre o IFC no período avaliado. CONTEXT: Peripheral nerve injuries result in sensory and motor losses in the innervated area and can hinder individuals’ daily activities. Objective: The objective was to analyze the influence of applying gallium-aluminum-arsenide (GaAlAs) laser (660Nm) on the functional recovery of the sciatic nerve in rats. METHODS: The sciatic nerve of 12 Wistar rats was subjected to injury consisting of neurotmesis and epineural anastomosis. The rats were divided into two groups: control and laser therapy. After the injury, a GaAlAs laser was used (660Nm, 4J/cm², 26.3mW and 0.63cm² beam) at three equidistant points on the injury, for 20 days. Footprint impressions were obtained from the animals before and seven, 14 and 21 days after the surgical procedure and the sciatic functional index (SFI) was calculated. RESULTS: Comparison of the SFI did not show any significant difference (p>0.05) between the two groups. CONCLUSIONS: The parameters and methods used for the laser therapy did not produce any effect on the SFI over the period evaluated.

CONTEXTUALIZAÇÃO: As lesões nervosas periféricas podem comprometer atividades diárias de um indivíduo e resultam em perda da sensibilidade e motricidade do território inervado. OBJETIVO: Com o intuito de acelerar os processos regenerativos, objetivou-se analisar a influência da aplicação do laser de arsenieto de gálio e alumínio (AsGaAl, 660Nm) sobre a recuperação funcional do nervo ciático de ratos. MATERIAIS E MÉTODOS: O nervo ciático de 12 ratos Wistar foi submetido à lesão por neurotmese e anastomose epineural e divididos em dois grupos: controle e laserterapia. Após a lesão, utilizou-se o laser de GaAlAs, 660Nm, 4J/cm², 26,3mW, feixe de 0,63cm², em três pontos eqüidistantes sobre a lesão, por 20 dias. As impressões das pegadas dos animais foram obtidas antes e após (sete, 14 e 21 dias pós-operatórios) o procedimento cirúrgico e calculou-se o índice funcional do ciático (IFC). RESULTADOS: A comparação do IFC não resultou em diferença significante (p>0,05) entre os grupos. CONCLUSÕES: Conclui-se que os parâmetros e métodos empregados na laserterapia demonstram resultados nulos sobre o IFC no período avaliado.CONTEXT: Peripheral nerve injuries result in sensory and motor losses in the innervated area and can hinder individuals’ daily activities. Objective: The objective was to analyze the influence of applying gallium-aluminum-arsenide (GaAlAs) laser (660Nm) on the functional recovery of the sciatic nerve in rats. METHODS: The sciatic nerve of 12 Wistar rats was subjected to injury consisting of neurotmesis and epineural anastomosis. The rats were divided into two groups: control and laser therapy. After the injury, a GaAlAs laser was used (660Nm, 4J/cm², 26.3mW and 0.63cm² beam) at three equidistant points on the injury, for 20 days. Footprint impressions were obtained from the animals before and seven, 14 and 21 days after the surgical procedure and the sciatic functional index (SFI) was calculated. RESULTS: Comparison of the SFI did not show any significant difference (p>0.05) between the two groups. CONCLUSIONS: The parameters and methods used for the laser therapy did not produce any effect on the SFI over the period evaluated.

Há evidências de que a terapia com o laser pode estimular a regeneração de nervos e esta hipótese foi testada em ratos. Uma lesão por esmagamento controlado foi produzida no nervo isquiático de 20 ratos Wistar, metade dos quais foram submetidos a irradiação efetiva com o laser de arseneto de gálio (AsGa) e a outra metade a irradiação simulada, durante dez dias consecutivos, começando no primeiro dia pós-operatório. Os resultados foram avaliados com três semanas pela medida do índice funcional do isquiático (IFC) em intervalos semanais e pela medida do número total de fibras nervosas e da densidade de fibras dos nervos, após o sacrifício dos animais na terceira semana, com o nível de significância de 5% (p

The aim of the present study was to compare and correlate histologically and electromyographically the effects of partial epineural burying of sural nerve segments in sectioned and sutured rat sciatic nerves. Sixty adult male Wistar rats were operated on 3 groups: Group 1, sural nerve graft, 9mm long, placed next to neurorrhaphy; Group 2, sural nerve graft, 9mm long, buryied 10mm distant from neurorrhaphy; Group 3, sural nerve graft, 18mm long, set next to neurorrhaphy. The morphological features were examined at light microscope after 3 months in 45 rats. The elements observed were: vascularization, vacuoles in nerve fibers, mastocytes and inflammatory infiltrate. The morphometry was made after 6 months in 15 rats from Group 1, 2 and 3, measuring external nerve fiber diameters and counting myelinated nerve fibers/mm². The electrophysiological study was perfomed after 6 months, registering maximum amplitude and frequency of EMG pontentials, at rest, in extensor digitorum longus muscle. Group 3 rats presented sciatic nerves better conserved morphologically and mean external nerve fiber diameters greater than those from Groups 1 and 2. There were no significant differences in density of nerve fibers/mm², and in the electrophysiological study in rats from Group 1, 2 and 3. The epineural burying of sural nerve grafts with greater length and placed next to the neurorrhaphy’s site had a significantly better regeneration of the histological features than the smaller ones distant from neurorrhaphy. O objetivo foi comparar e correlacionar, histológica e eletromiograficamente, os efeitos do sepultamento parcial de segmentos de nervo sural em nervos ciáticos de rato, seccionados e suturados. Sessenta ratos adultos, da linhagem Wistar, foram operados em três Grupos: Grupo 1 , um segmento de nervo sural com 9mm. de comprimento colocado próximo à neurorrafia; Grupo 2 , um segmento de nervo sural com 9mm. de comprimento sepultado 10mm. distante da neurorrafia ; Grupo 3, um enxerto de nervo sural com 18mm. de comprimento, posicionado próximo à neurorrafia. Os pormenores histológicos foram examinados sob microscopia de luz em 45 ratos, 3 meses depois. Os elementos observados foram : vascularização, vacúolos nas fibras nervosas, mastócitos e infiltrado inflamatório. A morfometria foi realizada, após 6 meses, em 15 ratos dos Grupos 1, 2 e 3, medindo-se os diâmetros externos e contando-se as fibras nervosas mielinizadas por mm². O estudo eletrofisiológico foi feito após 6 meses, registrando a amplitude máxima e a freqüência dos potenciais eletromiográficos no músculo extensor longo dos dedos, em repouso. Os ratos do Grupo 3 apresentaram-se morfologicamente melhor conservados e com diâmetros de fibras maiores do que nos Grupos 1 e 2. Não houve diferença na densidade de fibras/mm² e no estudo eletrofisiológico entre os ratos dos Grupos 1 , 2 e 3. O sepultamento epineural de segmentos de nervo sural com maior comprimento e colocados próximos à neurorrafia apresentaram pormenores morfológicos de regeneração significantemente melhores do que os menores e posicionados distantes da sutura do nervo.

Submitted by Guilherme Lemeszenski (guilherme@nead.unesp.br) on 2013-08-22T19:05:58Z No. of bitstreams: 1 S1516-31802012000600004.pdf: 303570 bytes, checksum: b5dc5ceab7c5ae3e20b093c709a232b4 (MD5) Made available in DSpace on 2013-08-22T19:05:58Z (GMT). No. of bitstreams: 1 S1516-31802012000600004.pdf: 303570 bytes, checksum: b5dc5ceab7c5ae3e20b093c709a232b4 (MD5) Previous issue date: 2012-01-01 Made available in DSpace on 2013-09-30T20:09:59Z (GMT). No. of bitstreams: 2 S1516-31802012000600004.pdf: 303570 bytes, checksum: b5dc5ceab7c5ae3e20b093c709a232b4 (MD5) S1516-31802012000600004.pdf.txt: 35971 bytes, checksum: eca60f9c3b17b6d2c9ce1449150d7b48 (MD5) Previous issue date: 2012-01-01 Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-20T13:32:22Z No. of bitstreams: 2 S1516-31802012000600004.pdf: 303570 bytes, checksum: b5dc5ceab7c5ae3e20b093c709a232b4 (MD5) S1516-31802012000600004.pdf.txt: 35971 bytes, checksum: eca60f9c3b17b6d2c9ce1449150d7b48 (MD5) Made available in DSpace on 2014-05-20T13:32:22Z (GMT). No. of bitstreams: 2 S1516-31802012000600004.pdf: 303570 bytes, checksum: b5dc5ceab7c5ae3e20b093c709a232b4 (MD5) S1516-31802012000600004.pdf.txt: 35971 bytes, checksum: eca60f9c3b17b6d2c9ce1449150d7b48 (MD5) Previous issue date: 2012-01-01 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) CONTEXTO E OBJETIVO: Uma das técnicas utilizadas para tratamento da paralisia facial é a dupla inervação muscular com neurorrafia término-terminal, seccionando-se nervos sadios. O objetivo deste trabalho foi avaliar a ocorrência de dupla inervação muscular através de neurorrafia término-lateral e a manutenção da inervação. TIPO DE ESTUDO E LOCAL: Estudo experimental desenvolvido no Centro de Pesquisa Experimental da Faculdade de Medicina de Botucatu, Unesp. MÉTODOS: Cem ratos foram distribuídos em cinco grupos: G1, controle; G2, secção do nervo fibular; G3, o nervo tibial foi seccionado e o coto proximal suturado na lateral do nervo fibular íntegro; G4, 120 dias após a cirurgia do G3, o nervo fibular foi seccionado proximal à neurorrafia; G5, 120 dias após a cirurgia do G3, os nervos fibular e tibial foram seccionados proximal à neurorrafia. RESULTADOS: Após 150 dias da cirurgia, não foi observada variação na massa do músculo tibial ou no diâmetro das fibras musculares no G3, porém, houve redução do diâmetro da fibra axonal do nervo fibular distal à neurorrafia. Embora, no G4, tenha ocorrido atrofia do músculo tibial cranial 30 dias após a secção do nervo fibular, os resultados do teste eletrofisiológico e da medida do diâmetro axonal confirmaram a ocorrência de reinervação muscular. CONCLUSÃO: Estes resultados sugerem que a dupla inervação muscular não ocorreu através da neurorrafia término-lateral; o nervo tibial não foi capaz de manter a inervação muscular após a secção do nervo fibular; contudo, ocorreu reinervação muscular 30 dias após a secção do nervo fibular. CONTEXT and OBJECTIVE: One of the techniques used for treating facial paralysis is double muscle innervation using end-to-end neurorrhaphy with sectioning of healthy nerves. The aim of this study was to evaluate whether double muscle innervation by means of end-to-side neurorrhaphy could occur, with maintenance of muscle innervation. DESIGN and SETTING: Experimental study developed at the Experimental Research Center, Faculdade de Medicina de Botucatu, Unesp. METHODS: One hundred rats were allocated to five groups as follows: G1, control group; G2, the peroneal nerve was sectioned; G3, the tibial nerve was transected and the proximal stump was end-to-side sutured to the intact peroneal nerve; G4, 120 days after the G3 surgery, the peroneal nerve was sectioned proximally to the neurorrhaphy; G5, 120 days after the G3 surgery, the peroneal and tibial nerves were sectioned proximally to the neurorrhaphy. RESULTS: One hundred and fifty days after the surgery, G3 did not show any change in tibial muscle weight or muscle fiber diameter, but the axonal fiber diameter in the peroneal nerve distal to the neurorrhaphy had decreased. Although G4 showed atrophy of the cranial tibial muscle 30 days after sectioning the peroneal nerve, the electrophysiological test results and axonal diameter measurement confirmed that muscle reinnervation had occurred. CONCLUSION: These findings suggest that double muscle innervation did not occur through end-to-side neurorrhaphy; the tibial nerve was not able to maintain muscle innervation after the peroneal nerve had been sectioned, although muscle reinnervation was found to have occurred, 30 days after the peroneal nerve had been sectioned. Universidade Estadual Paulista Faculdade de Medicina de Botucatu Department of Surgery and Orthopedics University Hospital Department of Plastic Surgery Lauro de Souza Lima Institute Universidade Estadual Paulista Faculdade de Medicina de Botucatu Universidade Estadual Paulista Faculdade de Medicina de Botucatu Department of Surgery and Orthopedics Universidade Estadual Paulista Faculdade de Medicina de Botucatu FAPESP: 04/13612-5 FAPESP: 04/13611-9

OBJETIVO: Realizar estudo histológico comparando o crescimento axonal após neurorrafia término-lateral com e sem epineurectomia. MÉTODOS: foram utilizados vinte ratos Wistar, machos, divididos em dois grupos de 10 ratos cada. Um segmento de 1,0cm do nervo tibial e, foi transposto para o lado contralateral, sendo suturado no nervo ciático D. No grupo I, a sutura foi realizada diretamente no epineuro, enquanto que no grupo II foi realizado epineurectomia. Após 4 semanas foi realizado avaliação histológica do segmento transposto e no nervo ciático D, no sitio distal à lesão. RESULTADOS: demonstrou-se baixa quantidade de fibras remielinizadas, variando de 7 a 51 fibras no Grupo I e de 10 a 91 fibras no Grupo II. Utilizou-se o teste U de Mann-Whitney, com p=0,31, demonstrando que não há diferença estatisticamente significante entre os dois grupos. Não há relação positiva entre o número de fibras remielinizadas no enxerto e no sitio distal à lesão do ciático. CONCLUSÃO: A neurorrafia término-lateral, com e sem janela epineural, não promove remielinização eficiente. Nivel de evidência: Nível II: Estudo prospectivo comparativo OBJECTIVE: The aim of this study was to histologically compare the axonal sprouting after end-to-side neurorrhaphy with or without epineurotomy. METHODS: twenty male Wistar rats were used, divided into two groups of 10 rats each. A 1.0cm segment of the tibial nerve E was dried and sutured on the opposite side, where it was sutured into the sciatic nerve D. In Group I, the suture was made directly in the epineurium and in Group II, epineurotomy was performed. After 4 weeks, histological evaluation was carried out of the transposed segment and the sciatic nerve distal to the suture. RESULTS: the results showed a small number of remyelinated fibers, varying from 7 to 51 fibers in Group I and from 10 to 91 fibers in Group II. The Mann-Whitney U test was used, with p=0.311, showing there is no statistically significant difference between the two groups. There was no positive relation between the number of remyelinated fibers in the graft and in the suture site distal to the sciatic lesion. CONCLUSION: lateral-ending neurorrhaphy, with or without epineural window, does not promote efficient remyelinization. Level of Evidence: Level II, prospective comparative study.

Os nervos periféricos sofrem constantes lesões de origem traumática, o que resulta em perdas funcionais. A terapia com laser de baixa potência vem sendo utilizada para minimizar os efeitos maléficos da inflamação e acelerar o processo de cicatrização dos tecidos lesados. Este estudo teve como objetivo verificar o efeito da irradiação do laser 830 nm no comportamento do nervo isquiático de ratos submetido a esmagamento. Foram utilizados 20 ratos, todos tendo tido o nervo isquiático esmagado, divididos em 4 grupos (n=5): P7 e P14, tratamento placebo por 7 e 14 dias; L7 e L14, tratamento por laser (dosagem de 4 J/cm²) por 7 e 14 dias. Os animais dos grupos P7 e P14 foram submetidos aos mesmos procedimentos, mas com o laser desligado. Os parâmetros analisados foram presença de infiltrado inflamatório e fibroblastos, destruição da bainha de mielina e degeneração axonal. Na análise estatística foi observada diferença estatística com relação a três parâmetros: os animais do grupo L14 apresentaram maior quantidade de fibroblastos (p=0,0001), menor degeneração da bainha de mielina (p=0,007) e menor quantidade de infiltrado inflamatório (p=0,001). A aplicação do laser de baixa potência contribuiu para a redução do processo inflamatório decorrente da lesão do nervo isquiático de ratos. Peripheral nerves are commonly subject to traumatic injuries, leading to functional loss. Low-power laser therapy has been used in order to minimize harmful effects of inflammation and to accelerate healing of injured tissues. The purpose of this study was to assess the effect of 830 nm-laser irradiation on rat sciatic nerves submitted to crush. Twenty male Wistar rats had their sciatic nerve crushed and were divided into 4 groups (n=5): Sham7 and Sham14, placebo-treated for 7 and 14 days; L7 and L14, laser-treated (at 4 J/cm²) for 7 and 14 days. Sham group animals were submitted to the same procedures, but with the laser turned off. Assessed parameters were inflammatory infiltrates, fibroblasts, myelin sheath destruction, and axonal degeneration. The statistical analysis showed significant differences in three parameters: L14 animals showed more fibroblasts (p=0.0001), lesser myelin sheath degeneration (p=0.007), and lesser inflammatory infiltrates (p=0.001). Low-power laser therapy hence contributed to reduce the inflammatory process due to rat sciatic nerve injury.

To assess the effect of N-Acetylmuramyl-L-Alanyl-D-Isoglutamine MDP topically administrated on the regenerating peripheral neurons, twelve male C57BL/6J adult mice were equally distributed into three groups. Four mice underwent unilateral sciatic nerve transection and polyethylene tubulization, with a 4mm gap between the proximal and distal nerve stumps and were implanted with collagen + PBS (COL). Other four animals underwent the same surgical procedure but received collagen + MDP (COL/MDP) inside the prosthesis. Four animals were not operated and served as control group (NOR). After 4 weeks, the regenerated nerve cables were processed for total myelinated axon counting and myelinated fiber diameter measurement. The L5 dorsal root ganglion (DRG) was also removed and sectioned for sensory neurons counting and measurement. The results revealed significant difference (p