AAHS ASPN ASRM - 2013 Annual Meeting - American Association ...

The Possibility to Use Laterally-sprouting Axons at The Nerve Repaired Site as Motor Sources to innervate a
Functioning Free Muscle Transplantation ( FFMT) - Study in Rats
Institution where the work was prepared: Chang gung memorial hospital, Taipei, Taiwan
C.K. Tsao; David CC Chuang; Rong-Kuo Lyu; Shih-Ming Jung; Chang Gung Memorial Hospital
Background:
Neuroma is a physiological response after a peripheral nerve repair. It contains a great quantity of wasted nerve fibers. Recycling these aberrant axons before
neuroma formation seems a promising way basing on the theory of neurotropism. The goal of this study was to determine if the laterally-sprouting axons from
the repaired site of a major peripheral nerve could be an adequate motor source for functioning free muscle transfer (FFMT).
Materials and Methods:
35 two-month-old S-D rats were separated into four groups. Group A (20 rats) underwent a cut-and-repair of the left median nerve (MN) at axillary area. And
then 1.5mm behind the repaired site of MN attached the distal part of the transected musculocutaneous nerve (MCN) (Fig. I). The biceps muscle was thus simulated
as a FFMT and intended guiding those aberrant axons from MN for re-innervation. Group B (5 rats) underwent the same procedures with group A except
the transected MCN was repaired directly. In group C (5 rats), the distal end of transected MCN was connected to the intact MN with end-to-side fashion.
Group D (5 rats) underwent the same procedures with group A except the distal end of the transected MCN was buried back into biceps without re-innervation.
4 months later, the animals were subjected to electrophysiological tests (Fig. II), sacrificed, and the nerves and muscles were taken for histological examination.
Results:
Obvious elbow flexion and adequate biceps contraction were observed on group A and B. Biceps atrophy and loss of elbow flexion were noted in group C and
D. The average recovery ratio (RR) of biceps in muscle mass and contractile force were 91.38% and 71.29% in group A. Histological study confirmed the growth
of nerve fibers from MN to MCN did happen in group A. No significant difference in the RR of flexor digitorum superficialis (FDS) was found between the
experimental and control groups.
Conclusion:
Our findings reveal the possibility to use the aberrant axons from the repaired site of nerve. Our design functionally re-innervates the biceps without interrupting
the recovery of muscles innervated by MN originally. It suggests that the repaired site of an injured peripheral major nerve could be an alternative motor
source to innervate functioning free muscle transplantation.
The Effect of VEGF Gene Therapy and Hyaluronic Acid Enriched Microenvironment on Peripheral Nerve
Regeneration
Institution where the work was prepared: Gulhane Military Medical Academy, Ankara, Turkey
fatih Zor; Mustafa Deveci; Abdullah Kilic; Fatih Ozdag; Bulent Kurt; Serdar Ozturk; Mustafa Sengezer; Gulhane Military Medical Academy
Despite the fact that the surgical techniques have reached a plateau, the functional results of nerve regeneration are still not satisfying. In this study the effect
of VEGF gene therapy and HA enriched microenvironment on nerve regeneration is investigated. Thirty-two male Sprague-Dawley rats weighting between 250-
300 gr were divided into four groups, 8 rats in each. Group I: After coaptation no treatment regimens were used in this group. Group II: Following the coaptation,
hyaluronic acid film sheath is administered. Group III: Following the coaptation, VEGF gene therapy is performed. Group IV: Both the VGEF gene therapy
and HA administration was performed. In order to show the VEGF gene expression, the mRNA of the VEGF gene was detected by RT-PCR technique.
Electrophysiologic evaluation of the rats was performed at the 4th week. Intraneural scar formation and myelinated axonal counts were obtained histopathologically.
Data was collected in SPSS and statistically analysed using Wilcoxon, Mann-Whitney U and Kruskall Wallis tests. RT-PCR studies indicated that the
gene is incorporated to the host muscle cell and began to secrete VEGF. Electrophysiologic studies showed a significant difference between group I and the
groups II, III and IV (p