Entrapment syndrome of multiple nerves in graft-versus-host disease.

INTRODUCTION: Peripheral nerve entrapment syndromes are associated with hereditary neuropathy with liability to pressure palsies and a variety of rheumatic and endocrinological diseases. METHODS: We report a patient with entrapment syndromes of multiple nerves associated with chronic graft-versus-host-disease (GVHD) after allogeneic hematopoietic stem cell transplantation. Nerve ultrasound, histology, and ultrastructural changes were assessed. RESULTS: The 51-year-old man had developed severe deep dermal sclerosis due to chronic GVHD with a progressive polyneuropathy and entrapment syndromes of multiple nerves. Pre-stenotic enlargement was shown by nerve ultrasound. Histology demonstrated fibrosis of the epineurium with scarce infiltration of macrophages. Electron microscopy demonstrated alterations of the myelin sheaths and marked depletion of normal-sized myelinated nerve fibers. CONCLUSIONS: In addition to polyneuropathy, chronic GVHD can be associated with peripheral nerve entrapment syndromes and should be added to the differential diagnosis of compressive neuropathies.

The digital venous drainage in the human embryonic hand.

The histogenesis and morphology of the digital venous drainage in human embryonic and fetal hands, aged from 6 to 12 weeks, were studied by light microscopy in 18 fingers. In the sixth week, capillaries could be identified around the cartilaginous models of the phalanges. By the ninth week, the neurovascular bundles were identifiable in the palmar part of the finger. In 12 week fetuses, all of the superficial and deep vascular venous system could be seen easily in the palmar aspect of the finger in positions similar to those in the adult hand. However, the arch systems, present on the dorsum of the finger in the adult hand, were not yet differentiated.

Bridging small-gap peripheral nerve defects using acellular nerve allograft implanted with autologous bone marrow stromal cells in primates.

This study evaluated the effects of the transplantation of a tissue-engineered nerve derived from an acellular allogenic nerve graft, combined with autologous bone marrow stromal cells (MSCs), into peripheral nerve defects. In a rhesus monkey model, nerve regeneration was evaluated across a 1-cm lesion in the radial nerve by using an acellular allogenic nerve injected with autologous MSCs. Simple acellular nerve allografts served as control. Eight weeks after surgery, immunofluorescence staining, histologic morphometrical analysis and electrophysiologic evaluation were performed. Fluorescence microscopy revealed that some MSCs were immunopositive to S-100 protein, indicating a Schwann cell (SC) phenotype. The group treated with cultured MSCs showed a statistically higher number of nerve fibers, with well-shaped remyelinated axons. The motor conduction velocities and the peak amplitudes of compound muscle action potentials (CMAP) for the group treated with MSCs were higher than those of the controls. This outcome indicated that MSCs are able to differentiate into Schwann-like cells in vivo and to promote nerve regeneration in primates. Furthermore, the acellular nerves injected with MSCs provided a favorable environment for the growth and myelination of regenerating axons when compared to acellular nerves alone.

Morfologia microscópica do nervo radial do gato doméstico (Felis catus domesticus LINNAEUS, 1758) / Microscopic morphology of the radial nerve in domestic cat (Felis catus domesticus LINNAEUS, 1758)

No presente estudo investigou-se a estrutura histológica do nervo radial do gato doméstico. Foram utilizados cinco gatos, três fêmeas e dois machos, sem raça definida, provenientes do CCZ de Jaboticabal, SP. Dividiu-se o nervo em três regiões e foram coletados três segmentos: proximal, médio e distal. Após procedimentos de rotina histológica convencional, observou-se três tecidos de sustentação: o epineuro, o perineuro e o endoneuro. O epineuro é formado por tecido conjuntivo denso modelado e não modelado, e também por conjuntivo frouxo. Do epineuro partem septos, constituídos por conjuntivo denso não modelado e frouxo, rico em células adiposas. O perineuro, que reveste grupo de feixes nervosos, formando os fascículos, possui de duas a quinze camadas de células justapostas concêntricas com núcleo fusiforme, citoplasma delgado e alongado, diferenciando duas camadas, uma externa e outra interna. O espaço interlaminar da camada externa é preenchido por fibras colágenas e o da camada interna por fibras colágenas e reticulares. O endoneuro é constituído por tecido conjuntivo frouxo que circunda axônios predominantemente mielinizados, apresentando fibras colágenas e reticulares. Analisou-se, também, no presente estudo, o arranjo dos fascículos nervosos, notando-se no segmento proximal média de 11,50 + ou - 5,40 pequenos fascículos de diâmetros variados. O segmento médio apresentou média de 10,20 + ou - 2,94 fascículos com diâmetros maiores que os do segmento proximal. O segmento distal apresentou média de 15,30 + ou - 3,89 fascículos exibindo várias dimensões e menores que os observados no segmento médio. A análise estatística dos resultados demonstra diferença significativa (p<0,05) para as comparações das médias efetuadas entre as regiões estudadas. Os tecidos de revestimento do nervo radial do gato se apresentaram de modo semelhante aos descritos nos animais domésticos.

The aim of this study was to describe the histological structure of the domestic cat´s radial nerve, which has three conjunctive tissues for sustentation. The epineurium is formed by dense modeled and non modeled conjunctive tissue, and loose conjunctive tissue. Of epineurium they break septum for perineurium. They are rich in adipose cells and are formed by dense non-modeled conjunctive tissue and by loose conjunctive tissue. The perineurium revests a group of nervous bundles and has from two to fifteen juxtaposed cells. These cells are concentric and they have a fusiform nucleus, a thin and prolonged cytoplasm that is divided in two layers – one external and other internal. The external layer´s interlaminar space is filled by collagen fibers and the internal layer´s by collagen and reticular fibers. The endoneurium is formed by loose conjunctive tissue that embraces predominantly myelinated axons, and also has collagen and reticular fibers. It was also analyzed in the present study the arrangement of the nervous fascicles, noticing in the proximal segment the average from 11.5 to 5.4 small fascicles of varied diameters. The medium segment presented the average from 10.2 to 2.94 fascicles with bigger diameters than the proximal segment. The distal segment presented the average from 15.3 to 3.89 fascicles showing a lot of dimensions and smaller than the observed ones in the medium segment. The statistic analysis of the results demonstrated significant difference (p<0.05) to the comparisons of the averages effected between the studied regions. The revestiment tissues of the radial nerve had been presented in a similar way to the described ones in the domestic animals.

A hypothetical mathematical construct explaining the mechanism of biological amplification in an experimental model utilizing picoTesla (PT) electromagnetic fields.

We seek to answer the conundrum: What is the fundamental mechanism by which very weak, low frequency Electromagnetic fields influence biosystems? In considering the hydrophobicity of intramembranous protein (IMP) H-bonds which cross the phospholipid bilayer of plasma membranes, and the necessity for photonic recycling in cell surface interactions after dissipation of energetic states, present models lack structure and thermodynamic properties to maintain (DeltaE) sufficient energy sources necessary for amplifications by factors of 10(12). Even though one accepts that the ligand-receptor association alters the conformation of extracellular, extruding portions of IMP's at the cell surface, and that this change can be transmitted to the cytoplasm by the transmembranous helical segments by nonlinear vibrations of proteins with generation of soliton waves, one is still unable to account for repair and balanced function. Indeed, responses of critical molecules to certain magnetic field signals may include enhanced vibrational amplitudes, increased quanta of thermal energies and order inducing interactions. We may accept that microtrabecular reticulum-receptor is associated with actin filaments and ATP molecules which contribute to the activation of the cyclase enzyme system through piezoelectricity. Magnetic fields will pass through the membrane which sharply attenuates the electric field component of an EM field, due to its high impedance. Furthermore, EM oscillations are converted to mechanical vibrations; i.e., photon-phonon transduction, to induce molecular vibrations of frequencies specifically responsible for bioamplifications of weak triggers at the membrane surface, as well as GAP junctions. The hydrogen bonds of considerable importance are those in proteins (10(12)Hz) and DNA (10(11)Hz) and may be viewed as centers of EM radiation emission in the range from the mm microwaves to the far IR. However, classical electrodynamical theory does not yield a model for biomolecular resonant responses which are integrated over time and account for the connection between the phonon field and photons. Jacobson Resonance does supply an initial physical mechanism, as equivalencies in energy to that of Zeeman Resonance (i.e., zero-order magnetic resonance) and cyclotron resonance may be derived from the DeBroglie wave particle equation. For the first time, we view the introduction of Relativity Theory to biology in the expression, mc(2)=BvLq, where m is the mass of a particle in the 'box' or 'string' (molecule in a biosystem), c is the velocity of electromagnetic field in space, independent of its inertial frame of reference, B is the magnetic flux density,v is the velocity of the carrier or 'string' (a one or two dimensional 'box') in which the particle exists, L is its dimension (length) and q represents a unit charge q=1C, by defining electromotive force as energy per unit charge. Equivalencies suggest that qvBL is one of the fundamental expressions of energy of a charged wave-particle in magnetic fields, just as Zeeman and cyclotron resonance energy expressions, gbetaB and qhB/2pim, and is applicable to all charged particles (molecules in biological systems). There may exist spontaneous, independent and incessant interactions of magnetic vector B and particles in biosystems which exert Lorentz forces. Lorentz forces may be transmitted from EM field to gravitational field as a gravity wave which return to the phonon field as microgravitational fluctuations to therein produce quantum vibrational states that increase quanta of thermal energies integrated over time. This may account for the differential of 10(12) between photonic energy of ELF waves and the Boltzman energy kT. Recent data from in vivo controlled studies are included as empirical support for the various hypotheses presented.

Myelin widenings and MGUS-IgA: an immunoelectron microscopic study.

A few studies have reported a variety of nonspecific histological lesions in patients with IgA monoclonal gammopathies and polyneuropathy. In our case, using electron microscopy, we observed widenings of the myelin lamellae identical to those commonly described in IgM neuropathies with anti-myelin-associated glycoprotein activity. Using immunoelectron microscopy, we demonstrated a direct involvement of IgA in myelin lesions. The search for a direct link between monoclonal dysglobulinemia, regardless of type, and polyneuropathy is important and may influence treatment.

The pathobiology of human neuromas: an electron microscopic and biochemical study.

The formation of neuroma scar after trauma or neurorrhaphy is believed to be mediated by the response of collagen forming fibroblasts. In this study of twenty human neuromas, myofibroblasts were identified as a component of the scar. These cells occurred singly or as aggregates. There was a qualitative increase of myofibroblasts during the period from two to six months post-injury. From six months to one and one-half years post-injury, numbers and aggregations of myofibroblasts diminished, concurrent with collagen proliferation. Ultrastructural alcian blue staining and biochemical analyses revealed a glucosamine--glycosaminoglycan matrix within neuromas when compared to control nerves. Myofibroblasts appear to play a part in the pathobiology of human neuromas.

Study of the evolution of nerve damage in leprosy. Part I--Lesions of the index branch of the radial cutaneous nerve in early leprosy.

A total of six index finger branch of the radial cutaneous (IRC) nerves from three BL, two BB and one BT cases of leprosy, with less than 6 months history of disease were subjected for nerve conduction velocity (NCV) studies followed by biopsy. The biopsy was divided into three parts and subjected for light microscopy quantitative histology, electron-microscopy and fibre tease studies. The nerves revealed a slight reduction in NCV and a varying degree of segmental demyelination ranging from 10% to 35%. The earliest changes observed were the thickening and proliferation of Schwann cell processes of the unmyelinated fibres and degeneration of their axons regardless of the type of leprosy.