Diffusion of contrast medium after perineural injection of the palmar nerves: an in vivo and in vitro study

REASONS FOR PERFORMING STUDY: Proximal diffusion of local anaesthetic solution after perineural anaesthesia may lead to the desensitisation of structures other than those intended. However, there is no evidence-based study demonstrating the potential distribution and diffusion of local anaesthetic solution after perineural analgesia in the distal limb. OBJECTIVE: To document the potential diffusion of local anaesthetic solution using a radiopaque contrast model and to evaluate the influence of walking compared with confinement in a stable after injection. METHODS: Radiopaque contrast medium was injected subcutaneously over one palmar nerve at the base of the proximal sesamoid bones in 6 nonlame mature horses. Horses were assigned randomly to stand still or walk after injection. Radiographs were obtained 0, 5, 10, 15, 20 and 30 min after injection and were analysed to determine the distribution and diffusion of the contrast medium. RESULTS: In 89% of injections an elongated pattern of the contrast medium was observed suggesting distribution along the neurovascular bundle. After 49% of injections a fine radiopaque line extended proximally from the contrast 'patch', and in 25% of injections a line extended distally. There was significant proximal and distal diffusion with time when sequential radiographs of each limb were compared. The greatest diffusion occurred in the first 10 min. Walking did not significantly influence the extent of either proximal or distal diffusion. CONCLUSIONS AND POTENTIAL RELEVANCE: Significant proximal diffusion occurs in the first 10 min after perineural injection in the distal aspect of the limb and should be considered when interpreting nerve blocks. Distribution of local anaesthetic solution outside the fascia surrounding the neurovascular bundle or in lymphatic vessels may explain delayed or decreased effects.

Ultrasound-guided block of sciatic and femoral nerves: an anatomical study

The sheep is a popular animal model for human biomechanical research involving invasive surgery on the hind limb. These painful procedures can only be ethically justified with the application of adequate analgesia protocols. Regional anaesthesia as an adjunct to general anaesthesia may markedly improve well-being of these experimental animals during the postoperative period due to a higher analgesic efficacy when compared with systemic drugs, and may therefore reduce stress and consequently the severity of such studies. As a first step 14 sheep cadavers were used to establish a new technique for the peripheral blockade of the sciatic and the femoral nerves under sonographic guidance and to evaluate the success rate by determination of the colorization of both nerves after an injection of 0.5 mL of a 0.1% methylene blue solution. First, both nerves were visualized sonographically. Then, methylene blue solution was injected and subsequently the length of colorization was measured by gross anatomical dissection of the target nerves. Twenty-four sciatic nerves were identified sonographically in 12 out of 13 cadavers. In one animal, the nerve could not be ascertained unequivocally and, consequently, nerve colorization failed. Twenty femoral nerves were located by ultrasound in 10 out of 13 cadavers. In three cadavers, signs of autolysis impeded the scan. This study provides a detailed anatomical description of the localization of the sciatic and the femoral nerves and presents an effective and safe yet simple and rapid technique for performing peripheral nerve blocks with a high success rate.

THE ULTRASTRUCTURAL ORGANIZATION OF THE HYPOGLOSSAL NUCLEUS IN THE RAT (SYNAPTOLOGY, CRANIAL NERVES)

An ultrastructural study of the hypoglossal nucleus (XII) in the rat has revealed two distinct neuronal populations. Hypoglossal motoneurons comprised the largest population of neurons in XII and were identified following injection of horseradish peroxidase (HRP) into the tongue. Motoneurons were large (25-50(mu)m), multipolar in shape and distributed throughout XII. The nucleus was large, round and centrally located, and the cytoplasm was characterized by dense lamellar arrays of rough endoplasmic reticulum. In contrast, a second population of small (10-18(mu)m), round to oval shaped neurons was found restricted to the ventral and dorsolateral regions of XII. The nucleus was markedly invaginated and eccentric, the cytoplasm scant and filled with free ribosomes, and the absence of lamellar arrays of rough endoplasmic reticulum was conspicuous. Neurons of this type were never found to contain HRP reaction product. These results demonstrate that the hypoglossal nucleus does not consist solely of motoneurons, but includes a distinctly separate, presumably non-motoneuronal pool. Arguments are presented in favor of this second neuron population being interneurons. The functional significance of these findings in relation to tongue control is discussed. ^

Skin wounds and severed nerves heal normally in mice lacking tenascin-C.

A large number of functions have been demonstrated for tenascin-C by antibody perturbation assays and in vitro cell culture experiments. However, these results contrast sharply with the lack of any apparent phenotype in mice with a genetic deletion of tenascin-C. A possible explanation for the lack of phenotype would be expression of some altered but functional tenascin-C in the mutant. We report the generation of an independent tenascin-C null mouse and conclude that the original tenascin-C knockout, which is genetically very similar to ours, is also a true null. As found previously, the absence of tenascin-C has no influence on development, adulthood, life span, and fecundity. We have studied in detail two models of wound healing. After axotomy, the regeneration of the sciatic nerve is not altered without tenascin-C. During healing of cutaneous wounds, deposition of collagen I, fibulin-2, and nidogen is identical in mutant and wild-type mice. In contrast. fibronectin appears diminished in wounds of tenascin-C-deficient mice. However, the lack of tenascin-C together with the reduced amount of fibronectin has no influence on the quality of the healing process.

Cryptorchidism and homeotic transformations of spinal nerves and vertebrae in Hoxa-10 mutant mice.

Homozygous mice mutated by homologous recombination for the AbdB-related Hoxa-10 gene are viable but display homeotic transformations of vertebrae and lumbar spinal nerves. Mutant males exhibit unilateral or bilateral criptorchidism due to developmental abnormalities of the gubernaculum, resulting in abnormal spermatogenesis and sterility. These results reveal an important role of Hoxa-10 in patterning posterior body regions and suggest that Hox genes are involved in specifying regional identity of both segmented and nonovertly segmented structures of the developing body.

The war of nerves with Iran - consequences for the South Caucasus and Russia. OSW Commentary No. 75, 2012-04-25

Tensions over Iran’s nuclear programme have risen considerably in recent months. This has been visible in numerous threats of – and much speculation about – an imminent Israeli (and US) attack on Iran’s nuclear installations. In this context, the support for the attacks that the countries of the South Caucasus (and Azerbaijan in particular) could provide has been the subject of lively debate, as has been the prospect of a Russian political and military offensive in the Caucasus in response to the attacks on Iran. It seems that the ongoing war campaign in the media has been aimed primarily at putting pressure on Iran and the international community to find a political solution to the Iranian problem. This also applies to the Caucasus’s involvement in the campaign. Given the outcome of the Istanbul round of talks on a political solution to the Iranian issue (14 April), which warrants moderate optimism, the threat of a conflict now appears more distant and this also indirectly proves the effectiveness of the campaign. The war of nerves with Iran, however, is already now actually affecting the stability of the Southern Caucasus. While it seems that Azerbaijan is not Israel’s partner in the preparations to attacks, and that there is no real link between the Iranian problem and the ongoing and planned movements of Russian troops in the Caucasus, the tensions between Iran and Azerbaijan are indeed high. Moreover, the global image of the Caucasus is deteriorating, the USA’s position in the region is becoming more complicated, and Russia’s room for manoeuvre is expanding.

A dissertation upon the nerves, containing an account : I. Of the nature of man, 2. Of the nature of brutes, 3. Of the nature and connection of soul and body, 4. Of the threefold life of man, 5. Of the symptoms, causes and cure of all nervous diseases /

Mode of access: Internet.

Observations on the nature cause and cure of those disorders which have been commonly called nervous, hypochondriac, or hysteric : to which are prefixed some remarks on the sympathy of the nerves /

Mode of access: Internet.

An essay on the use of the ganglions of the nerves /

Mode of access: Internet.

Anatomical remembrancer or complete pocket anatomist : containing a concise description of the bones, ligaments, muscles, and viscera, the nerves ...

Mode of access: Internet.

The Dublin dissector, or manual of anatomy : comprissing a concise description of the bones, muscles, vessels, nerves and viscera, also the relative anatomy of the different regions of the human body.../

Mode of access: Internet.

The anatomy of the human bones, nerves and lacteal sac and duct .../

Mode of access: Internet.

References to nerves : being tabular views of the motor nerves to muscles, the nervous supply of the principal articulations and of the skin, the deep and superficial origins of the cranial nerves; with the most important effects following solution of continuity of nerves.

Mode of access: Internet.