Nerve transfer for restoration of lower motor neuron-lesioned bladder function. Part 2: correlation between histological changes and nerve evoked contractions.
Nerve transfer for restoration of lower motor neuron-lesioned bladder function. Part 2: correlation between histological changes and nerve evoked contractions.
复制标题
DOI：
10.1152/ajpregu.00300.2020
复制
发表时间：
2021-06-01
期刊：
影响因子：
--
通讯作者：
Ruggieri MR Sr
中科院分区：
文献类型：
--
作者：
Barbe MF;Testa CL;Cruz GE;Frara NA;Tiwari E;Hobson LJ;McIntyre BS;Porreca DS;Giaddui D;Braverman AS;Day EP;Amin M;Brown JM;Mazzei M;Pontari MA;Wagner IJ;Ruggieri MR Sr
1年后，我们确定盆腔器官分散和神经再支配对膀胱组织学和功能的影响。对19只犬采用双侧切断尾部和骶部(S)脊神经根、L(7号)腰背根和腹下神经的方法。排除后，8例患者在去中心化12 后，分别用闭孔-盆腔神经移位术和坐骨神经-阴部神经移位术重新支配神经，8-12 -mo后实施安乐死。四只长期担任分散化的动物。安乐死前，刺激盆神经或移位神经和L1~S3脊神经根，记录最大逼尿肌压力(MDP)。收集膀胱标本进行组织学和体外平滑肌收缩性能研究。与对照组相比，再神经支配和去中心化动物的尿路上皮细胞减少或剥离，壁内神经节减少，炎症和胶原增加，尽管肌肉百分比保持不变。在再支配动物中，pgp9.5+轴突密度高于去中心化动物。体外平滑肌收缩对氯化钾的反应与粘膜下炎症、逼尿肌厚度和pgp9.5+轴突密度呈正相关。在体内，再神经支配的动物在刺激L1-L6神经根后的MDP高于其横断的L7-S3神经根，而再神经支配和分散的动物在刺激神经后的MDP低于对照组(可能是由于纤维神经被包裹)。MDP与逼尿肌胶原和炎症呈负相关，与pgp9.5+轴突密度和壁内神经节数目呈正相关。这些结果表明，在去中心化后1年，闭孔神经转移到盆腔神经可以改善膀胱功能，尽管纤维化和炎症的发展与收缩功能的降低有关。
We determined the effect of pelvic organ decentralization and reinnervation 1 yr later on urinary bladder histology and function. Nineteen canines underwent decentralization by bilateral transection of all coccygeal and sacral (S) spinal roots, dorsal roots of lumbar (L)7, and hypogastric nerves. After exclusions, eight were reinnervated 12 mo postdecentralization with obturator-to-pelvic and sciatic-to-pudendal nerve transfers, then euthanized 8-12 mo later. Four served as long-term decentralized only animals. Before euthanasia, pelvic or transferred nerves and L1–S3 spinal roots were stimulated and maximum detrusor pressure (MDP) recorded. Bladder specimens were collected for histological and ex vivo smooth muscle contractility studies. Both reinnervated and decentralized animals showed less or denuded urothelium, fewer intramural ganglia, and more inflammation and collagen, than controls, although percent muscle was maintained. In reinnervated animals, pgp9.5+ axon density was higher compared with decentralized animals. Ex vivo smooth muscle contractions in response to KCl correlated positively with submucosal inflammation, detrusor muscle thickness, and pgp9.5+ axon density. In vivo, reinnervated animals showed higher MDP after stimulation of L1–L6 roots compared with their transected L7–S3 roots, and reinnervated and decentralized animals showed lower MDP than controls after stimulation of nerves (due likely to fibrotic nerve encapsulation). MDP correlated negatively with detrusor collagen and inflammation, and positively with pgp9.5+ axon density and intramural ganglia numbers. These results demonstrate that bladder function can be improved by transfer of obturator nerves to pelvic nerves at 1 yr after decentralization, although the fibrosis and inflammation that developed were associated with decreased contractile function.
登录
查看更多内容
影响因子：
4.2
作者：
Chen SF;Chang CH;Kuo HC
通讯作者：
Kuo HC
DOI：
10.1002/ar.23808
发表时间：
2018-08
期刊：
Anatomical record (Hoboken, N.J. : 2007)
影响因子：
--
作者：
Barbe MF;Gomez-Amaya SM;Salvadeo DM;Lamarre NS;Tiwari E;Cook S;Glair CP;Jang DH;Ragheb RM;Sheth A;Braverman AS;Ruggieri MR
通讯作者：
Ruggieri MR
DOI：
10.3171/2012.7.spine12214
发表时间：
2012-10
期刊：
Journal of neurosurgery. Spine
影响因子：
--
作者：
Brown JM;Barbe MF;Albo ME;Lai HH;Ruggieri MR Sr
通讯作者：
Ruggieri MR Sr
影响因子：
2
作者：
ATTA M A;FRANCK J I;ELBADAWI A
通讯作者：
ELBADAWI A
影响因子：
2.5
作者：
BARON, R;JANIG, W;MCLACHLAN, EM
通讯作者：
MCLACHLAN, EM