Diss. (sammanfattning) Stockholm : Karol. inst., 2000. / Härtill 6 uppsatser.

No description available.

Peripheral nerve injuries can cause serious health problems and result in lifelong disabilities. Although researchers have been studying peripheral nerve injuries, patients may not regain complete function of their muscles even after surgeries to repair their nerves are performed. However, animal studies have shown that after peripheral nerve cut and repair (muscle self-reinnervation), stretch-reflex in the affected muscles does not recover, which may affect the muscle electromyographic (EMG) activity of all muscle synergists, as well as joint kinematics. The aim of this study is to determine the effects of the self-reinnervation of the lateral gastrocnemius (LG) and soleus (SO) muscles in the hind limb of felines on the mean EMG activity of the intact synergist medial gastrocnemius (MG), as well as the moments at the knee and ankle joints during different walking conditions: level (0%), downslope (-50%), and upslope (+50%). The EMG activity and joint kinematics were recorded on the three different walking conditions before and 12 weeks after the self-reinnervation of LG and SO when these muscles recovered their activity. The self-reinnervation of the two muscles caused the MG EMG activity to increase for all walking conditions. However, the changes in the knee and ankle moments differed depending on the three different walking conditions. It was concluded that the changes in EMG and joint moments after self-reinnervation could be caused by the absence of stretch-reflex in the affected muscles and/or changes in physiological properties of muscles.

Diss. (sammanfattning) Linköping : Univ., 2002. / Härtill 5 uppsatser.

Previous studies have suggested that sympathetic sprouting in the periphery may contribute to the development and persistence of sympathetically-maintained pain in animal models of neuropathic pain. The purpose of this thesis was to examine morphological changes in the cutaneous innervation in rats after chronic constriction injury (CCI) to the sciatic nerve. More specifically, this study addresses the question of whether sympathetic fibres sprout de novo into the upper dermis of the rat hindpaw skin after CCI of the sciatic nerve. We also determined changes in peptidergic sensory innervation following CCI. / At several periods post-injury, hind paw skin was harvested and processed using a monoclonal antibody against dopamine-beta-hydroxylase to detect sympathetic fibres and a polyclonal antibody against calcitonin gene-related peptide to identify peptidergic sensory fibres. We observed migration and branching of sympathetic fibres into the upper dermis of the hind paw skin, from where they were normally absent. This migration was first detected at 2 weeks, peaked at 4 to 6 weeks and lasted for at least 20 weeks post-lesion. At 8 weeks post-lesion, there was a dramatic increase in the density of peptidergic fibres in the upper dermis. Quantification revealed that densities of peptidergic fibres 8 weeks post-lesion were significantly above levels of sham animals. Interestingly, the ectopic sympathetic fibres did not innervate blood vessels but formed a novel association and wrapped around sprouted peptidergic nociceptive fibres. Our data show a long-term sympathetic and sensory innervation change in the rat hind paw skin after the chronic constriction injury. This novel fibre arrangement after nerve lesion may play an important role in the development and persistence of sympathetically-maintained neuropathic pain after partial nerve lesions.

No description available.

<p>Det har länge varit känt att patientens perioperativa position kan orsaka symtom som förmodas uppstå genom tryck och sträckningar. Positionen vid laparosko-piska operationer anses öka risken för symtom och därför är perioperativ om-vårdnad av betydelse. Syftet var därför att undersöka hur frekvent positions- relaterade symtom förekommer vid laparoskopiska ingrepp och vilken betydelse de har för patienten. Studien genomfördes som en deskriptiv tvärsnittstudie och datainsamlingen gjordes med hjälp av symtomskattning och semistrukturerade intervjuer. Totalt 60 respondenter i åldern 19 till 75 år deltog i studien som pågick under åtta månader. Resultatet visade att en fjärdedel av respondenterna drab-bades av nytillkomna eller förvärrade symtom. Dessa uppmärksammades postoperativt eller några dagar efter operationen och var oberoende av ingrepp, perioperativ tid eller armarnas position. Några av respondenterna upplevde smärta och domningar i nacke, axlar och händer som ledde till inskränkningar i det dagliga livet och krävde hjälp av närstående. Det är viktigt att fortsätta arbetet med att förebygga positionsrelaterade skador, för att förhindra postoperativa symtom, genom att placera patienten så nära ett neutralläge som möjligt och ge denne möjlighet att känna efter hur det känns före nedsövning.</p> / <p>It has long been assumed that a patient’s perioperative position can cause symp-toms which appear from pressure and strains on the body. The position in lapa-roscopic surgery is considered to increase the risk of symptoms, perioperative care is therefore important. The scope of this study was therefore to survey how frequent symptoms associated with the patient’s position occur and why they are important to the patient. The survey was made as a descriptive cross-section study. The data collection was made by way of patients own estimates of their symptoms and by semistructured interviews. 60 respondents aged between 19 and 75 took part in the study. The result showed that a fourth of the respondents experienced new or aggravated symptoms. These were observed postoperatively or a few days after surgery and were independent of operations, perioperative time or position of the arms. Some of the respondents felt pain and numbness in the neck, shoulders and hands which led to restrictions in their daily life and required help from someone close. It is important to continue working with preventing postoperative symptoms, by placing the patient as close to a neutral position as possible and give her the possibility to feel comfortable before the anesthetization.</p>

Det har länge varit känt att patientens perioperativa position kan orsaka symtom som förmodas uppstå genom tryck och sträckningar. Positionen vid laparosko-piska operationer anses öka risken för symtom och därför är perioperativ om-vårdnad av betydelse. Syftet var därför att undersöka hur frekvent positions- relaterade symtom förekommer vid laparoskopiska ingrepp och vilken betydelse de har för patienten. Studien genomfördes som en deskriptiv tvärsnittstudie och datainsamlingen gjordes med hjälp av symtomskattning och semistrukturerade intervjuer. Totalt 60 respondenter i åldern 19 till 75 år deltog i studien som pågick under åtta månader. Resultatet visade att en fjärdedel av respondenterna drab-bades av nytillkomna eller förvärrade symtom. Dessa uppmärksammades postoperativt eller några dagar efter operationen och var oberoende av ingrepp, perioperativ tid eller armarnas position. Några av respondenterna upplevde smärta och domningar i nacke, axlar och händer som ledde till inskränkningar i det dagliga livet och krävde hjälp av närstående. Det är viktigt att fortsätta arbetet med att förebygga positionsrelaterade skador, för att förhindra postoperativa symtom, genom att placera patienten så nära ett neutralläge som möjligt och ge denne möjlighet att känna efter hur det känns före nedsövning. / It has long been assumed that a patient’s perioperative position can cause symp-toms which appear from pressure and strains on the body. The position in lapa-roscopic surgery is considered to increase the risk of symptoms, perioperative care is therefore important. The scope of this study was therefore to survey how frequent symptoms associated with the patient’s position occur and why they are important to the patient. The survey was made as a descriptive cross-section study. The data collection was made by way of patients own estimates of their symptoms and by semistructured interviews. 60 respondents aged between 19 and 75 took part in the study. The result showed that a fourth of the respondents experienced new or aggravated symptoms. These were observed postoperatively or a few days after surgery and were independent of operations, perioperative time or position of the arms. Some of the respondents felt pain and numbness in the neck, shoulders and hands which led to restrictions in their daily life and required help from someone close. It is important to continue working with preventing postoperative symptoms, by placing the patient as close to a neutral position as possible and give her the possibility to feel comfortable before the anesthetization.

No description available.

This study examines the prospects of using the electrospinning process to fabricate tissue engineering scaffolds targeting a variety of regenerative applications, with a primary focus on the production of nerve guides for the treatment of long-defect nerve injuries in the peripheral nervous system. A basic overview of the conventional electrospinning process is provided, and the utility of this fabrication scheme in the production of collagen-based tissue engineering scaffolds is demonstrated. Next, a novel modification of the basic electrospinning process is presented. This process, called two pole air gap electrospinning, was developed to produce nerve guides that exhibit an anisotropic structure that mimics the extracellular matrix of native peripheral nerve tissue. This electrospinning process makes it possible to produce macroscopic nerve guides that are cylindrical in shape and composed of dense arrays of nano- to micron-scale diameter fibers. Unlike, conventional hollow core nerve guides, these electrospun constructs lack a central lumen, hence the designation 3D (for three-dimensional) nerve guide. The fibers are nearly exclusively arrayed in parallel with the long axis of the construct. This architectural feature provides thousands of individual channels, and aligned fibers that provide guidance cues that are designed to drive regenerating axons to grow in a highly directed fashion down the longitudinal axis of the guide. To supplement the structural cues provided by the fibrillar arrays of the electrospun 3D nerve guides, an alginate-based platform designed to deliver therapeutic reagents was developed and characterized. This platform makes it possible to fabricate gradients of therapeutic reagents within the fibrillar arrays of an electrospun nerve guide. Functional and structural analyses of these constructs supplemented with or without a gradient of NGF, in a long-defect nerve injury in the rodent sciatic nerve indicate that the 3D design is superior to the gold standard treatment, the autologous nerve graft. Animals treated with the 3D grafts recovered motor and sensory function faster and exhibited far higher nerve-to-nerve and nerve-to-muscle signal amplitudes in electrophysiological studies than animals treated with autologous grafts or conventional hollow core cylindrical grafts.