| Project/Area Number |
10671383
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Orthopaedic surgery
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| Research Institution | Keio University |
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Principal Investigator |
TAKAYAMA Shinichiro Full-time Lecturer, Department of Orthopaedic Surgery, School of Medicine, Keio University, 医学部, 講師 (40138045)
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| Co-Investigator(Kenkyū-buntansha) |
堀内 行雄 慶應義塾大学, 医学部, 助教授 (10138125)
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| Project Period (FY) |
1998 – 1999
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| Project Status |
Completed (Fiscal Year 1999)
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| Budget Amount *help |
¥2,600,000 (Direct Cost: ¥2,600,000)
Fiscal Year 1999: ¥700,000 (Direct Cost: ¥700,000)
Fiscal Year 1998: ¥1,900,000 (Direct Cost: ¥1,900,000)
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| Keywords | perineurial window / perineurium / peripheral nerve / needle / entrapment neuropathy / blood nerve barrier |
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| Research Abstract |
To investigate the pathomechanism of perineurial development and nerve damage in the perineurial window, we designed the following two different sized models of perincurial windows using tibial nerves of Wistar rats : a 1 mm length window as a small perincurial window model and a 5 mm length window as a large window model. In the 1 mm model window group, marked herniation of the endoncurial contents was observed by 12 weeks, and the initial histological change was slight but it was sustained for a long time. In contrast, such herniation was not so prominent in the 5 mm model window group and although the initial nerve damage was severe, it recovered within 12 weeks. The regeneration of the perincurium and nerve fibers in the 1 mm model was slow compared with the 5 mm model. These results suggest that the main pathomechanism of nerve damage in the perineurial window is entrapment of nerve fibers at the window rather than disruption of endoneurial homeostasis. Herniation of endoneurial contents was observed and histological change was sustained by 24 weeks. This result suggests that the perineurial window might not heal naturally.
To investigate the treatment of the perineurial window, we designed two different procedures, (1) sutured group : closing the window by suturing the perincurium, (2) releasied group : releasing the entrapment by clongating the window. The treatment of the perineurial window obtained a good result both in sutured group and released group. In clinical cases, which are usually chronic injuries, releasing the entrapment might be more useful.
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