Koshima I, Moriguchi T, Soeda S
Department of Plastic and Reconstructive Surgery, Kawasaki Medical School, Okayama, Japan.
Plast Reconstr Surg. 1992 Feb;89(2):243-8; discussion 249-50.
Amputated human fingers were used to observe the morphologic changes in degeneration of Pacinian corpuscles, and postoperative moving two-point discrimination of the replanted fingers was examined to analyze sensory recovery after replantation. Normal corpuscles are composed of an axon terminal and inner and outer cores, resembling a sliced onion. The inner core is composed of thin, multilayered lamellar cells, and the outer core consists of multiple layers of thin perineurial cells. Based on our morphologic findings, following mitochondrial degeneration in the axon terminal, the terminal and inner core cells disappeared within 9 to 16 hours, but the outer core did not lose its structure until more than 24 hours after amputation. Collagen fibrils in the corpuscles appeared from 5 hours after amputation and periodically increased their amount up to 27 hours after amputation. Postoperative sensory recovery of the replanted fingers was significantly poorer with 9 hours or more of cold ischemia. These findings suggest that the inner core cells originating from Schwann cells degenerate at over 9 hours after amputation, and this may be related to the poor sensory recovery of replanted fingers. It also appears that the outer core cells originating from the perineurial cells in the amputated fingers survive even up to 27 hours after amputation and produce collagen fibrils in the extramatrix spaces of the outer core cells.
采用断离的人手指观察环层小体退变的形态学变化，并检测再植手指术后的移动两点辨别觉，以分析再植后的感觉恢复情况。正常的环层小体由一个轴突终末以及内、外核心组成，形似一个切开的洋葱。内核心由薄的多层板层细胞组成，外核心由多层薄的神经束膜细胞组成。基于我们的形态学发现，轴突终末的线粒体发生退变后，终末和内核心细胞在9至16小时内消失，但外核心直至断指后24小时以上才失去其结构。环层小体内的胶原纤维在断指后5小时出现，并在断指后27小时内其数量呈周期性增加。冷缺血9小时或更长时间后再植手指的术后感觉恢复明显较差。这些发现表明，源自施万细胞的内核心细胞在断指后9小时以上发生退变，这可能与再植手指感觉恢复较差有关。还似乎表明，源自断指神经束膜细胞的外核心细胞在断指后甚至可存活至27小时，并在外核心细胞的细胞外基质空间产生胶原纤维。
