Morioka H
Department of Orthopaedic Surgery, School of Medicine, Keio University, Tokyo, Japan.
Nihon Seikeigeka Gakkai Zasshi. 1988 Jan;62(1):43-55.
The author investigated the possibility and the mechanism of reinnervation of "endplate-free denervated muscle" by direct neurotization, using the anterior tibial muscles of rats. The proximal stump of the posterior tibial nerve, which was severed at the ankle level, was embedded into the transected distal 1/5 (5 mm) of the endplate-free segment of the muscle. M-waves by electromyogram appeared 6 weeks after neurotization. In the histological specimens with acetylcholine-esterase (Ach-E) stain, accumulations of Ach-E activity were detected from one week after neurotization. These increased gradually in both number and size. In the electron microscopy specimens, axons were seen in the synaptic fold-like indentations of the thickened sarcoplasm in 4 weeks. Eight weeks after neurotization, synaptic vesicles were observed in the axons. It was established by this study that direct neurotization resulted in the formation of new motor endplates and in the reinnervation of "endplate-free denervated muscle".
作者利用大鼠胫前肌,研究了通过直接神经植入使“无终板失神经肌肉”重新神经支配的可能性及机制。将在踝关节水平切断的胫后神经近端残端,植入该肌肉无终板节段横断的远端1/5(5毫米)处。神经植入6周后,肌电图出现M波。在乙酰胆碱酯酶(Ach-E)染色的组织学标本中,神经植入1周后检测到Ach-E活性积聚。其数量和大小均逐渐增加。在电子显微镜标本中,4周时可见轴突位于增厚肌浆的突触褶样凹陷处。神经植入8周后,在轴突中观察到突触小泡。该研究证实,直接神经植入可导致新运动终板的形成以及“无终板失神经肌肉”的重新神经支配。