Search

Although there are many studies of the neuropathology of the ischemic degeneration of peripheral nerves, the pathogenesis is not well-understood. The roles of several biomolecules on this process were previously reported. An adhesion molecule, fibronectin, which is applied locally (as a conduit material), is very effective in nerve recovery. This study was carried out to evaluate the roles of fibronectin, lipid peroxidation, and nitric oxide (NO) in an experimental model of peripheral nerves. Ischemia and reperfusion injury of sciatic nerves was rendered by clamping the femoral artery and vein. Rats were divided into nine groups. Ischemia and reperfusion were not applied to group 1. In group 2, only ischemia was performed, but reperfusion was not accomplished. For groups 3-9, 1, 2, and 24 h and 1, 2, 3, and 4 weeks of reperfusion were applied following 3 h of ischemia. Then NO, malondialdehyde (MDA), and fibronectin levels were observed in serum samples of rats. Colorimetric and nephelometric assays were used for determination of the levels of these parameters. In this study, all biochemical parameters were found to be increased in the ischemia groups when compared with the control group 1 (P0.05). A significant difference was observed between study groups with respect to MDA, NO, and fibronectin levels (P0.05). Also, some correlations were established between biochemical parameters in the same group, depending on the varying reperfusion time (r0.50). Ischemia causes some important changes in biochemical parameters, and depending on the reperfusion time, nerve injury continues for a while. In our study, we observed that serum levels of MDA decreased in the periods when NO and fibronectin simultaneously increased. Such increases may contribute to neural recovery, and there may be interactions among them.

A 13-year-old girl was referred to our dermatology outpatient clinic for the treatment of a congenital, circumscribed, hypertrichotic area on the lumbosacral region because it was cosmetically embarrassing. Dermatologic examination revealed a 25 × 15 cm circumscribed hypertrichotic area on the lumbosacral region. Coarse, dark, terminal hairs were observed, but the underlying skin was normal (Fig. 1). The lesion had been present since birth. Her history also revealed back pain, which developed by 3 years of age, and a long history of urinary incontinence. On neurologic examination, no motor weakness or sensory changes were observed. On orthopedic examination, minimal atrophy and 2 cm shortening of the right leg were detected, and the right foot was smaller than the left. There was an accentuation of lumbar lordosis. There was no history of a similar lesion in the family. There was no consanguinity in the relatives. Figure 1. Clinical appearance of the patient 6 months after operation Magnetic resonance imaging and computed tomography findings included diastematomyelia between T10 and L2 levels, minimal spina bifida at L2–L3 levels, mild tethered cord, and a fat density mass at L1 level behind the left lamina. Complete blood cell count, erythrocyte sedimentation rate, and blood chemistry were within the normal ranges. The patient underwent lumbar laminectomy with excision of the lipoma and release of the tethered cord, and a type II diastematomyelia was detected at operation. A diagnosis of faun tail with underlying spinal dysraphism was made. There was also associated foot deformity and urinary incontinence as late sequelae of spinal dysraphism. The patient had been shaving the lesion periodically. We recommended laser epilation.