myelin-basic-protein and Cadaver

Ultrasound-guided puncture is indispensable for the injection of local anesthetic in the interfascial space, the space between 2 muscle fasciae. Interfascial infiltration or block may be useful in treating myofascial pain in the trapezius muscle.. (1) In 5 cadavers, we studied the diffusion of a physiological saline and latex solution in the interfascial space of the upper muscles of the back, and performed a histological study of the fasciae. (2) We performed an interfascial block in 25 patients with myofascial pain in the trapezius muscle. Depending on the trigger point location, the block was performed between the trapezius and the levator scapulae or between the trapezius and the rhomboideus major.. In all cadavers, anatomical dissection showed the latex in the interfascial space. The histological study confirmed the presence of nerve structures in the fasciae and in the interfascial space itself. Pain was assessed in all patients on a visual analog scale (VAS) before and after the injection (at rest and in motion). Preinjection: mean VAS 6.4 (at rest) and 7.6 (in motion). Postinjection: mean VAS 1 (at rest) and 1.6 (in motion).. The anatomical, histological, and ultrasound findings in the cadaver study confirmed the diffusion of the solution in the interfascial space. Study in patients confirms that the interfascial block in the back musculature can be as effective as in the abdominal musculature. The presence of nerve structures in this space, confirmed by the histological study, seems to explain the pain relief reported by the patients with this interfascial technique.

Topics: Adult; Aged; Aged, 80 and over; Anesthetics, Local; Cadaver; Facial Pain; Fascia; Female; Follow-Up Studies; Humans; Male; Middle Aged; Myelin Basic Protein; Nerve Block; Nerve Growth Factors; Pain Measurement; Punctures; S100 Calcium Binding Protein beta Subunit; S100 Proteins; Ultrasonics

Calcitonin gene-related peptide (CGRP) has a key role in migraine pathophysiology and is associated with activation of the trigeminovascular system. The trigeminal ganglion, storing CGRP and its receptor components, projects peripheral to the intracranial vasculature and central to regions in the brainstem with Aδ- and C-fibers; this constitutes an essential part of the pain pathways activated in migraine attacks. Therefore it is of importance to identify the regions within the brainstem that processes nociceptive information from the trigeminovascular system, such as the spinal trigeminal nucleus (STN) and the C1-level of the spinal cord. Immunohistochemistry was used to study the distribution and relation between CGRP and its receptor components - calcitonin receptor-like receptor (CLR) and receptor activity modifying protein 1 (RAMP1) - in human and rat STN and at the C1-level, using a set of newly well characterized antibodies. In addition, double-stainings with CGRP and myelin basic protein (MBP, myelin), synaptophysin (synaptic vesicles) or IB4 (C-fibers in general) were performed.. In the STN, the highest density of CGRP immunoreactive fibers were found in a network around fiber bundles in the superficial laminae. CLR and RAMP1 expression were predominately found in fibers in the spinal trigeminal tract region, with some fibers spanning into the superficial laminae. Co-localization between CGRP and its receptor components was not noted. In C1, CGRP was expressed in fibers of laminae I and II. The CGRP staining was similar in rat, except for CGRP positive neurons that were found close to the central canal. In C1, the receptor components were detected in laminae I and II, however these fibers were distinct from fibers expressing CGRP as verified by confocal microscopy.. This study demonstrates the detailed expression of CGRP and its receptor components within STN in the brainstem and in the spinal cord at C1-level, and shows the possibility of CGRP acting postjunctionally in these areas putatively involved in primary headaches.

Topics: Aged; Aged, 80 and over; Animals; Cadaver; Calcitonin Gene-Related Peptide; Calcitonin Receptor-Like Protein; Cervical Vertebrae; Coloring Agents; Female; Humans; Immunohistochemistry; Male; Myelin Basic Protein; Nerve Fibers, Unmyelinated; Rats; Rats, Sprague-Dawley; Receptor Activity-Modifying Protein 1; Receptors, Calcitonin Gene-Related Peptide; Tissue Fixation; Trigeminal Nuclei; Trigeminal Nucleus, Spinal

We present a qualitative and semi-quantitative description of palmar and plantar digital nerves obtained from cadavers prepared for routine class dissection. The fingertips of the three most functionally important and sensitive digits, namely thumb, index and middle fingers, received more myelinated axons than those of the ring and little fingers. In both palmar and plantar nerves the numbers of myelin basic protein (MBP)-positive myelinated axons decreased proximodistally along each digit and also from thumb to little finger and hallux to little toe respectively. Our results suggest that there are up to ten times more myelinated axons in palmar digital nerves than in plantar nerves.

Topics: Aged; Aged, 80 and over; Axons; Cadaver; Female; Fingers; Foot; Hand; Humans; Immunohistochemistry; Male; Myelin Basic Protein; Peripheral Nerves; S100 Proteins; Toes