Siyatik sinir kesi modelinde eritropoetin ile gelsolin'in rejenerasyon üzerine etkisinin karşılaştırılması
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Tarih
2014
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Yayıncı
Selçuk Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Giriş: Kaza, kitle basısı, ameliyat vb nedenlerle hasarlanan periferik sinirlerde meydana gelen fonksiyon kaybının geriye dönmesi oldukça uzun zaman almakta bazen de hiç dönmemektedir. Yaralanma sonrası hastaların bırakın eski yaşam konforuna dönmesini, çoğu zaman hastanın hayat kalitesi oldukça azalmaktadır. Çeşitli çalışmalarda Eritropoetin (EPO) nın sinir iyileşmesi üzerinde olumlu etkileri bildirilmiştir. Bu çalışmada EPO ve Gelsolin'ın, sinir iyileşmesi üzerindeki etkilerini, gerçeğe daha yakın değerlendirme testlerinden olan izole sinir üzerinde çalışılarak karşılaştırılması amaçlandı. Gereç ve yöntem: İkinci ve dördüncü ayda fonksiyonel ,elektrofizyolojik ve histopatolojik değerlendirmeler yapılmak üzere 80 adet dişi Wistar albino sıçan 5 gruba ayrıldı. İlk grup kontrol grubuydu ve hiçbir işlem yapılmayan siyatik sinirlerinden oluşturuldu. İkinci grupta (Kesi grubu) kontrol grubu sıçanlarının sağ siyatik siniri kesildikten sonra sadece dikildi. Üçüncü grupta (EPO grubu), siyatik sinir kesilerek dikildikten sonra intraperitoneal EPO uygulandı. Dördüncü grupta (Gelsolin I.V.) grubu, sinir kesildikten sonra dikildi ve kuyruk veninden gelsolin uygulandı. Beşinci grupta (Gelsolin Lokal) grubu sinir kesildikten sonra dikildi ve sinir üzeirne gelsolin uygulandı Sıçanlar derin anestezi altındayken elektrofizyolojik değerlendirme amacıyla EMG ölçümü yapıldı. Sonrasında %10'luk formole konan sinirler enine kesitlerde Hematoksilen-Eozinle boyanarak, sinir genel yapısı , Schwann sayısı , akson alanı ve yapısal morfometrik incelemeler yapıldı. Ayrıca Toluidine Blue boyası ile demonstre edildi. Bulgular: Histopatolojik olarak 2 ve 4. ayda Gelsolin lokal grubu Kesi grubuna göre anlamlı olarak daha iyi bulundu. Kesi ile EPO grubu arasında fark anlamlı bulunmasına rağmen değerler gelsolin grubuna yaklaşamdı. Kontrol grubu ile tüm deney grupları arasındaki fark anlamlı bulundu. Elektrofizyolojik ölçümlerde Gelsolin grubunda tüm sıçanlarda kas ve sinir latans ve amplitüd değerleri kesi ve EPO grubuna göre anlamlı olarak farklı tespit edildi. Fakat iletim kalitesini gösteren verilerde kontrol grubu ile tüm deney grupları arasında fark anlamlı iken deney gruplarının kendi arasında anlamlı fark tespit edilemedi. Tartışma-sonuç: Sinir fonksiyonları hakkında gerçeğe daha yakın bilgiler veren izole sinir tekniği ile yapılan çalışmamızda, Gelsolin'in Kesi grubuna göre iyileşme üzerinde belirgin üstünlüğünün olduğu gözlendi. Özellikle EPO uygulamasının kontrole kıyaslanınca gelsolin kadar fayda sağlamadığı kanısındayız. Ayrıca histopatolojik olarak Gelsolin gurubunun sonuçlarının daha iyi olması, tüm deneklerde distalden iletim alınabilmesi ama iletim kalitesinin iyi olmaması nedeniyle Gelsolin üzerinde daha detaylı araştırmalar yapmak gerektiğini düşünmekteyiz. Sonuç olarak sinir yaralanması sonrasında en önemli ve en iyi tedavi yönteminin deneyimli bir cerrah tarafından yapılacak itinalı ve özenli bir cerrahi olduğu kanısındayız.
Introduction: Peripheral nevre injury that occur due to accident, mass compression, surgery etc., loss of nerve function after injury, it takes quite time to heal or sometimes never return. Let us return to the comfort of the old life of patients after injury, quite often decreases the patient's quality of life. Several studies, erythropoietin (EPO) of the reported positive effects on nerve healing. In this study, compare the effect of the Gelsolin and EPO on nerve healing closer to the truth by working on isolated nerve to use evaluation testing. Material and methods: Functional, Electrophysiological and histopathological assessments to be made at the second and fourth month of 80 female Wistar albino rats were divided into 5 groups. The first group was the control group and the sciatic nerves was created without any action. In the second group (Cut group), right sciatic nerve of control group rats was only repaired after cut off. The third group (EPO group), the sciatic nerve were cut and intraperitoneal injection of EPO performed after the repair. The fourth group (Gelsolin I.V. group), the nerve is cut off and repaired and I.V.Gelsolin was performed. The fifth group (Gelsolin Local group), the nerve is cut off and repaired and Local Gelsolin was performed. Sciatic functional index (SFİ) were measured for each group. The rats under deep anesthesia electrical activity was measured with neuromonitorization system. Then put in 10% formalin nerves cross sections stained with Hematoxylin - Eosin and unit cross-sectional area were counted in akson, schwann numbers and the structural forms. Toluidine Blue staining was also demonstrated. Findings: At 2 and 4 months Gelsolin groups were significantly better than in the incision group histopathologically. There was significant difference between the cut with the EPO group,but not more Gelsolin groups and found significant difference between the control group and all experimental groups. Electrophysiological measurements in all rats into the Gelsolin groups (100%) the transmission are taken to distal from incision site. EPO-group, identified distal transmission in 85.7%- 75% of the rats, 71.4%- 80% transmission was obtained in rats of cut group. But showing the data transmission quality was significant between all experimental groups and the control group but in the experimental groups, no significant difference could not be determined between them. Discussion-conclusion: In the study found that the providing information closer to reality about the functions of the nerve with the technique of isolated nerve, the EPO and Gelsolin was not significant improvement on healing according to the cut group. Particularly we believe that the application of EPO does not provide any benefit compared to primary repair. In addition, the Gelsolin group was histopathologically to have better outcomes, and taken distal conduction of all subjects but not good quality transmission more detailed research on the need to consider. Our opinion after the nerve injury as a result of the most important and best method of treatment by an experienced surgeon, a surgical that careful and attentive.
Introduction: Peripheral nevre injury that occur due to accident, mass compression, surgery etc., loss of nerve function after injury, it takes quite time to heal or sometimes never return. Let us return to the comfort of the old life of patients after injury, quite often decreases the patient's quality of life. Several studies, erythropoietin (EPO) of the reported positive effects on nerve healing. In this study, compare the effect of the Gelsolin and EPO on nerve healing closer to the truth by working on isolated nerve to use evaluation testing. Material and methods: Functional, Electrophysiological and histopathological assessments to be made at the second and fourth month of 80 female Wistar albino rats were divided into 5 groups. The first group was the control group and the sciatic nerves was created without any action. In the second group (Cut group), right sciatic nerve of control group rats was only repaired after cut off. The third group (EPO group), the sciatic nerve were cut and intraperitoneal injection of EPO performed after the repair. The fourth group (Gelsolin I.V. group), the nerve is cut off and repaired and I.V.Gelsolin was performed. The fifth group (Gelsolin Local group), the nerve is cut off and repaired and Local Gelsolin was performed. Sciatic functional index (SFİ) were measured for each group. The rats under deep anesthesia electrical activity was measured with neuromonitorization system. Then put in 10% formalin nerves cross sections stained with Hematoxylin - Eosin and unit cross-sectional area were counted in akson, schwann numbers and the structural forms. Toluidine Blue staining was also demonstrated. Findings: At 2 and 4 months Gelsolin groups were significantly better than in the incision group histopathologically. There was significant difference between the cut with the EPO group,but not more Gelsolin groups and found significant difference between the control group and all experimental groups. Electrophysiological measurements in all rats into the Gelsolin groups (100%) the transmission are taken to distal from incision site. EPO-group, identified distal transmission in 85.7%- 75% of the rats, 71.4%- 80% transmission was obtained in rats of cut group. But showing the data transmission quality was significant between all experimental groups and the control group but in the experimental groups, no significant difference could not be determined between them. Discussion-conclusion: In the study found that the providing information closer to reality about the functions of the nerve with the technique of isolated nerve, the EPO and Gelsolin was not significant improvement on healing according to the cut group. Particularly we believe that the application of EPO does not provide any benefit compared to primary repair. In addition, the Gelsolin group was histopathologically to have better outcomes, and taken distal conduction of all subjects but not good quality transmission more detailed research on the need to consider. Our opinion after the nerve injury as a result of the most important and best method of treatment by an experienced surgeon, a surgical that careful and attentive.
Açıklama
Anahtar Kelimeler
Eritropoietin, Erythropoietin, Gelsolin, Rejenerasyon, Regeneration, Sinir dejenerasyonu, Nerve degeneration, Sinir ezilmesi, Nerve crush, Sinir lifleri, Nerve fibers, Sinir rejenerasyonu, Nerve regeneration, Siyatik sinir, Sciatic nerve, Yaralar ve yaralanmalar, Wounds and injuries
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Künye
Kıraç, Y. (2014). Siyatik sinir kesi modelinde eritropoetin ile gelsolin'in rejenerasyon üzerine etkisinin karşılaştırılması. Selçuk Üniversitesi, Yayımlanmış uzmanlık tezi, Konya.
