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J Korean Assoc EMG Electrodiagn Med 1999;1(1):105-115.
Published online January 1, 1999.
Effects of 21-Aminosteroid and Methylprednisolone on Nerve Regeneration atter Sciatic Nerve Crush Injury in Rats
Abstract
Objectives: To investigate the effect of 21-Aminosteroid and Methylprednisolone on the regeneration of peripheral nerves after a crush injury. Methods : Eighty Wistar adult male rate were randomly divided into four groups of twenty. One group was normal control and the other three injured groups received a crush injury to the right sciatic nerve. Among the injered groups, the first group was given 21-aminosteroid (initially 10㎎/㎏, ip, afterwards 5㎎/㎏, ip ; AS group), second group was given methylprednisolone (initially 30㎎/㎏, ip, afterwards 15㎎/㎏, ip ; MP group), and the third group received no medication (no-treatment-group). Each medication was given 30 minutes before the injury, 30 minutes after the injury and then every 6 hours until 48 hours after the injury. A nerve conduction study was performed at the 2nd day, and at the 2nd, 4th, 8th, and 12th weeks after the crush injury while a histologic study was done at the 8th and the 12th weeke atter the crush injury to all groups. Results : 1) In the normal control group, the compound muscle action potential (CMAP) study revealed 1.03±0.15 msec in latency, 25.14±7.93㎷ in amplitude, and 28.44±8.46 msecㆍ㎷ in area. Total area of cut surface of myelinated fibers was 3319.76±118.69μm² per unit area (4,800μm²) in transverse sections of the sciatic nerve. Distribution of the diamerer of myelinated fibers showed a bimodal peak patten (3-4μm and 7-8μm). 2) Two days after the injury, all the injured groups showed a decreased latency of CMAP, compared to the normal control group. This delay in the latency continued to increase until the 4th weeks after the injury and between the 8th and the 12th week, the latency began to decrease. Compared to the no-treatment-group, the AS group showed a significant decrease in the latency of CMAP. 3) Two days after the injury, all the injured groups showed a severe decrease in the amplitude and the area of CMAP, compared to the normal control group. the amplitude and the area of CMAP began to increase from four weeks after the injury, and the amplitude and the area of CMAP of the AS and the MP groups reached a statistically significant increase between the 8th and the 12th weeks after the injury, compared to the no-treatment-group. 4) After 8 weeks after the injury, recovery of the conduction velocity and the amplitude of CMAP in all experimental groups correlated with a relative increase in the number of myelinated fibers greater than 5 μm in diameter. These values may be good indicators of the nerve regeneration process. Comclusion : From these experimental results, it is evident that the use of 21-aminosteroid and Methylprednisolone can facilitate the nerve regeneration process after a crush injury of peripheral nerves.
Key Words: Nerve injury, 21-aminosteroid and Methylprednisolone, Axonal degeneration, Regeneration
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