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. Evidence indicates that autophagy [ 3 , 4 ] and UPS [ 5 , 6 ] are impaired and linked to accumulated protein aggregates in neurodegenerative diseases such as Alzheimer’s disease and Parkinson’s disease. Nevertheless, existing data regarding their changes in nervous tissue injury are incomplete. Increased activity of autophagy was observed in brain and spinal cord injuries [ 7 , 8 , 9 , 10 ]. Activated autophagy was also shown after cranial and spinal nerve injuries [ 11 , 12 , 13 ]. However, the changes in the dorsal root ganglia (DRG) and nerve segments adjacent

in procedures of peripheral nerves blockade. Bosn J Basic Med Sci. 2006;6(4):5-12. 5. Hadzic A, Dilberovic F, Shah S, et al. Combination of intraneural injection and high injection pressure leads to fascicular injury and neurologic deficits in dogs. Reg Anesth Pain Med. 2004;29(5):417-423. 6. Lupu CM, Kiehl TR, Chan VW, El-Beheiry H, Madden M, Brull R. Nerve expansion seen on ultrasound predicts histologic but not functional nerve injury after intraneural injection in pigs. Reg Anesth Pain Med. 2010;35(2):132-139. 7. Yang S, Abrahams MS, Hurn PD, Grafe MR, Kirsch


Background: Nerve injury results in axonal degeneration and loss of sensory neurons in dorsal root ganglia (DRG). Enhanced oxidative stress was also observed following injury, suggesting potential efficacy of antioxidant therapy.

Objective: To examine the effects of vitamin E on nerve regeneration after nerve injury in rats.

Method: Unilateral sciatic nerve crush was performed on rats which were divided into three groups: control and 2 doses of vitamin E. The control group received only vehicle (corn oil) and vitamin E groups received α-tocopherol 500 and 1,000 mg/kg/day once daily by gavage. Regeneration was evaluated at 10 days post-injury. In a second experiment, there were two groups, vehicle and vitamin E 500 mg/kg/day, and the regeneration duration was extended to 3 weeks.

Result: The first experiment showed that vitamin E 500 and 1,000 mg/kg/day could significantly reduce DRG neuronal loss from 31.5% in the control group to 17.1% and 13.5%. However, the regeneration distances were not significantly different among groups. In the second experiment, although vitamin E 500 mg/kg/day significantly increased the plasma vitamin E level, motor recovery of the hind limb, as assessed by walking track analysis, was not significantly improved. By contrast, nerve morphometry revealed increased density and number of myelinated fiber after vitamin E treatment.

Conclusion: Vitamin E may be beneficial to sensory neuronal loss and nerve regeneration after nerve trauma

References Alvarez FJ, Bullinger KL, Titus HE, Nardelli P, and Cope TC. Permanent reorganization of Ia afferent synapses on motoneurons after peripheral nerve injuries. Ann N Y Acad Sci. 2010;1198:231-241. Amado S, Armada-da-Silva PAS, João F, Ana C. Maurício AC, Luís AL, Simöes MJ, Veloso AP. The sensitivity of two-dimensional hindlimb joint kinematics analysis in assessing functional recovery in rats after sciatic nerve crush. Beh Brain Res. 2011; 225:562-573. Basso DM, Beattie MS, Bresnahan JC. A sensitive and reliable locomotor rating scale for open field

generation of neuropathic pain. Br J Anaesth 2013, 111:26-37. 24. Naik AK, Latham JR, Obradovic A, Jevtovic-Todorovic V: Dorsal root ganglion application of muscimol prevents hyperalgesia and stimulates myelin protein expression after sciatic nerve injury in rats. Anesth Analg 2012, 114:674-82. 25. Huston JP, Schulz D, Topic B: Toward an animal model of extinction-induced despair: focus on aging and physiological indices. J Neural Transm 2009, 116:1029-36. 26. Ryan CG, Gray HG, Newton M, Granat MH: The relationship between psychological distress and free-living physical

nerve involvement in bisphosphonate-related osteonecrosis of the jaw. J Oral Maxillofac Surg, 2009; 67:589-592. 5. Yu W, Wang J, Yin J. Platelet-rich plasma: a promising product for treatment of peripheral nerve regeneration after nerve injury. Int J Neurosci, 2011; 121:176-180. 6. Anitua E, Prado R, Orive G. A lateral approach for sinus elevation using PRGF technology. Clin Implant Dent Relat Res, 2009; 11:e23-e31. 7. Freiberger JJ, Feldmeier JJ. Evidence supporting the use of hyperbaric oxygen in the treatment of osteoradionecrosis of the jaw. J Oral Maxillofac Surg

References 1. Robert RC, Bachetti P, Pogrel MA. Frequency of trigeminal nerve injuries following third molar removal. J Oral Maxillofac Surg, 2005; 63:732-735. 2. Kraut RA, Chahal O. Management of patients with trigeminal nerve injuries after mandibular implant placement. J Am Dent Assoc, 2002; 133:1351-1354. 3. Grotz KA, Al-Nawas B, De Aguiar EG, Schulz A, Wagner W. Treatment of injuries to the inferior alveolar nerve after endodontic procedures. Clin Oral Investig, 1998; 2:73-76. 4. Chaushu G, Taicher S, Halamish-Shani T, Givel N. Medicolegal aspects of altered


The aim of the study is to evaluate the surgical treatment comparing the results obtained with different techniques. We revised 68 cases with acute Achilles tendon rupture who underwent surgical correction between 2004 and 2011, with a 40 month average follow-up. 34 of these were submitted to a classical open repair using the Kessler or Krakow technique, 25 to a mini-invasive technique (Achilon) and 9 to a percutaneous technique (Tenolig). We report a 29% rate of complications when using the classical technique: the major complications were one re-rupture, two surgical wound dehiscences, one infection and one sural nerve injury. In the mini-invasive/percutaneous techniques, two re-ruptures occurred (5.9% total, one in each technique) and one fistula at the needle insertion location. In regards to the percutaneous and mini-invasive techniques, the functional results and degree of satisfaction were higher, with fewer complications, reflecting a trend that has been expressed in the international literature.


Introduction: The imaging method of cone beam is an improved, extremely accurate computed tomography applicable in the whole field of dentistry. Due to its ability to locate the exact position of the impacted teeth, CBCT software has an important role in the management of difficult cases of impacted third molar. In some situations, the lower third molar is quite near to the inferior alveolar nerve that the surgical extraction can present a high risk of post-operative sensitive impairs of the skin and mucosa of the lower lip and chin on the same side. Presentation of case series: Our study tried to assess the contribution of CBCT in the pre-operative evaluation and further treatment of patients with impacted third molars in mandibular bone with high risk of inferior alveolar nerve injury. The paper presents three clinical cases showing positive signs on standard OPG, which exhibit indicators of a potential contact between the inferior alveolar nerve and the impacted lower third molars. For an improved exploration Dental CT Scan, DICOM image acquisition program, and 3D reconstruction with a special software were used. Conclusions: The study showed that compared with panoramic radiography, CBCT improve the evaluation of the surgical risk and allow a more accurate planning of surgery.

Electrophysiological Evaluation of the Incidence of Martin-Gruber Anastomosis in Healthy Bosnian Population

Background: Martin-Gruber anastomosis (MGA) is the well known anostomosis that occur at the various levels between the median and ulnar nerves. This anastomosis involves axons leaving either the main trunk of median nerve or the anterior interosseous nerve, crossing through the forearm to join the ulnar nerve. Knowledge of the incidence of this anastomosis is necessary because MGA can cause confusion in the assesment of nerve injuries and compressive neuropathies.

Aim: We aimed to assess the occurance and motor velocities of median to ulnar nerve communication (MGA) in the forearm of Bosnian population by electrophysiological examinations.

Material and Methods: One hundred and twenty forearms from a series of 60 volunteers (25 females, 35 males, 23-78 years of age) were studied electrophysiologically using needle recording electrodes. Volunteers with peripheral neuropathies were excluded from the study. Needle recording electrodes were places on the thenar and hypothenar muscles. The median and ulnar nerves were stimulated supramaximally at the wrist and the elbow and compound muscle action potentials (CMAPs) were recorded as well as motor conduction velocities of median and ulnar nerves.

Results: Martin-Gruber anastomosis was found in 27 of 120 forearms; it was bilateral in 7 and unilateral in 13, on the right side in nine and on the left side in four forearms. There were no significant sexual differences in the incidence. In MGA, when stimulating median nerve the respond of abductor digiti minimi was registered in 11, whereas the respond of opponens pollicis when stimulating ulnar nerve was registered in 18 subjects. This finding was statistically significant.

Conclusion: With high incidence of MGA in Bosnian population, it is necessary to be aware of the existance of this anomaly, location and its possible presentation.