Nervous System Commons^™

Sensory Dysfunction And The Role Of Nrf2 In The Production Of Pain In Chronic Hindlimb Ischemia, Oliver Kitzerow

Theses & Dissertations

Peripheral arterial disease (PAD) is a progressive and debilitating atherothrombotic disorder that is estimated to impact >200 million people worldwide. Higher physical activity levels are associated with better overall survival rates, slower decline of functional capability, and improved quality of life. However, intermittent claudication, pain produced by physical activity, severely limits functional capacity in PAD patients. Despite known sensory dysfunction and documented neuropathy in diseased patients, the neural mechanisms that produce pain in PAD are yet to be identified. Importantly, few animal models of hindlimb ischemia (HLI) successfully recapitulate chronic human PAD. We developed a chronic animal model of HLI …

Botulinum Toxin Type A Injections For Refractory Abdominal Dystonia: A Case Report, William J. Naber Ii, Jodi M. Wilhelm, Kurt A. Kuhlman, Gabriel Howard

Graduate Medical Education Research Journal

Background: A 58-year-old male with chronic bilateral treatment resistant abdominal spasms secondary complications of ascites/ alcoholic cirrhosis. Spasms would occur 4-5 times/day, lasting minutes to hours despite a 2-year course of therapeutic and pharmacological interventions. Due to treatment refraction, 6 uniformly spaced botulinum toxin type A (BTX-A) injections were placed per side, using electromyography for audible intramuscular syringe placement confirmation, while visual confirmation was made via ultrasound. During the initial trial, 6 evenly spaced injections were performed bilaterally, uniformly distributing 80U/side. Injections began bilaterally just medial to the junction of the inferior rib cage border/ anterior axillary line and progressed …

Stellate Ganglion Block For Refractory Raynaud’S Phenomenon- A Case Report, William J. Naber Ii, Derik J. Scribner, Gabriel Howard

Graduate Medical Education Research Journal

Introduction: Raynaud’s phenomenon (RP) is predominately a sympathetically mediated ischemic vasospastic disease involving the distal limbs and is associated with sharp pains, numbness, and dermatological color changes. The symptoms are commonly induced by cold weather, stress, and trauma and it is known to affect 4.85% of the population. There are few well-defined treatments for patients with RP that are refractory to 1st-line therapies. We present a case of intractable RP with corresponding response to stellate ganglion block (SGB) which demonstrates the efficacy profile and safety of SNS blocks in treatment of resistant RP.

Methods: Per Bon Secours Mercy Health …

Variations In Source And Pattern Of Arterial Supply To The Trigeminal Ganglion With Clinical Relevance, William S. Srinivasan

Theses & Dissertations

The trigeminal ganglion (TG) is known to receive its arterial supply from branches of the internal carotid artery (ICA), middle meningeal artery (MMA), accessory meningeal artery (AMA), or superior cerebellar artery (SCA). Existing information about the prevalence and patterns of blood supply to the TG is limited despite their high clinical relevance to basicranial surgeries. The objective of this study is to investigate the source and pattern of arterial supply to TG and discuss their clinical relevance. Left and right TG were examined on 75 embalmed human cadavers from an ethically approved anatomical donor program. A literature review was conducted, …

Effective Emodule Design For First-Year Medical Student Anatomy Curricula, Taylor J. Kratochvil Ms, Kaeli K. Samson Ma, Mph, Kari L. Nelson Phd, Travis L. Mccumber Phd

EMET Projects

Introduction: It is critical to evaluate student experience with any newly integrated educational resource. In 2018, a Distal Upper Limb (DUL) Anatomy eModule was developed for first-year medical students at the University of Nebraska Medical Center, who have historically identified the DUL as a region of difficulty. This mixed methods study sought to (1) evaluate learner perception of the eModule relative to other resources, and (2) identify eModule content and features that students found valuable.

Methods: The DUL eModule was made available to first-year medical students in 2019 (n= 132), 2020 (n=131), and 2021 (n=131) as a voluntary, …

Anatomical Variations Of The Sciatic Nerve Divisions In Relation To The Piriformis Muscle And Clinical Implications, Jonathan I. Van Erdewyk

Theses & Dissertations

The goal of this project was to identify and quantify the anatomical variations of the sciatic nerve divisions in relation to the piriformis muscle and compare the data collected to the primary literature. This was done in an effort to provide awareness of sciatic nerve entrapments within the subgluteal space that may be responsible for posterior hip and buttock pain. While the current means of diagnosis are through physical examination, imaging techniques, and surgery, the results of this present study indicate that new methods of diagnosis need to be explored.

The Role Of Glutaminase And Extracellular Vesicles In Macrophages And Microglia, Beiqing Wu

Theses & Dissertations

Glutamate serves as a crucial excitatory neurotransmitter that is essential for the proper functioning of the brain. However, excess levels of glutamate are neurotoxic and contribute to the pathogenesis of various neurodegenerative diseases, inducing HIV-1 associated neurocognitive disorders (HAND). Glutaminase 1 (GLS1) is an important mitochondrial enzyme responsible for producing glutamate from glutamine. GLS1 is upregulated during HAND and released from mitochondria to cytosol and extracellular space. However, why and how GLS1 is released remains unknown. In chapter II, we demonstrated that extracellular vesicles (EVs) carry GLS1 as cargos from cytosol to extracellular space during HIV infection and innate immune …