02209nas a2200325   4500000000100000008004100001260001300042653001500055653001000070653001100080653001100091653001200102653000900114653001600123653002300139653002200162100001300184700002100197700001300218700001200231700001200243700001600255245008600271856005900357300001000416490000700426050003200433520140400465022001401869       1993                            d  c1993 Dec10aAdolescent10aAdult10aFemale10aHumans10aleprosy10aMale10aMiddle Aged10aNerve Regeneration10aPeripheral nerves1 aMiko T L1 aGschmeissner S E1 aMaitre C1 aKinfu Y1 aKazen R1 aPereira J H00aRegeneration at the predilective damage sites of nerve trunks in treated leprosy.  uhttp://leprev.ilsl.br/pdfs/1993/v64n4/pdf/v64n4a07.pdf  a330-70 v64  aInfolep Library - available3 a<p>Superficially located large and medium sized mixed peripheral limb nerves in active leprosy have previously been shown to have well-recognized fusiform swellings. It is generally agreed that these are the sites of predilective nerve involvement where the severest degeneration and fibrosis occur. A semiquantitative histopathological study on one of these sites, the flexor retinaculum region of the posterior tibial nerve, has been carried out on 14 treated leprosy patients who suffered from total sensory loss to the foot for between 2 and 40 years. The following observations were made: (1) large-scale nerve regeneration was present as characterized by numerous Schwann cells and unmyelinated axons which formed regeneration clusters; (2) thick myelinated axons were either absent or present only in very low numbers; (3) the intraneural fibrosis was usually not severe; (4) the presence of active inflammation probably interfered with nerve regeneration; (5) it appeared that this regeneration started shortly after the onset of therapy and persisted for decades; (6) lepromatous cases were characterized by evenly distributed pathology, whereas borderline tuberculoid cases had an unevenly distributed pathology; (7) the massive nerve regeneration observed was functionally ineffective--these findings indicate that the total nerve damage may affect the more peripheral nerve branches.</p>  a0305-7518