氯胺酮对大鼠颈上交感神经节神经元烟碱诱发电流的影响

目的 评价氯胺酮对大鼠颈上交感神经节神经元烟碱诱发电流的影响.方法 采用胰酶消化法急性分离新生Wistar大鼠颈上交感神经节神经元,接种于培养皿,培养5～7d后采用膜片钳全细胞模式测定烟碱诱发电流,记录50 μmol/L烟碱和与不同浓度(10、25、50、100 μmol/L)氯胺酮混合溶液作用下烟碱诱发的峰电流及受体失敏时间常数,计算其抑制烟碱诱发电流的半数有效浓度.结果 10、25、50和100 μmol/L氯胺酮呈浓度依赖性地抑制烟碱诱发的峰电流(P＜0.05).与50 μmol/L烟碱诱发电流相比,氯胺酮50、100 μmol/L给药后受体快失敏相和慢失敏相时间常数均缩短(P＜0.05).氯胺酮对烟碱诱发电流的抑制作用符合指数方程,其抑制烟碱诱发电流的半数有效浓度＜20μmol/L.结论 氯胺酮可呈浓度依赖性地抑制大鼠颈上交感神经节神经元烟碱诱发电流,提示氯胺酮对交感神经节神经元活动具有抑制作用,可能是其在某些特定情况下降低血压的机制之一.     

罗哌卡因对交感神经节钠通道电流的抑制作用

目的研究罗哌卡因对交感神经节钠通道电流的影响,探讨交感神经节在局麻药诱发心肌毒性反应中的作用.方法酶消化法急性分离SD大鼠(7～10d)颈上交感神经节细胞,全细胞膜片钳技术记录罗哌卡因对其钠通道电流的影响.结果在钳制电压(Vh)-80mV,刺激电压(Vt)0mV条件下,0.01umol/L罗哌卡因使钠电流峰值降低30.02%(P<0.01),其抑制作用与浓度呈正相关(r=0.99,P<0.01),IC50为2.68μmol/L.钳制电位不同,抑制作用也不同(P<0.01),Vh-60mV时的IC50为1.55μmol/L.1.0μmol/L罗哌卡因使电流-电压曲线峰值电流平均降低30.66%,但不影响其形状;对激活曲线无明显的影响(P>0.05),用药前、后50%的通道激活时的去极化电压(V1/2)分别为-25.2mV、-22.64mV;使稳态失活曲线向超极化方向移动(3.56mV,P<0.01),用药前、后50%的通道灭活时的条件脉冲电压(V1/2)分别为-52.99mV、-56.44mV.结论低于致惊厥浓度的罗哌卡因对交感神经节钠通道电流有明显的抑制作用,且呈浓度及电压依赖性;其抑制作用主要与优先结合钠通道的失活状态而影响钠通道的失活有关.提示交感神经节参与介导了罗哌卡因的心肌毒性反应.     

咪达唑仑对交感神经元N-型钙通道电流的影响

目的；通过观察咪达唑仑对交感神经元全细胞N－型钙电流的影响，评价其对交感神经元的抑制作用。方法：用酶消化法获得急性分离的SD大鼠（7－10d）颈上交感神经节细胞，应用膜片钳技术记录不同浓度的咪达唑仑（0．1、0．3、3．0、10、50、100μmol/L）对N－型钙电流的影响。结果：在钳制电位（Vh)-80mV，刺激电压（Vt)-30mV- 10mV条件下，不同浓度的咪达唑仑对N－型钙电流均有抑，且呈浓度依赖性（r=0.964，P＜0．01）。临床相关浓度的咪达唑仑（0．3μmol/L）使钙通道电流峰值下降35％（P＜0．01）。50％钙通道电流峰值受抑制的μmol/L浓度（IC50）约为4．25μmol/L。结论：临床 相关浓度的咪达唑仑对交感神经元全细胞N－型钙电流有明显的抑制作用，提示咪哒唑仑的循环抑 制作用可能与抑制交感神经系统的活动有关。     

异丙酚对小鼠脑动脉血管平滑肌细胞自发性瞬时外向钾电流的影响

目的 探讨异丙酚对小鼠脑动脉血管平滑肌细胞自发性瞬时外向钾电流的影响.方法 昆明小鼠,体重18～22 g,雌雄不拘,分离脑底部Willis动脉环,经两步法酶消化分离血管平滑肌细胞,选取5个血管平滑肌细胞,采用穿孔全细胞膜片钳技术,于钳制电位为- 30 mV时记录加入56μmol/L异丙酚前后自发性瞬时外向钾电流,分析其幅度、频率、曲线下面积和时间半宽.结果 与给药前比较,给药后自发性瞬时外向钾电流的幅度、频率和曲线下面积升高(P＜0.05或0.01),时间半宽差异无统计学意义(P＞0.05).结论 异丙酚可激活小鼠脑动脉血管平滑肌细胞自发性瞬时外向钾电流,诱发血管平滑肌舒张.     

不同时间失神经支配对小鼠骨骼肌乙酰胆碱受体活性的影响

目的 探讨不同时间失神经支配对小鼠骨骼肌乙酰胆碱受体(AChRs)活性的影响.方法 Balb/C小鼠14只,体重18～22 g.采用切断坐骨神经的方法制备骨骼肌失神经支配模型.于切断坐骨神经前(T0)、切断后1、4、7、14、21和28 d(T1～6)时取2只小鼠,急性分离趾短屈肌后,急性分离骨骼肌细胞,每只小鼠取5个骨骼肌细胞,采用全细胞膜片钳技术记录模式.骨骼肌细胞先用含30μmol/L乙酰胆碱的细胞外液灌注10 s,记录乙酰胆碱电流(I1),随后细胞外液冲洗60 s,然后依次用含0、0.1、1、10、30、100、1000、3000或10 000 nmol/L阿曲库铵的细胞外液平衡灌注3 min,再用含30 μmol/L乙酰胆碱和上述不同浓度阿曲库铵的细胞外液分别灌注10 s,记录乙酰胆碱电流,随后细胞外液冲洗60s,再次用含30 μmlo/L乙酰胆碱的细胞外液灌注10 s,记录乙酰胆碱电流(I2),取I1和I2的平均值作为对照电流,计算对照电流抑制百分比,采用非线性回归分析计算阿曲库铵阻滞AChRs的半数有效抑制浓度(IC50).结果 与T0时比较,T1～6时阿曲库铵IG0升高(P＜0.05)；T1～3时阿曲库铵IG0逐渐升高(P＜0.05)；与T3时比较,T4～6时阿曲库铵IC50逐渐降低(P＜0.05).结论 骨骼肌失神经支配可抑制AChRs的活性,该效应与骨骼肌失神经支配的时间有关.     

异丙酚对交感神经元钠通道电流的影响

目的 研究异丙酚对交感神经元他细胞钠通道电流的影响。探讨基金上 因管扩张机制。方法 酶消化法急性分离ＳＤ大鼠（８～１２ｄ）颈上交感神经节细胞,应用全细胞膜片钳技术记录异丙酚对钠通道电流以的影响。结果 在钳制电压（Ｖｈ）～８０ｍＶ,刺激电压（Ｖｔ）０ｍＶ条件下,临床相关浓度的异丙酚（５．６μｍｏｌ／Ｌ）使钠通道电流峰值降２７．６６％（Ｐ〈０．０１）,随浓度增加,抑制作用逐渐增强（ｒ＝０．９８２。Ｐ〈     

异丙酚、咪达唑仑复合对交感神经元钠通道电流的影响

异丙酚与咪达唑仑联合应用可达到增加麻醉效能 ,减轻循环抑制的目的[1 ] 。既往的研究表明 ,交感神经节钠通道可能参与介导异丙酚的循环抑制作用[2 ] 。本文旨在研究异丙酚、咪达唑仑对交感神经节细胞钠通道电流的联合作用 ,探讨复合诱导循环稳定的可能机制。材料与方法大鼠颈上交感神经节细胞急性分离的方法及全细胞膜片钳记录技术同前[2 ] 。在Ｖｈ - 80ｍＶ、Ｖｔ 0ｍＶ条件下 ,记录不同浓度的异丙酚、咪达唑仑及其复合在给药前、给药 30ｓ后的钠通道电流。药物相互作用分析 :首先应用公式ｙ =Ａ1 (Ａ2 -Ａ1) [1 10 ^(ｌｏｇＸ0 -Ｘ) ｘ…     

氟哌利多对大鼠背根神经节细胞钠电流的影响

目的 研究氟哌利多对大鼠背根神经节细胞钠通道电流的影响。方法 在急性分离的大鼠背根神经节细胞标本上,应用全细胞膜片钳技术记录氟哌利多对钠通道电流的影响。结果3～300μmol·L-1的氟哌利多对钠电流的抑制率为14.12％～78.46％（P<0.01,n=7）,该抑制作用具有浓度依赖性。钳制电位不同,氟哌利多对钠电流的抑制作用亦不同,在Vh分别为-80mV与-60mV时,其IC50值分别为（48.72±10.67）μmol·L-1和（35.37±10.51）μmol·L-1（P<0.05,0=7）。30μmol. L-1的氟哌利多使电流-电压曲线峰值平均降低53.18％（P<0.01,n=7）,对激活曲线无明显影响（P>0.05,n=7）,但可使稳态失活曲线向超极化方向移动7.95mV,用药前、后的V1/2分别为-28.58mV和-36.06mV（P<0.01,n=7）。结论 氟哌利多对背根神经节细胞钠通道电流有明显的抑制作用,且呈浓度依赖性,提示硬膜外镇痛时应用临床浓度的氟哌利多具有增强硬膜外镇痛效果的作用。     

儿童嗜铬细胞瘤的诊断与治疗

儿童嗜铬细胞瘤可发生在肾上腺髓质（肿瘤或增生）、肾上腺外的嗜铬组织中或交感神经节、旁交感神经节。因分泌过多的儿茶酚胺引发高血压和一系列以糖代谢紊乱为主的综合征，故又称为儿茶酚胺增多症。与成人嗜铬细胞瘤的组织发生一样，是起源于外胚层的神经嵴，在组织发育后分布于自颈交感神经链至盆腔的诸多部位，其内分泌组织的细胞在组织化学上是属于氨前体摄取和氨基酸脱羧基酶活性细胞，简称为APUD细胞。APUD细胞合成35种生理活性多肽，但仅极少几种有生物活性，主要是儿茶酚胺（CA）包括多巴胺、去甲。肾上腺素和。肾上腺素。因儿童的特殊生理期，儿童嗜铬细胞瘤在许多方面如疾病的发生、临床表现和临床诊治方面都明显的有别于成人。     

钙池操纵的钙通道抑制剂对大鼠肝细胞钙池操纵的钙通道电流的影响

目的探讨钙池操纵的钙通道(SOC)抑制剂(2APB)对大鼠肝细胞SOC电流(Isoc)的影响。方法急性分离大鼠肝细胞,应用全细胞膜片钳记录技术测定大鼠肝细胞Isoc,并观察2APB对该电流的影响。结果在急性分离的大鼠肝细胞记录到Isoc,从其电流电压(IV)曲线可以看出该Isoc的反转电位为-2.5mV左右。在钳制电位为-100mV时,该Isoc为(-664.52±140.44)pA(n=8);20、40、60、80、100μmol/L的2APB分别使Isoc由给药前的(-664.52±140.44)pA下降至给药后的(-564.80±111.01)、(-490.11±73.97)、(-362.01±55.91)、(-295.64±50.03)、(-232.12±46.47)pA,给药前后比较差异有统计学意义(P<0.05或P<0.01);2-APB的抑制作用呈浓度依赖性增强,其EC50为(64.63±10.56)μmol/L。结论2APB对急性分离的大鼠肝细胞Isoc具有显著的抑制作用,这对于进一步深入进行肝细胞钙超载的发生机制和防治具有重要意义。     

维生素D受体在糖尿病肾病足细胞损伤及蛋白尿缓解中的作用

目的探讨维生素D受体(VDR)在糖尿病肾病(DKD)足细胞中的表达水平及在足细胞损伤及蛋白尿缓解中的作用。方法(1)本研究纳入了65例诊断患有2型糖尿病(伴或不伴蛋白尿)的患者,并纳入了25例年龄和性别相匹配的健康体检者为对照组。根据白蛋白/肌酐(ACR)的尿排泄比例对2型糖尿病患者进行分组,分别为无蛋白尿(ACR<30 mg/g,n=24)、微量白蛋白尿(ACR 30~300 mg/g,n=18)和临床蛋白尿(ACR>300 mg/g,n=23)。另选择25例经肾活检确诊的DKD患者作为DKD组。正常肾脏组织标本均取自泌尿外科同一时期肾脏肿瘤切除患者10例。将各组检测指标进行对比,同时采用实时定量PCR、ELISA法和免疫组化法检测VDR在各组患者的血液、尿液样本和肾脏组织中的表达情况,以及使用Pearson相关分析分析VDR与尿蛋白的相关性。(2)在2型糖尿病肾病小鼠模型中对上述结果进行验证,将遗传背景均为C57BLKs/J的雄性db/db小鼠及同窝出生的db/m小鼠,随机分为正常对照组(A组)、DKD对照组(B组)、DKD二甲基亚砜处理组(C组)、DKD帕立骨化醇(VDR激动剂)处理组(D组),C、D组连续腹腔注射处理8周,对照组不做任何处理。小鼠10周龄时开始连续干预8周,在小鼠22周龄(开始干预后12周)检测各组小鼠体重、血、尿生化指标对比;Western印迹法检测β⁃catenin、VDR的变化;免疫荧光观察足细胞标志蛋白podocin及足细胞损伤蛋白α⁃SMA的表达变化。结果(1)与正常健康对照组相比,无蛋白尿组、微量白蛋白尿组和临床蛋白尿组的糖尿病患者血浆中VDR的mRNA和蛋白水平均较低(均P<0.05);与无蛋白尿组的糖尿病患者相比,微量白蛋白尿组和临床蛋白尿组的糖尿病患者血浆中VDR的mRNA和蛋白水平均较低(均P<0.05)。(2)与正常健康对照组相比,无蛋白尿糖尿病组和DKD组患者血浆中VDR的mRNA和蛋白水平均较低(均P<0.05);与无蛋白尿糖尿病组患者相比,DKD组患者血浆中VDR的mRNA和蛋白水平亦较低(均P<0.05)。(3)免疫组化结果显示,DKD组肾组织中VDR的表达明显少于正常对照组。(4)DKD患者血浆中VDR mRNA相对水平与ACR呈负相关(r=-0.342,P<0.05)。(5)各组尿液上清液中VDR的水平与血浆中的水平呈相反趋势。(6)Western印迹结果显示,B组、C组肾小球足细胞β⁃catenin蛋白表达高于D组(均P<0.05),VDR蛋白的表达低于D组(均P<0.05);免疫荧光结果显示,B组、C组肾小球足细胞podocin的表达低于D组(均P<0.05),α⁃SMA的表达高于D组(均P<0.05)。结论VDR高表达缓解DKD足细胞损伤及蛋白尿。     

罗伊适应模式对腹股沟疝无张力疝修补术后恢复情况的影响

目的探讨罗伊适应模式对患者腹股沟疝无张力疝修补术后恢复情况的影响。 方法将2016年1月至2019年5月在秦皇岛市第二医院择期进行无张力修补术治疗的120例腹股沟疝患者，按照随机数字法分为对照组和观察组，每组各60例。对照组采用常规护理治疗，观察组在对照组的基础上采用罗伊适应模式。比较2组患者的术后临床指标、心理状态、围手术期并发症发生情况及满意度。 结果术后观察组患者的首次排气时间、恢复正常饮食时间、离床活动时间和术后住院时间均低于对照组（P<0.05）；术后观察组患者的抑郁自评量表（SDS）和焦虑自评量表（SAS）评分显著低于对照组（P<0.05）；术后2组患者均无切口感染发生，2组患者尿潴留、急性疼痛、认知功能障碍、发热、血肿等发生率相比无统计学差异（P>0.05）；术后观察组患者护理满意度为96.67%，显著高于对照组的83.33%（P<0.05）。 结论在常规护理的基础上，罗伊适应模式用于患者腹股沟疝无张力修补围手术期，能有效改善术后患者的焦虑/抑郁情绪，不增加围手术期并发症，促进术后患者的恢复及提高治疗满意度。     

Long-term follow-up of callotasis lengthening of the capitate after resection of the lunate for the treatment of stage III lunate necrosis

The callotasis lengthening technique was used to gradually lengthen the capitate after resection of the lunate in stage IIIa necrosis in 23 patients. Results of ten patients with a follow-up of at least 5 years showed rapid and sufficient callus formation in every patient regardless of age. The callotasis lengthening modification of the Graner II operation provides all advantages and avoids the major inconvenience of the traditional Graner II operation. There was no increased rate of disturbed fracture healing. Results of the DTPA-gadolinium MRI study did not show any significant impairment of vascularization within the region of the capitate bone. With the “intrinsic bone formation,” contrary to every other intercarpal arthrodesis at the wrist, there is no need for an additional bone graft.     

Comparison of University of Wisconsin and University of Pittsburgh solutions for heart transplantation

The effectiveness of University of Wisconsin (UW) and University of Pittsburgh (UP) solutions for the preservation of rat hearts was compared. Lewis rat hearts were preserved with UW (group A, n=45) or UP (group B, n=45) solution for 0 or 24 h and then transplanted heterotopically into the recipients' abdomen. Ten recipients in each group were observed to obtain 1-week graft survival rates. Tissue water content and tissue content of adenine nucleotides were measured 2 h after transplantation in six grafts from each group. Six hearts preserved for 0 h and seven hearts preserved for 24 h were taken from each group 24 h after grafting for histopathology. The 1-week graft survival rates of groups A24 and B24 were 60% and 10%, respectively. In the 24-h preserved grafts, adenosine triphosphate (ATP) and energy charge [(ATP+adenosine diphosphate/2)/(ATP+adenosine diphosphate+adenosine monophosphate)] of groups A and B were 0.972±0.165 and 0.200±0.123 mg/g wet tissue (P<0.05) and 74.4% and 61.1% (P<0.05), respectively. The tissue water content of group A24 was 71.7%, whereas that of group B24 was 74.1% (P<0.05). Histopathology revealed more severe muscle edema and necrosis and infiltration of polymorphonuclear cells in group B24 than in group A24. We conclude that UW solution is more appropriate for rat heart preservation than UP solution.     

不同尿钙水平的Gitelman综合征患者临床特点比较

目的观察不同尿钙水平Gitelman综合征(GS)患者的临床特点,探讨尿钙在GS疾病临床分型中的价值。方法收集2016—2018年来自中国国家罕见病注册系统(NRSC)、在北京协和医院行SLC12A3基因检测诊断为GS患者的临床资料,分析其尿钙特点,比较不同尿钙水平患者的临床和实验室检查指标。氢氯噻嗪试验按照标准操作流程进行,测定患者基线和用药后3 h内氯离子排泄分数改变量的最大值(ΔFECl)。结果共有83例GS患者被纳入研究,其中低尿钙患者53例(63.86%)。低尿钙组尿钙/肌酐比明显低于非低尿钙组[(0.085±0.058)mmol/mmol比(0.471±0.284)mmol/mmol,t=7.349,P<0.001]。两组患者在年龄、性别、估算肾小球滤过率、血压、血尿电解质水平、代谢性碱中毒方面差异均无统计学意义。低尿钙组患者乏力(χ2=4.595,P=0.032)及多尿(χ2=5.778,P=0.016)发生比例低于非低尿钙组,两组患者在其他临床症状方面差异无统计学意义。低尿钙和非低尿钙组各有16例患者行氢氯噻嗪试验,中位ΔFECl结果分别为0.539%(0.430%,1.283%)和0.829%(0.119%,1.298%),均提示对氢氯噻嗪无反应,组间差异无统计学意义(U=130.000,P=0.956)。结论GS患者中低尿钙比例为63.86%,尿钙水平与疾病临床表型、NCC功能损伤严重程度之间均无明确相关性。     

Fibrinogen-thrombin collagen patch reinforcement of highrisk colonic anastomoses in rats

AIM To evaluate the effectiveness of human fibrinogenthrombin collagen patch(TachoSil~?) in the reinforcement of high-risk colon anastomoses.METHODS A quasi-experimental study was conducted in Wistar rats(n = 56) that all underwent high-risk anastomoses(anastomosis with only two sutures) after colectomies. The rats were divided into two randomized groups: Control group(24 rats) and treatment group(24 rats). In the treatment group, high-risk anastomosis was reinforced with TachoSil~? (a piece of Tacho Sil? was applied over this high-risk anastomosis, covering the gap). Leak incidence, overall survival, intra-abdominal adhesions, and histologic healing of anastomoses were analyzed. Survivors were divided into two subgroups and euthanized at 15 and 30 d after intervention in order to analyze the adhesions and histologic changes. RESULTS Overall survival was 71.4% and 57.14% in the TachoSil~? group and control group, respectively(P = 0.29); four rats died from other causes and six rats in the treatment group and 10 in the control group experienced colonic leakage(P 0.05). The intra-abdominal adhesion score was similar in both groups, with no differences between subgroups. We found non-significant differences in the healing process according to the histologic score used in both groups(P = 0.066).CONCLUSION In our study, the use of TachoSil~? was associated with a non-statistically significant reduction in the rate of leakage in high-risk anastomoses. TachoSil~? has been shown to be a safe product because it does not affect the histologic healing process or increase intra-abdominal adhesions.     

Role of Conventional and Diffusion-Weighted Magnetic Resonance Imaging of Spinal Treatment Protocol for Hydatid Disease

Objective:

To demonstrate the role of magnetic resonance imaging (MRI) in determining the treatment protocol for hydatid disease of the spine.

Design:

Case report; literature review.

Findings:

Diffusion-weighted MRI can help differentiate complicated infected hydatidosis from abscesses, epidermoid cysts from arachnoid cysts, and benign from malignant vertebral compression fractures. It is also helpful in differentiating between abscesses and necrotic tumors.

Conclusion:

Diffusion-weighted MRI can help differentiate between infections requiring immediate surgery and those that can be treated medically with antihelmintic treatment.     

Safety and tolerability of single intravenous doses of sugammadex administered simultaneously with rocuronium or vecuronium in healthy volunteers

BACKGROUND: Sugammadex rapidly reverses rocuronium- and vecuronium-induced neuromuscular block. To investigate the effect of combination of sugammadex and rocuronium or vecuronium on QT interval, it would be preferable to avoid the interference of anaesthesia. Therefore, this pilot study was performed to investigate the safety, tolerability, and plasma pharmacokinetics of single i.v. doses of sugammadex administered simultaneously with rocuronium or vecuronium to anaesthetized and non-anaesthetized healthy volunteers. METHODS: In this phase I study, 12 subjects were anaesthetized with propofol/remifentanil and received sugammadex 16, 20, or 32 mg kg(-1) combined with rocuronium 1.2 mg kg(-1) or vecuronium 0.1 mg kg(-1); four subjects were not anaesthetized and received sugammadex 32 mg kg(-1) with rocuronium 1.2 mg kg(-1) or vecuronium 0.1 mg kg(-1) (n=2 per treatment). Neuromuscular function was assessed by TOF-Watch SX monitoring in anaesthetized subjects and by clinical tests in non-anaesthetized volunteers. Sugammadex, rocuronium, and vecuronium plasma concentrations were measured at several time points. RESULTS: No serious adverse events (AEs) were reported. Fourteen subjects reported 23 AEs after study drug administration. Episodes of mild headache, tiredness, cold feeling (application site), dry mouth, oral discomfort, nausea, increased aspartate aminotransferase and gamma-glutamyltransferase levels, and moderate injection site irritation were considered as possibly related to the study drug. The ECG and vital signs showed no clinically relevant changes. Rocuronium/vecuronium plasma concentrations declined faster than those of sugammadex. CONCLUSIONS: Single-dose administration of sugammadex 16, 20, or 32 mg kg(-1) in combination with rocuronium 1.2 mg kg(-1) or vecuronium 0.1 mg kg(-1) was well tolerated with no clinical evidence of residual neuromuscular block, confirming that these combinations can safely be administered simultaneously to non-anaesthetized subjects. Rocuronium and vecuronium plasma concentrations decreased faster than those of sugammadex, reducing the theoretical risk of neuromuscular block developing over time.     

Prolongation of lung xenograft survival in rats with a short course of deoxyspergualin and cyclosporin A

The efficacy of 15-deoxyspergualin (DSG), cyclosporin A (CyA), and splenectomy-alone or in combination-in prologing the survival of concordant lung xenotransplants was studied in the hamster-to-rat model. In the untreated group, rejection occurred within 3 days, with an elevation of lymphocytotoxic antibody titers. The rejected lung revealed that ED1+cells were more prevalent than MRC OX8+cells in the perivascular infiltrates. In the DSG group, the antibody response was suppressed and median survival increased to 7.5 days. The rejected lungs demonstrated a highly significant depression in ED1+cellular infiltration and a moderate MRC OX8+cellular infiltration. When maintenance CyA was combined with a short course of DSG, survival dramatically increased to beyond 100 days. There were no deposits of IgM, IgG, or C3 or of any cell infiltrate in the grafts of two animals sacrificed 107 and 119 days post-transplantation. We conclude that initial treatment with DSG combined with continuous CyA can suppress acute rejection in the hamster-to-rat lung xenograft model, resulting in longterm graft survival.     

Anterior Interosseous Nerve Palsy After Shoulder Arthroscopy Treated With Surgical Decompression: A Case Series and Systematic Review of the Literature

Background: Anterior interosseous nerve (AIN) palsy is a very uncommon cause of upper extremity pain and weakness that comprises less than 1% of all upper extremity nerve palsies. Rarely reported but also mentioned in the literature is AIN palsy after shoulder arthroscopy. Methods: A systematic review of the literature to date using PubMed was conducted to identify patients who suffered AIN palsy after shoulder arthroscopy procedures. Articles included met the following criteria: (1) published in English; (2) primary presentation of the data; (3) patients had undergone shoulder arthroscopy before developing symptoms of AIN palsy; and (4) diagnosis was confirmed with clinical symptoms of AIN palsy. Measured outcomes included patient demographics, specific shoulder procedure, anesthesia procedure, intra-operative patient positioning, intra-operative compressive dressing, intra-operative traction, surgical versus conservative treatment, abnormal findings during decompression procedure, proposed mechanism of injury, and follow-up. Results: The search yielded 6 articles, of which 4 (13 cases) met inclusion criteria. An additional 2 cases were included in this report totaling 15 cases. The average patient age was 49 years (range: 31-64) with 73% males. At average follow-up of 24 months, 67% of patients experienced complete resolution of symptoms—more than half of which underwent surgical decompression. Patients who failed to progress experienced weakness of the flexor digitorum profundus and flexor pollicis longus muscles. Conclusions: Proposed injury mechanisms for AIN palsy after shoulder arthroscopy range from mechanical trauma, compressive hematoma, and direct anesthetic neurotoxicity. Management should be directed by clinical symptoms, imaging, and patient factors with majority of patients expected to have excellent clinical outcomes.