Effect of Pulsed and Continuous Ultrasound Therapy on the Degree of Collateral Axonal Branching at the Lesion Site,Polyinnervation of Motor End Plates,and Recovery of Motor Function after Facial Nerve Reconstruction

The aim of the present study is to test whether ultrasound therapy of muscles denervated by nerve injury would improve the quality of their reinnervation by reduction of the collateral axonal branching at the lesion site and poly-innervation degree at the neuromuscular junctions. After transection and suture of the buccal branch of the facial nerve, pulsed or continuous type of ultrasound therapy was applied to the paralyzed whisker pad muscles of rats in the course of 2 months. Instead of reduction, we found a significant increase in the collateral axonal branching after continuous ultrasound therapy when compared to the branching determined after pulsed or sham ultrasound therapy. Both types of ultrasound therapy also failed to reduce the proportion of polyinnervated end plates in the reinnervated facial muscles. Accordingly, continuous ultrasound therapy failed to restore any parameter of the motor performance of the vibrissal hairs. Application of pulsed ultrasound therapy promoted slight improvements of the functional parameters angular velocity and acceleration. The inhomogeneous structural and functional results achieved after both types of ultrasound therapy let us conclude that further studies are required to evaluate its effects on peripheral nerve regeneration. Anat Rec, 302:1314–1324, 2019. © 2019 Wiley Periodicals, Inc.     

Cardiac Denervation for Arrhythmia Treatment with Transesophageal Ultrasonic Strategy in Canine Models

Stellate ganglion (SG) modification has been investigated for arrhythmia treatment. In this study, transesophageal SG imaging and intervention were explored using a homemade 30F integrated focused ultrasonic catheter in healthy mongrel canines in vivo. Anatomic details of SGs were ultrasonically imaged and evaluated. SG had a heterogeneous echoic structure and characteristic profiles sketched by hyper-echoic outlines in an ultrasonogram. Left SGs in the experimental group were successfully ablated through the esophagus under ultrasonic guidance provided by the catheter itself. Two weeks after the ablation, the QT and QTc of the experimental group decreased compared with those of the sham group and at baseline (both p values < 0.001). Histologic examination revealed that left SGs were destroyed. No major complications were observed. This approach may be further explored as a method for ganglia remodeling evaluation and as a strategy of ganglia modification for arrhythmia and for other diseases.     

Prenatal diagnosis of caudal regression with heterotaxy syndrome: “A mermaid with a broken heart”

Caudal regression syndrome (CRS) is a rare congenital malformation with varying degrees of early gestational developmental failure. It is characterized by agenesis of the sacrum and lumbar spine, with lower limb neurological deficit and accompanying deformities of the pelvis, lower extremities, genitourinary, and gastrointestinal systems. We report a case of CRS associated with rare complex congenital heart defect, that is, heterotaxy syndrome, diagnosed prenatally.     

Ultrasound‐Guided Therapeutic Scapulothoracic Interval Injections

Scapulothoracic pain is a common ailment, but the underlying cause can be difficult to diagnose in a timely manner, and treatment options are limited. We retrospectively review our experience using ultrasound‐guided therapeutic scapulothoracic interval steroid injections to treat scapulothoracic pain and review correlative magnetic resonance imaging findings over a 5‐year period. Although a variety of structural causes are known to cause scapulothoracic pain, in our experience, most cases lack correlative imaging findings. Ultrasound‐guided scapulothoracic interval injections provide a safe, easily performed diagnostic and therapeutic tool for treating patients with periscapular pain, providing at least short‐term symptom relief.     

高强度聚焦超声联合甲氨蝶呤在瘢痕子宫妊娠行宫腔镜微创清宫术中的应用效果分析

目的 探究采用高强度聚焦超声(HIFU)联合甲氨蝶呤(MTX)在瘢痕子宫妊娠行宫腔镜微创清宫术中的应用效果。方法 选择2018年5月—2019年5月在本院接受宫腔镜治疗的108例瘢痕子宫妊娠患者,依据随机数字表法分为研究组与对照组,每组各54例。对照组使用HIFU预处理,研究组则使用HIFU联合MTX的方式预处理,处理后两组均行宫腔镜辅助微创清宫术。通过随访分析比较两组的治疗效果及妊娠结局。结果 研究组术后7 d血清β-HCG水平为(28 598.38±2 176.52)U/L,低于对照组的(32 423.13±2 734.65)U/L,差异有统计学意义(t=8.042,P<0.001);研究组血清β-HCG转阴时间、月经恢复时间、住院时间分别为(21.33±3.78)d、(28.21±3.83)d、(6.53±2.12)d,分别短于对照组的(26.72±4.83)d、(33.82±4.91)d、(9.53±2.67)d,差异具有统计学意义(t=6.458、6.620、6.466,P均<0.001)。两组均随访≥24个月,宫内妊娠、未孕、流产、再次瘢痕子宫妊娠、异位妊娠比较,差异无统计学意义(χ2=1.895,P>0.05);宫内妊娠中足月分娩与早产比较,差异无统计学意义(χ2=0.131,P>0.05),研究组并发症发生率为22.58%,低于对照组的37.50%,差异有统计学意义(χ2=5.296,P=0.021)。结论 在宫腔镜辅助微创清宫术治疗瘢痕子宫妊娠前使用HIFU联合MTX预处理的效果优于单一使用HIFU预处理,可明显缩短患者血清β-HCG转阴时间、月经恢复时间与住院时间,但对女性的妊娠结局无影响,妇产科临床治疗前可结合患者需求择取最合适的预处理方案。