Arm function after axillary dissection for breast cancer: a pilot study to provide parameter estimates.

Sixty-three women participated in a study in Calgary, Alberta to assess the rate of arm recovery and factors affecting it up to one year after axillary node dissection for breast cancer. Outcomes included objective measures of swelling, mobility, and strength, and subjective assessments of pain (at rest and with movement) and stiffness. Approximately 42% of women had residual impairment of at least one type one year after surgery, the most common problems being pain (16%) and reduced grip strength (16%). Except for lymphedema, measurements one year after surgery showed little change from measurements at 6 months, suggesting that the shorter follow-up may be appropriate for assessing the long term effects of axillary dissection. Lymphedema was the only sequela which increased over time. The results provide parameter estimates for designing studies to evaluate the role of physiotherapy after axillary dissection.     

同型半胱氨酸对大鼠血管平滑肌细胞胶原蛋白合成及其mRNA表达的影响

目的 :观察同型半胱氨酸 ( Hcy)对血管平滑肌细胞 ( VSMCs)胶原合成的影响 ,并探讨其作用机制。方法 :本实验采用体外培养的大鼠 VSMCs,加入不同浓度的 Hcy,通过 3 H-脯氨酸掺入、α1[ ]型胶原测定观察 Hcy对 VSMCs胶原合成的影响 ,并通过半定量 RT- PCR检测其对 α1[ ]型胶原 m RNA表达的影响。结果 :Hcy促进 VSMCs的胶原合成及 α1[ ]型胶原 m RNA表达 ,并呈剂量依赖效应。结论 :Hcy促进 VSMCs的胶原合成 ,可能是通过促进 α1[ ]型胶原 m RNA表达实现的。提示 Hcy促进胶原合成可能是动脉粥样硬化的发病机制之一     

pH control in rat skeletal muscle during exercise,recovery from exercise,and acute respiratory acidosis

We used ³¹P magnetic resonance spectroscopy to compare the response of rat skeletal muscle to three kinds of proton load. During exercise (tetanic sciatic nerve stimulation), protons from lactic acid were buffered passively and consumed by net hydrolysis of phosphocreatine (PCr). During recovery from exercise, the pH-dependent efflux of protons produced by PCr resynthesis could be partially inhibited by amiloride or 4,4′-diisothiocyanostilbene-2,2′-disulphonate (DIDS), implicating both sodiudproton and bicarbonatelchloride exchange, but was not inhibited by simultaneous respiratory acidosis. In early recovery, up to 30% of proton efflux was mediated by lactatelproton cotransport. During acute respiratory acidosis at rest, the eventual change in muscle pH was consistent with passive buffering and was unaffected by amiloride or DIDS, implying no significant contribution of proton fluxes.     

一次手术治愈外直肌全麻痹

过去，为了保证前段的血液供应，外直肌全麻痹的手术治疗要分２～３次完成，考虑到全麻痹的外直肌已无功能，我们提出在这种条件下可以不动含睫状前动脉的外直肌，只退后内直肌和将上，下直肌的外侧１／２移到外直肌的附着处，如此安排，可以一次手术完成治疗，这样可以缩短治疗时间，减少病人的痛苦和负担，我们治疗了７例８眼，结果比较满意。     

Neuronal adrenergic and muscular cholinergic contractile hypersensitivity in canine jejunum after extrinsic denervation

Extrinsic denervation may be responsible for motor dysfunction after small bowel transplantation. The aim of this study was to examine the role of extrinsic innervation of canine jejunum on contractile activity. An in vitro dose response of cholinergic and adrenergic agonists was evaluated in canine jejunal strips of circular muscle at 0, 2, and 8 weeks in a control group and after jejunoileal extrinsic denervation (EX DEN). Neurons in circular muscle were quantitated by means of immunohistochemical techniques. Adrenergic and cholinergic responses did not differ at any time in the control group. However, at 2 and 8 weeks, extrinsic denervation caused an increased sensitivity to the procontractile effects of the cholinergic agonist bethanechol at the level of the smooth muscle cells, and increased sensitivity to the inhibitory effects of the adrenergic agent norepinephrine mediated at the level of the enteric nervous system. Immunohistochemical analysis showed a reduction in all neurons and a complete lack of adrenergic fibers in the EX DEN group after 2 and 8 weeks. Extrinsic denervation induces enteric neuronal cholinergic and adrenergic smooth muscle hypersensitivity in canine jejunal circular muscle. Presented in part at the annual meeting of the American Gastroenterological Association, Orlando, Florida, May 18, 1999 (poster presentation), and published as an abstract in Gastroenterology 116:A1075, 1999. Supported by United States Public Health Service grant DK39337 from the National Institutes of Health (M.G.S.); the Swiss National Science Foundation; the Swiss Society of Gastroenterology and Hepatology; the Swiss Foundation for Medical and Biological Science; the Novartis Foundation; Astra Zeneca Pharmaceuticals, Switzerland; and the Department of Visceral and Transplantation Surgery, University of Bern, Switzerland.     

Low energy charge and high adenosine content in smooth muscle of human bladder in comparison with striated muscle

Summary This study determined the energy charge, adenosine and inosine content of human bladder smooth muscle in comparison with striated muscle of the same individual. Biopsies were obtained from 21 women who were subjected to urethrocystopexy because of urinary stress incontinence. We found that the ATP content of bladder smooth muscle was only about one-eighth of that of striated muscle. The energy charge of bladder smooth muscle was 0.78±0.13, which is low compared with striated muscle (0.92±0.02). The adenosine content of bladder smooth muscle was 6.7 times higher than striated muscle and the adenosine/ATP ratio was 1∶9 compared with 1∶450 for striated muscle. These findings were in accordance with our previous studies on uterine smooth muscle.     

人心和山羊心脏上、下腔静脉肌袖大体解剖

目的:观测人和山羊上、下腔静脉肌袖结构特点,为治疗局灶性心房颤动积累解剖学资料。方法:采用大体解剖方法观测人心(20例)和羊心(40例)的上、下腔静脉及其表面的心肌纤维。结果:人心上腔静脉肌袖的长和宽分别为(1.91±0.39)cm、(2.41±0.26)cm,下腔静脉肌袖的长和宽分别为(1.32±0.32)cm,(3.06±0.52)cm;羊心上(前)腔静脉肌袖的长和宽分别为(1.41±1.00)cm、(1.05±0.26)cm,下(后)腔静脉肌袖的长和宽分别为(0.81±0.48)cm,(1.03±0.28)cm。人和羊心脏的上腔静脉肌袖出现率均为100%;下腔静脉肌袖的出现率分别为88.89%和98%。肌纤维多数来源于右心房前后壁,也有来自于左心房或左右心房的。结论:①上腔静脉肌袖是人和羊普遍存在的解剖结构,人的下腔静脉肌袖出现率明显低于羊,可能是上腔静脉肌袖引起局灶性心房颤动多于下腔静脉肌袖的解剖学基础。②上腔静脉肌袖是构成左右房的又一重要通路。     

Cross talk in surface electromyograms of human hamstring muscles.

Signals generated from muscles other than the muscle(s) of interest (cross talk) can confound the interpretation of surface electromyograms (EMGs). In this study, the amount of cross talk in surface EMGs of human hamstring muscles was estimated using a protocol in which the quadriceps femoris was electrically stimulated via the femoral nerve. EMGs were recorded from the vastus lateralis and the medial and lateral hamstring muscle groups. The amplitude of the EMG response of the vastus lateralis to electrical stimulation was adjusted to match that of its maximum voluntary effort (MVE) under isometric conditions. Subsequent power density spectrum analysis showed that the median frequencies of the signals generated by electrical stimulation and MVE were not significantly different. In conventional bipolar recordings, cross talk in lateral hamstring EMGs averaged 17.1% MVE and in medial hamstring EMGs 11.3% MVE (average-rectified values). The double differential technique significantly reduced cross talk to 7.6% MVE for the lateral hamstrings, and to 4.2% MVE for the medial hamstrings. The double differential technique appears to be more selective than the bipolar technique when recording EMGs from muscles with highly active neighbors and thus should be used in such situations. Software simulations of the double differential technique also appear to be more selective than the bipolar technique and may be used when the number of amplifiers available is limited.