- Ultrasonography-guided anterior approach for axillary nerve blockade: An anatomical study. [Journal Article]
- CAClin Anat 2019 May 03
- Combined ultrasound (US)-guided blockade of the suprascapular and axillary nerves (ANs) has been proposed as an alternative to interscalene blockade for pain control in shoulder joint pathology or po…
Combined ultrasound (US)-guided blockade of the suprascapular and axillary nerves (ANs) has been proposed as an alternative to interscalene blockade for pain control in shoulder joint pathology or postsurgical care. This technique could help avoid respiratory complications and/or almost total upper limb palsy. Nowadays, the AN blockade is mostly performed using an in-plane caudal-to-cephalic approach from the posterior surface of the shoulder, reaching the nerve immediately after it exits the neurovascular quadrangular space (part of the spatium axillare). Despite precluding most respiratory complications, this approach has not made postsurgical pain relief any better than an interscalene blockade, probably because articular branches of the AN are not blocked.Cephalic-to-caudal methylene blue injections were placed in the first segment of the AN of six Thiel-embalmed cadavers using an US-guided anterior approach in order to compare the distribution with that produced by a posterior approach to the contralateral AN in the same cadaver. Another 21 formalin-fixed cadavers were bilaterally dissected to identify the articular branches of the AN.We found a good spread of the dye on the AN and a constant relationship of this nerve with the subscapularis muscle. The dye reached the musculocutaneous nerve, which also contributes to shoulder joint innervation. We describe the anatomical landmarks for an ultrasonography-guided anterior AN blockade and hypothesize that this anterior approach will provide better pain control than the posterior approach owing to complete blocking of the joint nerve. Clin. Anat., 2019. © 2019 Wiley Periodicals, Inc.
- Hominem Sine Opus Spatium: Where Do the Ideas Come from to Move the Brain, Mind, Behaviour and Neurosciences in Malaysia? [Editorial]
- MJMalays J Med Sci 2018; 25(2):1-14
- People can work wonders without a room. Rooms make people think within a box, and people who are not confined within a room can wonder while thinking and solve problems as they see them in the enviro…
People can work wonders without a room. Rooms make people think within a box, and people who are not confined within a room can wonder while thinking and solve problems as they see them in the environment. The dearth in the growth of professionals trained in the neurosciences who will use neurotechnology in the future is a dire situation facing Malaysia, according to the Academy of Sciences Malaysia's 2017 Emerging Science, Engineering and Technology (ESET) study. Further, this human resource needs to be fundamentally cultivated at schools from a very young age. The author describes the activities that have taken place in the country via a bottom-up approach over the last two years and hopes that eventually these endeavours will end with the creation of an ASEAN Brain, Mind, Behaviour and Neuroscience Institute for Creativity and Innovation being established with the full support of the Government of Malaysia or other local and international financial donors.
- Treatment of multi-segmental cervical spondylotic myelopathy by posterior spatium intermusculare approach for spinal canal expansion and laminoplasty. [Journal Article]
- MCMinerva Chir 2018; 73(2):248-249
- Percutaneous versus traditional and paraspinal posterior open approaches for treatment of thoracolumbar fractures without neurologic deficit: a meta-analysis. [Review]
- ESEur Spine J 2017; 26(5):1418-1431
- CONCLUSIONS: The functional and the radiological outcome of percutaneous approach would be better than open approach in the long term. Although trans-muscular spatium approach belonged to open fixation methods, it was strictly defined as less invasive approach, which provided less injury to the paraspinal muscles and better reposition effect.
- [Mini-open trans-spatium intermuscular versus percutaneous short-segment pedicle fixation for the treatment of thoracolumbar mono-segmental vertebral fractures]. [Journal Article]
- ZGZhongguo Gu Shang 2015; 28(11):1008-12
- CONCLUSIONS: The mini-open trans-spatium intermuscular and percutaneous short-segment pedicle fixation have similar clinical effects and radiographic outcomes in treating thoracolumbar mono-segmental vertebral fractures without neurological deficits. However, in this study, the mini-open trans-spatium intermuscular approach has a short learning curve and more advantages in hospitalization cost and intraoperative radiation exposure times, and is recommendable.
- [Application of the expanding forming under the plate through cervical spatium intermusculare approach in treating multi-segmental myelopathic cervical spondylosis]. [Journal Article]
- ZGZhongguo Gu Shang 2015; 28(9):815-9
- CONCLUSIONS: Application of the expanding forming under the plate through cervical spatium intermusculare approach to treat multi-segmental myelopathic cervical spondylosis, through muscular clearance, can retain complete cervical back muscle, maintain stability of cervical spine, and vertebral canal can get effective decompression at the same time.
- [Laparoscopic resection of persistent patent urachus]. [Case Reports]
- OHOrv Hetil 2015 Sep 20; 156(38):1547-50
- The urachus in the foetus is a fibromuscular duct, which connects the allantois to the bladder and it is usually occluded in the 4-5th gestation months. Incomplete occlusion of the urachus at the tim…
The urachus in the foetus is a fibromuscular duct, which connects the allantois to the bladder and it is usually occluded in the 4-5th gestation months. Incomplete occlusion of the urachus at the time of birth is considered to be physiological, but later it can lead to recurrent discharge and inflammation of the umbilicus. To establish the diagnosis, ultrasound is the first examination of choice. A 19-year old obese female patient presented with umbilical discharge, and a persistent urachus was detected by ultrasound. After incision of the peritoneum the duct was excised from the umbilicus to the dome of the bladder by 3-port laparoscopy where the duct was clipped. The operation time was 38 minutes. The patient required minor analgesia on one single occasion in the postoperative period and was discharged on the first postoperative day. The authors recommend laparoscopic operation for the urachal remnant; the enlarged duct on the ventral abdominal wall can be better detected from the umbilicus to the Retzius spatium with 30-degree camera, and the cosmetic outcome is also more favourable.
- Reimplanting large section of free infected tibia which revascularised in spatium intermusculare to repair bone defect: A case report. [Case Reports]
- IInjury 2015; 46(11):2288-91
- Ectopic osteogenesis and scaffold biodegradation of nano-hydroxyapatite-chitosan in a rat model. [Journal Article]
- PlosPLoS One 2015; 10(8):e0135366
- The bone-formation and scaffold-biodegradation processes have not been fully characterized. This study aimed to determine the osteogenic ability of nHA-CS osteo-induced bone marrow mesenchymal stem c…
The bone-formation and scaffold-biodegradation processes have not been fully characterized. This study aimed to determine the osteogenic ability of nHA-CS osteo-induced bone marrow mesenchymal stem cell (BMSC) composites and to explore the relationship between bone formation and scaffold biodegradation. The nHA-CS osteo-induced BMSC composites (nHA-CS+cells group) and the nHA-CS scaffolds (nHA-CS group) were implanted into the femoral spatium intermusculare of SD rats. At 2, 4, 6, 8, and 12 weeks post-implantation, the rat femurs were scanned using computerized tomography (CT), and the CT values of the implants were measured and comparatively analyzed. The implants were then harvested and subjected to hematoxylin and eosin (HE) and Masson's trichrome staining, and the percentages of bone area, scaffold area and collagen area were compared between the two groups. The CT values of the implants were higher in the nHA-CS+cells group than the nHA-CS group at the same time points (P < 0.05). Histological analysis revealed that de novo bone and collagen formation in the pores of the scaffolds gradually increased from 2 weeks post-implantation in both groups and that the scaffold gradually degraded as bone formation proceeded. However, more de novo bone and collagen formation and scaffold degradation occurred in the nHA-CS+cells group than in the nHA-CS group at the same time points (P < 0.05). In conclusion, nHA-CS osteo-induced BMSC composites are promising bone tissue engineering substitutes, and osteo-induced BMSCs can significantly enhance the osteogenic ability and play an active role in the degradation of nHA-CS scaffolds on par with bone formation.
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- Hematopoietic stem and progenitor cells can be enriched by implanting biomaterial into spatium intermusculare. [Journal Article]
- BRBiomed Res Int 2015; 2015:398642
- Hematopoietic stem and progenitor cells (HSPCs) have been used successfully to treat patients with cancer and disorders of the blood and immune systems. In this study, we tried to enrich HSPCs by imp…
Hematopoietic stem and progenitor cells (HSPCs) have been used successfully to treat patients with cancer and disorders of the blood and immune systems. In this study, we tried to enrich HSPCs by implanting biomaterials into the spatium intermusculare of mice hind limbs. Gelatine sponges were implanted into the spatium intermusculare of mice and then retrieved after 12 days. The presence of HSPCs in the migrating cells (MCs) was detected by phenotypically probing with CD34(+)Sca-1(+) and functionally confirming the presence of using colony-forming cell assay and assessing the long-term reconstitution ability. The frequency of CD34(+), Sca-1(+), and CD34(+)Sca-1(+) cells and colony formation unit in the MCs was much higher than that in the bone marrow (BM). Moreover, transplanted MCs were able to home to BM, muscle, and spleen, which induced an efficient long-term hematopoietic reconstitution in vivo. In addition, HSPCs within the MCs originated from the BM. Furthermore, the administration of G-CSF greatly reduced the time of implantation, and increased the number of MCs and frequency of HSPCs in the MCs. These data provide compelling evidence that HSPCs can be enriched by implanting biomaterial into spatium intermusculare. Implantation of biomaterial may be seen as the first step to a proof of their applicability to clinical practice in enriching HSPCs.