这项工作是通过TL1TR001069奖Borstad博士俄勒冈州立大学的CCTS计划的部分资助。我们要感谢阿梅利亚·西莱斯，百白破，NCS为她宝贵的测量见解和萨拉·亚历山大为她与编辑这篇稿子的最后草案援助。

1.设计和视觉画面和急速的制造（请参阅“表材料”的所有必需的设备和材料）： <ol><li>组装的视觉屏幕（ 图1）： <ol><li>切成四片0.5英寸的PVC管（材料a）至10英寸（这些形成屏幕的碱）。切成三块0.5英寸PVC管到20英寸（这些形成屏幕的直立部）。 </li><li>将两块10英寸的管道到两个PVC T恤的（并行口）（材料B）。插入两块20英寸的管道进入每个的聚氯乙烯三通的（垂直于10英寸件）剩余的孔。插入聚氯乙烯弯头（材料c）关于每个20英寸管的开口端。 </li><li>插入第三个20英寸PVC管的每个端部到每个开口的PVC肘部。千万不要粘上PVC接头是否可视画面更容易折叠/存储需要。胶PVC接头一个永久性的视觉画面，如果需要的话。斗篷枕头套（本草LD）在顶管。安全与长尾夹（材料e）或安全别针。 </li></ol></li></ol><img alt="图1" src="/files/ftp_upload/53178/53178fig1.jpg" /> 图1：设置了急速的参与者应在一张桌子坐下。参加者与测试对象之间的视觉屏幕。一个试验的对象从检测试剂盒取出，并提供给参与者按以下顺序：测试对象，再分别在三个可能的匹配，在附录1所示的顺序：行政指令和评分表<a href="https://www.jove.com/files/ftp_upload/53178/53178fig1large.jpg" target="_blank">请点击这里查看该图的放大版本。</a> <ol start="2"><li>组装的急速测试试剂盒（包括9测试对象，重复组9样品的对象，和3的例子中的物体）（图2） <ol><li>切21片1.5英寸直径的PVC管（材质六）为4英寸的长度。切软木（材料G）为21条，每4×7英寸。相互叠加软木PVC上，以确保接缝或管道的两端没有重叠。 </li><li>修剪多余的软木刷新到边缘。大衣各21个管（一个接一个）的所有目的水泥（材料H）的，敷用软木塞。 </li><li>测量和切割6 4×7英寸件自粘合体（材料i）和6 4×7英寸件的牛皮纸（材料j）条。修剪多余的。包裹六件与自粘层合体。 </li><li>大衣六件与所有的目的水泥包装用牛皮纸包装。外套一件与所有用途的水泥，敷用砂纸（材料K）。大衣两件与所有用途的水泥，敷有光泽卡片纸（材料1）。 </li><li>测量并制定出八片粘土（材料M），每次称重2.2盎司。测量并制定出六块黏土，每块重3.2盎司。测量并制定出七块粘土，每块重4.2盎司。 </li><li>模二2。2盎司，3.2盎司和4.2盎司件粘土成固体块以填充管的直径。将每到管道盖用牛皮纸包裹的中心。与覆盖着软木和自粘层压管重复步骤。 </li><li>模制两种2.2盎司件粘土成固体块以填充管的直径。将一进一出管覆盖光滑的卡片和一个进入管道覆盖砂纸的中心。 </li><li>模具1 4.2盎司一块粘土成固体块以填充管的直径。插入到管道覆盖光泽卡片的中心。 </li><li>每根管填充与闭孔泡沫包装（材料n）的能力。称量组件，以确保重提高到0.1盎司。 </li><li>大衣各端盖（材料O）的所有用途的水泥，坚决插入到每根管的两端。 </li><li>标记每个对象与重量（在底部）和数（顶部），为是可见的检验。 </li><li>覆盖工商业污水附加费吨对象1T，2T和3T软木塞，然后牛皮纸，并称重到6，7，和8盎司，分别。遮盖试验对象4T，5T，6T和只，体重为6，7和8盎司，分别。遮盖试验对象7T，8T，9T和软木，然后自粘层压体，并称重到6，7，和8盎司，分别。 </li><li>标签样本对象1-9（测试对象的精确副本）。 </li><li>标签的三个示例对象A，B和C盖例如对象A和B有光泽卡片纸（重达6和8盎司，分别）。盖砂纸例如对象C（重达6盎司）。 （实施例的对象未在图2中示出 ）。 </li><li>疼痛和运输所有测试项目均在一个塑料储物箱（材料P）。 </li></ol></li></ol><img alt="图2" src="/files/ftp_upload/53178/53178fig2.jpg" /> 图2：在急速测试的组织对象的测试对象是有序的1-9和标有“T”。 n个INE样品对象，参与者匹配的测试对象（重量）或纹理，也编号1-9和有序的，如图所示。 2.管理匆忙： <ol><li>在标准高度表（〜29英寸）和椅座参与者（〜18英寸）。调整高度，使参与者可以休息和移动测试手臂舒适地放在桌上。将测试臂下一个可视屏幕， 如图3中，为了防止从参与者看到试验臂，对象，或检查者。 注：第一次测试中受损较少上肢，如果被测试的参与者都有一个越障上肢。 </li><li>指导学员掌握和提升的例子对象，以自由决定的重量和质地之间的差异。提供反馈只有两个示范试验。 </li><li>辖两个示范试验之前得分。有与会者比较对象A和B来说明权重的差异。有着参加对象比较A和C来说明质感的差异。 </li><li>在拿下测试试验不提供病人的绩效反馈。不协助病人与手动勘探中的对象。通过保持物体的数字顺序组织测试材料的全部18个试验。 （图2） </li><li>提供口头指示，参与者：“用一只手先手动探索测试对象。然后，探索每三个可能的匹配，它由重量或质感，但从来没有这两个中的一个试验有所不同。找到了比赛。根据需要确定答案触摸​​每个对象多次。会有18试验。最多为5分钟，使每个试验“。 </li><li>考试管理过程中重复测试说明在考官的判断或根据参加者的要求。不要告诉参与者哪个对象属性（重或纹理），他们正在试验中的匹配。 </li><li>滑动反对和远离参加者的手，每参与者的请求时，如果他或她的肘或肩运动防止它们（图3）的对象之间移动。 </li><li>有参加者表示他们的选择口头或通过在找到匹配指着自己的选择。辖下试。没有参与形容，以任何方式，对象的属性或解释为什么他们选择，他们没有比赛。 </li><li>通过确定共有每手18试验正确匹配的数目评分测试。使用附录1：行政指导和评分表，并以减少误差考官如图2所示的整体组织。 </li><li>分析和解释急速分数作为触觉性能以下考虑的措施。 注：在仓促，顺序量表等级之间的间隔可能不一致，不得为known。然而，象许多临床措施，也可能是有意义的，适当的应用统计推断仿佛数据分别为间隔， 如图4。 </li></ol><img alt="图3" src="/files/ftp_upload/53178/53178fig3.jpg" /> 图3：提供的急速对象到与会者的对象可以被放置在参与者的手，但考官应避免协助参与者与对象操作。

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The authors declare they have no competing financial interests.

有证据表明，以下中风类似于马达恢复，体感恢复需要任务的专门培训。18,19，20。因此，如果我们的目标是改善手性能作为触觉受体，触觉障碍必须被识别。15量化触觉能力的机会在临床和实验室受到了限制，在一定程度的基础上，有效和可靠的结果的措施的可用性。而大量的中风患者的体感障碍权证必须要以有效和可靠的临床结果的措施，其中识别障碍，并告知个性化的康复方...

想象一下，一个爱的人的手的感觉。这是老茧或光滑？强或精致？温暖或凉爽？你的握手或十指紧扣持有吗？如果你已经勾起了记忆，它很可能是建立在你使用你的手的运动，征求体感的信息，这就是所谓的触觉触摸，或主动感知能力。能与触觉触摸来确定特征包括大小，形状，重量，质地，表面顺从和温度。触觉受体包括本体感受器，其被发现于皮肤，肌肉，腱和关节，以及皮肤的受体，这两者都手工探索的对象的过程中被激活。不同的手的动作有助于对象特性的测定。例如，多次跨越对象进行横向摩擦运动可能会使纹理特性，或解除对象在手上可以揭示物体的重量。因此，无论是手巧和somatosensation是触觉性能和人类的经验至关重要。 中风后，既体感和运动障碍有助于减弱触觉性能。1卒中后运动障碍是常见的，明确定义的，与中风生还者约70％经历轻瘫的某一水平。1躯体感觉损伤后行程中也很常见，在47-发生89％的个体2-4。研究人员认为，中风后两者皮肤和本体感觉障碍是常见的。对于中风的凯里的体感域，读者可以参考该作品的后果的透彻描述。等，2康奈尔等人，5和Sullivan 4 体感障碍但有助于减少的康复结果，6上肢的协调，7功能和生活质量。8，曲体感障碍，尤其是有源感，的antification是缺乏部分临床实践，由于这一事实，即体感损失少清楚和更难以量化比电动机损伤。已开发量化活性感觉9的措施包括BYL-Chyney -Boczai感官鉴（BCB），10修订诺丁汉感官评价，11的功能触觉物体识别测试（fTORT），12手动表格感知测试（感官信息和现实测试的子集），13的 stereognosis组分和触觉物体识别测试（HORT）。14虽然这些措施，但最近的系统性回顾，试图描述的手臂和手的体感障碍是如何与中风后上肢的问题，得出的结论是临床医生和研究人员目前缺乏有效的，可靠somatosensation测试。15 </SUP&gt;因此，解决的触觉表现临床上有用的参数化和无害措施的可用性是至关重要的。 该手活动感觉测试（急速）的重量和质地歧视的18项比赛对样品测试，最初是由威廉姆斯和他的同事发表于2006年16仓促是触觉触摸的措施，是在触觉障碍敏感中风个人（通过少于13正确匹配表示）。随着急速的目的来衡量触觉感知，作为最小的标准，个人需要的能力，掌握并解除与手和手臂，并按照测试说明。在功能，残疾和健康（ICF）模型，17国际分类急速被认为是活动水平的测量。匆忙需要15-30分钟之间每手测试管理。匆忙的优点包括，它是廉价的，总的材料价格为2015年估计$ 100美元，并容易构造和它的18分制提供有关性能比“完整”或“受损”比较常见的二元特性更高的分辨率。 本文的目的是描述过于匆忙的设计，制造和管理。虽然可以推断测试设置从原来的急速出版物，本文提供了详细的方法用于制造视觉屏幕和一个急速试验试剂盒，在测试过程中都使用。组装所需的设备，以及所需的所有材料的详细列表中列出的材料表中。与管理和得分急速还提供了如下说明单个表： 附录1：急速行政指令和评分表参与者编号#_______ Date_______ 硒牛逼向上：座椅试验参与者在一个表（表〜29英寸高，椅座〜18英寸高）与，最初，在桌子上占主导地位的还是少受损上肢休息和下装配可视屏幕放置。在试验期间，保持所有的对象中的数值以保持组织。 示范试验：辖两个示范试验之前得分。提供对象A和B的参与者，并指示他/她比较对象的权重。然后，提供对象A和C的参与，并指示他/她比较对象的纹理。提供反馈信息只为示范试验。 刻划试验：将有18试验得分每端，最大为5分钟允许每个。指示参与者手工探索规定的试验对象（确定在下表中“测试”）与显性或更少受损手，然后前PLORE每三个可能的目标匹配（低于每一次试验箱内编号以其他方式）与此相同的手。可能的比赛将通过重量或质地各不相同，但从来没有由双方在一个试验。根据需要确定一个答案指导学员找到原始对象的匹配，并告诉他/她，他们可以触摸的每个对象多次。不要告知参与者哪个对象属性（纹理或重量），他或她是一个试验中的匹配，不协助手动探索的对象的参与者。用于指示表中的每个试验参与者的最终答案低于盘旋该对象的数量。测试越障上肢参与完成测试与受损较少上肢后。使用下面的表格，通过确定共有每手18试验（按照以下试一箱）正确匹配的数量得分的考验。 口头INSTRuctions与会人：“用一只手先手动探索测试对象。然后，探索每三个可能的匹配，它由重量或质感，但从来没有由双方在一个试验有所不同。找到了比赛。因为你需要确定你的答案，你可以触摸的每个对象多次。会有18试验。你有最多5分钟，使每个试验。“ <img alt="记分卡" src="/files/ftp_upload/53178/53178scorecard.jpg" />

<table border="0" cellpadding="0" cellspacing="0">
	<tbody>
		<tr>
			<td>Equipment Needed for Assembly</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Tape measure</td>
			<td></td>
			<td></td>
			<td>To measure lengths of materials</td>
		</tr>
		<tr>
			<td>PVC saw</td>
			<td></td>
			<td></td>
			<td>To cut PVC pieces to appropriate lengths given below</td>
		</tr>
		<tr>
			<td>Scissors</td>
			<td></td>
			<td></td>
			<td>To cut paper, cork and laminating material</td>
		</tr>
		<tr>
			<td>Scale accurate to 0.1 ounce</td>
			<td></td>
			<td></td>
			<td>To determine exact weight of test objects</td>
		</tr>
		<tr>
			<td>Sharpie Permanent Marker</td>
			<td></td>
			<td></td>
			<td>To label test item number and weight</td>
		</tr>
		<tr>
			<td>Visual Screen Materials</td>
			<td>Company</td>
			<td>Catalog Number</td>
			<td></td>
		</tr>
		<tr>
			<td>0.5-inch PVC Pipe (Sch. 40 Plain-End Pipe)</td>
			<td>Home Depot</td>
			<td>530048</td>
			<td>104 inches total, will be cut into four 10-inch and three 20-inch pieces</td>
		</tr>
		<tr>
			<td>0.5-inch PVC Tee (Sch. 40 SxSxS Tee)</td>
			<td>Home Depot</td>
			<td>406005RMC</td>
			<td>Two pieces</td>
		</tr>
		<tr>
			<td>PVC Elbow (Lasco 0.5-inch Dia 90 degree PVC Sch 40 Side Outlet Elbow)</td>
			<td>Home Depot</td>
			<td>413005RMC</td>
			<td>Two pieces</td>
		</tr>
		<tr>
			<td>Pillowcase</td>
			<td></td>
			<td></td>
			<td>One to be hung from the PVC frame as a visual shield</td>
		</tr>
		<tr>
			<td>ACCO Binder Clips, Medium</td>
			<td>amazon.com</td>
			<td>72050</td>
			<td>Two to hold the pillowcase to the PVC frame</td>
		</tr>
		<tr>
			<td>Testing Kit Materials</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>1.5-inch PVC Sch. 40 DWV Plain End Pipe</td>
			<td>Home Depot</td>
			<td>531111</td>
			<td>85 inches total, will be cut into 21 4-inch pieces</td>
		</tr>
		<tr>
			<td>Quartet Cork Roll, 1/16-inch thick</td>
			<td>amazon.com</td>
			<td>NA</td>
			<td>1 roll, 24x48 inches, will be cut into 42 4x7-inch pieces to cover all test and example items</td>
		</tr>
		<tr>
			<td>Oatey all purpose cement for CPVC and PVC</td>
			<td>Home Depot</td>
			<td>308213</td>
			<td>8 ounce can, to use to adhere cork, paper and end caps to PVC test items</td>
		</tr>
		<tr>
			<td>Avery Self-Adhesive Laminating Roll</td>
			<td>amazon.com</td>
			<td>73610</td>
			<td>One 24x600-inch roll, will be cut into six 4x7-inches pieces to cover cork on six test objects</td>
		</tr>
		<tr>
			<td>Brown Builder&#39;s Paper</td>
			<td>Home Depot</td>
			<td>35140</td>
			<td>One roll, will be cut into six 4x7-inch pieces to cover cork on six test objects</td>
		</tr>
		<tr>
			<td>3M Pro Grade 9 Sandpaper</td>
			<td>Home Depot</td>
			<td>25060P-G</td>
			<td>One piece 4x7 inches, to use to cover one example item</td>
		</tr>
		<tr>
			<td>Ranger Glossy Cardstock</td>
			<td>amazon.com</td>
			<td>NA</td>
			<td>One 8.5x11-inch, 10-Pack, white, will be cut into two 4x7-inch pieces to cover example items</td>
		</tr>
		<tr>
			<td>Marblex-durable self modeling clay in moist form</td>
			<td>amaco.com/shop/</td>
			<td>X-242</td>
			<td>One 5-pound package, used to achieve correct weights of test objects</td>
		</tr>
		<tr>
			<td>Medium density polyethylene packing foam</td>
			<td>amazon.com</td>
			<td>NA</td>
			<td>One foam sheet, 220 poly, charcoal, 2x24x18 inches, to fill the remaining space in test objects after clay has been inserted</td>
		</tr>
		<tr>
			<td>Knock Out Plug for 1.5-inch PVC</td>
			<td>Home Depot</td>
			<td>85000</td>
			<td>42 caps to seal the ends of the 21 test items</td>
		</tr>
		<tr>
			<td>Sterilite 6-quart plastic storage box</td>
			<td>Home Depot</td>
			<td>16428960</td>
			<td>One to store/transport test objects</td>
		</tr>
	</tbody>
</table>

design, fabrication, and administration of the hand active sensation test (haste)

The concept of personalizing neurologic rehabilitation, based on individual impairments, has experienced a recent surge. In parallel, the number of outcome measures of upper extremity motor performance has grown. However, clinicians and researchers lack practical, quantitative measures of the hand&#8217;s natural role as a receptor of the environment. The Hand Active Sensation Test (HASTe), developed by Williams and colleagues in 2006, is a valid and reliable measure of haptic performance. Though not available commercially, the HASTe can be fabricated from inexpensive materials, and it has been used successfully to identify impairments in haptic touch in individuals with stroke. (Williams, 2006). This paper presents the methods of design and fabrication of the HASTe testing kit, as well as a visual screen to be used during administration, and instructions for the tests administration and scoring.

威廉姆斯和同事发表了最初的研究，从而确立了急速的可靠性和有效性，于2006年在此基础上研究，个人得分少于13日的急速正确的匹配将被视为已受损的触觉表现，而那些13之间的得分和18都被认为具有未受损伤触觉性能。16当个人得分6个或更少正确的匹配，它被认为是一个机会得分，基于在一个18试验/ 3项匹配来样设计的可能性。 时的仓促之重测信度为所有组强（ICC...

Watch this Scientific Journal Video about Design, Fabrication, and Administration of the Hand Active Sensation Test HASTe at JoVE.com

Design, Fabrication, and Administration of the Hand Active Sensation Test HASTe

The Hand Active Sensation Test (HASTe) is a valid and reliable measure of haptic performance, which has been used successfully to identify impaired haptic touch in individuals with stroke. The purpose of this paper is to describe the design, fabrication and administration of the HASTe.

设计，制造管理的手，和活动感觉测试（急速）

The concept of personalizing neurologic rehabilitation, based on individual impairments, has experienced a recent surge. In parallel, the number of ...

design-fabrication-administration-hand-active-sensation-test

Research

JoVE Journal

Medicine

Design, Fabrication, and Administration of the Hand Active Sensation Test (HASTe)

9.0K 次观看.  The Ohio State University. The Hand Active Sensation Test (HASTe) is a valid and reliable measure of haptic performance, which has been used successfully to identify impaired haptic touch in individuals with stroke. The purpose of this paper is to describe the design, fabrication and administration of the HASTe. 

视频: Design, Fabrication, and Administration of the Hand Active Sensation Test HASTe

Real-time Digital Imaging of Leukocyte-endothelial Interaction in Ischemia-reperfusion Injury (IRI) of the Rat Cremaster Muscle

Ischemia-reperfusion injury (IRI) has been implicated in a large array of pathological conditions such as cerebral stroke, myocardial infarction, intestinal ischemia as well as following transplant and cardiovascular surgery.1 Reperfusion of previously ischemic tissue, while essential for the prevention of irreversible tissue injury, elicits excessive inflammation of the affected tissue. Adjacent to the production of reactive oxygen species, activation of the complement system and increased microvascular permeability, the activation of leukocytes is one of the principle actors in the pathological cascade of inflammatory tissue damage during reperfusion.2, 3 Leukocyte activation is a multistep process consisting of rolling, firm adhesion and transmigration and is mediated by a complex interaction between adhesion molecules in response to chemoattractants such as complement factors, chemokines, or platelet-activating factor.4
While leukocyte rolling in postcapillary venules is predominantly mediated by the interaction of selectins5 with their counter ligands, firm adhesion of leukocytes to the endothelium is selectin-controlled via binding to intercellular adhesion molecules (ICAM) and vascular cellular adhesion molecules (VCAM).6, 7 
Gold standard for the in vivo observation of leukocyte-endothelial interaction is the technique of intravital microscopy, first described in 1968.8
Though various models of IRI (ischemia-reperfusion injury) have been described for various organs, 9-12 only few are suitable for direct visualization of leukocyte recruitment in the microvascular bed on a high level of image quality.8 
We here promote the digital intravital epifluorescence microscopy of the postcapillary venule in the cremasteric microcirculation of the rat 13 as a convenient method to qualitatively and quantitatively analyze leukocyte recruitment for IRI-research in striated muscle tissue and provide a detailed manual for accomplishing the technique. We further illustrate common pitfalls and provide useful tips which should enable the reader to truly appreciate, and safely perform the method.
In a step by step protocol we depict how to get started with respiration controlled anesthesia under sufficient monitoring to keep the animal firmly anesthetized for longer periods of time. We then describe the cremasteric preparation as a thin flat sheet for outstanding optical resolution and provide a protocol for leukocyte imaging in IRI that has been well established in our laboratories.

Real-time Digital Imaging of Leukocyte-endothelial Interaction in Ischemia-reperfusion Injury IRI of the Rat Cremaster Muscle

Digital intravital epifluorescence microscopy of postcapillary venules in the cremasteric microcirculation is a convenient method to gain insights into leukocyte-endothelial interaction in vivo in ischemia-reperfusion injury (IRI) of striated muscle tissue. We here provide a detailed protocol to safely perform the technique and discuss its applications and limitations.

实时数字成像大鼠提睾肌缺血再灌注损伤（IRI）的白细胞 - 内皮细胞相互作用

Ischemia-reperfusion injury (IRI) has been implicated in a large array of pathological conditions such as cerebral stroke, myocardial infarction, ...

科研

医学

Utility of Dissociated Intrinsic Hand Muscle Atrophy in the Diagnosis of Amyotrophic Lateral Sclerosis

The split hand phenomenon refers to predominant wasting of thenar muscles and is an early and specific feature of amyotrophic lateral sclerosis (ALS). A novel split hand index (SI) was developed to quantify the split hand phenomenon, and its diagnostic utility was assessed in ALS patients. The split hand index was derived by dividing the product of the compound muscle action potential (CMAP) amplitude recorded over the abductor pollicis brevis and first dorsal interosseous muscles by the CMAP amplitude recorded over the abductor digiti minimi muscle. In order to assess the diagnostic utility of the split hand index, ALS patients were prospectively assessed and their results were compared to neuromuscular disorder patients. The split hand index was significantly reduced in ALS when compared to neuromuscular disorder patients (P&#60;0.0001). Limb-onset ALS patients exhibited the greatest reduction in the split&#160;hand index, and a value of 5.2 or less reliably differentiated ALS from other neuromuscular disorders. Consequently, the split&#160;hand index appears to be a novel diagnostic biomarker for ALS, perhaps facilitating an earlier diagnosis.

Dissociated atrophy of intrinsic hand muscles, termed the split hand, appears to be a specific feature of amyotrophic lateral sclerosis (ALS).&#160;Consequently, a novel neurodiagnostic test, termed the split hand&#160;index, was developed to quantify the clinical phenomenon of the split hand, which differentiated ALS from mimic disorders.

在肌萎缩侧索硬化症的诊断游离本质手部肌肉萎缩实用工具

The split hand phenomenon refers to predominant wasting of thenar muscles and is an early and specific feature of amyotrophic lateral sclerosis (ALS). A ...

Ischemic Tissue Injury in the Dorsal Skinfold Chamber of the Mouse: A Skin Flap Model to Investigate Acute Persistent Ischemia

Despite profound expertise and advanced surgical techniques, ischemia-induced complications ranging from wound breakdown to extensive tissue necrosis are still occurring, particularly in reconstructive flap surgery. Multiple experimental flap models have been developed to analyze underlying causes and mechanisms and to investigate treatment strategies to prevent ischemic complications. The limiting factor of most models is the lacking possibility to directly and repetitively visualize microvascular architecture and hemodynamics. The goal of the protocol was to present a well-established mouse model affiliating these before mentioned lacking elements. Harder et al. have developed a model of a musculocutaneous flap with a random perfusion pattern that undergoes acute persistent ischemia and results in ~50% necrosis after 10 days if kept untreated. With the aid of intravital epi-fluorescence microscopy, this chamber model allows repetitive visualization of morphology and hemodynamics in different regions of interest over time. Associated processes such as apoptosis, inflammation, microvascular leakage and angiogenesis can be investigated and correlated to immunohistochemical and molecular protein assays. To date, the model has proven feasibility and reproducibility in several published experimental studies investigating the effect of pre-, peri- and postconditioning of ischemically challenged tissue.

The window of the murine dorsal skinfold chamber presented visualizes a zone of acute persistent ischemia of a musculocutaneous flap. Intravital epi-fluorescence microscopy permits for direct and repetitive assessment of the microvasculature and quantification of hemodynamics. Morphologic and hemodynamic results can further be correlated with histological and molecular analyses.

在背皮褶商会鼠标的缺血性组织损伤：一个皮瓣模型，探讨急性缺血持续

Despite profound expertise and advanced surgical techniques, ischemia-induced complications ranging from wound breakdown to extensive tissue necrosis are ...

Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer

Unilateral facial paralysis is a common disease that is associated with significant functional, aesthetic and psychological issues. Though idiopathic facial paralysis (Bell&#8217;s palsy) is the most common diagnosis, patients can also present with a history of physical trauma, infectious disease, tumor, or iatrogenic facial paralysis. Early repair within one year of injury can be achieved by direct nerve repair, cross-face nerve grafting or regional nerve transfer. It is due to muscle atrophy that in long lasting facial paralysis complex reconstructive methods have to be applied. Instead of one single procedure, different surgical approaches have to be considered to alleviate the various components of the paralysis.
The reconstruction of a spontaneous dynamic smile with a symmetric resting tone is a crucial factor to overcome the functional deficits and the social handicap that are associated with facial paralysis. Although numerous surgical techniques have been described, a two-stage approach with an initial cross-facial nerve grafting followed by a free functional muscle transfer is most frequently applied. In selected patients however, a single-stage reconstruction using the motor nerve to the masseter as donor nerve is superior to a two-stage repair. The gracilis muscle is most commonly used for reconstruction, as it presents with a constant anatomy, a simple dissection and minimal donor site morbidity.
Here we demonstrate the pre-operative work-up, the post-operative management, and precisely describe the surgical procedure of single-stage microsurgical reconstruction of the smile by free functional gracilis muscle transfer in a step by step protocol. We further illustrate common pitfalls and provide useful tips which should enable the reader to truly comprehend the procedure. We further discuss indications and limitations of the technique and demonstrate representative results.

The use of the masseteric nerve as donor nerve represents a single-stage alternative to the criterion standard two-stage procedure of cross-facial nerve grafting and free muscle transfer in facial paralysis. We provide a detailed description to safely perform this technique with a gracilis muscle transfer and discuss indications and limitations.

在不可逆面瘫的微笑通过免费功能肌肉交接单级动态Reanimation来

Unilateral facial paralysis is a common disease that is associated with significant functional, aesthetic and psychological issues. Though idiopathic ...

Step By Step: Microsurgical training method combining two nonliving animal models

The learning of microsurgical techniques and the maintenance of microsurgical skills have been traditionally based on the use of living animals, mainly laboratory rats. This method although extremely valuable can be economically demanding both for the surgeon and the sponsoring institution; it also requires special training facilities that may not always be available or accessible. Furthermore ethical concerns can limit the use of living animals for training purposes. Alternative training methods, such as inert tubes and gloves have not gained popularity among surgeons since they do not offer an experience similar to that of a clinical situation. Non-living animal models include the use of chicken thighs and wings; they offer a practice experience that resembles a clinical situation to a considerable extent. This type of training is relatively cheap and easily available. The microscope and instruments required can be acquired over the internet, and the chicken pieces can be bought at the local supermarket.
This approach allows a motivated trainee to rehearse different types of surgical techniques several times at a reasonable expense, helping to develop or maintain his surgical expertise if more complex facilities are not available. On the current manuscript we describe how to setup a small practice station, how to dissect the specimens, and how to practice both with the chicken thighs and with the chicken wings in a progressive fashion. This approach takes advantage on the versatility of the chicken thigh model and the small size of the chicken wing Brachial artery.

Here we describe how to set up a small microsurgical practice station and a simple and inexpensive method for the training of microsurgery with non-living animal models.

一步一步：显微外科培训方法相结合的两个无生命的动物模型

The learning of microsurgical techniques and the maintenance of microsurgical skills have been traditionally based on the use of living animals, mainly ...

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings

The available routes of administration commonly used for medications and fluids in the acute care setting are generally limited to oral, intravenous, or intraosseous routes, but in many patients, particularly in the emergency or critical care settings, these routes are often unavailable or time-consuming to access. A novel device is now available that offers an easy route for administration of medications or fluids via rectal mucosal absorption (also referred to as proctoclysis in the case of fluid administration and subsequent absorption). Although originally intended for the palliative care market, the utility of this device in the emergency setting has recently been described. Specifically, reports of patients being treated for dehydration, alcohol withdrawal, vomiting, fever, myocardial infarction, hyperthyroidism, and cardiac arrest have shown success with administration of a wide variety of medications or fluids (including water, aspirin, lorazepam, ondansetron, acetaminophen, methimazole, and buspirone). Device placement is straightforward, and based on the observation of expected effects from the medication administrations, absorption is rapid. The rapidity of absorption kinetics are further demonstrated in a recent report of the measurement of phenobarbital pharmacokinetics. We describe here the placement and use of this device, and demonstrate methods of pharmacokinetic measurements of medications administered by this method.

This study presents a novel device that offers an easy route to quickly provide medications and fluids in patients with limited or difficult IV access. This small-diameter device is placed in the distal third of the rectum, allowing for ongoing medication and fluids administration.

应急方案和设置药物和液体管理的新方法

The available routes of administration commonly used for medications and fluids in the acute care setting are generally limited to oral, intravenous, or ...

Stromal Vascular Fraction-enriched Fat Grafting for the Treatment of Symptomatic End-neuromata

The purpose of this study was to methodically illustrate and highlight the crucial steps of stromal vascular fraction (SVF)-enriched fat grafting as a novel treatment of symptomatic end-neuromata of peripheral sensory nerves, and in this study, specifically of the superficial branch of the radial nerve (SBRN). Despite a multitude of existing treatments, persistent postoperative pain and common pain relapse are still very common, independent of the procedure assessed. The neuroma is microsurgically excised accordingly to standardized protocol. Instead of the relocation of the regenerating nerve stump in neighboring anatomical structures, such as muscle or bone, a fat graft is applied perifocally and acts as a mechanical barrier. In order to reduce the fat resorption rate and boost the regenerative potential of the graft, the highly concentrated SVF is integrated in the grafting. The SVF is isolated from subcutaneous fat by enzymatic and mechanic separation of the lipoaspirate by a specific commercial isolation system. The SVF-enriched fat graft provides both a mechanical barrier and various biological effects at the cellular level, including improving angiogenesis, inflammation, and fibrosis. Both mechanical and biologic effects help to reduce the disorganized axonal outgrowth of the nerve stump during nerve regeneration and hence prevent the recurrence of painful end-neuromata.

The purpose of the study is to illustrate the technical procedure of stromal vascular fraction (SVF)-enriched fat grafting as a novel treatment of symptomatic end-neuromata. This technique provides advantages of both the mechanical barrier and the biological action at the cellular level by the processed and concentrated SVF.

基质血管部分富集脂肪移植治疗症状性端 neuromata

The purpose of this study was to methodically illustrate and highlight the crucial steps of stromal vascular fraction (SVF)-enriched fat grafting as a ...

Taste Exam: A Brief and Validated Test

The emerging importance of taste in medicine and biomedical research, and new knowledge about its genetic underpinnings, has motivated us to supplement classic taste-testing methods in two ways. First, we explain how to do a brief assessment of the mouth, including the tongue, to ensure that taste papillae are present and to note evidence of relevant disease. Second, we draw on genetics to validate taste test data by comparing reports of perceived bitterness intensity and inborn receptor genotypes. Discordance between objective measures of genotype and subjective reports of taste experience can identify data collection errors, distracted subjects or those who have not understood or followed instructions. Our expectation is that fast and valid taste tests may persuade researchers and clinicians to assess taste regularly, making taste testing as common as testing for hearing and vision. Finally, because many tissues of the body express taste receptors, taste responses may provide a proxy for tissue sensitivity elsewhere in the body and, thereby, serve as a rapid, point-of-care test to guide diagnosis and a research tool to evaluate taste receptor protein function.

This protocol measures human taste responses and includes a brief anatomical assessment, a short taste test, and a validation method using the subject&#39;s reported sensation and taste receptor genotype.

味觉考试: 一个简短的验证测试

The emerging importance of taste in medicine and biomedical research, and new knowledge about its genetic underpinnings, has motivated us to supplement ...

Traditional Trail Making Test Modified into Brand-new Assessment Tools: Digital and Walking Trail Making Test

The Trail Making Test (TMT) is a well-accepted tool for evaluating executive function. The standard TMT was invented more than 60 years ago and has been modified into many versions. With the development of digital technologies, TMT is now modified to a digitized version. The present study demonstrated digital TMT (dTMT) performed on a computer, and Walking TMT (WTMT) on the floor. Both revealed more information compared with the traditional version of TMT.

Here, we present a protocol to show how to perform two types of cognitive assessment tools derived from the paper-pencil version of the Trail Making Test.

传统跟踪测试修改为全新的评估工具：数字和步行路线制作测试

The Trail Making Test (TMT) is a well-accepted tool for evaluating executive function. The standard TMT was invented more than 60 years ago and has been ...

Intratracheal Administration of Dry Powder Formulation in Mice

In the development of inhalable dry powder formulations, it is essential to evaluate their biological activities in preclinical animal models. This paper introduces a noninvasive method of intratracheal delivery of dry powder formulation in mice. A dry powder loading device that consists of a 200 &#181;L gel loading pipette tip connected to an 1 mL syringe via a three-way stopcock is presented. A small amount of dry powder (1-2 mg) is loaded into the pipette tip and dispersed by 0.6 mL of air in the syringe. Because pipette tips are disposable and inexpensive, different dry powder formulations can be loaded into different tips in advance. Various formulations can be evaluated in the same animal experiment without device cleaning and dose refilling, thereby saving time and eliminating the risk of cross-contamination from residual powder. The extent of powder dispersion can be inspected by the amount of powder remaining in the pipette tip. A protocol of intubation in mouse with a custom-made light source and a guiding cannula is included. Proper intubation is one of the key factors that influences the intratracheal delivery of dry powder formulation to the deep lung region of the mouse.

Dry powder formulations for inhalation have great potential in treating respiratory diseases. Before entering human studies, it is necessary to evaluate the efficacy of the dry powder formulation in preclinical studies. A simple and noninvasive method of the administration of dry powder in mice through the intratracheal route is presented.

小鼠干粉配方的内经管理

In the development of inhalable dry powder formulations, it is essential to evaluate their biological activities in preclinical animal models. This paper ...