この作品は、博士BorstadにTL1TR001069賞を通じてOSUのCCTSプログラムによって部分的にサポートされていました。我々は、この原稿の最終草案を編集すると彼女の援助のためのアメリアシレス、DPT、NCS彼女の貴重な測定のための洞察力とサラアレキサンダーを承認したいと思います。

1.デザインとビジュアル画面と速攻の作製（必要なすべての機器と材料のための「材料の表」を参照してください）​​： <ol><li>ビジュアル画面 （図1）をアセンブルします。 <ol><li> 10インチ（これらは、画面のベースを形成する）に0.5インチのPVCパイプ（材料A）の4枚をカット。 （これらは、画面の起立部を形成する）は、20インチに0.5インチのPVCパイプの三枚をカット。 </li><li>両方のPVCティーの（パラレル開口部）（B材）に10インチのパイプを2枚挿入します。 PVCティーの（10インチ片に垂直な方向）の残りの穴のそれぞれに20インチのパイプを2枚挿入します。 20インチのパイプの開放端のそれぞれにPVCの肘（材料c）を挿入します。 </li><li>オープン塩ビ肘のそれぞれに第20インチのPVCパイプの両端を挿入します。視覚画面を簡単に折りたたみ/ストレージを希望する場合、PVCジョイントを接着しないでください。必要に応じて接着剤PVCは、永久的な視覚的な画面のためのジョイント部。ドレープピローケース（マテリアトップパイプの上にLD）。バインダークリップ（材料E）または安全ピンで固定します。 </li></ol></li></ol><img alt="図1" src="/files/ftp_upload/53178/53178fig1.jpg" /> 図1：ヘイストのセットアップ参加者がテーブルに座ってする必要があります。参加者とテストオブジェクト間の視覚的な画面。 1裁判のためのオブジェクトが検査キットから削除され、次の順序で参加者に提供されています。テストオブジェクトまず、次の3つの一致する可能性のそれぞれを、 付録1に示すために：管理命令とシートのスコア<a href="https://www.jove.com/files/ftp_upload/53178/53178fig1large.jpg" target="_blank">はこちらをクリックしてくださいこの図の拡大版を表示します。</a> <ol start="2"><li>速攻テストキット（9テスト対象、9サンプルオブジェクトの複製セット、および3例のオブジェクトを含む）（ 図2）を構築 <ol><li> 1.5インチ径のPVCパイプの21個（材料をカットf）は、4インチの長さに。 21ストリップ、各4×7インチにコルク（材料g）をカットします。縫い目やパイプの両端の重なりを確保しないように、PVCの上に、各コルクをオーバーレイ。 </li><li>エッジに過剰コルクフラッシュトリム。コー​​ト万能セメント（材料H）とパイプ（1対1）の21個のそれぞれとコルクで包みます。 </li><li>測定し、自己接着性積層体（材料i）の6 4×7インチ片と茶色の紙（材料j）の6 4×7インチの部分をカット。過剰トリム。自己粘着性ラミネートで6枚をラップします。 </li><li>茶色の紙包装でコーティング万能セメントとラップで6枚を。コー​​トワンピースすべての目的のセメントとし、サンドペーパー（材料K）でラップします。光沢のある厚紙（材料L）を持つすべての目的セメントとラップでコート2枚。 </li><li>測定し、粘土の8個（材料m）、各重量2.2オンスをレイアウト。測定し、粘土の6個、各重量3.2オンスをレイアウト。測定し、粘土の7枚、各重量4.2オンスをレイアウト。 </li><li>金型2 2。固体ブロックに粘土の2オンス、3.2オンス、4.2オンスの作品は、パイプの直径を埋めるために。茶色の紙包装でカバーパイプの中央にそれぞれを挿入します。コルクと自己粘着性ラミネートで覆われたパイプと手順を繰り返し。 </li><li>パイプの直径を埋めるために、固体ブロックに粘土の2 2.2オンス片を成形。光沢のある厚紙やサンドペーパーで覆われたパイプに1で覆われたパイプの中央に1を挿入します。 </li><li>パイプの直径を埋めるために、固体ブロックに粘土の4.2オンスピースを成形。光沢のある厚紙で覆われたパイプの中央に挿入します。 </li><li>クローズドセルパッキングフォーム（材料N）との容量に各パイプを埋めます。 0.1オンスの重量の精度を確保するための成分を秤量します。 </li><li>コー​​ト各エンドキャップ（材料O）は、すべての目的のセメントと、しっかりと各パイプの両端に挿入。 </li><li>審査官に見えるようにした重量（下の）と（上の）数と、各オブジェクトにラベルを付けます。 </li><li>カバーTEStはその後、茶色の紙1T、2Tとコルクと3Tを、オブジェクト、およびそれぞれ、図6、図7、図8オンス重量を量ります。カバーテストは4T、5T、6Tだけをオブジェクトと、それぞれ、図6、図7、図8オンス重量を量ります。カバーテストはコルクと7T、8T、9Tおよびオブジェクトは、自己粘着性ラミネート、それぞれ、図6、図7、図8オンス重量を量ります。 </li><li>ラベルのサンプルは、1-9（テスト対象の正確な複製を）オブジェクト。 </li><li> 3例では、B、Cのカバーの例では、光沢のあるカードストック（それぞれ、6,8オンス）でAとBをオブジェクトオブジェクトラベル。 （6オンス）サンドペーパーの例のオブジェクトCをカバー。 （実施例の目的は、図2に示されていません。） </li><li>痛みやプラスチック製の収納ボックス（材料P）内のすべてのテスト項目を運びます。 </li></ol></li></ol><img alt="図2" src="/files/ftp_upload/53178/53178fig2.jpg" /> 図2：速攻テスト・オブジェクトの組織検査対象が1-9を注文し、「T」が付いています。 N参加者は重量やテクスチャによってテストオブジェクトに一致INEサンプルオブジェクトも、1-9の番号が付けられて、図のように、注文しました。 速攻の​​2.管理： <ol><li>標準の高さのテーブル（〜29インチ）、椅子にシート参加（〜18インチ）。参加者はテーブルの上に快適にテスト腕を休まして移動することができるように高さを調整します。テストアーム、オブジェクト、または審査官を見てから参加者を防ぐために、 図3に示すように、視覚的な画面の下でテストアームを配置します。 注：テストされている参加者がより損なわ上肢を持っている場合、最初にあまり損なわ上肢をテストします。 </li><li>自由に体重とテクスチャ間の違いを決定するために、例のオブジェクトをつかみ、持ち上げるために参加者に指示します。 2つだけのデモ試験のためのフィードバックを提供します。 </li><li>前スコアリングには2つのデモ試験を管理します。参加者は、体重の違いを説明するためにオブジェクトAとBを比較しています。持っています参加者は、テクスチャの違いを説明するために、オブジェクトAとCを比較します。 </li><li>得点試験の試験中に患者のパフォーマンスに関するフィードバックを提供していません。オブジェクトの手動探査で患者を支援しないでください。番号順にオブジェクトを保持することによって、すべての18の試験のための試験材料を整理します。 （ 図2） </li><li> 「手動で最初のテストオブジェクトを探索するために、1つの手を使用します。参加者に口頭で指示を提供します。その後、一試行内の重量や質感が、決して両方によって異なり3可能な一致、のそれぞれを探ります。一致を検索します。答えを決定するために必要な回数だけ各オブジェクトをタッチします。 18件の試験があります。各試験のための5分の最大値を有します。」 </li><li>審査官の裁量や参加者の要求に応じて、テスト投与中にテスト命令を繰り返します。プロパティ（重量やテクスチャを）objectにどのよう彼らは裁判の中に一致している参加者に通知しないでください。 </li><li>彼または彼女の肘や肩の動きは、オブジェクト（ 図3）との間を移動するのを防ぐ場合はスライド、参加者の要求ごとに、離れた参加者の手からに反対と。 </li><li>口頭または一致を検出すると、その選択にポイントすることで自分の選択肢を示し、参加者を持っています。次の試行を管理します。参加者は、任意の方法で、オブジェクトのプロパティを記述するか、彼らは彼らがした試合を選んだ理由を説明していません。 </li><li>手あたり18試行の合計から、正しい一致の数を決定することによって、テストのスコア。管理手順とシートと審査官の誤差を低減するために、 図2に示した組織全体のスコア： 付録1を使用してください 。 </li><li>次の考慮事項と触覚性能の尺度として速攻スコアを分析し、解釈します。 注：速攻のランクの間隔、順序尺度は、一貫性がない可能性があり、Kではないかもしれませんノウン。しかしながら、多くの臨床尺度と同様に、データの区間であるかのように、図4に示すように、統計的推論を適用するために有意義かつ適切であり得ます。 </li></ol><img alt="図3" src="/files/ftp_upload/53178/53178fig3.jpg" /> 図3：参加者に急いオブジェクトを提供するオブジェクトは、参加者の手に入れることができますが、審査官は、オブジェクト操作で参加者を支援することは避けてください。

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The authors declare they have no competing financial interests.

証拠は、体性感覚の回復は、タスク固有のトレーニングを脳卒中後の運動回復に似て必要であることを示唆している。18,19、20をそのため、私たちは触覚受容体としての手のパフォーマンスを改善することを目指した場合、触覚障害が識別されなければならない。15触覚能力を定量化する機会をクリニックや研究室で有効かつ信頼性の高いアウトカム指標の可用性に基づいて、...

愛する人の手の感触を想像してみてください。これは、硬くまたは平滑ですか？強いまたは繊細な？暖かいまたはクール？あなたが握手または絡み合う指でそれを保持していますか？あなたは、メモリを誘発している場合、それはおそらく、触覚タッチと呼ばれる体性感覚情報、またはアクティブな感覚を求めるためにあなたの手の動きを使用する機能に接地されています。触覚タッチで決定することができる特性は、サイズ、形状、重さ、質感、表面コンプライアンス、および温度が含まれます。触覚受容体は、オブジェクトを手動で探査中に活性化され、どちらも肌で発見されている固有受容、筋肉、腱、および関節だけでなく、皮膚の受容体が含まれます。さまざまな手のアクションは、オブジェクトの特性の決意を支援。例えば、繰り返しテクスチャのプロパティを公開することができるオブジェクト全体に横方向擦り運動を行う、またはオブジェクトの重量を明らかにすることができるの手で物を持ち上げます。したがって、両方の手先の器用さとsomatosensationは、触覚、パフォーマンスと人間の経験に不可欠です。 脳卒中に続いて、両方の体性感覚および運動障害の低下触覚性能に貢献しています。1脳卒中後の運動障害が一般的であり、明確に定義され、麻痺のいくつかのレベルを経験脳卒中生存者の約70％。1体性感覚障害が脳卒中後に発生する、また一般的です47-個体の89％2-4。研究者は、皮膚と自己受容の両方の障害は、脳卒中後に共通していることに同意します。読者はキャリーの作品と呼ばれる体性感覚のドメインでストロークの結果の徹底的な特徴づけのためら 、2コネルら 、5とサリバン。4 体性感覚障害が減少リハビリの成果、6上肢の調整、7機能と生活の質に貢献する。8しかし、ク体性感覚障害のantification、特に活性感覚が、原因で体性感覚の喪失が運動障害未満明らかと定量化することがより困難であるという事実に一部臨床実践に欠けている。アクティブな感覚を定量化するために開発されている9対策Byl-Chyneyを含みます-Boczai感覚弁別（BCB）、10改訂ノッティンガム官能評価、11機能触覚物体認識テスト（fTORT）、12マニュアルフォーム知覚テスト（感覚情報とプラクシスのテストのサブセット）、13の立体認知コンポーネントとハプティック物体認識試験（HORT）。14これらの措置は、利用可能であるが、腕や手に障害が脳卒中後の上肢の問題にどのように関係するかを体性感覚説明しようとした最近の系統的レビューは、臨床医や研究者が現在有効に欠けていると結論し、 somatosensationの信頼性をテストします。15 </SUP&gt;したがって、触覚性能の臨床的に有用な、パラメータ音対策の可用性に対処することが不可欠です。 ハンドアクティブ感覚テスト（ヘイスト）もともと2006年16ウィリアムズらによって公表された重量と質感差別の18項目の一致・ツー・サンプルテストは、速攻は、触覚タッチの尺度であり、触覚障害に敏感ですストロークを持つ個体（より少ない13正しい対応で示されています）。速攻を最低基準として、触覚の知覚を測定することを目的として、個人が把握し、手で持ち上げて、腕とテスト手順に従って能力を必要としています。機能し、障害と健康（ICF）モデルの国際分類では、17速攻が活動レベルの測定と考えられています。速攻は、試験手ごとに管理するために15〜30分かかります。速攻の​​利点は、それが安価であることを含む、2015年の材料価格の合計は$ 100と見積もら、および構築し、それが18点満点が「そのまま」または「減損」のより一般的な二分法の特性評価よりも高い解像度に関する性能を提供していますことが容易です。 本稿の目的は、ヘイストの設計、製造、管理を記述することです。それは、元の速攻の出版物からテスト・セット・アップを推測することは可能であるが、本稿では、視覚的な画面と速攻検査キットを製造するための詳細な方法、テスト中に使用されるように両方を提供します。組み立てに必要な機器だけでなく、すべての必要な材料の詳細なリストは、材料の表に記載されています。速攻を投与し、得点するための指示書を備えた単一のシートは、以下のように提供されます。 付録1：速攻管理手順とスコアシートの参加者ID #_______ Date_______ セTアップ：テーブルにテスト参加者を着座（表〜29インチ高と座椅子〜18インチ高）で、テーブルの上に最初に、支配的な以下損なわ上肢休息と組み立て視覚画面下に置きました。試験中、組織を維持する番号順にすべてのオブジェクトを保持します。 実証試験：前得点に2デモ試験を管理します。オブジェクトAとBで参加者を提供し、オブジェクトの重みを比較するために、彼/彼女に指示します。そして、物体AとCで参加者を提供し、オブジェクトのテクスチャを比較するために、彼/彼女に指示します。唯一のデモ試験のためのフィードバックを提供します。 得点試験：それぞれに許可され、5分間の最大で、先端あたり得点18件の試験があります。手動で指定された検査対象物を探索するために、参加者に指示し支配以下損なわ手で（下記の表中の「テスト」を識別される）、その後元この同じ手で（以下各試験ボックス内でそれ以外の番号）は、3つの可能なオブジェクトの一致のそれぞれをplore。一致する可能性は、決して一試行内​​の両方で、体重やテクスチャのいずれかによって異なります。元のオブジェクトの一致を検索し、答えを決定するために必要に応じて、彼らが何回として、各オブジェクトに触れることができ、彼/彼女に伝えるために、参加者に指示します。プロパティ（テクスチャや体重を）objectにどのように彼または彼女は裁判の中にマッチングされた参加者に通知しないでください、とオブジェクトのマニュアル探査で参加者を支援していません。そのオブジェクトの数を周回することにより、以下の表の各試験のための参加者の最終的な答えを示します。参加者が少ない損なわ上肢でのテストを完了した後に、より障害のある上肢をテストします。以下の表を使用して、手あたり18件の試験（以下裁判につき1箱）の合計から、正しい一致の数を決定することによって、テストのスコア。 口頭命令バイト参加者にuctions：「手動で最初のテストオブジェクトを探索するために、1つの手を使用します。その後、重量や質感、決して一試行内​​の両方のいずれかによって異なります3一致する可能性、のそれぞれを探ります。一致を検索します。あなたがあなたの答えを決定する必要があるとして、あなたは何回として、各オブジェクトに触れることができます。 18件の試験があります。各試験のために5分の最大を持っています。」 <img alt="スコアカード" 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.

ウィリアムズらはその研究に基づいて2006年に、速攻の信頼性と妥当性を確立した最初の研究を、公表されたもの13との間とを得点しながら、急いでより少ない13正しいマッチを採点個人は、触覚性能を減損したと考えられています18は損なわれていない触覚性能を有すると考えられる。個々のスコア6以下の正しい対応は、それは偶然のスコアを考えられている16、デザインをサンプリ?...

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.

ハンドアクティブ感覚テスト（ヘイスト）の設計、製造、および管理

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 ビュー.  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. 

ビデオ: 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.

ラットの精巣挙筋の虚血再灌流障害における白血球 - 内皮相互作用のリアルタイムデジタルイメージング（IRI）

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

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.

筋萎縮性側索硬化症の診断で解離極限ハンド筋萎縮の有用性

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.

マウスの背部皮脂商工における虚血性組織損傷：皮膚弁モデル急性永続虚血を調査する

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.

フリー機能性筋肉転送により不可逆顔面神経麻痺が笑うの単段ダイナミック蘇生

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.

2非生物の動物モデルを組み合わせた顕微トレーニング方法：ステップバイステップ

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.

緊急シナリオと設定における医薬品および流体の投与のための新しいアプローチ

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.

間質血管分数濃縮脂肪移植症候性の終わり neuromata の治療のため

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.

味試験: 検証して簡単なテスト

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.

従来のトレイルメイキングテストを新しい評価ツールに変更:デジタルトレイルとウォーキングトレイルメイキングテスト

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.

マウスにおける乾燥粉末製剤の気管内投与

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