Brachial plexus block: is a half-ring injection necessary?
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Biomedical subjects
Publications and source records attributed to R Martin.
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Four local or regional anesthesia techniques for the insertion of cardiac pacemaker were studied prospectively in 40 patients. The four techniques studied were: local anesthesia, field block of the supraclavicular nerves, interscalene block at C4, and interscalene block at C6. The three goals of the study were to find the technique that gave the best quality of analgesia, the incidence of complications related to each technique, and the area of sensory innervation of C4. No technique was found to be superior to the others with regard to the quality of analgesia. Interscalene blocks at C4 and C6 were associated with complications and side effects more often than the two other techniques. The authors also suggest that the dermatome of C4 is not under the clavicle but above the clavicle. It was concluded that local anesthesia infiltration at the site of cardiac pacemaker insertion or field block of the supraclavicular nerves are the best techniques for cardiac pacemaker insertion.
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In liver cytosol of adrenalectomized female Wistar rats the concentration of unoccupied glucocorticoid binding sites is increased in ageing compared with young animals. The affinity of hormone to the receptor protein ist not changed significantly.
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Hydrocortisone effect on the transcription intensity of several RNA syntheses in the liver of rats of different age was studied in vivo and in vitro. It was shown that hydrocortisone injection to young and adult animals leads to marked stimulation of RNA synthesis in hepatocytes, manifested in increased specific radioactivity of RNA fractions or enhanced RNA-polymerase A and B activities. In old rats the intensity of the nuclear precursor synthesis of ribosome RNA is also significantly grows under hormone influence, whereas the informative RNA intensity does not markedly change.
By means of the experimental-gerontological literature the question of causality between oxygen and ageing and the age-associated alterations, influencing oxygen utilisation, were discussed. Under normal conditions there are no significant decreases of high-energy compounds in the most organs, although under a strain of organism it is possible to show a reduction of adaptation and regulation on different levels. Oxygen deficiency as a primary cause of ageing could not be showed experimentally. On the other hand the classification of free radicals (= the products of oxygen activation) as primary factors of ageing are more conceivable. The estimation of causal relations is difficult because of the interlocking of physiological and pathological processes of ageing.
We present a patient with severe tricuspid stenosis whom at the age of 13 developed a brain abscess successfully treated by surgical means.