ABSTRACT
The dorsal scapular nerve, a proximal branch of the brachial plexus, may be imaged using ultrasound. This nerve supplies the rhomboid and levator scapulae muscles while providing significant sensory innervation to the scapula. An ultrasound-guided nerve block of the dorsal scapular nerve provided analgesia after surgery of the scapula. Selective blockade of this nerve, without blocking the remainder of the brachial plexus, results in specific analgesia of the scapula, sparing sensory and motor function of the ipsilateral arm.
Subject(s)
Nerve Block/methods , Scapula/innervation , Shoulder/surgery , Adult , Brachial Plexus/diagnostic imaging , Female , Humans , Ultrasonography, InterventionalABSTRACT
Loss of skeletal muscle mass is a poorly understood complication of end-stage liver disease (ESLD). Based on recent stem cell literature, we hypothesized that the potent negative regulator of muscle mass, myostatin, could play a role in the muscle loss associated with ESLD. In this preliminary investigation, we measured myostatin levels in patients undergoing liver transplant evaluation, using a novel enzyme-linked immunosensitivity assay. Myostatin levels were significantly elevated in patients with ESLD compared with healthy controls. These data suggest that myostatin deserves further investigation as a target for therapies designed to preserve muscle mass in patients with ESLD.
