Objective The aim of the study was to investigate the efficacy of immunocytochemistry and related gene detection using cell block for the diagnosis and individualized treatment of advanced lung cancer.Methods Sixty-fi...Objective The aim of the study was to investigate the efficacy of immunocytochemistry and related gene detection using cell block for the diagnosis and individualized treatment of advanced lung cancer.Methods Sixty-five malignant pleural effusion specimens were collected to make cell blocks, which were used for hematoxylin and eosin(H&E) staining, immunocytochemical studies, and gene sequencing of the tumors to guide the individualized diagnoses and treatment of the given tumors. Results The tumor cells in the cell block sections were abundant in number with high quality cellular structures, and the histological morphological characteristics were partially maintained. Immunocytochemical staining was helpful in identifying the cell origin and tumor classification, and amplification refractory mutation system(ARMS) was used to determine the mutation status of epidermal growth factor receptor(EGFR). Of the 65 samples, 50 had a diagnosis of adenocarcinoma, 7 were pulmonary squamous cells, 6 were small cell carcinoma of the lung, and 2 were mesothelioma. The morphological features of the tumors were as follows: acinar formation, papillary and single cells for adenocarcinoma;intercellular bridges for squamous cell carcinoma;and morphology of the small cells is similar to that of the smear. Correlating with the results of immunocytochemical staining and clinical data analysis, 40 cases were confirmed as pulmonary adenocarcinoma, with an additional 4 cases of breast cancer, 3 cases of ovarian adenocarcinoma, and 3 cases of colorectal adenocarcinoma. Of the 47 non-small cell lung carcinoma(NSCLC) patients, EGFR mutations were detected in 26 cases(55.3%) by ARMS, with four mutation types: exon 19 deletion(13 cases, 50.0%), exon 2l point mutations L858R(11 cases, 42.3%) and L861Q(1 case, 3.8%), and exon 18 point mutation G719X(1 case, 3.8%). Conclusion Malignant pleural effusion cell blocks combined with immunocytochemical markers and molecular pathology are helpful for the diagnosis of advanced tumors, the identification of tumor properties and histological tumor origin, and the selection of individualized treatment for advanced lung cancer.展开更多
Objective: The tumor tissues used in molecular pathological detection were usually obtained by surgery, which would cause trauma and may not be suitable for the terminal cancer patients. This paper evaluated the value...Objective: The tumor tissues used in molecular pathological detection were usually obtained by surgery, which would cause trauma and may not be suitable for the terminal cancer patients. This paper evaluated the value of the non-small cell lung cancer(NSCLC) pleural effusion cell blocks as tumor tissues replacement materials in the application of molecular pathological detection. Methods: Tumor cells were made into cell blocks through stratified centrifugal from 30 NSCLC patients with the pleural effusion. The immunohistochemistry, fluorescence in situ hybridization(FISH) and gene sequencing methods were employed in our experiments. Results: The tumor cells of cell block section were rich and could keep part of histological structure. Immunohistochemistry staining could assist diagnosis and tumor parting. Epidermal growth factor receptor(EGFR) FISH-positive was found in 33.33% of the group, high polysomy in 6 cases, amplification in 4 cases. EGFR gene mutations were found in 8 cases of 30 samples, with an incidence of 26.67%, 6 cases were detected in the exon 19, and 2 cases were detected in the exon 21. Conclusion: The NSCLC pleural effusion cell blocks are useful for the diagnosis and determining the primary source of tumor, instructed targeted therapy.展开更多
Great advances in screening have lowered the death rate from cervical cancer in the advanced countries. The major advances in cervical cancer screening include the Papanicolaou (Pap) test and liquid-based cytology (LB...Great advances in screening have lowered the death rate from cervical cancer in the advanced countries. The major advances in cervical cancer screening include the Papanicolaou (Pap) test and liquid-based cytology (LBC). In this study, we aimed to use cell remnants from LBC specimens from uterine cervix and endometrium, aspirates from breast and thyroid tumors, and liquid samples (ascites, pleural effusion, and urine). Cell blocks made from cell remnants of LBC specimens were immunohistochemically or immunocytochemically stained for several biomarkers including certain tumor markers such together with hematoxylin and eosin staining for accurate diagnosis of malignancies in different samples. The findings from the cell blocks stained with these biomarkers combined with those from Pap stain led to easily diagnosis of the presence or absence of malignancies. Our findings suggest the utility of LBC and cell blocks from cell remnants in cytologic diagnosis in certain specimens.展开更多
Programmed cell death （PCD） signaling pathways are import- ant contributors to acute neurological insults such as hypox- ic-ischemic brain damage, traumatic brain injury, stroke etc. The pathogenesis of all these di...Programmed cell death （PCD） signaling pathways are import- ant contributors to acute neurological insults such as hypox- ic-ischemic brain damage, traumatic brain injury, stroke etc. The pathogenesis of all these diseases is closely linked with ab- erration of apoptotic cell death pathways. Mitochondria play a crucial role during PCD, acting as both sensors of death signals, and as initiators of biochemical path- ways, which cause cell death （Bras et al., 2005）. Cytochrome c was the firstly identified apoptogenic factor released from mitochondria into the cytosol, where it induces apoptosome formation through the activation of caspases. Other proteins, such as apoptosis inducing factor （AIF）, have been subsequently identified as mitochondrial released factors. AIF contributes to apoptotic nuclear DNA damage （Bras et al., 2005）. in a caspase-independent way展开更多
BACKGROUND： Endoscopic ultrasound-guided fine-needle aspiration cytology was demonstrated to be a useful tool for the diagnosis and staging of pancreaticobiliary neoplastic le- sions. Nonetheless, the diagnostic valu...BACKGROUND： Endoscopic ultrasound-guided fine-needle aspiration cytology was demonstrated to be a useful tool for the diagnosis and staging of pancreaticobiliary neoplastic le- sions. Nonetheless, the diagnostic value of this procedure may be limited by low cellularity of the specimen, contamination of intestinal cells and unfeasibility of ancillary immunocy- tochemical procedures. The present study was to evaluate its usefulness in the diagnosis of neoplastic lesions.展开更多
The presence of cancer cells in circulating blood and the possibility of colonization in the tissues of the body worsen in a determinant way the prognosis of the disease. Nevertheless, there are factors in the body th...The presence of cancer cells in circulating blood and the possibility of colonization in the tissues of the body worsen in a determinant way the prognosis of the disease. Nevertheless, there are factors in the body that can lead to a prognostic improvement, even in such conditions. In addition to the immune system, other favorable factors can act at the level of the microenvironment of the tumor so much that cases of spontaneous total regression, not only of primary tumors but also metastases, have been reported in the literature. Since it was recently reported that patients with renal tumors and in permanent hemodialysis present at post mortem examination, a metastatic spread much less extensive than observed in patients deceased for renal tumors but not on hemodialysis. The authors maintain it likely that the dialytic membrane concurs to block at least in part the cancer cells circulating in the blood. The possibility to block cancer cells can be extended in addition to the dialytic membrane also to other types of filters inserted in the extracorporeal circulation. The block of the cancer cells thus is obtained and that occurs in regional lymph nodes and in the microenvironment of the tumor causing a relative increase in the elements of the immune system compared to the number of cancer cells, which could determine clearly positive therapeutic results also in cases with advanced metastatic spread.展开更多
Endoscopic transpapillary brush cytology and forceps biopsy during endoscopic retrograde cholangiopancreatology are generally used to obtain pathological evidence of biliary strictures. Recently, the new endoscopic sc...Endoscopic transpapillary brush cytology and forceps biopsy during endoscopic retrograde cholangiopancreatology are generally used to obtain pathological evidence of biliary strictures. Recently, the new endoscopic scraper Trefle~? has been reported and demonstrated high cancer detectability in malignant biliary strictures. This device is used to scrape the stricture over the guidewire, and, in the original method, the tissue and/or cell samples obtained are subjected to histological and/or cytological analysis separately. However, discrimination of chunks of tissue is hampered by the opacity of the surrounding fluid. We have developed a cell block technique for the Trefle~? device without dividing obtained specimens into tissue and cellular components, which is the simplest method and enables immunohistochemical analysis. We present a case of obstructive jaundice diagnosed immunohistochemically as pancreatic metastasis from colon cancer using cell block sections obtained with the Trefle~? device, which procedure is as easy as conventional brush cytology.展开更多
Scaffold-free techniques in the developmental tissue engineering area are designed to mimic in vivo embryonic processes with the aim of biofabricating,in vitro,tissues with more authentic properties.Cell clusters call...Scaffold-free techniques in the developmental tissue engineering area are designed to mimic in vivo embryonic processes with the aim of biofabricating,in vitro,tissues with more authentic properties.Cell clusters called spheroids are the basis for scaffold-free tissue engineering.In this review,we explore the use of spheroids from adult mesenchymal stem/stromal cells as a model in the developmental engineering area in order to mimic the developmental stages of cartilage and bone tissues.Spheroids from adult mesenchymal stromal/stem cells lineages recapitulate crucial events in bone and cartilage formation during embryogenesis,and are capable of spontaneously fusing to other spheroids,making them ideal building blocks for bone and cartilage tissue engineering.Here,we discuss data from ours and other labs on the use of adipose stromal/stem cell spheroids in chondrogenesis and osteogenesis in vitro.Overall,recent studies support the notion that spheroids are ideal"building blocks"for tissue engineering by“bottom-up”approaches,which are based on tissue assembly by advanced techniques such as three-dimensional bioprinting.Further studies on the cellular and molecular mechanisms that orchestrate spheroid fusion are now crucial to support continued development of bottom-up tissue engineering approaches such as three-dimensional bioprinting.展开更多
Four numerical schemes are introduced for the analysis of photocurrent transients in organic photovoltaic devices.Themathematicalmodel for organic polymer solar cells contains a nonlinear diffusion-reaction partial di...Four numerical schemes are introduced for the analysis of photocurrent transients in organic photovoltaic devices.Themathematicalmodel for organic polymer solar cells contains a nonlinear diffusion-reaction partial differential equation system with electrostatic convection attached to a kinetic ordinary differential equation.To solve the problem,Polynomial-based differential quadrature,Sinc,and Discrete singular convolution are combined with block marching techniques.These schemes are employed to reduce the problem to a nonlinear algebraic system.The iterative quadrature technique is used to solve the reduced problem.The obtained results agreed with the previous exact one and the finite element method.Further,the effects of different times,different mobilities,different densities,different geminate pair distances,different geminate recombination rate constants,different generation efficiencies,and supporting conditions on photocurrent have been analyzed.The novelty of this paper is that these schemes for photocurrent transients in organic polymer solar cells have never been presented before,so the results may be useful for improving the performance of solar cells.展开更多
Back interface passivation reduces the back recombination of photogenerated electrons, whereas aggravates the blocking of hole transport towards back contact, which complicate the back interface engineering for ultrat...Back interface passivation reduces the back recombination of photogenerated electrons, whereas aggravates the blocking of hole transport towards back contact, which complicate the back interface engineering for ultrathin CIGSe solar cells with a Schottky back contact. In this work, theoretical explorations were conducted to study how the two contradictory electrical effects impact cell performance. For ultrathin CIGSe solar cells with a pronounced Schottky potential barrier(E_(h)> 0.2 eV), back interface passivation produces diverse performance evolution trends, which are highly dependent on cell structures and properties. Since a back Ga grading can screen the effect of reduced recombination of photogenerated electrons from back interface passivation, the hole blocking effect predominates and back interface passivation is not desirable. However, when the back Schottky diode merges with the main pn junction due to a reduced absorber thickness,the back potential barrier and the hole blocking effect is much reduced on this occasion. Consequently, cells exhibit the same efficiency evolution trend as ones with an Ohmic contact, where back interface passivation is always advantageous.The discoveries imply the complexity of back interface passivation and provide guidance to manipulate back interface for ultrathin CIGSe solar on TCOs with a pronounced Schottky back contact.展开更多
Erector spinae plane block (ESPB) is a novel fascial plane block that was first described in 2016. It is considered an alternative for brachial plexus blocks in shoulder surgeries as the erector spinae muscle extends ...Erector spinae plane block (ESPB) is a novel fascial plane block that was first described in 2016. It is considered an alternative for brachial plexus blocks in shoulder surgeries as the erector spinae muscle extends to the cervical level. Herein, we present a successful multilevel ESPB plus an interscalene block using liposomal bupivacaine in a 45-year-old female patient with metastatic sarcoma who presented for scapula and proximal humerus resection. The post-operative course was smooth, and the patient was discharged home on post-operative day 2 with minimal narcotic requirements.展开更多
以蔗糖、麦芽糖醇及二者复配的三元溶液为渗透溶液,探究渗透脱水处理对黄桃果块质构特性、介电特性、细胞壁多糖含量以及微观结构的变化,并利用核磁共振氢谱(1H nuclear magnetic resonance,1H NMR)技术测定了可溶性糖含量的变化,明确...以蔗糖、麦芽糖醇及二者复配的三元溶液为渗透溶液,探究渗透脱水处理对黄桃果块质构特性、介电特性、细胞壁多糖含量以及微观结构的变化,并利用核磁共振氢谱(1H nuclear magnetic resonance,1H NMR)技术测定了可溶性糖含量的变化,明确麦芽糖醇和蔗糖的协同作用在渗透脱水过程中对黄桃果块特性的改善作用。结果表明:相较于对照组,SM14(蔗糖、麦芽糖醇质量比1∶4的溶液)显著降低黄桃果块的硬度、咀嚼性和黏附性。渗透脱水处理导致黄桃果块的阻抗和有效电阻显著降低,同时诱导静电容量显著增加,表明渗透脱水可能作用于细胞壁多糖而使果肉细胞特性改变。1H NMR检测结果发现,与蔗糖组相比,三元渗透液处理显著降低了黄桃果块组织中蔗糖的含量,其中SM14处理组蔗糖信号强度仅为19803.9±156.00,麦芽糖醇信号强度为54934.9±1239.11。此外,相比较对照组,SM14组水溶性果胶和鳌合性果胶含量均显著增加,分别为(26.63±1.80)mg/g和(21.59±0.71)mg/g,碱溶性果胶含量显著降低,为(27.24±0.46)mg/g。微观结构观察发现,SM14处理组细胞圆润且完整度较高,塌陷程度低,细胞壁厚度明显增加,这可能是由于蔗糖与麦芽糖醇之间的交互作用有对细胞的协同保护作用。因此,蔗糖与麦芽糖醇复配的三元渗透溶液可以有效地改善二元渗透脱水导致的黄桃果块品质劣变等问题,同时拓宽了糖醇的应用场景。展开更多
基金Supported by a grant from the Natural Sciences Foundation of Inner Mongolia(No.2017MS08147)
文摘Objective The aim of the study was to investigate the efficacy of immunocytochemistry and related gene detection using cell block for the diagnosis and individualized treatment of advanced lung cancer.Methods Sixty-five malignant pleural effusion specimens were collected to make cell blocks, which were used for hematoxylin and eosin(H&E) staining, immunocytochemical studies, and gene sequencing of the tumors to guide the individualized diagnoses and treatment of the given tumors. Results The tumor cells in the cell block sections were abundant in number with high quality cellular structures, and the histological morphological characteristics were partially maintained. Immunocytochemical staining was helpful in identifying the cell origin and tumor classification, and amplification refractory mutation system(ARMS) was used to determine the mutation status of epidermal growth factor receptor(EGFR). Of the 65 samples, 50 had a diagnosis of adenocarcinoma, 7 were pulmonary squamous cells, 6 were small cell carcinoma of the lung, and 2 were mesothelioma. The morphological features of the tumors were as follows: acinar formation, papillary and single cells for adenocarcinoma;intercellular bridges for squamous cell carcinoma;and morphology of the small cells is similar to that of the smear. Correlating with the results of immunocytochemical staining and clinical data analysis, 40 cases were confirmed as pulmonary adenocarcinoma, with an additional 4 cases of breast cancer, 3 cases of ovarian adenocarcinoma, and 3 cases of colorectal adenocarcinoma. Of the 47 non-small cell lung carcinoma(NSCLC) patients, EGFR mutations were detected in 26 cases(55.3%) by ARMS, with four mutation types: exon 19 deletion(13 cases, 50.0%), exon 2l point mutations L858R(11 cases, 42.3%) and L861Q(1 case, 3.8%), and exon 18 point mutation G719X(1 case, 3.8%). Conclusion Malignant pleural effusion cell blocks combined with immunocytochemical markers and molecular pathology are helpful for the diagnosis of advanced tumors, the identification of tumor properties and histological tumor origin, and the selection of individualized treatment for advanced lung cancer.
文摘Objective: The tumor tissues used in molecular pathological detection were usually obtained by surgery, which would cause trauma and may not be suitable for the terminal cancer patients. This paper evaluated the value of the non-small cell lung cancer(NSCLC) pleural effusion cell blocks as tumor tissues replacement materials in the application of molecular pathological detection. Methods: Tumor cells were made into cell blocks through stratified centrifugal from 30 NSCLC patients with the pleural effusion. The immunohistochemistry, fluorescence in situ hybridization(FISH) and gene sequencing methods were employed in our experiments. Results: The tumor cells of cell block section were rich and could keep part of histological structure. Immunohistochemistry staining could assist diagnosis and tumor parting. Epidermal growth factor receptor(EGFR) FISH-positive was found in 33.33% of the group, high polysomy in 6 cases, amplification in 4 cases. EGFR gene mutations were found in 8 cases of 30 samples, with an incidence of 26.67%, 6 cases were detected in the exon 19, and 2 cases were detected in the exon 21. Conclusion: The NSCLC pleural effusion cell blocks are useful for the diagnosis and determining the primary source of tumor, instructed targeted therapy.
文摘Great advances in screening have lowered the death rate from cervical cancer in the advanced countries. The major advances in cervical cancer screening include the Papanicolaou (Pap) test and liquid-based cytology (LBC). In this study, we aimed to use cell remnants from LBC specimens from uterine cervix and endometrium, aspirates from breast and thyroid tumors, and liquid samples (ascites, pleural effusion, and urine). Cell blocks made from cell remnants of LBC specimens were immunohistochemically or immunocytochemically stained for several biomarkers including certain tumor markers such together with hematoxylin and eosin staining for accurate diagnosis of malignancies in different samples. The findings from the cell blocks stained with these biomarkers combined with those from Pap stain led to easily diagnosis of the presence or absence of malignancies. Our findings suggest the utility of LBC and cell blocks from cell remnants in cytologic diagnosis in certain specimens.
文摘Programmed cell death （PCD） signaling pathways are import- ant contributors to acute neurological insults such as hypox- ic-ischemic brain damage, traumatic brain injury, stroke etc. The pathogenesis of all these diseases is closely linked with ab- erration of apoptotic cell death pathways. Mitochondria play a crucial role during PCD, acting as both sensors of death signals, and as initiators of biochemical path- ways, which cause cell death （Bras et al., 2005）. Cytochrome c was the firstly identified apoptogenic factor released from mitochondria into the cytosol, where it induces apoptosome formation through the activation of caspases. Other proteins, such as apoptosis inducing factor （AIF）, have been subsequently identified as mitochondrial released factors. AIF contributes to apoptotic nuclear DNA damage （Bras et al., 2005）. in a caspase-independent way
文摘BACKGROUND： Endoscopic ultrasound-guided fine-needle aspiration cytology was demonstrated to be a useful tool for the diagnosis and staging of pancreaticobiliary neoplastic le- sions. Nonetheless, the diagnostic value of this procedure may be limited by low cellularity of the specimen, contamination of intestinal cells and unfeasibility of ancillary immunocy- tochemical procedures. The present study was to evaluate its usefulness in the diagnosis of neoplastic lesions.
文摘The presence of cancer cells in circulating blood and the possibility of colonization in the tissues of the body worsen in a determinant way the prognosis of the disease. Nevertheless, there are factors in the body that can lead to a prognostic improvement, even in such conditions. In addition to the immune system, other favorable factors can act at the level of the microenvironment of the tumor so much that cases of spontaneous total regression, not only of primary tumors but also metastases, have been reported in the literature. Since it was recently reported that patients with renal tumors and in permanent hemodialysis present at post mortem examination, a metastatic spread much less extensive than observed in patients deceased for renal tumors but not on hemodialysis. The authors maintain it likely that the dialytic membrane concurs to block at least in part the cancer cells circulating in the blood. The possibility to block cancer cells can be extended in addition to the dialytic membrane also to other types of filters inserted in the extracorporeal circulation. The block of the cancer cells thus is obtained and that occurs in regional lymph nodes and in the microenvironment of the tumor causing a relative increase in the elements of the immune system compared to the number of cancer cells, which could determine clearly positive therapeutic results also in cases with advanced metastatic spread.
文摘Endoscopic transpapillary brush cytology and forceps biopsy during endoscopic retrograde cholangiopancreatology are generally used to obtain pathological evidence of biliary strictures. Recently, the new endoscopic scraper Trefle~? has been reported and demonstrated high cancer detectability in malignant biliary strictures. This device is used to scrape the stricture over the guidewire, and, in the original method, the tissue and/or cell samples obtained are subjected to histological and/or cytological analysis separately. However, discrimination of chunks of tissue is hampered by the opacity of the surrounding fluid. We have developed a cell block technique for the Trefle~? device without dividing obtained specimens into tissue and cellular components, which is the simplest method and enables immunohistochemical analysis. We present a case of obstructive jaundice diagnosed immunohistochemically as pancreatic metastasis from colon cancer using cell block sections obtained with the Trefle~? device, which procedure is as easy as conventional brush cytology.
基金the Coordination for the Improvement of Higher Education Personnel(CAPES),No.88882.366181/2019-01the Carlos Chagas Filho Foundation for Research Support of the State of Rio de Janeiro(FAPERJ),No.E-26/202.682/2018National Council for Scientific and Technological Development(CNPq),No.467513/2014-7
文摘Scaffold-free techniques in the developmental tissue engineering area are designed to mimic in vivo embryonic processes with the aim of biofabricating,in vitro,tissues with more authentic properties.Cell clusters called spheroids are the basis for scaffold-free tissue engineering.In this review,we explore the use of spheroids from adult mesenchymal stem/stromal cells as a model in the developmental engineering area in order to mimic the developmental stages of cartilage and bone tissues.Spheroids from adult mesenchymal stromal/stem cells lineages recapitulate crucial events in bone and cartilage formation during embryogenesis,and are capable of spontaneously fusing to other spheroids,making them ideal building blocks for bone and cartilage tissue engineering.Here,we discuss data from ours and other labs on the use of adipose stromal/stem cell spheroids in chondrogenesis and osteogenesis in vitro.Overall,recent studies support the notion that spheroids are ideal"building blocks"for tissue engineering by“bottom-up”approaches,which are based on tissue assembly by advanced techniques such as three-dimensional bioprinting.Further studies on the cellular and molecular mechanisms that orchestrate spheroid fusion are now crucial to support continued development of bottom-up tissue engineering approaches such as three-dimensional bioprinting.
文摘Four numerical schemes are introduced for the analysis of photocurrent transients in organic photovoltaic devices.Themathematicalmodel for organic polymer solar cells contains a nonlinear diffusion-reaction partial differential equation system with electrostatic convection attached to a kinetic ordinary differential equation.To solve the problem,Polynomial-based differential quadrature,Sinc,and Discrete singular convolution are combined with block marching techniques.These schemes are employed to reduce the problem to a nonlinear algebraic system.The iterative quadrature technique is used to solve the reduced problem.The obtained results agreed with the previous exact one and the finite element method.Further,the effects of different times,different mobilities,different densities,different geminate pair distances,different geminate recombination rate constants,different generation efficiencies,and supporting conditions on photocurrent have been analyzed.The novelty of this paper is that these schemes for photocurrent transients in organic polymer solar cells have never been presented before,so the results may be useful for improving the performance of solar cells.
基金Project supported by the National Natural Science Foundation of China (Grant No. 51802240)。
文摘Back interface passivation reduces the back recombination of photogenerated electrons, whereas aggravates the blocking of hole transport towards back contact, which complicate the back interface engineering for ultrathin CIGSe solar cells with a Schottky back contact. In this work, theoretical explorations were conducted to study how the two contradictory electrical effects impact cell performance. For ultrathin CIGSe solar cells with a pronounced Schottky potential barrier(E_(h)> 0.2 eV), back interface passivation produces diverse performance evolution trends, which are highly dependent on cell structures and properties. Since a back Ga grading can screen the effect of reduced recombination of photogenerated electrons from back interface passivation, the hole blocking effect predominates and back interface passivation is not desirable. However, when the back Schottky diode merges with the main pn junction due to a reduced absorber thickness,the back potential barrier and the hole blocking effect is much reduced on this occasion. Consequently, cells exhibit the same efficiency evolution trend as ones with an Ohmic contact, where back interface passivation is always advantageous.The discoveries imply the complexity of back interface passivation and provide guidance to manipulate back interface for ultrathin CIGSe solar on TCOs with a pronounced Schottky back contact.
文摘Erector spinae plane block (ESPB) is a novel fascial plane block that was first described in 2016. It is considered an alternative for brachial plexus blocks in shoulder surgeries as the erector spinae muscle extends to the cervical level. Herein, we present a successful multilevel ESPB plus an interscalene block using liposomal bupivacaine in a 45-year-old female patient with metastatic sarcoma who presented for scapula and proximal humerus resection. The post-operative course was smooth, and the patient was discharged home on post-operative day 2 with minimal narcotic requirements.
