Diffusion of contrast medium after perineural injection of the palmar nerves: an in vivo and in vitro study

REASONS FOR PERFORMING STUDY: Proximal diffusion of local anaesthetic solution after perineural anaesthesia may lead to the desensitisation of structures other than those intended. However, there is no evidence-based study demonstrating the potential distribution and diffusion of local anaesthetic solution after perineural analgesia in the distal limb. OBJECTIVE: To document the potential diffusion of local anaesthetic solution using a radiopaque contrast model and to evaluate the influence of walking compared with confinement in a stable after injection. METHODS: Radiopaque contrast medium was injected subcutaneously over one palmar nerve at the base of the proximal sesamoid bones in 6 nonlame mature horses. Horses were assigned randomly to stand still or walk after injection. Radiographs were obtained 0, 5, 10, 15, 20 and 30 min after injection and were analysed to determine the distribution and diffusion of the contrast medium. RESULTS: In 89% of injections an elongated pattern of the contrast medium was observed suggesting distribution along the neurovascular bundle. After 49% of injections a fine radiopaque line extended proximally from the contrast 'patch', and in 25% of injections a line extended distally. There was significant proximal and distal diffusion with time when sequential radiographs of each limb were compared. The greatest diffusion occurred in the first 10 min. Walking did not significantly influence the extent of either proximal or distal diffusion. CONCLUSIONS AND POTENTIAL RELEVANCE: Significant proximal diffusion occurs in the first 10 min after perineural injection in the distal aspect of the limb and should be considered when interpreting nerve blocks. Distribution of local anaesthetic solution outside the fascia surrounding the neurovascular bundle or in lymphatic vessels may explain delayed or decreased effects.

Translational diffusion of water in compacted clay systems

The translational diffusion of water in compacted clays at a high hydration level has been investigated by quasielastic neutron scattering at a time-of-flight spectrometer FOCUS (SINQ). Four compacted clays with systematic structural differences have been studied: Na-montmorillonite, Na-illite, kaolinite and pyrophyllite. The QENS experiments were performed using two different incident wavelengths in order to access a larger Q range and verify the data analysis. The translational diffusion coefficient for water in Na-montmorillonite and Na-illite are lower than those for bulk water, whereas the preliminary results for kaolinite and pyrophyllite show larger diffusion coefficient.

In-situ diffusion of HTO, 22Na+, Cs+ and I- in Opalinus Clay at the Mont Terri underground rock laboratory

The diffusion properties of the Opalinus Clay were studied in the underground research laboratory at Mont Terri (Canton Jura, Switzerland) and the results were compared with diffusion data measured in the laboratory on small-scale samples. The diffusion of HTO, Na-22(+), Cs+ and I- were investigated for a period of 10 months. The diffusion equipment used in the field experiment was designed in such a way that a solution of tracers was circulated through a sintered metal screen placed at the end of a borehole drilled in the formation. The concentration decrease caused by the diffusion of tracers into the rock could be followed with time and allowed first estimations of the effective diffusion coefficient. After 10 months, the diffusion zone was over-cored and the tracer profiles measured. From these profiles, effective diffusion coefficients and rock capacity factors Could be extracted by applying a two-dimensional transport model including diffusion and sorption. The simulations were done with the reactive transport code CRUNCH. In addition, results obtained from through-diffusion experiments oil small-sized samples with HTO, Cl-36(-) and Na-22(+) are presented and compared with the in situ data. In all cases. excellent agreement between the two data sets exists. Results for Cs+ indicated five times higher diffusion rates relative to HTO. Corresponding laboratory diffusion measurements are still lacking. However. our Cs+ data are in qualitative agreement wish through-diffusion data for Callovo-Oxfordian argillite rock samples. which also indicate significantly higher effective diffusivities for Cs+ relative to HTO.

Diffusion of HTO, Br-, I-, Cs+, Sr-85(2+) and Co-60(2+) in a clay formation: Results and modelling from an in situ experiment in Opalinus Clay

The migration of radioactive and chemical contaminants in clay materials and argillaceous host rocks is characterised by diffusion and retention processes. Valuable information on such processes can be gained by combining diffusion studies at laboratory scale with field migration tests. In this work, the outcome of a multi-tracer in situ migration test performed in the Opalinus Clay formation in the Mont Terri underground rock laboratory (Switzerland) is presented. Thus, 1.16 x 10(5) Bq/L of HTO, 3.96 x 10(3) Bq/L of Sr-85, 6.29 x 10(2) Bq/L of Co-60, 2.01 x 10(-3) mol/L Cs, 9.10 x 10(-4) mol/L I and 1.04 x 10(-3) mol/L Br were injected into the borehole. The decrease of the radioisotope concentrations in the borehole was monitored using in situ gamma-spectrometry. The other tracers were analyzed with state-of-the-art laboratory procedures after sampling of small water aliquots from the reservoir. The diffusion experiment was carried out over a period of one year after which the interval section was overcored and analyzed. Based on the experimental data from the tracer evolution in the borehole and the tracer profiles in the rock, the diffusion of tracers was modelled with the numerical code CRUNCH. The results obtained for HTO (H-3), I- and Br- confirm previous lab and in situ diffusion data. Anionic fluxes into the formation were smaller compared to HTO because of anion exclusion effects. The migration of the cations Sr-85(2+), Cs+ and Co-60(2+) was found to be governed by both diffusion and sorption processes. For Sr-85(2+), the slightly higher diffusivity relative to HTO and the low sorption value are consistent with laboratory diffusion measurements on small-scale samples. In the case of Cs+, the numerically deduced high diffusivity and the Freundlich-type sorption behaviour is also supported by ongoing laboratory data. For Co, no laboratory diffusion data were yet available for comparison; however, the modelled data suggests that Co-60(2+) sorption was weaker than would be expected from available batch sorption data. Overall, the results demonstrate the feasibility of the experimental setup for obtaining high-quality diffusion data for conservative and sorbing tracers. (C) 2007 Elsevier Ltd. All rights reserved.

The diffusion of /l/ -vocalization in Swiss German

Several western Swiss German dialects roughly grouped around the nation's capital Bern show /l/ > [u] vocalization in various contexts. The spatial boundaries of /l/-vocalization in Swiss German are suspected to have been expanding since being described in the Linguistic Atlas of German-Speaking Switzerland in the middle of the 20th century. The present study assesses the overall expansion of /l/-vocalization by means of a rapid anonymous survey in 20 urban regional centers situated just beyond the traditional boundaries of /l/-vocalization highlighted by the Atlas. Results show that the expansion of /l/-vocalization mainly progresses in southeasterly, southerly, and westerly directions, but with much less success to the north and northwest, where the equally influential dialectal areas of Basel and Zürich seem to exert opposing influences. Further analysis of the data indicates that somewhat differing constraint hierarchies are at work in the different places to which vocalization has diffused.

Diffusion of contrast medium after four different techniques for analgesia of the proximal metacarpal region: an in vivo and in vitro study

REASONS FOR PERFORMING STUDY: There is limited information on potential diffusion of local anaesthetic solution after various diagnostic analgesic techniques of the proximal metacarpal region. OBJECTIVE: To document potential distribution of local anaesthetic solution following 4 techniques used for diagnostic analgesia of the proximal metacarpal region. METHODS: Radiodense contrast medium was injected around the lateral palmar or medial and lateral palmar metacarpal nerves in 8 mature horses, using 4 different techniques. Radiographs were obtained 0, 10 and 20 min after injection and were analysed subjectively. A mixture of radiodense contrast medium and methylene blue was injected into 4 cadaver limbs; the location of the contrast medium and dye was determined by radiography and dissection. RESULTS: Following perineural injection of the palmar metacarpal nerves, most of the contrast medium was distributed in an elongated pattern axial to the second and fourth metacarpal bones. The carpometacarpal joint was inadvertently penetrated in 4/8 limbs after injections of the palmar metacarpal nerves from medial and lateral approaches, and in 1/8 limbs when both injections were performed from the lateral approach. Following perineural injection of the lateral palmar nerve using a lateral approach, the contrast medium was diffusely distributed in all but one limb, in which the carpal sheath was inadvertently penetrated. In 5/8 limbs, following perineural injection of the lateral palmar nerve using a medial approach, the contrast medium diffused proximally to the distal third of the antebrachium. CONCLUSIONS AND POTENTIAL RELEVANCE: Inadvertent penetration of the carpometacarpal joint is common after perineural injection of the palmar metacarpal nerves, but less so if both palmar metacarpal nerves are injected using a lateral approach. Following injection of the lateral palmar nerve using a medial approach, the entire palmar aspect of the carpus may be desensitised.