Anatomical Differences Research Articles

Increasing clinical and experimental evidence suggests that the upper and lower jaw exhibit pronounced functional and structural disparities that cannot be explained solely by classical anatomical differences. A central, yet unresolved question is whether periodontal ligament stem cells (PDLSCs) from these distinct regions display site-specific molecular signaling patterns in response to mechanical stress. We propose that PDLSCs derived from maxillary and mandibular regions activate distinct kinase signaling networks upon mechanical stimulation, thereby establishing a jaw-specific mechanobiological fingerprint. PDLSCs were isolated from seven healthy donor teeth and exposed to a static compressive force of 2g/cm2. Kinase activity was profiled using a high-throughput PamChip® peptide arrays that target both protein tyrosine kinases (PTKs) and serine/threonine kinases (STKs). Downstream pathway enrichment analyses were conducted using the Wikipathways, Gene Ontology (GO), KEGG, and Enriched pathways databases. Mechanical stimulation induced distinct kinase activation signatures depending on jaw origin. Maxillary PDLSCs displayed a predominance of STK activation, while mandibular cells showed a relative reduction in PTK signaling. Only two PTKs and four STKs were consistently regulated across both regions, supporting the presence of a region-specific mechanotransduction profile. These findings support our hypothesis that localized differences in kinase signaling may constitute a molecular basis for the clinically observed jaw-specific phenomena, such as heterogeneous orthodontic tooth movement and alveolar bone remodeling. Jaw-dependent mechanotransduction pathways can therefore be considered key determinants of periodontal biology and may provide a basis for follow-up studies aimed at enabling the development of personalized orthodontic and regenerative strategies.

Pediatric deep neck infections (DNIs) pose diagnostic and therapeutic challenges due to their varied presentation across age groups. Current management strategies lack age-specific guidelines despite known anatomical and clinical differences. Our study aims to evaluate age-related variations in clinical presentation, imaging use, treatment approach and outcomes in pediatric DNIs, and to assess potential implications for modifying existing management algorithms. This retrospective study analyzed 268 pediatric patients diagnosed with retropharyngeal or parapharyngeal infections between 2009 and 2020 at a tertiary pediatric center. Patients were stratified into 3 age groups: <1 year, 1-6 years and >6 years. Clinical features, imaging modality, treatment and outcomes were compared across age groups. Multivariate logistic regression was used to identify predictors for surgical drainage and prolonged hospitalization. Retropharyngeal infections were predominant in children under 6, while parapharyngeal infections were more common in those over 6. The clinical presentation varied significantly by age, with infants more likely to present with nonspecific symptoms and older children presenting with localized signs. Computed tomography scan performance was the strongest predictor for surgical drainage (P < 0.001). However, age did not significantly influence the surgical intervention rate or hospitalization length. The overall rate of surgical drainage was low (7.8%). Pediatric DNIs exhibit distinct age-related patterns in presentation and infection site, though outcomes remain consistent across groups. These findings support the need for age-specific clinical algorithms, particularly regarding diagnostic imaging and thresholds for intervention, to optimize care and reduce unnecessary procedures in young children.

Although the normal aortic and pulmonary roots have some features in common, they also exhibit important anatomical and functional differences. These differences increase when compared with surgically created neo-aortic roots in individuals with congenitally malformed hearts, with the substrates initially having been either a pulmonary root originating from the right or left ventricle, or a truncal root with variable ventricular origin. With the increasing application and success of these surgeries, our attention has now turned toward understanding late outcomes. Subsequent dilation, usually producing neo-aortic valvar regurgitation, is the most common cause of reoperation in any procedure involving a neo-aortic root. In this review, we describe and compare the detailed anatomy of the normal aortic, pulmonary, and common truncal roots, comparing them with the changes observed in the neo-aortic root following various common surgeries providing biventricular repair for congenital cardiac malformations. We focus on the dilated and dysfunctional neo-aortic root, assessing how the anatomical information relates to contemporary surgical techniques. Furthermore, we aim to review risk factors as they relate to the adverse anatomical features which become evident when the new root is dysfunctional, hoping to provide surgical insight toward optimizing its function and durability.

Owing to the prevalence of congenital single eyelids among Asians, methods are needed to create a double-eyelid fold. Incisional blepharoplasty is considered an ideal method for this purpose. The classical approach tends to create a stable but less dynamic fold. Subsequent refinements aim to achieve a balance between stability and dynamism. However, there are many procedural variations due to anatomical differences, which may account for the varying surgical outcomes. This systematic review explored the current techniques used in Asian blepharoplasty and focuses on the efforts to balance stability and dynamism in double-eyelid-fold creation. A literature search was conducted across PubMed and EMBASE databases. We analyzed the effect of different surgical procedures on fold formation in Asians on the basis of anatomical features. We identified the essential steps of blepharoplasty: debulking the upper eyelid tissue (removing skin, orbicularis, retro-orbicularis oculi fat, and orbital fat), preparing the dynamic system by adjusting the aponeurosis and surrounding structures for proper corneal coverage, and establishing a connection between the anterior and posterior lamellae for a double-eyelid fold. However, debates are still ongoing on the best approach to achieve an ideal balance between stability and dynamism. Research interest in the identification of methodologies for optimizing the effects of incisional blepharoplasty has increased substantially. Further studies should aim to develop surgical strategies tailored to patients' anatomical characteristics. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Access cavity preparation is an important part of endodontic therapy, affecting the effectiveness of canal instrumentation and the durability of the tooth over time. Currently, most access preparation protocols are based on information from a Western population and do not address the anatomical differences of different ethnic groups. This retrospective CBCT study assessed specific odontometric measurements in maxillary anterior teeth-central incisors, lateral incisors and canines-using an Indian population to help identify a clinically relevant and conservative access cavity preparation. A total of six hundred cone-beam computed tomography (CBCT) images of maxillary central incisors, lateral incisors, and canines (n = 200 per tooth) were evaluated. Three measurements were made in sagittal view: the distance from the central fossa to the pulp chamber roof (CF-PC), the incisal edge to pulp chamber (IE-PC), and the central fossa to cingulum (CF-C). These images were obtained from Indian individuals aged 18 to 25 years. Differences attributable to sex-based variation, and between teeth, were statistically significant (p < 0.05). The lateral incisors had the largest amount of anatomical variability, while the canines had the steepest trajectory of access. These findings provide the first population-based CBCT base-line morphometric values for maxillary anterior teeth in India, and a practical guide to help achieve safe access design that is mindful of tooth anatomy and minimizes the invasiveness of the access.

Dogs are classified according to their total cephalic index into three biotypes: dolichocephalic, mesocephalic, and brachycephalic. The latter has emerged due to the deliberate selection of extreme phenotypic traits during breeding, which has intensified the expression of associated conformational defects and led to several medical disorders. The Brachycephalic Obstructive Airway Syndrome (BOAS) is a respiratory condition directly linked to these conformational traits. Dogs affected by BOAS present a wide range of clinical signs, including respiratory noise, exercise intolerance, syncope episodes, or even sudden death. This study aimed to evaluate craniofacial anatomical differences and similarities among dogs of different cephalic biotypes (dolichocephalic, mesocephalic, and brachycephalic) and to determine how two exercise tolerance tests—a 6 min walk and a 1000 m walk—influence physiological parameters. Eighty dogs from different breeds were included and classified according to their biotype. Morphometric data from the head, body, and limbs were obtained. Additionally, physiological parameters, including heart rate, respiratory rate, blood pressure, oxygen saturation, and rectal temperature, were evaluated before and after the tolerance tests. The results indicated that dogs tolerated both exercise tests. Dolichocephalic and mesocephalic dogs showed a greater tolerance to or greater respiratory adaptation during walking. Despite the brachycephalic biotype, a wide dispersion at a distance of 1000 m, indicating that those with a higher BOAS grade did not require emergency medical assistance during the tests. However, evidence of rostral shortening (&lt;38 mm), together with facial foreshortening and measurements ≥ 20 mm for necks, chest circumference, and nasal fold, suggested a higher risk of airway obstruction in brachycephalic dogs diagnosed with BOAS grades 2 and 3 compared to dolichocephalic and mesocephalic dogs. This anatomical conformation was associated with significant alterations in physiological parameters including heart rate, respiratory rate, oxygen saturation below 90%, and temperature, which did not return to baseline values 10 min post-exercise. This showed significant differences between the biotypes in the distance in the 1000 m test (H = 11.74; p = 0.0028) and between the subdivisions (p = 0.0389), where G3 covered less distance than G2 (699.1 m vs. 932.77 m. These findings suggest that extreme brachycephalic conformation impairs the respiratory function and leads to thermoregulatory inefficiency, potentially compromising the animals’ survival under physical stress. Moreover, the application of safe walking tests and non-invasive morphometric measurements is suggested to facilitate prompt diagnosis of BOAS.

High myopia is a growing eye health problem in the modern era and carries an increased risk of ocular comorbidity. Contact lens use, refractive surgery, phakic intraocular lenses, retinal problems, and a history of retinal surgery are more common in eyes with high myopia. The anatomical differences in high myopic eyes and surgical interventions performed on the eye make cataract surgery different from the normal eyes. Lens power calculation and intraocular lens selection are different in myopic eyes, and potential retinal pathologies require long-term follow-up. Patients should be thoroughly informed about refractive surprises and complications.

Summary Background Volvulus nodosus is a strangulating lesion of the small intestine described only in foals and in just one case in older horses. Huskamp et al. (1982, 1998) described the pathophysiology of volvulus nodosus in foals, but to date, there is no description of the pathophysiology of volvulus nodosus in adults. Objectives To describe the different features of volvulus nodosus in adult horses and foals. Study design Clinical case series. Methods Analysis of the clinical and anatomical features of two foals and three adults presenting with volvulus nodosus. Results Clinical presentation between foals and adults differed mainly in the mild or absent pain shown by older horses. Clinical and ultrasonography findings were similar. At surgery or necropsy, we found anatomical differences between adults and foals. In adults, the volvulus did not involve the mesentery that instead forms a hernia sac in foals. Further, in adults, there was no involvement of the ileum, but two loops of jejunum resulted in one wrapped around another in all three cases. After accurate analysis of one case at necropsy, we found that in adults, one loop acts as a ‘post’ around which another loop turns. The weight of this loop then causes the formation of a half‐hitch formed by the two loops and their mesentery. This causes strangulation and necrosis of two separate tracts of jejunum. Main limitations Small number of cases included. Conclusions Volvulus nodosus may occur in adult horses with significant differences compared to foals. Knowing the presentation and pathophysiology of volvulus nodosus may help equine surgeons resolve selected cases of small intestinal strangulation in adult horses.

Earthquakes are chaotic events that cause severe physical and psychological devastation. Due to their anatomical and physiological differences and fragile nature, pediatric earthquake survivors require special attention in anesthesia management. This retrospective study aims to share our experiences and anesthesia techniques applied to pediatric earthquake victims in our tertiary care pediatric hospital. Furthermore, the study aimed to determine the time spent under rubble cutoff value for the development of crush syndrome and creatine kinase cutoff value for the development of acute kidney injury in child earthquake victims. Child earthquake victims under the age of 18 who underwent anesthesia in our hospital after the earthquake that occurred on February 6, 2023, were included in this study. Demographic data, Glasgow Coma Scale scores at admission, the time spent under rubble, existing injuries, Injury Severity Score, presence of crush syndrome and acute kidney injury, need for hemodialysis, length of hospital and intensive care unit stay, type of surgical intervention, and preoperative and discharge laboratory results were analyzed. The type of anesthetic agents used and airway management techniques were recorded. A total of 45 pediatric earthquake victims underwent 362 surgical interventions. Extremity injuries were more common in our patients. We most frequently administered the MAC technique to our patients using sedation and ketamine-based general anesthesia. For airway management, nasal O2 support (44.0%) and SGA (43.2%) were most commonly used. The mean Injury Severity Score was calculated as 22.18 (95% CI: 19.17-25.18). We found that a cutoff value of ≥ 22.5 min spent under debris strongly predicted the development of crush syndrome, and a creatine kinase cutoff value of ≥ 32 029 IU/L strongly predicted the development of AKI. The findings of our study may serve as a guide for anesthesia management and perioperative processes in pediatric earthquake victims in future disaster scenarios. ClinicalTrials.gov identifier: NCT06310265.

Maximising olfactory deposition of a valproic acid (VPA)-loaded nanostructured lipid carriers (NLC) formulation.

Tuncer, D, Altay, E, and Furuncu, B. Physical performance in young adult women with high femoral anteversion. J Strength Cond Res XX(X): 000-000, 2025-Women with high femoral anteversion (HFA) demonstrate significantly increased hip internal rotation and anteversion angles than controls, which may affect lower extremity biomechanics. This cross-sectional observational study aimed to evaluate the impact of HFA on physical performance in young adult women. Twenty-two women with HFA (age 21.36 ± 1.89 years) and 22 age-matched controls (age 22.23 ± 2.05 years) were assessed. Femoral anteversion was assessed using both the Craig test and goniometric measurements of hip internal and external rotation. Physical performance was evaluated using sit-and-reach flexibility test, hand-grip strength, back-leg-chest dynamometry, double- and single-leg horizontal jump tests, and 6-minute walk test. The HFA group exhibited significantly increased internal rotation and decreased external rotation ranges of motion, along with higher femoral anteversion angles as determined by the Craig test (p < 0.001). No statistically significant differences were found between groups for most physical performance measures (p > 0.05), although back-leg-chest strength tended to be lower in the HFA group (p = 0.05, moderate effect size). These findings suggest that despite marked anatomical differences, physical performance in young adult women with HFA is largely comparable with controls. Future research should investigate symptomatic individuals and the potential functional impact of higher anteversion angles.

Paediatric facial fractures are relatively rare due to the elasticity of children´s bones. This elasticity can also make such fractures more challenging to diagnose. Additionally, anatomical differences between juveniles and adults influence the types of fracture observed. In general, boys are more susceptible to trauma; however, this trend does not seem to differ in cases of facial fractures. The aim of this study is to investigate the association between sex and trauma mechanisms in paediatric facial fractures. A retrospective cohort study was conducted on paediatric patients diagnosed with facial bone fractures between 2008 and 2018 at Päijät-Häme Central Hospital (Lahti, Finland). Inclusion criteria were one or more fractures in facial bones in patients under 18years of age. Of the 37 study subjects, 19% were female and 81% were male. Among females, the most common trauma mechanisms were bicycle accidents and sports related incidents (both 8.1%), whereas in males, motor vehicle accidents and sports related incidents were equally prevalent (both 24%). Associated injuries were uncommon, occurring only in 16% of cases, and they were particularly linked to motor vehicle accidents. Paediatric facial fractures are rare. Mandibular fractures are more frequent in both the 6-12 and 13-18-year age groups. No consistent association between dentition stage and fracture site is observed. In both sexes, sports related incidents are the most common trauma mechanism, followed by bicycle accidents in girls and MVAs in boys. Differences between trauma mechanisms and facial fracture locations are minor. Associated injuries are infrequent and typically occur in connection with high-energy trauma, such as MVAs.

Introduction: Axillary reverse mapping (ARM) aims to reduce the risk of breast cancer-related lymphedema (BCRL) by preserving and limiting dissection of arm-draining lymphatics. The ideal type of dye and the location of injection, which maximize the sparing of lymphatics and improve outcomes of immediate lymphatic reconstruction (ILR), remain under-studied. The current literature reports inconsistent visualization of lymphatics using blue dye alone, whereas indocyanine green (ICG) near-infrared (NIR) lymphography has shown improved rates. However, optimized dual-dye workflows integrating breast–plastics co-surgery are lacking. Methods: A retrospective review of patients who underwent ILR following ALND for breast cancer between June 2021 and June 2023 was conducted. Patients who underwent ARM using our dual-dye technique were included, utilizing intradermal injections of indocyanine green (ICG) into the wrist and isosulfan blue (ISB) into the upper arm. Axillary reverse mapping channels were categorized by the type of dye used to visualize. Dye injection site, number of lymphatic channels visualized, channel diameter (mm), time-to-first channel, coordinates relative to fixed landmarks, ILR configuration, and pathologic findings were reviewed. Mann–Whitney U tests were used to compare channel visualization rates between types of dye. Results: Of 26 patients, 21 underwent dual-dye mapping and were included. A total of 115 ARM channels were identified: 99 (86%) via ICG and 29 (25%) via ISB. A total of 64 lymphaticovenous anastomoses were performed (mean: 2.46 per patient). Both dyes were identified in the axilla in only 11.7% of patients. At the end of the study, the lymphedema rate was 12%. Conclusions: We developed a reproducible dual-dye ARM technique for ALND with planned ILR, reducing lymphedema risk while maintaining oncologic safety. Dual-dye mapping reveals that proximal and distal lymphatics exhibit both overlapping and divergent drainage to axillary nodes. ICG’s higher axillary detection rate may reflect true anatomical differences or dye properties. These findings support the need for individualized lymphatic mapping during breast cancer surgery to guide preservation techniques and reduce the risk of BCRL.

Tomographic comparison of the cochlea, oval window, round window and facial nerve between adults and children and their influence on cochlear implant surgery.

Pediatric anesthesia presents unique challenges due to children’s distinct physiological and anatomical characteristics, including variations in drug metabolism, airway structure, and respiratory and circulatory regulation. Despite significant advances in patient safety that have reduced anesthesia-related mortality over recent decades, the declining pediatric population has made specialized training and clinical practice increasingly difficult. This narrative review addresses practical aspects of pediatric anesthesia, emphasizing patient monitoring, airway management, and recent clinical advances. Oxygen supply targets in children require careful titration to ensure adequate tissue oxygenation while avoiding oxygen toxicity and its associated complications, such as bronchopulmonary dysplasia and retinopathy of prematurity. Quantitative monitoring of neuromuscular blockade, such as with train-of-four stimulation, is essential to prevent postoperative respiratory complications. Temperature monitoring is equally critical in pediatric surgery because children and neonates are highly susceptible to intraoperative hypothermia. Airway management in infants and young children is complicated by anatomical differences, and while video laryngoscopy offers advantages, evidence for its benefits in neonates remains inconclusive. Extubation strategies must be individualized, taking into account risks such as laryngospasm and airway obstruction, as both deep and awake extubation have demonstrated comparable safety profiles. Emerging modalities, such as transfontanelle ultrasonography, provide real-time cerebral blood flow assessment and enhance perioperative brain monitoring. Regional anesthesia techniques in neonates and infants reduce exposure to general anesthetics and facilitate faster recovery but require meticulous technique and monitoring to ensure safety. Multidisciplinary collaboration and effective communication with parents are essential to achieving optimal outcomes.

Natural History of Atrial versus Ventricular Secondary Tricuspid Regurgitation: Insights From the Bronx-Valve Registry.

Both thalami can be connected by the Interthalamic Adhesion (IA), a white matter tract that crosses the 3rd ventricle. Its presence varies among individuals and remains poorly understood. This study examines the IA’s prevalence, anatomical variations, genetic determinants, and cognitive associations. Data from 591 healthy subjects (25–35 years) from the Human Connectome Project were analyzed, and grouped into monozygotic (MZ) or dizygotic (DZ) twins, non-twin siblings, and unrelated individuals. MRI was used to characterize the IA, while neuropsychological assessments and Freesurfer parcellations were used to assess cognition and anatomical differences between subjects with or without an IA. The IA was absent in 12.7% of subjects, more commonly in males (20.0%) than females (6.3%). No significant differences in age, education, or cognition were found between individuals with or without an IA. IA absence was associated with increased cerebrospinal fluid volumes, enlarged third ventricles, and thinning in several cortical areas. Genetic analysis on the IA presence or absence revealed a heritability estimate of 34% with a higher concordance among MZ twins (96%) than in other groups. The remaining 4% discrepancy was observed in male pairs only. This study underscores the genetic basis of IA, highlighting sexual dimorphism and neuroanatomical differences associated with its absence, despite unaffected cognition in healthy individuals.Supplementary InformationThe online version contains supplementary material available at 10.1038/s41598-025-20469-w.

HighlightsWhat are the main findings?The study demonstrated that boys with both-bone forearm fractures had greater initial radius angulation and longer forearm bones compared to girls. Surgical intervention was required only in boys, whereas overall complication rates did not differ significantly between sexes.What is the implication of the main finding?These results indicate that male-specific anatomical characteristics predispose boys to unstable fracture patterns and a higher likelihood of surgical treatment. Considering sex-based anatomical differences in treatment planning may improve early risk stratification and guide timely surgical decisions.Background: Both-bone forearm fractures (BBFF) are among the most common pediatric injuries. While most cases in younger children can be managed non-operatively, older children and adolescents exhibit less predictable remodeling and longer healing times, potentially leading to higher complication rates. This study aimed to evaluate sex-based anatomical differences in BBFF and their association with complications. Methods: We retrospectively reviewed 163 patients (129 boys, 34 girls; age range: boys > 10 years, girls > 8 years, both < 16 years) with unilateral BBFF treated between 2017 and 2020. All underwent biplanar radiographs of both forearms pre-reduction, post-reduction, and at 8-week follow-up. Measurements included radius and ulna angulation, bone length, maximum radial bow (%), and location of maximum bow (mm). Complications and surgical interventions were recorded. Results: Boys demonstrated significantly greater initial radius angulation on the lateral view (p < 0.05) and longer radius and ulna lengths on the unaffected side (p < 0.05). Maximum radial bow (%) did not differ between sexes; however, the location of maximum bow varied between unaffected and fractured sides within each sex (p < 0.05). Twenty boys (15.5%) required surgery, compared with none of the girls (p = 0.007). Overall complication rates were 44.8% (n = 73) with no significant sex difference (p = 0.074). Conclusions: In older children and adolescents with BBFF, boys exhibit anatomical characteristics—such as longer forearms and greater initial angulation—associated with unstable fracture patterns and higher surgical intervention rates. Recognizing these differences may improve early risk stratification and management strategies. Level of Evidence: IV.

Simple SummaryHypertrophic cardiomyopathy is the most common form of cardiomyopathy in cats. When accompanied by left ventricular outflow tract obstruction, the condition is typically managed with medical therapy in humans. Beta-blockers are generally the first-line treatment, but some cases do not respond to them. In such instances, the antiarrhythmic drug disopyramide is considered as an adjunctive therapy. However, its use in cats has only been documented in a case report. This study aimed to evaluate the efficacy of disopyramide as co-therapy in cats with hypertrophic cardiomyopathy and left ventricular outflow tract obstruction that are refractory to beta-blockers. In this study, adding disopyramide resulted in the alleviation of left ventricular outflow tract obstruction and improvement in myocardial function. Furthermore, disopyramide reduced cardiac troponin I levels, a cardiac biomarker indicating myocardial injury. The results suggest that disopyramide may be a potential therapeutic option for feline obstructive HCM, as no significant side effects were observed.Hypertrophic cardiomyopathy (HCM) is the most common cardiomyopathy in cats and is classified as obstructive (HOCM) or non-obstructive based on anatomical differences in the left ventricular outflow tract (LVOT). In severe obstructive cases, while beta-blockers are the recommended initial treatment in humans, some patients exhibit treatment resistance. For these cases, the addition of the antiarrhythmic agent disopyramide is common. However, its use in cats has only been documented in a case report. In this study, the use of disopyramide resulted in a significant reduction in the LVOT velocity and cardiac troponin I levels. Additionally, no significant adverse effects were observed. These findings suggest that disopyramide could be a potential therapeutic option for the treatment in cats with HOCM.

Typha domingensis is the most abundant species in a petroleum-contaminated area impacted by one of Brazil’s largest environmental disasters in 2000. This pioneering study evaluates this species in situ and aims to analyze the anatomical and morphological differences in T. domingensis from the contaminated site compared to a nearby uncontaminated area (control). Morphological, anatomical, and histochemical analyses were performed, along with gas chromatography and fluorescence microscopy, to assess the plant’s potential for petroleum uptake. Results indicated that individuals from the contaminated site developed longer leaves, produced phenolic compounds, and formed aerenchyma as adaptive responses to environmental stress, while leaf count remained unchanged, and no evidence of xenobiotic absorption was found. This lack of uptake likely explains the absence of significant growth inhibition or severe anatomical damage. These findings suggest that T. domingensis has successfully adapted to the contaminated environment, possibly using petroleum degradation by-products to enhance its growth. Its anatomical and histochemical adaptations underscore its strong potential as a sustainable phytoremediation tool.