Anterior Part Research Articles

Thickness and width of the menisci of adult knee joint: a descriptive cross-sectional observational study in cadavers.

The goal was to determine the thickness and width of the knee joint meniscus at their different regions. The objective was to compare the dimensions at these regions and over the right- and left-sided specimens. The present study included 50 adult cadaveric knee joints, and 100 menisci (50 medial menisci and 50 lateral menisci) were studied. The meniscus was distributed into anterior, middle and posterior parts. Thickness and width at the mid-point of these three parts were determined by using the Vernier caliper. The breadth of the medial meniscus was 8.38 ± 1.64 mm, 7.68 ± 1.92 mm and 13.93 ± 2.69 mm at the anterior, middle and posterior one-third regions. Same measurements for the lateral menisci at these regions were 9.84 ± 1.78 mm, 8.82 ± 2.01 mm and 10.18 ± 2.23 mm, respectively. The thickness of the medial meniscus was 4.49 ± 0.78 mm, 4.07 ± 0.81 mm and 4.79 ± 0.93 mm at these regions. The lateral meniscus thickness was 3.82 ± 0.69 mm, 4.43 ± 0.98 mm and 4.36 ± 0.8 mm, respectively. It is believed that this data is enlightening to the arthroscopic surgeon during the meniscus transplantation either by using synthetic material or allograft as the proper sizing of the meniscus is important to prevent complications due to inaccurate sizing.

Posterolateral Paramass Approach to Lesions Located at the Anterior C1-2 Level: A Cadaver Study

A novel posteriolateral surgical approach is described that will provide safe access to intradural and extradural lesions located in the anterior part of the spinal cord (SC) at the C1-2 level and to the odontoid in single session. A total of five cadavers and two dry C1 vertebrae were used in this study. The study involved obtaining computed tomography magnetic resonance imaging scans and magnetic resonance imaging of all cadaver groups before and after the procedures. Group 1: Control; Group 2: Unilateral C1 posterior arch was removed, the inferomedial part of C1 lateral mass was removed, and access the anterior and lateral aspects of the SC. Group 3: In addition, odontoid was removed, Group 4: In addition, unilateral C1- C2 screw was placed. Group 5: In addition, bilateral C1-C2 screw was placed. The median distance from the midpoint of C1 posterior tubercle to vertebral groove which was removed in groups is 21.4 ± 2.88mm. The average width of C1 lateral mass was 13.4±2.4mm. After the lateral mass was drilled, its width decreased to 10,2mm.This area was sufficient to open a surgical corridor and reach the anterior of SC and odontoid. After the procedure, no instability was found in group 2 without instrumentation on computed tomography and magnetic resonance imaging scans. It is possible to access the anterior C1-C2 via a posterolateral paramass approach by drilling 20%-30% of the lateral mass, providing an open pathway for easy intervention in C1-C2 intradural lesions. It is also possible to perform odontoid resection using this approach.

Effects of upper-limb exoskeleton on muscle activity in tasks requiring arm elevation: Part II - In-field experiments in construction industry settings.

The body of literature regarding the use of an upper limb exoskeleton during authentic working conditions is sparse. The aim of this study was to evaluate the effectiveness of an upper limb exoskeleton in reducing muscle strain during authentic industrial construction work. Fifteen male participants, comprising of roofers, scaffolders, builders, bricklayers, and graders performing overhead work participated in the study. During work without (REF) and with exoskeleton (EXO), muscle activity from 8 muscles, heart rate (HR), metabolic equivalent (MET), and upper arm elevation angles were recorded. When using the exoskeleton, a significant reduction of 20.2% in average muscle activity of 8 muscles was found. The largest effect focused on m. deltoideus, where 46.2 and 32.2% reduction occurred in medial and anterior parts of the muscle, respectively. HR and MET were unaffected. Upper arm elevation angles were similar between REF and EXO, indicating equal biomechanical loading. This study indicates that exoskeletons show great promise in reducing the potential for musculoskeletal strain during authentic overhead construction work.

ANATOMICAL AND FUNCTIONAL OUTCOME IN THE MANAGEMENT OF NON-ARTERITIC ANTERIOR ISCHEMIC OPTIC NEUROPATHY

Introduction: Non-arteritic anterior Ischemic optic neuropathy refers to condition in which damage to the anterior optic nerve is presumed to be secondary to ischemia of the anterior part of the optic nerve. This condition is irreversible, and the visual prognosis is generally guarded. To date, there is no definitive high-grade evidence for an effective treatment of NAION. The purpose of this literature review is to assess the results of currently published literatures regarding the management of non-arteritic anterior ischemic optic neuropathy, taking anatomical and functional outcomes into consideration. Methods: A comprehensive literature search was conducted using online databases (PubMed, EBSCO, Clinical Key, and Google Scholar) using relevant search terms. Included studies were selected based on predefined inclusion criteria. Results: Systemic and locally-administered corticosteroid indicated various responses, as well as anti-VEGF, however suggesting no positive effects. Rho-kinase as a vasodilator improved visual acuity in a small study. Erythropoietin and cytidine diphosphocoline (citicoline) suggested visual acuity improvement, while only citicoline improved visual field improvement and prevent further RNFL thinning, in non-randomized controlled studies. Conclusion: No high-quality evidence of intervention has been shown to enhance both anatomical and functional outcome. Many studies were also insufficient to conclude. Further studies are needed, including neuroprotective and novel vasodilator agents.

Atypical case of anterograde amnesia after cerebral infarction and anti-NMDA encephalitis post Covid 19 infection: A complex clinical case

IntroductionOnly a few cases of primary anterograde amnesia with confabulation after severe complex brain damage have been described in the literature.ObjectivesTo describe a case of anterograde amnesia with confabulation in a patient with severe and extensive brain damage.Methodscase reportResultsCase presentation: A 48-year-old male patient with a medical history of diabetes mellitus type II, hypertension, presented to a psychiatric clinic for the first time. He was admitted to the hospital due to the manifestation of disruptive aggressive behaviour, aimless wandering, and excessive, impulsive expenditure of financial resources. At the time of hospitalization and during the hospital stay, the patient exhibited a state of elevated mood and anterograde amnesia compounded by the presence of prominent confabulation, easily irritable mood with a tendency to conflict. No physical limitations.Background: The patient is an active long-distance driver for 15 years. A year before hospitalization in psychiatric clinic, he was travelling to Moscow, he had episode of headache and unconsciousness after which hospitalization. Diagnosed with multiple infarcts of embolic origin in the right frontal lobes, both cortical and subcortical, on the right side at the level of the uncus, in the medial anterior parts of the right occipital lobe, on the left side in the insula and at the level of the capsula externa, in the anterior basal part of the left temporal lobe. After hemodynamic stabilization, he was repatriated to Latvia. Stationary positive SARS-CoV-2 PCR, O2 support therapy required. The patient develops auditory and visual hallucinations, which do not correct on antipsychotic therapy. Lumbar puncture was performed, which showed positive anti-NMDA antibodies, magnetic resonance - autoimmune limbic encephalitis with damage to the gyrus cinguli of the insula cortex of both temporal lobes and the right subfrontal part with spread throughout the right temporal lobe, bilaterally in the mediobasal structures of the temporal lobes and the right thalamus with progressive changes. The patient receives immunomodulatory therapy, plasma exchange and immune globulin. Hallucinations decrease on the background of therapy. At discharge - moderate ataxia in the legs, disorientation in time, severe short-term memory disorders.The patient in his mind lives like nothing has happened and the same life continues.Image:Image 2:ConclusionsThe long-term prognosis for the patient remains uncertain, given the multifaceted nature of the condition and the extent of brain damage. Continuous monitoring, rehabilitation, and ongoing support will be essential to assess cognitive recovery and improve the patient’s quality of life.Disclosure of InterestNone Declared

Duox activation in Drosophila Malpighian tubules stimulates intestinal epithelial renewal through a countercurrent flow

The gut must perform a dual role of protecting the host against toxins and pathogens while harboring mutualistic microbiota. Previous studies suggested that the NADPH oxidase Duox contributes to intestinal homeostasis in Drosophila by producing reactive oxygen species (ROS) in the gut that stimulate epithelial renewal. We find instead that the ROS generated by Duox in the Malpighian tubules leads to the production of Upd3, which enters the gut and stimulates stem cell proliferation. We describe in Drosophila the existence of a countercurrent flow system, which pushes tubule-derived Upd3 to the anterior part of the gut and stimulates epithelial renewal at a distance. Thus, our paper clarifies the role of Duox in gut homeostasis and describes the existence of retrograde fluid flow in the gut, collectively revealing a fascinating example of inter-organ communication.

A Novel Ligamentous Complex in the Anteromedial Region of the Knee: A Cadaveric Study.

The medial knee structures have a primary role in stabilizing valgus and rotational stress, which makes them important in assessing the ligament-injured knee globally and choosing the most adequate treatment. To conduct a layer-by-layer dissection of the knee's anteromedial side and provide a qualitative and quantitative description of the anatomy and histology of a ligament in the anteromedial region of the knee, which we have termed the anterior oblique ligament (AOL). Also, to describe the AOL relationship with what we have termed the medial cross-a ligament complex that stabilizes the medial pivot. Descriptive laboratory study. A total of 35 fresh-frozen knees from transfemoral amputations that were exclusively performed for vascular reasons were dissected. Structures were identified after meticulous dissection, respecting the same protocol, measured with a digital caliper rule, and histologically studied for data. The AOL was found in all dissected knees, with a mean length of 31.47 ± 5.06 mm. This structure presented a ligament histology with densely organized collagen fibrils. The medial cross was represented by the superficial medial collateral ligament, AOL (anterior region), and posterior oblique ligament. This study demonstrated the presence of a ligament in the anteromedial region of the knee, termed the AOL. This structure was in the anterior part of a ligament complex-the medial cross. Studying and revisiting the medial compartment can provide important information for understanding joint instability and promoting better results in ligament reconstructions.

Change in taste sensation after orthognathic surgery

ObjectiveThe objective of this study was to evaluate the effect of orthognathic surgery on taste sensation.Materials and methodsThirty-five patients scheduled to undergo Le Fort I osteotomy (LFIO), sagittal split ramus osteotomy (SSRO), and bimaxillary surgery (BMS) were evaluated by administering localized and whole-mouth taste tests preoperatively and postoperatively at months 1, 3, and 6. The patients were asked to identify the quality of four basic tastes applied to six locations on the palate and tongue and to rate the taste intensities they perceived. Taste recognition thresholds and taste intesity scores were evaluted according to operation groups and follow-ups.ResultsThere were significant decreases in the quinine HCl recognition thresholds at the postoperative follow-ups compared to the preoperative in LFIO patients (p = 0.043). There were significant decreases in sucrose taste intensity scores in the right posterolateral part of the tongue at months 3 and 6 compared to preoperative in SSRO patients (p = 0.046), and significant increases in quinine HCL taste intensity scores in the right and left anterior parts of the tongue at month 6 compared to preoperative in LFIO patients (p < 0.05).ConclusionTaste perception is affected due to potential damage to the chemosensory nerves during orthognathic surgical procedures. Generally, non-significant alterations have been observed in taste perception after orthognathic surgery, except for significant alterations in bitter and sweet taste perceptions.Clinical relevanceMaxillofacial surgeons should be aware of taste perception change after orthognathic surgery procedures and patients should be informed accordingly.The trial registration number (TRN)NCT06103422/Date of registration: 10.17.2023 (retrospectively registered).

Нейровізуалізаційні особливості нервової системи в дітей раннього віку з епілептичними енцефалопатіями за даними МР-трактографії

The aim is to analyze neuroimaging changes in the nervous system of children of an early and preschool age with epileptic encephalopathies (EE) according to MR-tractography to improve the diagnosis of these conditions. Materials and methods. 157 children aged 0 to 6 years with EE, epileptiform and developmental encephalopathies (DEE) were examined. The study included MR-tractography using a 3 Tesla MR scanner. Fractional anisotropy (FA) and average diffusion coefficient (ADC) were determined in Broca's and Wernicke's areas, left arcuate tract, both uncinate tracts, corpus callosum and thalamus. The examined children were divided into 3 groups: I - 75 children with EE, with the onset of seizures before 1 year of age; II - 44 children with EE, with the onset of seizures at the age of 1-3 years; III - 38 children with DEE. Differences between groups were assessed using the Kruskal-Wallis test and Pearson's Chi-square (χ²) test. Results. In children with EE from groups I and II, there was a significant decrease in FA and an increase in ADC in the areas of both language centers and the right uncinate tract in comparison with children of group III (p&lt;0.05). In the group I with EE, there was a significant decrease in FA in the left uncinate tract, knee and trunk of the MT in comparison with the groups II and III of children (p&lt;0.05). It was found that more than 60% of children from group I had destruction of the fibers of the arcuate tract and in the area of one of the speech centers, and 70% had hypoplasia and destruction of the left uncinate tract. In the children of group II with EE, hypoplasia of the anterior (63.6%) and posterior (65.9%) parts of the arcuate tract and the right uncinate tract (81.8%) was detected. Among children from group III, more than 60% had an abnormal location of Broca's speech center, and more than 70 % had an abnormal location of Wernicke's center, almost 80 % had an abnormal location of the left uncinate tract. Conclusions. It was found that in children with EE and DEE, according to MR tractography, there is a decrease in FA indicators and an increase in ADC in all studied structures (arcuate and uncinate tract, corpus callosum, thalamus) in comparison with the reference values given in the scientific literature. The detected changes indicate a violation of the structural integrity of the white matter in Broca's and Wernicke's centers and associative pathways, which will lead to the optimization of early diagnosis and prognosis of consequences in children with EE and DEE. The study was carried out in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committees of the institutions indicated in the work. The informed consent of the children's parents was obtained for conducting the research. No conflict of interest was declared by the authors.

The Origin and Course of the Blood Supply to the Lower Eyelid Orbital Fat: Anatomical Study and Clinical Significance.

The aim of this study is to investigate the origin and course of the orbital fat arterial supply in the lower eyelid using traditional anatomy and three-dimensional computed tomography (CT). Twenty-seven cadaver heads were infused with mercury sulfide contrast media through the ophthalmic artery, maxillary artery, transverse facial artery, and facial artery. CT images were obtained after contrast agent injection, three-dimensional CT scans were reconstructed, and the cadaver heads were dissected. Forty-five qualified hemifaces showed that the orbital fat arterial supply in the lower eyelid originates primarily from the inferomedial muscular trunk (IMT) of the ophthalmic artery and the orbital branch of the infraorbital artery. The medial branch of the IMT terminated at the medial fat pad (35.6%) or the orbital floor (64.4%). The lateral branch terminated at the inferior oblique (IO) muscle (28.9%) or the central and lateral fat pads (17.8%). In 53.3%, the lateral branch extended to the anterior part of the lateral fat pad and terminated in the orbital wall or the zygomaticoorbital foramina. The orbital branch of the infraorbital artery coursed between the orbital floor and the orbital fat, providing supply to the IO muscle, inferior rectus (IR) muscle, nasolacrimal duct, and orbital fat. This study elucidated the origin and course of the orbital fat arterial supply in the lower eyelid, which may help to avoid reducing the blood supply of the orbital fat pedicles during surgery. 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 .

Macro and Micro Anatomical Comparative Study for Liver, Kidney and Testis Between the Albino Rat and Pigeon

The present study was designed to demonstrate the anatomical and histological variations between the certain organs in both the rat as a model of experimental mammals and pigeon as an avian model. Five albino rats and five pigeons were utilized, the liver, kidney and the testicles were taken from those animals after scarifying and specimens were taken from those organs, fixed in 10 % formalin for 24 hours before transferred for histological technique, the slices were stained with hematoxylin and eosin. The anatomical observation indicated that the liver of rat was formed by right, left lobes and intermediate, located in the anterior part of abdomen, in the pigeon, had two lobes without gall bladder. The kidney of the rat was bean shaped, brown reddish color with idented medial border present in the abdominal cavity near and around the lumbar vertebrae, the kidney of pigeon was lobulated into three and the kidney was lodged on the ventral aspect of the synsacrum.&#x0D; The testis of rat was oval in shape present in the scrotum, and in the pigeon located in the abdominal and pelvic cavity. The histological result indicated the liver of rat was with columns of polygonal liver cells surrounded by blood sinusoids draining in the central vein, while in the pigeon, the cells were present in groups also had blood sinusoids with Kupffer cells and central vein for draining the blood outside the liver, the kidney of both types had an cortex and medulla with presence of glomeruli in the cortex, both had proximal and distal convoluted tubules , in the pigeon there is no thin segment of Henle loops .&#x0D; The testis was occupied by seminiferous tubules in both types and each tubule was containing the different types of spermatic cells and spermatozoa, also Leydig cells were present in groups, spermatogenesis was intensive in pigeon in cases of seasonal phase in conclusion, variation for the visceral organs in both rats and pigeon were determined also histological differences were present, otherwise similarities were also observed.

Kleptoparasitism in Micrurus mipartitus (Squamata, Elapidae) competing for the same Caecilia sp. (Gymnophiona, Caeciliidae) in western Colombia

Kleptoparasitism, or food theft, is seldom reported in wild populations of snakes. Here, we describe as case where two Red-tailed Coral Snakes, Micrurus mipartitus, were observed competing for the same caecilian prey, either Caecilia leucocephala or C. perdita. This took place at night in a rainforest habitat in Valle del Cauca Department, western Colombia. Upon our arrival, the battle had already started as the two coral snakes kept bite-holds on the caecilian. They continued biting the prey at different places on the anterior parts and tugging in opposite directions. The snakes also made rotations along the longitudinal axis as they maintained their bite-holds. Surprisingly, one snake also bit the body of the other snake once. After 17 minutes of observation, the losing coral snake released its bite-hold on the caecilian. The winner then moved away from the losing snake which did not follow. It is well-known that M. mipartitus and other coral snakes eat caecilians, but this is the first observation of kleptoparasitism in elapid snakes in the wild. It is considered likely that they rely on chemoreception when detecting caecilians, notably in this case as two coral snakes detected the same prey item. In general, kleptoparasitism may occur more frequently amongst snakes than indicated by the very few published cases considering that numerous cases from captivity are known.

Beyond skeletal studies: A computational analysis of nasal airway function in climate adaptation.

Ecogeographic variation in human nasal anatomy has historically been analyzed on skeletal morphology and interpreted in the context of climatic adaptations to respiratory air-conditioning. Only a few studies have analyzed nasal soft tissue morphology, actively involved in air-conditioning physiology. We used in vivo computer tomographic scans of (N = 146) adult individuals from Cambodia, Chile, Russia, and Spain. We conducted (N = 438) airflow simulations during inspiration using computational fluid dynamics to analyze the air-conditioning capacities of the nasal soft tissue in the inflow, functional, and outflow tract, under three different environmental conditions: cold-dry; hot-dry; and hot-humid. We performed statistical comparisons between populations and sexes. Subjects from hot-humid regions showed significantly lower air-conditioning capacities than subjects from colder regions in all the three conditions, specifically within the isthmus region in the inflow tract, and the anterior part of the internal functional tract. Posterior to the functional tract, no differences were detected. No differences between sexes were found in any of the tracts and under any of the conditions. Our statistical analyses support models of climatic adaptations of anterior nasal soft tissue morphology that fit with, and complement, previous research on dry skulls. However, our results challenge a morpho-functional model that attributes air-conditioning capacities exclusively to the functional tract located within the nasal cavity. Instead, our findings support studies that have suggested that both, the external nose and the intra-facial soft tissue airways contribute to efficiently warming and humidifying air during inspiration. This supports functional interpretations in modern midfacial variation and evolution.

The Origin and Regulation of Neuromesodermal Progenitors (NMPs) in Embryos.

Neuromesodermal progenitors (NMPs), serving as the common origin of neural and paraxial mesodermal development in a large part of the trunk, have recently gained significant attention because of their critical importance in the understanding of embryonic organogenesis and the design of in vitro models of organogenesis. However, the nature of NMPs at many essential points remains only vaguely understood or even incorrectly assumed. Here, we discuss the nature of NMPs, focusing on their dynamic migratory behavior during embryogenesis and the mechanisms underlying their neural vs. mesodermal fate choice. The discussion points include the following: (1) How the sinus rhomboidals is organized; the tissue where the neural or mesodermal fate choice of NMPs occurs. (2) NMPs originating from the broad posterior epiblast are associated with Sox2 N1 enhancer activity. (3) Tbx6-dependent Sox2 repression occurs during NMP-derived paraxial mesoderm development. (4) The nephric mesenchyme, a component of the intermediate mesoderm, was newly identified as an NMP derivative. (5) The transition of embryonic tissue development from tissue-specific progenitors in the anterior part to that from NMPs occurs at the forelimb bud axial level. (6) The coexpression of Sox2 and Bra in NMPs is conditional and is not a hallmark of NMPs. (7) The ability of the NMP pool to sustain axial embryo growth depends on Wnt3a signaling in the NMP population. Current in vitro models of NMPs are also critically reviewed.

Spinal Cord Infarction Following Transarterial Chemoembolization of Hepatocellular Carcinoma with Chest Wall Metastasis: A Case Report and Review of the Literature

Spinal cord infarction (SCI) is a rare but detrimental complication following transarterial chemoembolization (TACE). The case report presented a case of hepatocellular carcinoma (HCC) involving the lateral chest wall for which the patient underwent TACE, targeted at the right ninth intercostal artery. After the intervention, the patient fully developed complete spinal cord syndrome immediately after TACE. Magnetic resonance images of the spinal cord showed abnormal hyperintense lesions on T2-weighted images involving the anterior and central part of the 9th to 11th thoracic spinal cord, compatible with SCI. Although corticosteroids were not administered, the patient’s condition subsequently improved, being capable of walking with a gait aid. SCI after TACE is a possible disabling adverse event. To prevent this complication, the collateral vessels of the spinal arteries, such as the intercostal arteries, should be avoided. Furthermore, monitoring for the symptoms of SCI, especially in the first 24 hours after the intervention, should also be done in all TACE cases. Keywords: Spinal cord injury; Spinal cord infarction; Transarterial chemoembolization; Hepatocellular carcinoma; Case report

MRI atlas of the pituitary gland in young female adults.

The probabilistic topography and inter-individual variability of the pituitary gland (PG) remain undetermined. The absence of a standardized reference atlas hinders research on PG volumetrics. In this study, we aimed at creating maximum probability maps for the anterior and posterior PG in young female adults. We manually delineated the anterior and posterior parts of the pituitary glands in 26 healthy subjects using high-resolution MRI T1 images. A three-step procedure and a cost function-masking approach were employed to optimize spatial normalization for the PG. We generated probabilistic atlases and maximum probability maps, which were subsequently coregistered back to the subjects' space and compared to manual delineations. Manual measurements led to a total pituitary volume of 705 ± 88mm³, with the anterior and posterior volumes measuring 614 ± 82mm³ and 91 ± 20mm³, respectively. The mean relative volume difference between manual and atlas-based estimations was 1.3%. The global pituitary atlas exhibited an 80% (± 9%) overlap for the DICE index and 67% (± 11%) for the Jaccard index. Similarly, these values were 77% (± 13%) and 64% (± 14%) for the anterior pituitary atlas and 62% (± 21%) and 47% (± 17%) for the posterior PG atlas, respectively. We observed a substantial concordance and a significant correlation between the volume estimations of the manual and atlas-based methods for the global pituitary and anterior volumes. The maximum probability maps of the anterior and posterior PG lay the groundwork for automatic atlas-based segmentation methods and the standardized analysis of large PG datasets.

Functional reliability of means of fixation for complex pelvic fractures. Part 1: Materials and methods

Due to the military aggression of the Russian Federation against Ukraine, a large number of soldiers and civilians were wounded and injured. Along with fractures of the long bones of the limbs, skull injuries, limb amputations, the number of injuries in the pelvic area with fractures of the pelvic bones as a result of being hit by high-velocity projectiles (shrapnel, bullets) has increased.This work is devoted to the preparation and research of the characteristics of stiffness and reliability of fixation of complex fractures of the pelvic bones in the area of the sacroiliac joint and the upper and lower branches of the pubic bone, which may occur as a result of injury by high-velocity projectiles that injure.The sacroiliac area was fixed with two cancellous screws with a parallel arrangement at the intersection of the horizontal and vertical planes (a typical technique for stabilizing the posterior parts of the pelvis). The anterior parts of the pelvic bones were stabilized with rod devices of external fixation with a typical location of the rods in the upper anterior iliac spine. The upper branch of the pubic bone was synthesized with a bony reconstructive plate with a typical location.

A Roentgenographic Comparative Investigation of The Midpalatal Suture Obliteration Evidenced Through Occlusal and Cone Beam CT Radiographs

Background: Assessing the midpalatal suture (MPS) maturation is crucial to successfully predict rapid maxillary expansion. Therefore, radiographic measurement of the suture width is vital for treatment planning. This study compared MPS ossification using cross-sectional maxillary occlusal radiographs and cone-beam computed tomography (CBCT) scans to aid clinicians in making better treatment decisions. Methods: In this study, 33 patients were selected as the study cohort and were categorized into two distinct groups according to their chronological age. Group I included individuals in the growth phase, aged between 8 to 16 years, while Group II encompassed post-adolescent and young adult participants aged between 16 to 25 years. The percentage of MPS ossification was calculated using the suture obliteration index calculated on axial cross-sectional images. Statistical analysis was performed utilizing the student t-test with a significance level set at 0.05. Results: No significant difference was found between occlusal radiographs and CBCT scans in the assessment of MPS ossification in the anterior part (P&gt;0.05). However, significant differences existed in the suture obliteration index in anterior part (P=0.031) and posterior part (P=0.035), with higher mean values obtained by occlusal radiographs. In contrast, significant differences favoring CBCT were found in the anterior part (P&lt;0.001) with higher mean values; no significant difference was found in the posterior part. Lastly, significant difference did not exist in the posterior part between the two imaging modalities (P&gt;0.05). Conclusion: For MPS assessment, both CBCT and occlusal radiography can provide predictable results. However, it is notable that CBCT still has an upper hand in providing better and more accurate results.

Characterization of Ultrasonic Vocalization-Modulated Neurons in Rat Motor Cortex Based on Their Activity Modulation and Axonal Projection to the Periaqueductal Gray.

Vocalization, a means of social communication, is prevalent among many species, including humans. Both rats and mice use ultrasonic vocalizations (USVs) in various social contexts and affective states. The motor cortex is hypothesized to be involved in precisely controlling USVs through connections with critical regions of the brain for vocalization, such as the periaqueductal gray matter (PAG). However, it is unclear how neurons in the motor cortex are modulated during USVs. Moreover, the relationship between USV modulation of neurons and anatomical connections from the motor cortex to PAG is also not clearly understood. In this study, we first characterized the activity patterns of neurons in the primary and secondary motor cortices during emission of USVs in rats using large-scale electrophysiological recordings. We also examined the axonal projection of the motor cortex to PAG using retrograde labeling and identified two clusters of PAG-projecting neurons in the anterior and posterior parts of the motor cortex. The neural activity patterns around the emission of USVs differed between the anterior and posterior regions, which were divided based on the distribution of PAG-projecting neurons in the motor cortex. Furthermore, using optogenetic tagging, we recorded the USV modulation of PAG-projecting neurons in the posterior part of the motor cortex and found that they showed predominantly sustained excitatory responses during USVs. These results contribute to our understanding of the involvement of the motor cortex in the generation of USV at the neuronal and circuit levels.

Invasion Patterns and Long-Term Clinical Outcomes of Diffuse Tenosynovial Giant Cell Tumor of the Ankle Joint.

The invasion patterns and long-term outcomes ofdiffuse tenosynovial giant cell tumor (D-TSGCT) of the ankle joint remain unclear. Seven patients who visited our department between 2011 and 2023 and were diagnosed withD-TSGCT of the ankle joint by contrast-enhanced MRI and a pathological diagnosis were included. The invasion patterns of ankle D-TSGCT on MRI were investigated. The recurrence rate and clinical symptoms were examined in five patients followed up for more than seven years after total resection. In seven patients (1 male/6 females, mean age 37.0±16.6 years, range 15-57 years) with D-TSGCT of the ankle joint, contrast-enhanced MRI at the initial presentation showed invasion within the ankle joint, extending along the tendon sheath, within the talocalcaneal joint, and in the tarsal sinus in 100% of cases, around the deltoid ligament in 86%, within the plantar surface in 43%, invasion of the interosseous membrane in 57%, around the Achilles tendon in 29%, and scalloping on the talocrural joint in 43%. The mean time from mass awareness to the first visit was 51.9±80.0 months (range 1-240 months). Gross total resection, defined as the removal of all tumors as gauged by MRI, was initially performed on 6/7 patients. One patient underwent partial resection of only the anterior part of the tumor. Of the six cases in which gross total resection was performed, 5 had long-term follow-up of more than seven years post-operatively, and one case is still only one year post-operatively. The long-term results offive patients followed for more than seven years after total resection were as follows: a mean follow-up period of 125 months (range 89-171 months), a 100% recurrence rate, a mean time to recurrence of 27.5±19.2 months (range 7-60 months), and a 16% reoperation rate. In the last follow-up, osteoarthritic changes were observed radiographically in 2/5 patients (40%), both of whom had scalloping of the talocrural joint on MRI at the time of the initial diagnosis. Four of the five patients (80%) had no clinical symptoms in the last follow-up. Ankle D-TSGCT presents with a strong local infiltrative pattern inside and outside the ankle joint along the tendon sheath, radical resection may be difficult, and the recurrence rate may be higher than previously reported. On the other hand, there are many cases that remain free of clinical symptoms in the long term after recurrence, and surgical indications for ankle D-TSGCT need to consider function preservation as well as recurrence rates.