Anterior Portion Research Articles

P22 Between the devil and the deep blue sea – a diagnostic dilemma

P22 Between the devil and the deep blue sea – a diagnostic dilemma

Analysis of cartilage injury patterns and risk factors for knee joint damage in patients with primary lateral patella dislocations.

BackgroundLateral patellar dislocation (LPD) frequently causes damage to the knee. Injury patterns and risk factors contributing to such injuries have not yet been examined in detail.MethodsWe retrospectively analyzed 50 consecutive patients with primary LPD. Two reviewers evaluated the MRI images regarding risk factors for LPD (Dejours classification; Caton-Deschamps Index, CDI; distance from the tibial tuberosity to trochlear groove, TT-TG; trochlear depth, TD) as well as joint damages according to the Whole-Organ Magnetic Resonance Imaging Score (WORMS).Results33 male and 17 female patients with a mean age of 23.2 (±9.6) years were included in this study. 52% were classified Dejours ≥ B, 34% had a CDI ≥ 1.3, 22% a TT-TG ≥ 20mm and 52% a TD < 3mm. 49 out of 50 patients (98%) showed abnormalities according to WORMS. The most frequently observed abnormalities were synovitis/effusion (49/50, 98%), bone marrow oedema (44/50, 88%) and cartilage damage (42/50, 84%). Most frequently affected subregions were medial (41/50, 82%) and lateral (31/50, 62%) patella as well as the anterior (43/50, 86%), central (42/50, 84%) and posterior (11/50, 22%) portion of the lateral femoral condyle. There was no significant correlation between any of the examined risk factors and joint damages according to WORMS. Male patients had higher scores regarding total cartilage damage (5.11 vs. 2.56, p = 0.029), total score for the lateral femorotibial joint (3.15 vs. 1.65, p = 0.026) and overall total WORMS score (12.15 vs. 8.29, p = 0.038).ConclusionRisk factors for LPD do not influence the risk of damages to the knee joint after primary LPD. Although LPD is generally known to affect more female than male patients, male patients suffered more severe injuries after primary LPD, particularly of the lateral femorotibial joint. Overall, our results underline the importance of MRI imaging after primary LPD.

Force production and muscle activation during partial vs. full range of motion in Paralympic Powerlifting.

Paralympic Powerlifting is a sport in which the strength of the upper limbs is assessed through bench press performance in an adapted specific bench. It is therefore essential to optimize training methods to maximize this performance. The aim of the present study was to compare force production and muscle activation involved in partial vs. full range of motion (ROM) training in Paralympic Powerlifting. Twelve male athletes of elite national level in Paralympic Powerlifting participated in the study (28.60 ± 7.60 years of age, 71.80 ± 17.90 kg of body mass). The athletes performed five sets of 5RM (repetition maximum), either with 90% of 1RM in full ROM or with a load of 130% 1RM in partial ROM. All subjects underwent both exercise conditions in consecutive weeks. Order assignment in the first week was random and counterbalanced. Fatigue index (FI), Maximum Isometric Force (MIF), Time to MIF (Time) and rate of force development (RFD) were determined by a force sensor. Muscle thickness was obtained using ultrasound images. All measures were taken pre- and post-training. Additionally, electromyographic signal (EMG) was evaluated in the last set of each exercise condition. Post-exercise fatigue was higher with full ROM as well as loss of MIF. Full ROM also induced greater. EMG showed greater activation of the Clavicular portion and Sternal portion of pectoralis major muscle and lower in the anterior portion of deltoid muscle when full ROM was performed. Muscle thickness of the pectoralis major muscle increased post-exercise. We concluded that training with partial ROM enables higher workloads with lower loss of muscle function.

Variable negative external pressure-an alternative to continuous positive airway pressure for the treatment of obstructive sleep apnea: a pilot study.

To assess variable negative external pressure (vNEP) therapy using a range of pressures and varying collar sizes and shapes to identify combinations that improve the efficacy and comfort of this emerging therapy for obstructive sleep apnea (OSA). This prospective, open-label pilot study included 28 eligible patients (71% men) having documented moderate OSA (apnea-hypopnea index [AHI] 15 events/h ≤ AHI ≤ 30 events/h) at 1 sleep clinic for an overnight, in-lab sleep trial. Each participant tested at least 2 of 6 available vNEP devices during sleep periods ≥ 2 hours. During the assessment of AHI by polysomnography, negative pressures of -20 cm H2O to -35 cm H2O were adjusted to improve each patient's response. Participants' therapeutic preferences were assessed by a questionnaire and interviews. Twenty (71%) of the participants responded to vNEP therapy: excellent response (AHI ≤ 5 events/h) was observed in 14 (50%); 6 (21%) achieved a partial response (AHI ≤ 50% baseline). For the 20 responders, the therapy reduced the fraction of total sleep time when peripheral oxygen saturation < 90% and improved minimum pulse oximetry oxygen saturation. Six patients experienced a minor, self-limited adverse event. Twenty-six participants (93%) stated that they would use vNEP nightly. In this pilot study, vNEP therapy markedly improved AHI and oxygenation in most patients with moderate OSA. The majority of participants found vNEP comfortable and preferable to prevailing OSA therapies. Further development and studies of vNEP are warranted. Registry: ClinicalTrials.gov; Name: Study of Variable Negative External Pressure (vNEP) in Reducing Respiratory Event in Individuals With OSA; URL: https://clinicaltrials.gov/ct2/show/NCT04718142; Identifier: NCT04718142. Kram JA, Pelayo R. Variable negative external pressure-An alternative to continuous positive airway pressure for the treatment of obstructive sleep apnea: A pilot study. J Clin Sleep Med. 2022;18(1):305-314.

S2373 A Case of a Deep Infiltrative Rectal Endometriosis Presenting as a Solitary Ulcer and Lumbosacral Shingles

Introduction: Deep bowel endometriosis is a rare, clinically challenging diagnosis mimicking many gastrointestinal diseases. There are no clear guidelines for the evaluation of patients with suspected bowel endometriosis, therefore a high index of suspicion is warranted. Case Description/Methods: A 39 year old female with a history remarkable for fibroidectomy and constipation presents for rectal bleeding and discomfort for 1 month. In 2012, FOBT was positive and colonoscopy findings were significant for a solitary rectal ulcer. Biopsies showed inflammation. Due to persistent symptoms, a flexible sigmoidoscopy (2013) with repeat biopsies confirmed the diagnosis of deep bowel endometriosis located at the anterior portion of the rectum. Hormonal therapy offered complete resolution of her symptoms. In 2021, due to menopausal symptoms, hormonal therapy was discontinued leading to recurrence of symptoms and new onset right sided lumbosacral shingles. Colonoscopy findings were significant for luminal narrowing and nodularity at the anterior portion of the rectum. Biopsies were nonspecific. Discussion: Given that endometriosis rarely infiltrates the submucosa or mucosa (6.4% of cases), initial colonoscopy and biopsy findings may be nonspecific. Hence, an initial inappropriate diagnosis may occur, demonstrating how challenging this diagnosis may become. Even though the gold standard for diagnosis is direct laparoscopic visualization or tissue diagnosis, imaging modalities such as transvaginal and transrectal US and MRI may diagnose and determine the extent of deep bowel endometriosis. Response to hormonal treatment in deeply infiltrating bowel endometriosis is unpredictable and may require a surgical approach. The natural course of bowel endometriosis has not been formally established. Some authors describe inactive endometriosis as a nodular and fibrotic lesion associated with adhesions and strictures. This correlated with the findings of our patient's latest colonoscopy. Association of endometriosis with rheumatological and autoimmune disorders have been established, where theories based on genetic dysregulation of immune, adhesion, and inflammatory processes take part in the disease pathology. This may explain the greater likelihood of shingles reactivation, such experienced by our patient, during an immunocompromised state such as menopause. Even though deep bowel endometriosis is poorly understood, a high index of suspicion is crucial to offer patients a correct diagnosis and appropriate treatment options.Figure 1.: Deep bowel endometriosis. (Top, left to right) Colonoscopy findings from 2012 (first 2 images) and 2013 respectively showing an abnormal mucosal lesion in the proximal portion of the anterior rectum. (Bottom, left to right) Colonoscopy findings from 2021 showing mucosal nodularity in the proximal portion of the anterior rectum.

Dual coding of knowledge in the human brain.

How does the human brain code knowledge about the world? While disciplines such as artificial intelligence represent world knowledge based on human language, neurocognitive models of knowledge have been dominated by sensory embodiment, in which knowledge is derived from sensory/motor experience and supported by high-level sensory/motor and association cortices. The neural correlates of an alternative disembodied symbolic system had previously been difficult to establish. A recent line of studies exploring knowledge about visual properties, such as color, in visually deprived individuals converge to provide positive, compelling evidence for non-sensory, language-derived, knowledge representation in dorsal anterior temporal lobe and extended language network, in addition to the sensory-derived representations, leading to a sketch of a dual-coding knowledge neural framework.

Editorial introductions.

Editorial introductions.

Fungal keratitis due to Rhodotorula glutinis: A Case Report

We describe a case of mycotic keratitis involving a rare fungus and review the literature on Rhodotorula keratitis. A 40-year-old man was struck in the right eye with a tree branch and developed a corneal ulcer involving the anterior portion of the cornea. Cultures grew Rhodotorula glutinis. The patient was initially treated with topical amphotericin, but only improved with topical and intracameral voriconazole administration. The corneal infiltrate resolved, leaving an anterior stromal scar, and the patient’s best-corrected visual acuity was 20/60 in the involved eye. Cases of Rhodotorula keratitis can pose a challenge to the ophthalmologist, with the diagnosis and the treatment regimen, as this yeast may not respond well to commercially available drugs. We report a case of Rhodotorula keratitis that was only resolved with voriconazole. Our case rein- forces the importance of the early diagnosis and correct management of fungal keratitis involving this rare, but potentially damaging yeast.

Transverse Growth of the Maxillo-Mandibular Complex in Untreated Children: A Longitudinal Cone Beam Computed Tomography Study.

The aim of this study is to evaluate the longitudinal transverse growth of the maxillo-mandibular complex in untreated children using the Cone Beam Computed Tomography (CBCT). Two sets of scans on 12 males (mean 8.75 years at T1 and 11.52 years at T2) and 18 females (mean 9.09 years at T1 and 10.80 years at T2) were analyzed using Dolphin 3D imaging. The transverse widths of various maxillary and mandibular skeletal landmarks and the dentoalveolar and dental landmarks at the level of first molars were measured. Overall, there were greater increases in the transverse dimension in the posterior than anterior portions of the maxilla and mandible. The increase in intergonial width of the mandible seems to be primarily due to the lengthening of the mandibular body. The dentoalveolar process at the first molar level increases at an equal rate corono-apically and is independent to the changes in molar inclination. When comparing maxillary dentoalveolar changes with that of the mandible, greater increases were noticed in the maxilla, which might be explained by the presence of sutural growth in the maxilla. Moreover, the first molars maintain their coordination with each other despite the differential increase in the maxillary and mandibular dentoalveolar processes.

Arthroscopic Labral Repair Using Knotless Suture Anchors in the Setting of a 270° Labral Tear of the Shoulder

Extensive glenoid labral tears, whether the result of repetitive instability or first-time dislocation, compromise the mechanical stability of the glenohumeral joint due to disruption of the anterior, inferior, posterior, and/or superior portions of the labrum. These lesions often result in recurrent multiplanar instability and pain that is nonresponsive to conservative management and difficult to diagnose due to variability in clinical presentation and advanced imaging findings. Arthroscopic repair techniques to address symptomatic shoulder instability have showed positive patient-reported outcomes, low failure rates, and high return-to-sport rates. The evolution of knotless suture anchors offers a fixation method that has proven to be functionally equivalent to knotted suture anchors while avoiding the risks of knotted anchors (knot loosening, knot migration, articular abrasion) and allowing easier placement and decreased operative time. The purpose of this technique is to describe our preferred method to treat a 270° labral tear through arthroscopic knotless anchor repair and demonstrate the expanded application of this technique for extensive glenoid labral pathology.

Systematic review of the genus Ostracodinium (Ciliophora, Entodiniomorphida, Ophryoscolecidae) and notes on the taxonomy of Ostracodinium rugoloricatum Kofoid amp; MacLennan, 1932.

The family Ophryoscolecidae (Ciliophora, Entodiniomorphida) constitutes a diverse and monophyletic group of symbiotic ciliates of herbivorous mammals. The family includes approximately 200 species, distributed in three subfamilies and sixteen genera. The subfamily Diplodiniinae is the most diverse group in Ophryoscolecidae and comprises the genus Ostracodinium, which includes species with two retractable ciliary zones in the anterior body portion, a broad skeletal plate covering almost all the right surface of the body and a variable number of contractile vacuoles. The genus currently comprises 28 species, classified according to body size and shape, position and shape of the nuclear apparatus, number and position of contractile vacuoles, and number and shape of caudal projections. The present study performs a systematic review of the genus Ostracodinium, based on morphological and molecular data, and provides data about geographic distribution and hosts of each species.

Epidermal Growth Factor Receptor Expression in the Corneal Epithelium.

A properly functioning cornea is critical to clear vision and healthy eyes. As the most anterior portion of the eye, it plays an essential role in refracting light onto the retina and as an anatomical barrier to the environment. Proper vision requires that all layers be properly formed and fully intact. In this article, we discuss the role of the epidermal growth factor receptor (EGFR) in maintaining and restoring the outermost layer of the cornea, the epithelium. It has been known for some time that the addition of epidermal growth factor (EGF) promotes the restoration of the corneal epithelium and patients using EGFR inhibitors as anti-cancer therapies are at increased risk of corneal erosions. However, the use of EGF in the clinic has been limited by downregulation of the receptor. More recent advances in EGFR signaling and trafficking in corneal epithelial cells have provided new insights in how to overcome receptor desensitization. We examine new strategies for overcoming the limitations of high ligand and receptor expression that alter trafficking of the ligand:receptor complex to sustain receptor signaling.

A Taxonomic Survey of Female Oviducal Glands in Chondrichthyes: A Comparative Overview of Microanatomy in the Two Reproductive Modes.

Simple SummaryThe oviducal gland (OG) is a specialized region of the reproductive female system in cartilaginous fish located in the anterior oviduct. Its biological importance is closely related to the reproductive modalities of these species, and its basic function is the production of the egg jellies, the tertiary envelope formation (egg case in oviparous and candle case in viviparous) and sperm storage. Since knowledge on the overall process of Chondrichthyes reproduction is still scarce, in this study we conducted morphological and morphometrical analysis on the OGs belonging to several cartilaginous fish displaying two different reproductive modalities (oviparity and viviparity). Moreover, we paid particular attention to the fate of spermatozoa in the female reproductive tract, which would be useful to better understand the ecology and population dynamics of these species.Oviducal glands (OGs) are distinct expanded regions of the anterior portion of the oviduct, commonly found in chondrichthyans, which play a key role in the production of the egg in-vestments and in the female sperm storage (FSS). The FSS phenomenon has implications for understanding the reproductive ecology and management of exploited populations, but little information is available on its taxonomic extent. For the first time, mature OGs from three lecithotrophic oviparous and four yolk-sac viviparous species, all considered at risk from the fishing impacts in the central western Mediterranean Sea, were examined using light microscopy. The OG microanatomy, whose morphology is generally conserved in all species, shows differences within the two reproductive modalities. Oviparous species show a more developed baffle zone in respect to viviparous ones because of the production of different egg envelopes produced. Among oviparous species, Raja polystigma and Chimaera monstrosa show presence of sperm, but not sperm storage as observed, instead, in Galeus melastomus and in all the viviparous sharks, which preserve sperm inside of specialized structures in the terminal zone.

Two new species of Dugesia (Platyhelminthes, Tricladida, Dugesiidae) from the tropical monsoon forest in southern China.

Two new species of the genus Dugesia (Platyhelminthes, Tricladida, Dugesiidae) from the tropical monsoon forest in southern China are described on the basis of an integrative taxonomic study involving morphology, karyology, histology, and molecular analyses. The new species Dugesiacircumcisa Chen & Dong, sp. nov. is characterised by asymmetrical openings of the oviducts; right vas deferens opening at anterior portion of the seminal vesicle and the left one opening at mid-lateral portion of the seminal vesicle; two diaphragms in ejaculatory duct, the latter being ventrally displaced and opening at the tip of the penis papilla, which is provided with a nozzle; wide duct connecting male atrium and common atrium; chromosome complement triploid with 24 metacentric chromosomes. The other new species, Dugesiaverrucula Chen & Dong, sp. nov., is characterised by the large size of the living worm, usually exceeding 3.5 cm in length; asymmetrical openings of the oviducts; subterminal opening of ventrally displaced ejaculatory duct; vasa deferentia symmetrically opening into the postero-lateral portion of the seminal vesicle; well-developed duct between the seminal vesicle and diaphragm; single dorsal bump near the root of the penis papilla; bursal canal with pleated wall and spacious posterior section; unstalked cocoons; chromosome complement diploid with 16 metacentric chromosomes. Inter-specific molecular distances and their positions in the phylogenetic tree reveal that D.circumcisa and D.verrucula are clearly separated from their congeners.

Digestive tube of an herbivorous fish (Rhytiodus microlepis) from the Amazonian floodplain lakes: A morphological and histochemical study.

This study describes the morphology and histochemistry of the digestive tube of the herbivorous fish Rhytiodus microlepis, which is commonly found in the Amazonian floodplain lakes, Brazil. Thirty-eight fish were used in this study. The digestive tube was measured and dissected for anatomical description, and stained with (i) haematoxylin and eosin, for histological analyses; (ii) periodic acid-Schiff, for detected neutral mucins; and (iii) Alcian Blue (AB) pH 1.0 and 2.5 for acid and sulphated acid mucins. The oesophagus, with its secretory cells and taste buds, is adapted for lubrication of vegetable matter, resistance to friction and reception of stimuli. The stomach is U-shaped and rich in gastric glands, particularly in cardiac and fundic regions, which are adapted to receive large amounts of food, and promotes the digestion. The intestine comprises more than 70% of the digestive tube. All portions of the intestine, except the rectum, have the same pattern of mucosal folds, and the goblet cells reacted positively to all histochemical methods (PAS, AB 1.0 and 2.5), while rodlet cells reacted only to periodic acid-Schiff (PAS) staining. Neutral mucins and sulphated acid mucins predominated in the anterior portion of the intestine and a high concentration of carboxylated acid mucosubstances were present in the other portions. The rectum showed a strong reaction to all histochemical methods. The muscular layer of the intestine consists of three layers, which showed features presumably related to the rigid nature of the food. A simple squamous epithelium constitutes the serous layer over the entire length of the tube.

Research Progress of Nanostructured Lipid Carriers in Ocular Drug Delivery

: The eye is the most important sensory organ, which restricts most of the active substances due to its static and dynamic barriers. The application of conventional eye drop is still popular, but it was found to be less permeable to both anterior and posterior eye portions, requiring more frequent administration. It seems to be a great challenge for the researcher to fabricate an ocular formulation that crosses the barriers and achieves an optimal therapeutic concentration at the ocular globe. Recent studies revealed that a nanostructured lipid carrier has great potential in ophthalmic use and has become more popular due to its permeability in the eye cavity. : This review describes the nanostructured lipid carriers with respect to the mechanism of ocular permeation, structural feature, manufacturing process, characterization, and its merits over other nanocarriers. In recent years, newly nanostructured-based ocular formulations have been developed, like surface-modified with various cationic compounds and their integration with different polymeric systems, to enhance ocular bioavailability in both regions of the eye. Newly developed nanostructured lipid carriers include surface modified cationic lipid, polymers, and thiolated compounds, etc., that increases mucoadhesive property. Finally, nanostructured incorporated forms, in situ gel, and hydrogel increase permeation in the posterior region of the eye.

Askin Tumor: A Case Report of a Rare Tumor

Askin tumor is a rare malignant neoplasm of neuro-ectodermal origin that emerges from the soft tissue of the thoraco-pulmonary wall and has aggressive activity. This paper presents a study on a 10-year-old boy having breathing difficulty and mass on the anterior portion of the left thoracic wall. On examination, there was a mass on the left anterior chest wall measuring 13x13 cm2, which was hard, tender, and fixed to the chest wall. There was associated pleural effusion and infiltration into the left lung. Histopathology confirmed primitive neuro-ectodermal tumor (Askin tumor) with IHC marker CD99 positive. Chemotherapy was used to treat the patient. Early detection of this tumor would necessitate a high index of suspicion, allowing for a better prognosis and result. The overall prognosis is poor due to the higher rate of local recurrence.

V13-01 EXTENDED URETERAL MEATOTOMY FOR OUTPATIENT CHEMOTHERAPY ADMINISTRATION AND URETEROSCOPY IN PATIENTS WITH UPPER TRACT UROTHELIAL CARCINOMA

You have accessJournal of UrologyBladder & Upper Tract Urothelial Oncology (V13)1 Sep 2021V13-01 EXTENDED URETERAL MEATOTOMY FOR OUTPATIENT CHEMOTHERAPY ADMINISTRATION AND URETEROSCOPY IN PATIENTS WITH UPPER TRACT UROTHELIAL CARCINOMA Nikhil Gopal, Sameh Naim, Bertie Zhang, John Phillips, and Majid Eshghi Nikhil GopalNikhil Gopal More articles by this author , Sameh NaimSameh Naim More articles by this author , Bertie ZhangBertie Zhang More articles by this author , John PhillipsJohn Phillips More articles by this author , and Majid EshghiMajid Eshghi More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002100.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Patients with ureteral tumors managed endoscopically often benefit from adjuvant immuno-chemotherapy and require interval upper tract surveillance with ureteroscopy. However, both often require general anesthesia, which can be problematic for a predominantly elderly population with multiple co-morbidities. Here we describe an endoscopic technique of ureteral meatotomy to not only predictably allow for reflux of intravesical agents through the ureter, but also to allow upper tract endoscopy to be performed in the office setting. METHODS: From 2015-2021, we performed ureteral meatotomy on 10 patients. All patients who underwent this procedure had upper tract urothelial tumors deemed suitable for primary endoscopic management, based on patient’s clinical characteristics; tumor number; size; location; and/or biopsy grade.Under general anesthesia, a 10 F dual lumen ureteral catheter or 6-12 F Nottingham dilator was inserted into the distal ureter in order to allow for alignment of the ureter towards the bladder neck and to ensure the orifice is incised in the correct direction. Using either a Holmium laser or Collin’s knife, a full-thickness 2 cm incision was made on the distal intramural ureter at the 12 o’clock position, until the anterior portion of the catheter was visualized. Intraoperative cystogram was used to confirm ureteral reflux. A double J stent was then left in place for 3 weeks for mucosal healing and reshaping of the distal ureteral segment. Postoperatively, patients underwent 6 cycles of mitomycin, either via indwelling Foley catheter or nephrostomy tube. Lower and upper urinary tract surveillance was performed using flexible cystoscope and/or ureteroscope in the office every 3-6 months for the first two years and annually thereafter. RESULTS: 10 patients with average age of 77 years, 40% of whom were male, underwent ureteral meatotomy between 2015 and 2021. 90% of tumors were either in the distal ureter or UPJ/renal pelvis. Average tumor size was 1.6 cm. 70% of tumors were low grade on biopsy. 3 patients had concomitant bladder cancer. There were no complications associated with chemotherapy instillation. Of the patients who had only upper tract disease, none developed a new recurrence in the bladder. CONCLUSIONS: We describe a novel anterior intramural ureteral incision technique in patients with ureteral tumors managed endoscopically that reliably allows for both chemotherapy administration and upper tract surveillance in an office setting. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e1078-e1078 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Nikhil Gopal More articles by this author Sameh Naim More articles by this author Bertie Zhang More articles by this author John Phillips More articles by this author Majid Eshghi More articles by this author Expand All Advertisement Loading ...

A case report of ectopic salivary gland tissue in the larynx

Submucosal laryngeal masses are challenging for ENT specialists as the diagnosis usually remains uncertain until histopathological examination is carried out. We report a case of a 54-year old man complaining of dysphonia and globus sensation. Flexible laryngoscopic examination showed a submucosal swelling in the right anterior laryngeal ventricle. Microlaryngoscopic excision of the submucosal mass was performed. Histological examination revealed salivary gland tissue. We found only a few cases in the literature of ectopic salivary gland tissue situated in the larynx. In these cases, the salivary gland tissue was also located at the anterior portion of the true or false vocal fold. Thus, it is necessary to consider this condition in the differential diagnosis of a submucosal mass in the anterior true or false vocal fold or laryngeal ventricle.

New specimens provide insights into the anatomy of the dinosauriform Lewisuchus admixtus Romer, 1972 from the upper Triassic levels of the Chañares Formation, NW Argentina.

Lewisuchus admixtus is an early dinosauriform described by Alfred Romer in 1972 on the basis of a single, incomplete skeleton, collected in lower Upper Triassic rocks of the renowned Chañares Formation, at the Los Chañares type-locality, La Rioja Province, north-western Argentina. Recent field explorations to the type-locality resulted in the discovery of two partial articulated skeletons, which provide significant novel information. The cranial bones, presacral series, femur, tibia, and proximal tarsals of the new specimens match the preserved overlapping anatomy of the holotype and previously referred specimens of L. admixtus, including the presence of unique combination of character states among dinosauriforms (anterior presacral column with additional ossification on the top of neural spines, dorsal neural spines fan-shaped, anterior surface of the astragalus with a dorsally curved groove, and an inflated area on the anterior portion of the medial surface of this bone). This new information improves our understanding of the anatomy and taxonomy of early dinosauriforms and reinforces the role of Argentinean beds on the study of the origin of dinosaurs.