Auricular Vein Research Articles

An unilateral double fenestration of the right external jugular vein: a rare variant.

This report presents a rare anatomical variation, double fenestration of the External jugular vein on the right side. During the routine dissection of a male cadaver aged 60 years, we observed a unilateral large double fenestration of the External jugular vein on the right side. After its formation from the posterior division of the retromandibular and posterior auricular veins, External jugular vein descended in the posterior triangle of neck. Here, it divided into medial, intermediate, and lateral veins that united again before draining into the subclavian vein. Lateral vein was the largest (7.2cm) and intermediate and medial veins were measuring 6.4cm each. Two large fenestrations, measuring 5.8cm each, arranged like a "double bubble" were seen in the External jugular vein extending from fourth to sixth cervical (C4 to C6) vertebrae. The medial branch of supraclavicular nerve was seen passing superficial to the distal part of External jugular vein. On the left side, the course of External jugular vein showed a standard pattern. Surgeons must be acquainted with the varied anatomy of the superficial neck veins to prevent major bleeding during operative procedures, including carotid endarterectomy, flap operations, & central venous catheterisation.

Mastoid Emissary Foramina in Dry Skulls: Its Morphometry, Topography, and Associated Clinical Implications.

Mastoid emissary foramen transmitting mastoid emissary vein connects the posterior auricular vein with the sigmoid sinus. This foramen and so the mastoid emissary vein varies in prevalence, number, size and location, knowledge of which is essential for carrying out uneventful surgeries, especially retrosigmoid, mastoidectomy, and skull base surgeries. There is a paucity of literature on this foramen in the Indian context, so the study was done. The purpose of the study is to elaborate on the prevalence, number, size, and location of mastoid foramen in dry adult skulls. The study was conducted in the Department of Anatomy using 90 dry skulls of unknown age and sex, and prevalence, number, size, and location in these skulls were noted. The mastoid foramen was detected in 27.8% of skulls, with an incidence of 31.1% and 12.2% on right and left sides of skulls, respectively. The number of foramina ranged between 1 and 4. The mean diameter of this foramen was 0.9mm, and the most frequent location was mastoid process. The detailed morphology and morphometry of mastoid foramen are of utmost use to neurosurgeons, ENT surgeons, radiologists, and vascular surgeons as it transmits mastoid emissary vein and meningeal branch of the occipital artery, which may be injured during various surgical procedures involving mastoid region and skull base causing catastrophic hemorrhage. In addition to this, mastoid emissary vein may be the source of thrombus, causing thrombus of sigmoid sinus creating helm of neurological complications.

A Rare Combined Variation of the Fenestrated External Jugular Vein, Absent Retromandibular Vein, and Hypoplastic Internal Jugular Vein

A unique venous pattern was observed on the left side of the neck in a 70-year-old male cadaver. Variations were observed in the formation of the external jugular vein (EJV) associated with a hypoplastic internal jugular vein (IJV). The retromandibular vein did not form, and the superficial temporal vein continued as the EJV. The linguofacial and maxillary veins united and drained into the EJV, whereas the posterior auricular vein was absent. In addition, a slit-like fenestration in the EJV was present in the middle of the vein, which was 41.54 mm long. IJV of the same side was hypoplastic throughout its course in the neck, and the external diameter was 6 mm. IJV and EJV are frequently accessed for central venous pressure monitoring or intravenous infusion and are encountered during cervical lymphadenectomy. Awareness of the anatomical irregularities is critical to avert unanticipated complications.

Network pharmacology and experimental verification to explore the anti-superficial thrombophlebitis mechanism of Mailuo shutong pill

Ethnopharmacological relevanceMailuo shutong pill (MLST) has been widely used in clinical treatment of superficial thrombotic phlebitis (STP). Nevertheless, the major active components of MLST and the mechanism of synergistic action have not been reported. Aim of the studyThe present study aimed to evaluate the improving effects and the underlying mechanism of MLST on mannitol-induced STP in rabbits. Material and methodsIn this study, Ultrahigh-performance liquid chromatography electrospray ionization quadrupole-exactive orbitrap mass spectrometry (UHPLC-ESI-Q-Exactive-Orbitrap-MS) was used to analyze and identify the chemical composition of MLST and the prototype components absorbed into the blood. Then, according to the prototype components in serum, the targets and mechanisms of MLST were explored by applying network pharmacology. The rabbit model of STP was established by injecting 20% mannitol into bilateral auricular vein. The pathological changes of rabbit ear tissues, inflammatory factors, coagulation function and hemorheology were detected. In addition, molecular docking verified the interaction between the main active ingredient and the key target. Finally, the PI3K/AKT pathway and its regulated downstream pathways were verified by Western blot. ResultsA total of 96 MLST components and 53 prototypical components absorbed into the blood were successfully identified. Based on network pharmacology, PI3K/AKT pathway and 10 chemical components closely related to this pathway were obtained. Hematoxylin-eosin (HE) staining results indicated that MLST effectively improved of the pathological damage of ear tissues. MLST decreased levels of tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6 and C-reactive protein (CRP). The expression of platelets (PLT) and fibrinogen concentration (FIB) was decreased, while prothrombin time (PT) and activated partial thromboplastin time (APTT) were prolonged. In addition, the plasma viscosity and whole blood viscosity in the MLST groups were significantly decreased. The more important discovery was that the expressions of P-PI3K, VEGF, P-AKT, P-IκB-α, P–NF-κB, NLRP3, ASC, Cleaved IL-1β and Cleaved Caspase-1 were effectively reversed after treatment with MLST. ConclusionsThis study comprehensively analyzed and characterized the chemical composition of MLST and the prototypical components absorbed into the blood. This study strongly confirmed the pharmacodynamic effect of MLST on STP. More importantly, this pharmacodynamic effect was achieved through inhibition of the PI3K/AKT pathway and its regulated NF-κB and NLRP3 pathways.

Regulatory mechanism of the six-method massage antipyretic process on lipopolysaccharide-induced fever in juvenile rabbits: A targeted metabolomics approach

ObjectiveTo investigate the mechanism of the six-method massage antipyretic process (SMAP) and its influence on the body's metabolic state. MethodsThe random number table method was used to divide 24 New Zealand 2-month-old rabbits with qualified basal body temperature into a control group, model group and massage group (n = 8 per group). The model group and massage groups were injected with 0.5 μg/ml lipopolysaccharide (1 ml/kg) into the auricular vein, and the control group was injected with the same amount of normal saline at the same temperature. One hour after modelling, the massage group was given SMAP (opening Tianmen, pushing Kangong, rubbing Taiyang, rubbing Erhougaogu, clearing the Tianheshui and pushing the spine). The change of anal temperature 5 h after moulding was recorded to clarify the antipyretic effect. ResultsAfter modelling, the rectal temperature of the juvenile rabbits in the three groups increased. The rectal temperature of the model group was higher than that of the control group 5 h after modelling, and the rectal temperature of the massage group was lower than that of the model group (P < 0.05). The antipyretic mechanism is related to the regulation of the synthesis of phenylalanine, tyrosine and tryptophan, as well as the pentose phosphate pathway. Compared with the model group, the plasma interleukin (IL)-1, IL-6, interferon-gamma, toll-like receptor 4, nuclear factor κB, the mechanistic target of rapamycin complex 1, indoleamine 2,3-dioxygenase 1, aryl hydrocarbon receptor, liver aspartate transaminase (AST), alanine transaminase (ALT) and l-glutamate dehydrogenase (L-GLDH) expression in the massage group were significantly decreased (P < 0.05). Compared with the model group, the massage group had significantly reduced AST, ALT and L-GLDH expression in plasma (P < 0.05). ConclusionThe mechanism of SMAP therapy is related to regulating the expression of peripheral inflammatory factors and metabolic pathways.

Abstract 019: Effective Diagnostic Testing For Uncommon Etiologies Of Venous Pulsatile Tinnitus

Introduction Pulsatile Tinnitus (PT) is a rhythmic sound in the ears. It can be incapacitating and is even associated with depression and suicidal ideationi. The etiology of PT can be grouped into vascular and non‐vascular causes. ii,iii While prominent venous structures may be believed to be the underlying cause of PT, interventions on these structures do not always result in symptom resolution. Successful treatment is contingent on correctly identifying culpable vascular targets. In this case series, we report 4 cases of pulsatile tinnitus that were successfully treated with endovascular intervention. Methods Retrospective chart review of patients who presented with symptoms of pulsatile tinnitus who were found to have symptoms that resolved on balloon‐occlusion‐testing of various cerebral veins. Results Case 1 A 42‐year‐old woman was referred for right‐sided PT which affected her sleep and quality of life. The initial venogram showed a right internal jugular (IJ) vein diverticulum, which was subsequently coiled. This resulted in a transient improvement in tinnitus. However, her symptoms returned within a few weeks and a repeat venogram showed an enlarged right MEV. She elected to undergo right MEV coil embolization. Two weeks post‐op she noted an improvement of her symptoms, with near resolution. On follow‐up exams, when she applied pressure on her right occipital groove, the tinnitus diminished. Under ultrasound guidance, her PT disappeared when the posterior auricular vein collapsed under applied pressure and returned when the pressure was released. For management she underwent coil embolization of the right occipital vein, as this was the vessel the posterior auricular vein was draining into. Following this intervention her tinnitus resolved. Case 2 A 73‐year‐old male was referred for bilateral pulsatile tinnitus. Initially, he underwent stent‐assisted coiling of a high‐riding jugular bulb with no change in symptoms. During a diagnostic venogram, a balloon‐occlusion test (BOT) of the right mastoid emissary vein (MEV) was performed. Following testing, he reported improved tinnitus. He underwent coil embolization of the right MEV which led to complete resolution of right‐sided PT. Case 3 A 50‐year‐old female was referred for evaluation of right‐sided PT. Catheter venography showed an enlarged right posterior condylar vein (PCV) and right IJ stenosis. Balloon occlusion test (BOT) of the PCV demonstrated improvement in PT. She underwent stent‐assisted coil embolization of the PCV and stenting of her IJ with resolution of her tinnitus. Case 4 A 56‐year‐old female was seen for left‐sided PT, ear fullness, and reduced hearing. A CT venogram revealed left IJ stenosis. Catheter venography showed minimal left IJ stenosis, but a dilated left MEV, measuring 7.31 mm in its widest dimension). BOT of the left MEV resulted in improvement in symptoms. She is scheduled for left MEV coil embolization. Conclusion In this report, we demonstrate 4 cases where abnormal venous structures were the suspected cause of tinnitus based on pre‐treatment occlusion testing. The 3 individuals who have undergone coil embolization of anomalous venous structures have experienced resolution of PT. Balloon occlusion is a useful diagnostic test for therapeutic targeting of abnormal venous etiologies of PT.

The effect of intravenous lipid emulsion (ILE) on the pharmacokinetic/toxicokinetic dispositions of ivermectin and carprofen in rabbits.

Intravenous lipid emulsion (ILE) has been widely used as an effective antidote in both veterinary and human medicine for the treatment of acute intoxications caused by drugs and pesticides with high lipid solubility. This study was conducted to investigate the effect of ILE co-administration on the kinetic dispositions of ivermectin (IVM) and carprofen (CRP) following intravenous bolus administration at subtoxic doses in rabbits.Twenty-four male New Zealand rabbits weighing 2.78 ± 0.2kg were used in this study. Rabbits were divided into four groups (Group 1: IVM and Group 2: IVM + ILE or Group 3: CRP and Group 4: CRP + ILE), each group consisting of 6 animals. In the IVM study, Group 1 received IVM (0.6mg/kg) alone while Group 2 received IVM (0.6mg/kg) and ILE (2.5ml/kg). In the CRP study, Group 3 received CRP (12mg/kg) alone while Group 4 received CRP (12mg/kg) and ILE (2.5ml/kg). In both drug groups, ILE was administered 3 times as an i.v. bolus at the 10th min and repeated 4th and 8th h after the drug administration. Blood samples were collected from the auricular vein at various times after drug administration. The drug concentrations in plasma samples were determined by high-pressure liquid chromatography. Kinetic parameters were calculated using a non-compartmental model for both CRP and IVM.The C0 and area under the concentration-time curve from zero up to ∞ (AUC0-∞) values were significantly greater with ILE co-administration (2136ng/ml and 360.84ng.d/ml) compared to the IVM alone (1340.63ng/ml and 206ng.d/ml), respectively. Moreover, the volume of distribution (Vdss) and clearance (Cl) of IVM were reduced by approximately 42% and 46% with ILE co-administration compared to IVM alone resulting in a reduction of the distribution and slower elimination, respectively. Similar differences in C0, and Vdss values were also observed in CRP with ILE co-administration compared to CRP alone. ILE co-administration changed significantly the kinetic profile of both IVM and CRP in rabbits, supporting the lipid sink theory in which highly lipid-soluble compounds are absorbed into the lipid phase of plasma from peripheral organs such as the heart and brain affected by the acute toxicity of the compounds.

Serum Biochemical Profile of Captive Asian Elephants (Elephas maximus) in Tamil Nadu, India

The experiment was carried out in 46 apparently health captive elephants maintained in different parts of Tamil Nadu, India during the period from August 2020 to April 2021 to assess and evolve the baseline reference values for serum biochemical parameters in captive Asian elephants raised in the Tamil Nadu state of India.As part of the periodical health assessment, blood samples were collected from auricular vein for 46 apparently healthy captive Asian elephants maintained in Tamil Nadu, India. Biochemical analyses were performed using auto biochemical analyzer using commercial kits as per the recommendations of the manufacturer. The mean±SE, lower and upper value, 95% and 99% of confidence interval of the serum biochemistry parameters comprised of glucose, total protein, albumin, globulin, cholesterol, blood urea nitrogen (BUN), creatinine, total bilirubin, direct bilirubin, calcium, phosphorus, and magnesium, serum enzymes AST, ALT, ALP, CK, GGT and LDH were evaluated. The observed values were found to be within the normal ranges reported for the captive elephants and there were no significant differences observed between the age groups. These serum biochemical values would serve as baseline reference to evaluate the health and clinical conditions of captive elephant populations, as well as for planning health care measures in elephants of this region and adjoining areas.

Bloodletting at auricular dorsal vein combined with auricular point sticking for menstrual migraine of qi stagnation and blood stasis and its effect on serum levels of E2 and 5-HT

To observe the clinical effect of bloodletting at auricular dorsal vein combined with auricular point sticking on menstrual migraine (MM) of qi stagnation and blood stasis, and explore its possible mechanism. A total of 102 cases of MM with qi stagnation and blood stasis were randomly divided into an observation group (51 cases, 3 cases dropped off) and a control group (51 cases, 2 cases dropped off). The patients in the observation group were treated with bloodletting at auricular dorsal vein combined with auricular point sticking. The bloodletting was performed at vein at upper 1/3 of the dorsalis near the ear helix; the auricular point sticking was performed at Pizhixia (AT4), Neifenmi (CO18), Jiaogan (AH6a), Nie (AT2), Zhen (AT3), Shenmen (TF4) and Yidan (CO11). The auricular points of both ears were alternate used. From 7 days before the onset of menstruation, bloodletting at auricular dorsal vein was given once every 7 days, 3 times were taken as a course of treatment, and 1 course of treatment was given; the auricular point sticking was given once every 3 days, and 6 times of treatment were given. The patients in the control group were treated with oral administration of flunarizine hydrochloride capsules. From 7 days before the onset of menstruation, flunarizine hydrochloride was given 2 capsules per time, once a day for 3 weeks. The menstrual headache index and visual analogue scale (VAS) score of the two groups were observed before treatment, one menstrual cycle into treatment and the first and the second menstrual cycle after treatment; the migraine-specific quality of life questionnaire (MSQ) score and the serum levels of estradiol (E2) and 5-hydroxytryptamine (5-HT) were compared before treatment and one menstrual cycle into treatment; the clinical efficacy was evaluated at one menstrual cycle into treatment. Compared before treatment, the menstrual headache index and VAS scores were reduced at one menstrual cycle into treatment and the first and second menstrual cycle after treatment in the two groups (P<0.05), and those in the observation group were lower than the control group (P<0.05). Compared before treatment, the MSQ scores and the serum levels of E2 and 5-HT in the two groups were increased at one menstrual cycle into treatment (P<0.05), and those in the observation group were higher than the control group (P<0.05). The total effective rate was 95.8% (46/48) in the observation group, which was higher than 73.5% (36/49) in the control group (P<0.05). Bloodletting at auricular dorsal vein combined with auricular point sticking could relieve headache intensity, improve the quality of life in patients with MM of qi stagnation and blood stasis, which may be achieved by raising the serum levels of E2 and 5-HT to improve the level of hormone in the body.

IL 6 levels in Periodontitis Induced Rabbits after Treatment with Neem Bark Extract

Background: IL-6 has crucial role in the response to microbial insults. It acts as pro-inflammatory and anti-inflammatory agent. Hence IL 6 is an important inflammatory marker of periodontal disease. Levels of IL6 in Gingival crevicular fluid strongly indicate presence of periodontal disease which ultimately results in many health hazards. Aims: To measure levels of IL 6 in periodontitis induced rabbits after treating animals with neem bark extract and amoxicillin at doses of 500mg/kg and 20mg/kg and to see anti-inflammatory effects of neem bark extract. Methods: Forty eight white New Zealand rabbits were divided in four groups A, B, C and D. Group A was healthy control. Group B was disease group. Group C was neem treated. Group D was amoxicillin treated. Periodontitis was induced and rabbits were given treatment with neem bark extract and amoxicillin for 10 days. Samples were obtained with the help of periopaper absorbent strip and marginal auricular vein and analyzed in laboratory. ELISA test was performed to find levels of IL 6 in all four groups. Practical implication: To gain the evidence that neem can be used in maintenance of oral hygiene and prevention of oral diseases. Results: Treatment with neem bark extract and amoxicillin equally reduced IL 6 levels among group c and D after treatment (0.033±0.003) in gingival crevicular fluid when compared with diseased group B (0.089±0.007).P value was less than 0.001. Conclusion: Neem bark extract has significant effects on reduction of IL 6 levels in gingival crevicular fluid of periodontitis induced rabbits Neem bark extract possess anti-inflammatory and anti-microbial action. Keywords: IL6, Periodontitis, GCF, Inflammation, Neem

Prevalence, morphology, morphometry and associated clinical implications of mastoid emissary veins: narrative review.

The mastoid emissary vein connects the posterior auricular vein to the sigmoid sinus and varies in size, number, location, and course, resulting in clinical complications. This study was conducted in response to the vast clinical implications associated with this vein. The aim of this review is to highlight and describe the prevalence, varied morphology, and morphometry of the mastoid emissary vein, how these varied parameters cause clinical complications, and how these can be rectified and avoided. A literature survey was conducted using various databases and different terms related to mastoid emissary vein were used to search the literature. Pitfalls related to surgery in the vicinity of this vein and their remedies were elucidated. The literature search revealed that the prevalence, morphology, and morphometry of mastoid emissary veins vary immensely and are responsible for morbidity and mortality. Pre-operative identification of mastoid veins is thus essential and so multidetector computed tomography of the temporal bone should be scheduled before planning surgery.

VARIANT OF FETAL TOPOGRAPHY OF THE JUGULAR VEINS

An atypical case of the topography of the left external jugular vein and some extracranial tributaries of the left internal jugular vein in a 7-month-old human fetus is presented. The left external jugular vein is formed by two tributaries: the anterior (submandibular vein) and the posterior (posterior auricular vein), it fl ows into the left subclavian vein. The confl uence of the left lateral saphenous vein into the left external jugular vein, the absence of the left anterior jugular and occipital veins, and the absence of the anastomosis of the mandibular and the deep facial vein were found. The described case of the fetal topography of the left jugular veins will be of interest to both morphologists and fetal surgeons.

PLATELET COUNT AND MEAN PLATELET VALUE OF RABBIT IMPLANTED BALI CATTLE BONE GRAFT

Platelets play an important role in fracture healing. However, its role is still underappreciated. Therefore, this study investigated the values of mean platelet volume (MPV) and platelet count (PC) as the parameters in fracture healing. This study used 10 male local rabbits which were divided into 2 groups randomly, KI (control group) and KII (treatment group). Each femur of both groups was drilled a hole with a diameter of 5 mm, where KI without any substitutes and KII was implanted by demineralized bali cattle bone graft. Each animal was evaluated by collecting its blood from the central auricular vein into an EDTA tube at 24 hours, week 2, 4, and 6 postoperative determining the values of MPV and PC. Results show that treatment shows no differences to MPV and PC, yet time observation does. Overall, MPV and PC were increased in number during observation and are correlated positively.

Ionized Calcium and Serum Electrolytes Profile in Captive Asian Elephants (Elephas maximus) of Tamil Nadu, India

Background: Serum electrolyte monitoring is essential in the health assessment of captive elephants. The major elements of calcium, sodium, potassium, chloride and bicarbonate are playing a major role in regulation of nerve and muscle functions and in maintaining acid base and water balance. Excess levels or loss of particular electrolytes may occur as secondary changes caused by certain diseases or changes in physiological regulations. The aim of this study was to evolve the baseline reference values for serum electrolyte levels in captive Asian elephants raised in Tamil Nadu state of India. Methods: As part of the periodical health assessment blood samples were collected from auricular vein for 42 apparently healthy captive Asian elephants in Tamil Nadu, India. Serum electrolyte levels such as sodium (Na+), potassium (K+), chloride (Cl-), ionized calcium (iCa), non-ionized calcium and total calcium (tCa) were determined by using an automated electrolyte analyzer. Result: Most of the ranges of electrolyte values observed in this study were similar to that of previous reports. As not much studies on ionized calcium are available on captive Asian elephants the value of ionized calcium found this study 1.16±0.13 mmol/L could serve as reference. There was no much variation observed in various age groups. This electrolyte profile values will serve as baseline values to evaluate the health and clinical conditions of captive elephant populations.

Toxicokinetic of cyphenothrin in rabbits.

Type II pyrethroids, including cyphenothrin, have a wider efficacy and spectrum of action because they have a killing effect rather than a knockdown effect on pests. For this reason, they are among the most widely used pyrethroid groups today. In addition, this group also has repellent activity. Thus, cyphenothrin is a commonly used pyrethroid, which poses an exposure/toxicity risk for living organisms. Toxicokinetic studies have an important place in predicting the toxicity risks of compounds and evaluating viable treatment options. In this study, the toxicokinetics of cyphenothrin were investigated in rabbits. The animal material of the study comprised 6-month-old female 14 New Zealand rabbits, each weighing 2-2.5kg. The animals were randomly assigned to two groups, each of 7 animals. The rabbits in group 1 were administered a single dose of 2.5mg/kg bw cyphenothrin in dimethyl sulfoxide as an intravenous bolus, while the rabbits in group 2 were administered a single dose of 2.5mg/kg bw cyphenothrin in the same vehicle as an oral bolus. Following the administration of cyphenothrin, blood samples were taken at certain intervals from the auricular vein into heparinized tubes. Plasma cyphenothrin levels were determined by gas chromatography, using a capillary column and a micro-electron capture detector. For orally administered cyphenothrin, the plasma maximum concentration (Cmax), time to reach the maximum value (tmax), half-life (t1/2β), mean residence time (MRT), area under the curve (AUC0→∞), and bioavailability (F) values were determined as 172.28 ± 47.30ng/ml, 1.07 ± 0.42h, 12.95 ± 1.11h, 17.79 ± 1.69h, 2220.07 ± 572.02ng/h/ml, and 29.50%, respectively. For intravenous cyphenothrin, the t1/2β, MRT and AUC0→∞ values were ascertained as 7.66 ± 0.74h, 9.28 ± 0.62h, and 7524.31 ± 2988.44ng/h/ml, respectively. Although the bioavailability of cyphenothrin was limited when taken orally, its half-life and mean residence time in the body were found to be long. This suggests that high doses of this pesticide may pose a poisoning risk.

Temporoparietal Fascia Flaps in Children Under 15 Years of Age: An Anatomic Investigation and Its Clinical Implications in Auricular Reconstruction.

Background:The temporoparietal fascia (TPF) flap has been successfully used in the treatment of microtia with primary or secondary cases. The literature contains numerous studies about its structure and vascular anatomy in adults. However, it is rare to study its vasculature and characteristics in children.Methods:From September of 2013 to May of 2020, 188 patients with average age of 9.8 years (range, 5–14 years) underwent total ear reconstruction with costal cartilage in 67 patients (68 ears) or porous polyethylene framework in 121 patients (128 ears) using 196 TPF flaps. The TPF flap was most commonly used in second-stage operations to elevate the reconstructed auricle in the costal cartilage group. Contrastingly, the TPF flap was routinely used in the porous polyethylene framework group. The vascular pattern and characteristics of the TPF flap were evaluated during flap elevation.Results:Only 140/196 cases (71.4%) showed a typical pattern with the superficial temporal artery and the superficial temporal vein in this study; others (28.6%) were supplied by combinations of the posterior auricular artery or vein, occipital vein, diploic vein, and superficial artery or vein. Meanwhile, there are variants of the STA and posterior origin-superficial temporal artery, which originates posterior to the lobule beneath the cartilage remnant (3/196, 1.5%).Conclusion:Surgeons should inspect the pattern of the TPF flap thoroughly before elevation in children, because of the variety of the vessels and anatomic patterns of TPF.

Aspiration Revisited: Prospective Evaluation of a Physiologically Pressurized Model With Animal Correlation and Broader Applicability to Filler Complications.

Aspiration testing before filler injection is controversial. Some believe that aspiration can help prevent inadvertent intravascular injection, whereas others cite false-negative results and question its value given that the needle position always changes somewhat during injection procedures. The authors sought to test the relation of false-negative results to the viscosity of the material within the needle lumen and determine whether a less viscous material within the needle lumen could decrease the incidence of false-negative results. In vitro aspiration tests were performed utilizing 30-G and 27-G needle gauges, 2 cross-linked hyaluronic acid fillers, normal saline bags pressurized at 140 and 10 mmHg to mimic human arterial and venous pressures, and 3 needle lumen conditions (normal saline, air, and filler). Testing was repeated 3 times under each study condition (72 tests in total). For in vivo correlation, aspiration tests were performed on femoral arteries and central auricular veins in 3 rabbits (4-5 aspirations per site, 48 tests in total). In vitro and in vivo testing utilizing 30-G needles containing filler both showed false-negative results on aspiration testing. In vitro and in vivo testing utilizing needles containing saline or air showed positive findings. False-negative results from aspiration testing may be reduced by pre-filling the needle lumen with saline rather than a filler. The pressurized system may help overcome challenges of animal models with intravascular pressures significantly different from those of humans. The adaptability of this system to mimic various vessel pressures may facilitate physiologically relevant studies of vascular complications.

Communicating vein between the right external and internal jugular veins: a case report

The external jugular vein is a superficial vein that has a relatively diagonal to vertical course in the neck region and runs superficial to the sternocleidomastoid muscle. This vein is formed by the union of the posterior division of the retromandibular vein with the posterior auricular vein and it is responsible for draining most of the scalp and face as well. Sound knowledge of variations of the external jugular veins and the internal jugular veins, is important as these veins are used or targeted in specific medical procedures such as external jugular vein cannulation or radical neck dissection, respectively. During routine postgraduate dissection of the neck region in a 58-year-old female cadaver, the right external jugular vein was seen communicating with the right internal jugular vein via a communicating vein. The communicating vein was located approximately at the lower border of the thyroid cartilage and the upper border of the cricoid cartilage. A thorough understanding of anatomical variations is important in various medical disciplines and more specifically to anatomists, radiologists, and surgeons. This case report does not solely aim to increase awareness regarding variations of the jugular veins that can be possibly encountered during a neck endovascular procedure, but also contribute to the identification of the prevalence rate of this variation.

A Pharmacokinetic-Pharmacodynamic Study of Intravenous Midazolam and Flumazenil in Adult New Zealand White-Californian Rabbits (Oryctolagus cuniculus).

Flumazenil, a competitive GABAA receptor antagonist, is commonly used in rabbits to shorten sedation or postanesthetic recovery after benzodiazepine administration. However, no combined pharmacokinetic (PK) and pharmacodynamic (PD) data are available to guide its administration in this species. In a prospective, randomized, blinded, crossover study design, the efficacy of IV flumazenil (FLU; 0.05 mg/kg) or saline control (SAL; equal volume) to reverse the loss of righting reflex (LORR) induced by IV midazolam (1.2 mg/kg) was investigated in 15 New Zealand white rabbits (2.73 to 4.65 kg, 1 y old). Rabbits were instrumented with arterial (central auricular artery) and venous (marginal auricular vein) catheters. After baseline blood sampling, IV midazolam was injected (T0). Flumazenil or saline (FLU/SAL) was injected 30 s after LORR. Arterial blood samples were collected at 1 and 3 min after midazolam injection, and at 1, 3, 6, 10, 15, 21, 28, 36, 45 and 60 min after injection with flumazenil. Plasma samples for midazolam, 1-OH-midazolam and flumazenil were analyzed using high performance liquid chromatography-high-resolution mass spectrometry and the time to return of righting reflex (ReRR) was compared between groups (Wilcoxon test). FLU terminal half-life, plasma clearance and volume of distribution were 26.3 min [95%CI: 23.3 to 29.3], 18.74 mL/min/kg [16.47 to 21.00] and 0.63 L/kg [0.55 to 0.71], respectively. ReRR was 25 times faster in rabbits treated with FLU (23 [8 to 44] s) compared with SAL (576 [130 to 1141] s; 95%CI [425 to 914 s]). Return of sedation (lateral recumbency) occurred in both groups (7/13 in FLU; 12/13 in SAL) with return of LORR in a few animals (4/13 in FLU; 7/13 in SAL) at 1540 [858 to 2328] s. In the population and anesthesia protocol studied, flumazenil quickly and reliably reversed sedation induced by midazolam injection. However, the potential return of sedation after flumazenil administration warrants careful monitoring in the recovery period.

HEMATOLOGICAL INDICES AND THE RATE OF GROWTH DEPENDING ON DURATION OF EMBRYONIC GROWTH OF PIGS OBTAINED BY COMMERCIAL CROSS-BREEDING

The studies were performed in pigs obtained by commercial cross-breeding under conditions of pig-breeding complex of Agricultural Open Joint-Stock Company Agrokombinat Kalyta. 115 crossbred breeding sows (Big White x Landras) – of similar age and development – were selected for the study; they were mated with purebred Big White boars. Three groups by five animals were selected from these breeding sows by pregnancy duration. The first one (control group, the pregnancy duration was the farm average) – 112-116 days; the second one (study group, reduced pregnancy duration) – 103-111 days; the third one (study group, extended pregnancy duration) – 117-120 days. The authors studied the growth duration and hematological parameters of these breeding sows’ offsprings after ablactation until the end of fattening. The piglets were ablactated at the age of 26 days. The young stock were fed with dry feed stuff according to the conventional technology. The feed level for the pigs of all groups was the same. The pigs were weighted upon birth at 1, 2, 4, 6 months, and the relative weight gain and actual growth rate of the pigs were determined by Shmalgauzen and Brody formula. Hematological tests were performed at the age of 2, 4 and 6 months in four animals from each group (two gilts and two boars). Blood for tests was collected from auricular veins before feeding. Red blood cell count and hemoglobin concentration were measured by hemascope, total protein, albumin and globulins were measured refractometrically. It has been established that the piglets obtained from the breeding sows with reduced pregnancy duration had the lowest body weight at birth, and the piglets obtained from the extended pregnancy had the highest body weight. From the age of two months, the young stock with the reduced embryonic growth duration were superior to the age-mates with the average and extended pregnancy in terms of body weight. The animals with reduced embryonic growth duration had higher relative weight gain and the actual growth rate factor, which characterizes their high growth intensity. The pigs obtained at commercial cross-breeding with different embryonic development duration had different blood composition. Thus, the piglets with reduced and average embryonic growth duration, had higher red blood cells count, hemoglobin and total protein content. Higher hematological indicators in pigs with reduced embryonic period coincide with the period of their higher growth energy which indicates the interrelation between the intensity of the animals’ growth and the red blood cell count, hemoglobin and total protein in blood. Therefore, the embryonic development period reduction positively affects the growth energy, that is associated with improved hematological indicators, which is advisable to consider in pigs selection program.