Capsular Origin Research Articles

The Hallux Metatarsophalangeal Capsule: An Anatomic Study With Respect to Percutaneous Hallux Valgus Correction.

Minimally invasive surgery for the treatment of hallux valgus deformities has become increasingly popular. Knowledge of the location of the hallux metatarsophalangeal (MTP) proximal capsular origin on the metatarsal neck is essential for surgeons in planning and executing extracapsular corrective osteotomies. A cadaveric study was undertaken to further study this anatomic relationship. Ten nonpaired fresh-frozen frozen cadaveric specimens were used for this study. Careful dissection was performed, and the capsular origin of the hallux MTP joint was measured from the central portion of the metatarsal head in the medial, lateral, dorsal, plantarmedial, and plantarlateral dimensions. The ten specimens had a mean age of 77 years, with 5 female and 5 male. The mean distances from the central hallux metatarsal head to the MTP capsular origin were 15.2 mm dorsally, 8.4 mm medially, 9.6 mm laterally, 19.3 mm plantarmedially, and 21.0 mm plantarlaterally. The MTP capsular origin at the hallux metatarsal varies at different anatomic positions. Knowledge of this capsular anatomy is critical for orthopaedic surgeons when planning and performing minimally invasive distal metatarsal osteotomies for the correction of hallux valgus. Cadaveric Study.

The Hallux Metatarsophalangeal Capsule: An Anatomic Study with Respect to Percutaneous Hallux Valgus Correction

Category:BunionIntroduction/Purpose:Minimally invasive surgery for the treatment of hallux valgus deformities has become increasingly popular. Knowledge of the location of the hallux MTP proximal capsular origin on the metatarsal neck is critical for surgeons in planning and executing extra-capsular corrective osteotomies. A cadaveric study was undertaken to further study this anatomic relationship.Methods:Ten nonpaired fresh-frozen frozen cadaveric specimens were used for this study. Careful dissection was performed, and the capsular origin of the hallux MTP joint was measured from the central portion of the metatarsal head in the medial, lateral, dorsal, plantarmedial, and plantarlateral dimensions.Results:The ten specimens had a mean age of 77 years, five female and five male. The mean distances from the central hallux metatarsal head to the MTP capsular origin was 15.2 mm dorsally, 8.4 mm medially, 9.6 mm laterally, 19.3 mm plantarmedially, and 21.0 mm plantarlaterally.Conclusion:The MTP capsular origin at the hallux metatarsal varies at different anatomic positions. Knowledge of this capsular anatomy is critical for orthopaedic surgeons when planning and performing minimally invasive distal metatarsal osteotomies for the correction of hallux valgus.

上腕二頭筋長頭腱の破格を伴う棘上筋腱腱内断裂の 1 例

上腕二頭筋長頭腱の破格を伴う棘上筋腱腱内断裂の 1 例

New Findings In Hip Capsular Anatomy: A Cadaveric Study of the Ligamentous and Muscular Contributions to the Hip Capsule

Interest in capsulotomy techniques for access to advanced arthroscopic procedures of the hip continues to grow. Extra-articular capsulotomy has been proposed as an expedient means of obtaining access to the periarticular structures of the hip. The purpose of this study was to establish consistent anatomical landmarks based on observed capsular attachments for safe and reproducible extra articular capsulotomy. Detailed dissections of twelve nonpaired, fresh-frozen cadaveric adult hips were performed. Using a modified hemi-quadrant system, capsular thickness at 40 locations across its length and circumference was recorded. The insertions and attachments of the surrounding pericapsular structures including the minimus, rectus femoris, and iliocapsularis muscles were also recorded according to footprint size and distance from reproducible osseous landmarks. The intra-articular distance of the capsular origin from the bony acetabular rim and the intra-articular distance of the capsular insertion from the femoral head-neck junction was measured. All measurements were made to the nearest 0.1 mm with a digital caliper (Neiko Tools; Ontario, CA) with measurement accuracy of ± 0.02 mm. The intraclass correlation coefficient (ICC) for all measurements taken was > 0.90. Along the acetabular origin, the capsule was thickest along its posterosuperior and superior hemi-quadrants. The midcapsular quadrants were thickest superolaterally. At its femoral insertion, the capsule was thickest anteriorly.Tabled 1QuadrantAcetabular OriginCenter of CapsuleFemoral InsertionPosterior2.1 ± 1.92.4 ± 0.80.5 ± 0.2Postero-Inferior1.9 ± 1.31.5 ± 0.30.8 ± 0.3Inferior1.3 ± 0.31.2 ± 0.41.7 ± 0.8Antero-Inferior1.3 ± 0.71.4 ± 0.53.3 ± 1.5Anterior1.2 ± 0.61.5 ± 0.93.4 ± 1.4Antero-Superior1.6 ± 0.92.3 ± 1.82.0 ± 0.6Superior5.1 ± 3.13.4 ± 2.11.3 ± 0.9Postero-Superior4.2 ± 3.45.3 ± 1.51.0 ± 0.3Capsular Thickness Open table in a new tab The iliocapsularis, indirect head of the rectus and gluteus minimus tendons all demonstrated consistent capsular contributions. Using extra-articular landmarks as a reference, the capsular origin was located approximately 13 mm distal to the AIIS and 11 mm lateral to the pectineal eminence. The mean distance of the capsular insertion along the proximal femur measured from the chondral head-neck junction was 26.2 mm. Safe Zone for Anterior Capsulotomy Our data demonstrates that the hip capsule is thickest along its anterior and superior quadrants. In addition, there are consistent and large muscular contributions from the iliocapsularis, gluteus minimus, and reflected head of the rectus. A precise understanding of the consistent relationships that exist between the pericapsular musculature and capsular thickness may facilitate the identification of a consistent "safe zone" for anterior capsulotomy during hip arthroscopy. Further research is needed to establish whether anterior capsulotomy can be reliably performed in a manner that minimizes damage to this anterior capsular anatomy.

Combined Posterior Bankart Lesion and Posterior Humeral Avulsion of the Glenohumeral Ligaments Associated With Recurrent Posterior Shoulder Instability

Recurrent posterior glenohumeral instability is uncommon and is often misdiagnosed. Damage to the posterior capsule, posteroinferior glenohumeral ligament, and posterior labrum have all been implicated as sources of traumatic posterior instability. We describe a case of traumatic recurrent posterior instability resulting from a posterior Bankart lesion accompanied by posterior humeral avulsion of the glenohumeral ligaments. The Bankart lesion was repaired using a single arthroscopic suture anchor at the glenoid articular margin. The posterior humeral avulsion of the glenohumeral ligaments was addressed with 3 suture anchors placed at the capsular origin at the posterior humeral head. Using these anchors, the posterior capsule was advanced laterally and superiorly for a secure repair. Arthroscopic anatomic reconstruction of both lesions resulted in an excellent clinical outcome.

The long head of the triceps: A detailed analysis of its capsular origin

Whether the triceps brachii muscle provides any significant contribution to stability about the shoulder girdle is unknown. This study seeks to document the anatomy of the origin of the long head of the triceps tendon and to resolve discrepancies in the anatomic literature. Fifteen fresh frozen cadaveric shoulder girdle specimens were dissected, the long head of the triceps and the posterior capsule being exposed. The long head origin averaged 29.5 mm (range, 26-34 mm) in width and 5.7 mm (range, 4-7 mm) in thickness. The average cross-sectional area of origin of the tendon was 168 mm2, and the fibrous contribution from the glenohumeral capsule averaged 2.3% (range, 1.4% to 3.1%) of the tendon's area. A capsular contribution was found in each specimen. The documentation of this capsular contribution may warrant further biomechanical and electromyographic study. (J Shoulder Elbow Surg 2000;9:332-5.)

ARTHROSCOPIC RESECTION OF THE DORSAL GANGLIA OF THE WRIST

Arthroscopic ganglion resection provides a means by which dorsal wrist ganglia may be safely resected while avoiding the requisite scar accompanying open resection. Use of the arthroscope provides a much more complete examination of the wrist, allowing assessment of the cause of the ganglion as well as associated intra-articular problems. In a previous pilot study, 50% of patients demonstrated visible intra-articular abnormalities, including SL ligament laxity and perforations, TFCC tears, or chondral degeneration at the radial and triquetral-hamate joints. Use of the shaver within the joint allows the surgeon to directly address the ganglion's site of capsular origin, ensuring that the "one-way valve" mechanism is resected. The authors' initial experience was that the recurrence rate after arthroscopic resection was equal to or lower than after open resection. There is now some suggestion that resection of only the ganglion stalk, without removal of the sac, is feasible, but may yield slightly higher recurrence rates than formal open resection of the sac and stalk. This may be attributed to cases in which the capsular attachment to the SL ligament is debrided without identification and removal of a true stalk. The recurrence rate of a ganglion that has previously recurred also appears to be higher than that of primary resection. The authors look forward to publishing their completed results of an on-going follow-up study comparing open, arthroscopic, and recurrent ganglion resections.

The Bankart repair illustrated in cross-section. Some anatomical considerations.

The Bankart repair for chronic anterior shoulder instability effectively addresses the pathologic components responsible for repeated dislocation or subluxation. However, contrary to popular belief, the Bankart repair does not precisely restore the premorbid anatomy. The capsule is reattached to the boney rim of the anterioinferior glenoid deep to and lateral to the torn cartilagenous labrum, thus excluding the labrum from the joint anteriorly. This was demonstrated by cross-sectional cadaver dissections performed to illustrate this complex surgical anatomy to orthopaedic residents in training. In addition, when correlated with double-contrast computerized axial tomography, we noted five predominant patterns of anatomical lesions which by common use have been collectively termed the "Bankart lesion." These are: 1) the rare "classic" Bankart lesion in which the cartilagenous labrum and capsular origin are torn from the glenoid rim; 2) the capsule stripped from the scapular neck and the labrum detached from the glenoid rim remaining fixed to the overlying capsule; 3) the capsule stripped from the scapular neck and the labrum separated from the glenoid rim, but separately; 4) the labrum abraded away and no longer radiographically detectable; and 5) glenoid rim fracture.

Soemmering's ring, an aspect of secondary cataract: a morphological description by SEM.

A Soemmering's ring attached to a patient's I.O.L. was removed and processed for SEM-examination. The enveloping structure of the Soemmering's ring was clearly of capsular origin, adherent along a single line and forming an envelope around the inner material. The envelope had a membranous character. The contents of the ring varied from the outside to the centre. Close to the capsule envelope a more or less amorphous material was found. Most of the contents of the ring was made up of lens-fibre material. Sometimes clear lens fibres were visible with densely packed lens-fibre proteins, sometimes with clusters of recrystallized proteins, rod-shaped or spherical, surrounded by what appeared to be amorphous material. The recrystallized and the amorphous lens-fibre material are similar to material found in cataractous lenses.

Structural studies of acidic glucomannans from strains of Serratia marcescens O14 and O6

Partially acetylated acidic glucomannans have been isolated from three strains of Serratia marcescens serogroup O14 and one strain of the cross-reacting serogroup O6. Degradative and spectroscopic studies established that the polysaccharides have branched tetrasaccharide repeating-units of the structure shown. Individual polymers may vary in the extent or location of O-acetylation, and in the extent of undefined heterogeneity apparently associated with the glucosyluronic acid residues. Although the polymers were obtained from lipopolysaccharide extracts, there are indications of a (micro)capsular origin. The acidic glucomannans may constitute a common antigen which defines the O14-O6 complex of S. marcescens.

Serological Studies of <i>Haemophilus influenzae</i>

Six capsulated <i>Haemophilus influenzae </i>strains, types a to f (Ma–Mf), and two non-iridescent, non-capsulated variants of the Ma and Md strains (Sa and Sd) were studied by means of double immunodiffusion and immuno-electrophoretic methods. A capsular antigen, designated precipitinogen 1, and a second antigen, designated precipitinogen 2, were demonstrated in extracellular (Ex) antigen preparations of the Ma–Mf strains. In addition to the serotvpe capsular antigen, traces of capsular antigen of at least one other serotype could be demonstrated in all Ex antigen preparations except in MaEx. In strain Sa, small amounts of capsular antigen a were found, whereas no capsular antigen d was revealed in the strain Sd. The precipitinogens 2 of the Ma and Md strains were also demonstrated in the S variants, indicating that this antigen may not be of capsular origin. Cross-reactions of precipitinogen 2 were seen between strains of three different serotypes (a, e and f).

Reproductive and endocrine organs of foetal, newborn and adult seals

Reproductive and endocrine organs of foetal, newborn and adult seals

The Development of The Chondrocranium of Heleophryne Purcelli Sclater with special Reference to the Palatoquadrate and the Sound‐conducting Apparatus

Abstract A description of the later phases of the ontogeny of the chondrocranium of Heleophryne purcelli is given. Special attention has been given to the development of the sound‐conducting apparatus and to the structural changes of the palatoquadrate during metamorphosis. The operculum, the pars interna plectri and the pars media plectri are apparently of capsular origin, whereas the pars externa plectri and the anulus tympanicus, which develop from a common blasteme, appear to the be derivatives of the palatoquadrate. It is suggested that the infrapharyngohyal had been incorporated into the otic capsule during the phylogeny, and that it gives rise to the operculum and the pars interna et media plectri, as well as to the floor of the fossa fenestrae ovalis and the otic ledge of the adult. Similarly, the epihyal became incorporated into the posterior portion of the larval palatoquadrate (epimandibular), and gives rise to the pars externa plectri of the adult. The suprapharyngohyal is represented by the otic process and the lateral portion of the parotic crest. The anulus tympanicus is probably the homologue of the stylohyal of fishes. The suprapharyngomandibular and the infrapharyngo‐mandibular are both absent in the adult skull.

IMMUNOLOGIC RELATIONSHIP OF DONOVANIA GRANULOMATIS TO GRANULOMA INGUINALE

1. A washed bacterial suspension of Donovan microorganisms cultivated in the yolk of chick embryos was used as an antigen in intracutaneous tests in 6 cases of granuloma inguinale in the active stage of the disease. These injections were responded to by an extensive erythematous and edematous reaction that reached its height in 24 hours and disappeared within 48 hours later. Four control cases without granuloma inguinale did not react to the injection to any greater extent than would be expected from the slight trauma incident to them. The skin of the reacting patients responded in a similar manner but to a lesser extent to a filtrate of infected yolk. Simultaneous control injections of filtered normal yolk demonstrated that sensitivity to normal yolk was not responsible for the reactions. 2. A mucoid material present in infected yolk, soluble in N/100 NaOH, and precipitable by N/100 HCl was recovered and purified by repeated acid precipitation, extraction with ether, washing in distilled water, and dissolution in N/100 NaOH. We regard this material to be of capsular origin. 3. The presumptive capsular material injected intradermally elicited a somewhat different and milder reaction in patients with active granuloma inguinale, but we regard it as specific. 4. The "capsularrdquo; material in suitable dilution elicited distinct precipitation reactions when mixed with the serum from 18 of 19 cases of active granuloma inguinale. Serum from 1 active case showed no precipitation. Sixty-four serums, including 6 from lymphopathia venereum patients and 18 from Wassermann- or Kahn-positive patients, and 1 from an early chancroid failed to precipitate. Two serums from a total of 66 used as controls showed a precipitate in the presence of the capsular material. These patients gave no history or evidence of granuloma inguinale. 5. The "capsular" material fixed complement in the presence of serum from patients with granuloma inguinale. Serum from 12 of 15 cases of granuloma inguinale demonstrated complement fixation. Three failed to fix complement. Of 19 control serums 18 failed to fix complement in the presence of the capsular material and 1 fixed only a very slight amount of complement. None of these serums nor the capsular material itself was anticomplementary. 6. The high proportion of precipitation and complement fixation reactions obtained from patients with active granuloma inguinale is indicative of a specific immunological relationship of the Donovan microorganism cultivated in embryonic yolk to the disease, granuloma inguinale. 7. We suggest that one or all of these methods might be so standardized as to be of distinct diagnostic value.