Collateral Branches Research Articles

Differences in the Ultrastructure of Neurons in the Spinal Ganglion and Dorsal Rootlet Between Rats Treated with Cisplatin Only versus Co-administration with a Sphingosine 1-Phosphate Receptor 2 Agonist in Attenuating Neuropathy and Allodynia.

Cisplatin is a chemotherapeutic agent for many types of cancer. The neurotoxicity of cisplatin includes neuropathy and allodynia. We aimed to study structural changes by using CYM54-78, attenuates cisplatin-induced neuropathy and blocks the pathogenesis in neurons and promotes axonal regeneration. TEM (Transmission electron microscopy) was used to distinguish ultrastructural changes in dorsal root ganglion (DRG) and dorsal rootlets (DR) between rats treated with cisplatin alone and rats co-treated with cisplatin and sphingosine -1-phosphate receptor2 (S1P2) agonist, CYM-5478. In DRG of rats treated with cisplatin alone, TEM micrographs showed necrosis and apoptotic cells. Neuronal cytoplasm showed numerous vacuole (stage C) and swelling (stage B➔C) mitochondrial degeneration. Neurons in DRG from cisplatin+CYM-5478 group showed a higher percentage of healthy mitochondria (from 5.3% to 75.6%) than those treated with cisplatin alone. DR of cisplatin only group showed abnormal axoplasm, axolemma and focal detached myelin sheaths, especially in Aδ (fast pain) and Aβ (touch) fibers and revealed collateral branches that sprouted from Aβ fibers, which is characteristic of allodynia. Moreover, vasoconstriction was observed in DRG and DR. Rats in cisplatin+CYM-5478 group showed not only fewer abnormal structures than those in cisplatin only group, but also showed Bands of Büngner and onion bulb-like structures, which are characteristic of nerve regeneration. Together with our previous study, showed that CYM-5478 attenuated neuropathy and allodynia in a rat model of cisplatin-induced neuropathy, these results suggest S1P2 agonists as a potential approach for treatment of cancer due to reduction of side-effects of cisplatin. This article is protected by copyright. All rights reserved.

Understanding the Brain-based Determination of Death When Organ Recovery Is Performed With DCDD In Situ Normothermic Regional Perfusion.

Understanding the Brain-based Determination of Death When Organ Recovery Is Performed With DCDD In Situ Normothermic Regional Perfusion.

Topographical and Chemical Inductive Cues Synergistically Enhance the Schwann Cell Differentiation of Aligned Dental Pulp Stem Cell Sheets

Peripheral nerves have an inherent capacity for regeneration, but these Schwann cell-mediated mechanisms are insufficient for severe injuries. With current clinical treatments, slow regeneration and aberrant reinnervation result in poor functional outcomes. Dental pulp stem cells (DPSCs) offer a promising source of therapeutic neurotrophic factors (NTFs), growth factors that stimulate axon regeneration. Previously, we established that DPSCs can generate scaffold-free sheets with a linearly aligned extracellular matrix (ECM). These sheets provide trophic cues via the DPSCs and directional cues through the aligned ECM to both accelerate and orient axon outgrowth, thus providing a biomaterial capable of addressing the current clinical challenges. DPSCs have a propensity for differentiating into Schwann cells (SC-DPSCs), further enhancing their endogenous NTF expression. Here, we evaluated the effect of inducing SC differentiation on the neuroregenerative bioactivity of our DPSC sheets. These sheets were formed on substrates with linear microgrooves to direct the cells to deposit an aligned ECM. Inducing differentiation using an SC differentiation medium (SCDM) increased NTF expression 2-fold compared to unaligned uDPSC sheets, and this effect was amplified in linearly oriented SC-DPSC sheets by up to 8-fold. Furthermore, these aligned SC-DPSC sheets remodeled the sheet ECM to more closely emulate a regenerative neural microenvironment, expressing 8-fold and 2 × 107-fold more collagen IV and laminin, respectively, than unaligned uDPSC sheets. These data demonstrate that the chemical cues of the SCDM and the mechanotransductive cues of the aligned cell sheet synergistically enhanced the differentiation of DPSCs into repair SC-like cells. To evaluate their functional effects on neuritogenesis, the DPSC sheets were directly cocultured with neuronally differentiated neuroblastoma SH-SY5Y cells. In this in vitro culture system, the aligned SC-DPSC sheets promoted oriented neurite-like outgrowth similar to aligned uninduced DPSC sheets and increased collateral branching, which may emulate stages associated with natural SC-mediated repair processes. Therefore, linearly aligned SC-DPSC sheets have the potential to both promote nerve regeneration and reduce aberrant reinnervation, thus providing a promising biomaterial for applications to improve the treatment of peripheral nerve injury.

Correlation between hepatic venous pressure gradient and portal pressure gradient in patients with autoimmune cirrhotic portal hypertension and collateral branches of the hepatic venous.

To assess the correlation and agreement between hepatic venous pressure gradient (HVPG) and portal pressure gradient (PPG) in patients with autoimmune liver diseases (ALD) and portal hypertension (PHT), and to investigate the extent to which hepatic vein collateralization affects the accuracy of this assessment. Ninety-eight patients with ALD between 2017 and 2021 who underwent transjugular intrahepatic portosystemic shunt (TIPS) with conventional and innovative 15 ml pressurized contrast were selected to measure wedged hepatic venous pressure (WHVP) and portal venous pressure (PVP) and to calculate the HVPG and PPG. Pearson's correlation was used for correlation analysis between the two groups. Bland-Altman plots were plotted to estimate the agreement between paired pressures. The r values of PPG and HVPG in the early, middle, late, and portal venous visualization were 0.404, 0.789, 0.807, and 0.830, respectively, and the R2 values were 0.163, 0.622, 0.651, and 0.690, respectively. The P-value for the r and R2 values in the early group was 0.015, and the P-values in the remaining groups were less than 0.001. Bland-Altman plots showed that patients in the portal venous visualization group had the narrowest 95% limits of agreement (LoA). The mean value of the difference was close to the zero-scale line. In patients with ALD, the correlation between the HVPG and PPG was good, and the later the collateral development, the better the correlation. Hepatic vein collateral was an essential factor in underestimating WHVP and HVPG, and the earlier the collateral appeared, the more obvious the underestimation. This article is protected by copyright. All rights reserved.

Laparoscopic ileocecal-sparing hemicolectomy for cancer of hepatic flexure and proximal transverse colon: A single arm prospective study.

e15650 Background: Traditional right hemicolectomy（TRH）is the standard operation for right colon cancer. The resection includes intestines from the terminal ileum to the middle of the transverse colon, as well as the ileocecum. The ileocecum is considered to have a “valve-like” function to reduce intestinal reflux and the incidence of diarrhea, which also play an important role in enterohepatic circulation and intestinal immunity. As for cancers in hepatic region and proximal transverse colon, is it possible to preserve ileocecum and ensure the oncological curative? Methods: We previously reported the procedure of laparoscopic ileocecal-sparing right hemicolectomy (LISH). The lymphatic adipose tissue around ileocolic artery and vein（ICA/ICV）,including 201d(lymph node around colic branch of ICA), 202, 203LN, was dissected. The colic branches of ICA/ICV were selectively ligated. The main trunk, cecal branches and ileal branches of ICA/ICV were preserved. The right colic artery/vein and middle colic artery/vein were ligated at roots，which was the same as TRH. End-to-end anastomosis between cecum and transverse colon was applied through an opening at the bottom of cecum. This was a single arm prospective study (NCT04479111) to evaluate the feasibility of LISH. Patients with hepatic flexure and proximal transverse colon cancer, aged 18-75, without distant metastasis were included. Primary endpoint was postoperative complications and 1-year local recurrence; secondary endpoints included rate of conversion to TRH, lymphadenectomy and complete mesocolic excision (CME) quality, surgical margin and 1-year disease-free survival (DFS) rate. Results: As of Jan.16th, 2022, 31 patients had been enrolled，including 9 patients with stage I, 9 patients with stage II and 13 patients with stage III. All enrolled patients received LISH successfully. The rate of high-quality lymphadenectomy (harvested LN > 12) was 96.8% and high-quality CME (Grade I/II) was 100%. All patients had negative resection margin and adequate proximal resection margin (median 9.1cm). 201d/202/203 lymph nodes were evaluated separately, and no metastatic 201d/202/203 LN were detected. Clavien-Dindo grade I adverse events within 90 days were occurred in 6 patients (19.4%), including wound infection(n = 2), anemia(n = 2), diarrhea(n = 1) and intestinal obstruction(n = 1). 1-year local recurrence rate is 0%, while 1-year DFS rate is 96.77%, only 1 stage III patient was diagnosed as ovarian metastases 9 months after radical operation. Conclusions: In this study, we provide a new radical operation choice for patients with hepatic flexure and proximal transverse colon cancer. LISH presented good perioperative safety，operation quality，and preliminary oncological safety within 1 year. We are launching a multicenter phase III study to verify the result and further explore the long-term oncological outcome. Clinical trial information: NCT04479111 .

PREVALENCE OF ANATOMICAL VARIATIONS OF CIRCLE OF WILLIS IN SOUTH INDIAN POPULATION SUCCUMBING TO ISOLATED TRAUMATIC BRAIN INJURY - A CADAVERIC STUDY

Introduction: The Circle of Willis (COW) is a large arterial anastomotic ring present at the basal cistern of the brain, uniting the internal carotid and the vertebro-basilar system. Sir Thomas Willis was the first to describe the importance of the circle in maintaining collateral flow. It was observed that there is very little mixing of blood between the collateral branches of the circle. These collaterals may however open up during occlusive episodes of the proximal feeding vessels or in case of severe stress such as stroke and traumatic brain injury (TBI) in order to maintain metabolic activity in the brain. This phenomenon is affected to various degrees in the presence of anomalies. The prevalence of anomalies of COW in the general population is up to 75.72% was demonstrated in other studies. Materials and Methodology: This is a cross sectional observational study. 20 consecutive patients above 18 years of age succumbed to isolated TBI who were subjected to medico-legal autopsy in our hospital were included. The anomalies were classified as per the criteria laid down by Stojanovi´c et al. Results: 9 Normal variants (Type A) of COW (45%) was found. The most common type of anomaly was Type C which was noted in 4 cases (20%). Conclusion: Anatomical variations of COW has proven association in the areas of stroke, aneurysm, migraine, carotid endarterectomy and ageing brains. Further studies are needed to determine whether the anomalies of COW really contribute to the mortality in TBI.

Forgotten Branch of the Intercostal Nerve: Implication for Cryoablation Nerve Block for Pectus Excavatum Repair

BackgroundWe first utilized and reported on the use of cryoanalgesia for postoperative pain control for Nuss procedure in 2016. We hypothesized that postoperative pain control could be optimized if the intercostal nerve anatomy is better understood. To test this hypothesis, human cadavers were dissected to elucidate the intercostal nerve anatomy. Cryoablation technique was modified. MethodsCadaver Study: Adult cadavers were used to visualize the branching patterns of the intercostal nerves. Cryoablation: Posterior to the mid-axillary line for intercostal nerves 4, 5, 6 and 7, main intercostal nerve, lateral cutaneous branch and collateral branch were cryoablated under thoracoscopic view. Verbal pain scores were obtained from patients one day after the procedure. ResultsThe study results were obtained during the years 2021 and 2022. Eleven cadavers were dissected. The path of the main intercostal and lateral cutaneous branch lie on the inferior rib surface of the corresponding intercostal nerve. Total of 92 lateral cutaneous branches of the intercostal nerve were dissected and measured as they pierced the intercostal muscle. Most lateral cutaneous branches of the intercostal nerve pierced the intercostal muscle anterior to midaxillary line 78.3%, posterior to midaxillary line 18.5% or on the midaxillary line 3.3%. The collateral branch of the intercostal nerve separated near the spine and traveled along the superior surface of the next inferior rib. Cryoablation: 22 male patients underwent Nuss procedure with cryoanalgesia. Median age of the patients was 15 years (IQR: 2), median Haller index was 3.73 (IQR: 0.85), median pain score (0–10 maximum pain) was 1 (IQR: 1.75). ConclusionCryoablation of the intercostal nerve and its two branches improves pain control after a Nuss procedure. Level of EvidenceLevel 4. Type of StudyObservational study.

Innovative angiography: a new approach to discover more hepatic vein collaterals in patients with cirrhotic portal hypertension

BackgroundThe hemodynamics of patients with cirrhosis and portal hypertension are complex and variable. We aimed to investigate differences in venous pressures determined by innovative angiography and conventional angiography using balloon occlusion of the hepatic veins in patients with alcoholic cirrhosis and portal hypertension.MethodsA total of 134 patients with alcoholic cirrhosis who fulfilled the inclusion criteria from June 2017 to June 2020 were included. During transjugular intrahepatic portosystemic shunt, conventional and innovative angiography were performed, and venous pressures were measured. A paired t-test and Pearson’s correlation coefficient were used for analysis.ResultsConventional and innovative hepatic angiography detected lateral branches of the hepatic vein in 26 (19.4%) and 65 (48.5%) cases, respectively (P < 0.001). Innovative angiography detected a total of 65 patients with lateral shunts, of whom 37 (56.9%) had initial shunts. The average wedged hepatic venous pressure and portal venous pressure of the initial lateral branches were 21.27 ± 6.66 and 35.84 ± 7.86 mmHg, respectively, with correlation and determination coefficients of 0.342 (P < 0.05) and 0.117, respectively. The mean hepatic venous pressure gradient and portal pressure gradient were 9.59 ± 7.64 and 26.86 ± 6.78 mmHg, respectively, with correlation and determination coefficients of 0.292 (P = 0.079) and 0.085, respectively.ConclusionsInnovative angiography reveals collateral branches of the hepatic veins more effectively than conventional angiography. Hepatic vein collateral branches are the primary factors leading to underestimation of wedged hepatic venous pressures and hepatic venous pressure gradients, with the initial hepatic vein collateral branches resulting in the most severe underestimations.

Teaching NeuroImages: Persistent anterograde amnesia due to sequential, bilateral vascular damage to the Papez circuit

A 62-year-old previously cognitively intact man presented to the emergency department with acute impairment of anterograde memory (ability to form new memories).1 Head CT did not show acute changes; however, amnesia persisted. MRI disclosed an acute infarct in the left posterior hippocampus and a nonacute lacunar stroke in the right anterior thalamus (figure). Memory testing showed severe deficits in verbal and visual memory, persisting after 2 months. Bilateral lesions located anywhere in the Papez circuit (hippocampal formations, mammillary bodies, anterior thalamic nuclei, cingulate and parahippocampal cortices, and their connections via fornix and mammillothalamic tracts) may be implicated in marked, persistent anterograde memory deficits.1,2 The hippocampus receives its blood supply from collateral branches of the posterior cerebral artery and the anterior choroidal artery.3 The anterior thalamus is supplied by the tuberothalamic artery.4

Anatomía de la arteria esplénica

Due to the importance and permanent iniprovementsas regards the treatmerit of different diseases involving abdominal urgans such as the abdonien, pailcreas and spleen. 1 was indined tu investigate, both from the anatonhje and surgical point ul view. une of the collateral arterial branches of the ccl iac trunk, which is possibly considered to be one the Ieast siudied and, historically one of the most torgotten by the vessels irrigating the liver and stoniLlch.Considering the fact that anatomic understanding is the startíng point of medical knowledge. and that its conquests give it perrnanently new fundamnents, 1 was deterinined to do research, intensely aixl thoruughly un splenic artery.This research work relates in detail, on the corresponcling chapters, the material and niethods used, which consist un human hodies and fietus tixed with 6.rmo1 and in a fresh condition. These human bodies and foestus were subnimtted tu disseetiun techniques of mnter-arterial injection with resmn, and then they were corroded with acid and angiographic studies. Fmnally selective artermographic tesis 'ere perlbmed un living beings by nieans of digitalis reinoval of the splenic artery.The following chapter deals with the results ubtained froni saied research work, showing that the splenic artery ormgmnates, in mill cases, from the celiac trunk, and this artery is the most iniportant with an average length uf 10.6 centimeters and of 2.3 flexuosities in all.This chapter also enumnerates the relatmonships exmsting betwecn the splenic artery and neighboring organs, the homonymnous vein, itscollateral and terminal branches which mu the hundred percent of cases showed une superior and une inferior, tu inimnedimitely subdivide mudifferent ones at the level of the splenic pedide.The collateral branches 6und were the fol lowing:- arterial pancreatic branches found in the 73 % of the cases with an average of 1 arteries in al].- posterior esophaguscardiotuberosity artery appearing in a 33% of the cases.- superior polar artery appearing in a 53% of the cases.- inferior polar artery appcaring mmm a 33% of the cases.- the short vessels appeared in the 100% of the cases, froni vich in a 73% were superior short vessels and in the remainmng 27% inferior short vessels.- the left gastruepiploon artery appeared in al the cases considered. 1 have discussed the anatomic inmportance of the splenic artery and gland with their niultiple variations and relationships. 1 have mIso considered the splenic pedicle, depending un the rear lixatmon which has the extremity of the pancreas and the splenic hillum of 2.2 ccntimeters, with final figures ranging frorn O to 4 centimeters. 1 have misometmoned the appcaramice of a 10' of super nunierary spleems. Fuially in our experience with splenic segnientatiun and with cormosionpharmaceut ical preparati un and artermograph mc studics as the baste mngredients, wc have found that in a 62.5% they have two segments. ¡ti a17% they have three segments, in a 12.5% llicy have l'our segmenis. m a 12.5 % they have tur segmcnts and in ami S% they have five segnienisin mli, in ihese cases generally dite to the high iniportance of'the polar artens. Likewise. it i s Li circulation is terminal and that spleen divistummnto segrnents is separated by non-vascular 1 evel s

Imaging findings of hepatocellular carcinoma with portal vein tumor thrombosis secondary to hepatic portal vein collateral circulation: a cross-sectional study.

Hepatic portal vein collateral circulation plays an important role in maintaining the perfusion of hepatic portal vein. However, at present, there is little research on collateral circulation of hepatic portal vein. Our study aims to analysis the imaging types and clinical value of hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT) invading and completely blocking different branches of portal vein, secondary to hepatic portal vein collateral circulation. This study retrospectively analyzed Hepatocellular carcinoma (HCC) with PVTT diagnosed with enhanced CT examination of the upper abdomen in our hospital from May 2020 to October 2021.The inclusion criteria for patients were the following: (I) ultimately diagnosed with HCC, (II) accompanied by complete obstruction of the main portal vein or left/right branches, and (III) with collateral circulation of the hepatic portal vein established. All images were postprocessed by multiplanar reconstruction (MPR), maximum intensity projection (MIP), and other reconstruction techniques to obtain images of the abnormal portal vein system and the collateral vessels running toward the hepatic portal veins. Three physicians jointly judged the imaging anatomical classification of each collateral vessel. The qualitative variables were compared by chi-squared test. A total of 125 hepatic portal vein collateral vessels were observed in MPR and MIP reconstruction images of 71 patients with portal vein cancer thrombosis with established hepatic portal vein collateral circulation. Common hepatic collateral branches in patients with PVTT mainly include the biliary collateral branch, gastric collateral branch, mesenteric collateral branch, accessory portal vein system and the splenic branch. The incidence rate was respectively 77.5%, 36.6%, 32.4%, 28.2%, 1.41%. The correct understanding of the imaging anatomical classification of the collateral vessels of the hepatic portal vein can provide clinicians with more information for diagnosis and treatment planning.

PALLAVA ELEMENTS IN SOUTH AND SOUTHEAST ASIAN ART – VISUAL APPRAISAL

It is a known fact that contact between the Tamil country and Southeast Asia, including Śrī Laṅkā and China was a long-established tradition. References to the yavanas in Tamil Caṅkam literature and the notes supplied by Greek, Roman, and Egyptian classical authors would establish the fact that commercial intercourse between the east and west was an immemorial process 1, datable to at least a few centuries earlier than the Christian era 2. However, it was under the Pallavas and Cōḻas that the arts of the country made a daring intrusion into the distant lands 3. In this process of sharing artistic idioms from the subcontinent, the Āndhras of the Amarāvati School, the Guptas, and the Pālas of Beṅgal played a vital role. The Pallava link with the Malaya peninsula was blood-based because a collateral branch of the family is said to have ruled the distant land under Hiranyavarmaṉ whose son Nandivarmaṉ Pallavamalla (731-96 CE) became the ruler of Kāñci when there was no direct male heir to occupy the throne after the premature death of Parameśvaravarmaṉ II (Minakshi (1941), Subramaniam (1967) 80-94).

PER1 promotes functional recovery of mice with hindlimb ischemia by inducing anti-inflammatory macrophage polarization

Hindlimb ischemia (HLI) is an arterial occlusive disease that exposes the patients to the risk of limb gangrene and loss. Polarization of macrophages is related to HLI-induced inflammation. Period circadian regulator 1 (PER1) is a core component of the circadian clock. We first showed, based upon bioinformatics analysis of microarray data, that PER1 expression was reduced in monocytes from patients with critical limb ischemia. The proximal femoral artery in the left hindlimb of male mice was ligated and then the femoral artery and its collateral branches were removed to establish the HLI mouse model. After modeling, a single intramuscular injection of 1 × 109 pfu Ad-PER1 was performed at the adductor and gastrocnemius muscles. The gastrocnemius muscle tissues were collected at day 0, 3, 7, 14, 21 post-HLI. There was obvious pathological necrosis, accompanied with reduced expression of PER1 in the muscle tissues of HLI mice. Expression of CD68 and CD31 seemed to be corresponded to PER1 in gastrocnemius muscle, implying the potential of PER1 in regulating macrophage-related inflammation and angiogenesis. PER1 overexpression diminished myocyte damage, promoted blood flow restoration and improved behavioral scores of HLI mice. Immunostaining of CD31 and α-SMA revealed that PER1 upregulation reversed HLI-induced decreases in capillary and arteriole density. In vitro, RAW264.7 cells were cultured in hypoxia (1% O2) for 24 h. The percentage of pro-inflammatory CD86+ macrophages (M1 type) was decreased and that of anti-inflammatory CD206+ macrophages (M2 type) was increased when PER1 was overexpressed. Moreover, the expression levels of TNF-α, IL-6 and M1-type marker iNOS were decreased, and levels of IL-10 and M2-type marker Arg-1 were increased by PER1 in gastrocnemius muscle of HLI mice and hypoxia-treated RAW264.7 cells. PER1 might reduce M1 macrophage polarization and promote M2 macrophage polarization, and thus exert anti-inflammatory and pro-angiogenic actions. Our findings suggest that PER1 overexpression promotes functional recovery of mice with HLI through regulating macrophage polarization.

Tapia syndrome: an Unusual Complication to Recognize at the Time of the COVID-19 Pandemic

Guidelines for acute respiratory distress syndrome (ARDS) management include sedation, neuromuscular blockade for protective ventilation and the need for the prone position. This technique can lead to neurologic sequelae like the Tapia syndrome following the patient position. We reported two ARDS COVD-19 patients with Tapia syndrome due to prone position. Both patients, a white European 57 year-old female and a Black African 50 year-old male, were intensive care unit (ICU) admitted for ARDS due to COVID-19. They were orotracheal intubated and mechanical ventilated for respectively 23 and 68 days with 7 and 4 sessions of prone position. Both were tracheotomized during their ICU stay. We observed during the respiratory weaning, swallowing difficulties associated with a tongue deviation during protusion and paralysis of the ipsilateral vocal cord suggesting a Tapia syndrome. Prone position for the treatment of hypoxic ARDS COVID-19 patients with lateral flexion of the head could induce a compression on the lower cranial nerves and their collateral branches and lead to the Tapia syndrome with long neurologic sequelae: swallowing disorder, dysarthria and dysphagia due to difficulty to move the tongue with paralysis of the vocal cord. Because mechanical ventilation on prone position is a cornerstone of the treatment of hypoxic COVID-19 patients, the number of patients with Tapia syndrome may increase in the future.

The relationship between neutrophil-to-lymphocyte ratio and cerebral collateral circulation in patients with symptomatic severe intracranial artery stenosis or occlusion

BackgroundThe neutrophil/lymphocyte ratio (NLR) has been considered a prognostic indicator for determining the systemic inflammatory response and atherosclerosis. We aimed to determine the relationship between NLR and the development of cerebral collateral circulation in patients with symptomatic severe stenosis or occlusion of intracranial arteries. MethodsAll patients underwent digital subtraction angiography (DSA) within 14 days of admission and were divided into a group with good collateral circulation (77 patients) and a group with poor collateral circulation (86 patients) according to the DSA collateral compensation grading method. Apo B, total cholesterol, LDL, and Neutrophil count in the poor side branch group were significantly higher than in the good side branch group. Multifactorial analysis showed that high NLR levels were a valid predictor of poor collateral circulation in patients with symptomatic severe intracranial artery stenosis or occlusion. Spearman correlation analysis showed that the size of the collateral branch score was negatively correlated with NLR (r = −0.509, P < 0.001) and cholesterol content (r = −0.249, P = 0.002). NLR predicted poor collateral circulation with an AUC of 0.620 (sensitivity 66.7 %, specificity 61.3 %, 95 % CI = 0.517–0.723,P < 0.05). ConclusionWe demonstrate a correlation between NLR levels and the development of collateral circulation in the brain in patients with symptomatic severe stenosis or occlusion of the intracranial arteries.

Anatomical study of the internal carotid artery of the aulacode (Thryonomys swindérianus, Temminck 1827)

The arterial circle at the base of the skull appears to be supplied only by the vertebrobasilar system. The anatomy of the internal carotid artery is not known. The aim of this study was to contribute to a better understanding of the anatomy of the arterial system of the aulacode. A total of twelve (12) carotid arteries from six (6) grasscutters were injected with neoprene latex to study the origin, path, termination, collateral branches and brain irrigation areas of the. internal carotid artery. Originating from the common carotid artery, the internal carotid arteries, right and left, flowed forward and out to reach the lateral surfaces of the trachea. In the cervical region, they emitted three collateral branches, the posterior laryngeal artery, the artery of the neck muscles, and the encephalic artery. These different arteries supplied the larynx, neck and brain, respectively. The encephalic arteries were either single or double. The arteries of the neck muscles were dividing at their endings or not. The observation of the latex in the brain reflects the participation of the internal carotid artery in the vascularization of the brain, or at least of anastomoses between its branches and those of the external carotid artery or the vertebro-basilar system.

Bulbar projecting subcortical GABAergic neurons send collateral branches extensively and selectively to primary olfactory cortical regions.

Circuit operations of the olfactory bulb are modulated by higher order projections from multiple regions, many of which are themselves targets of bulbar output. Multiple glutamatergic regions project to the olfactory bulb, including the anterior olfactory nucleus (AON), prefrontal cortex (PFC), piriform cortex (PC), entorhinal cortex (EC), and tenia tecta (TT). In contrast, only one region provides GABAergic projections to the bulb. These GABA neurons are located in the horizontal limb of the diagonal band of Broca extending posteriorly through the magnocellular preoptic nucleus to the nucleus of the lateral olfactory bulb. However, it was unclear whether bulbar projecting GABAergic neurons collaterallize projecting to other brain regions. To address this, we mapped collateral projections from bulbar projecting GABAergic neurons using intersectional strategies of viral and traditional tract tracers. This approach revealed bulbar projecting GABAergic neurons show remarkable specificity targeting other primary olfactory cortical regions exhibiting abundant collateral projections into the accessory olfactory bulb, AON, PFC, PC, and TT. The only "nonolfactory" region receiving collateral projections was sparse connectivity to the medial prefrontal orbital cortex. This suggests that basal forebrain inhibitory feedback also modulates glutamatergic feedback areas that are themselves prominent bulbar projection regions. Thus, inhibitory feedback may be simultaneously modulating both synaptic processing of olfactory information in the bulb and associational processing of olfactory information from primary olfactory cortex. We hypothesize that these olfactory GABAergic feedback neurons are a regulator of the entire olfactory system.

Trigeminal Sensory Supply Is Essential for Motor Recovery after Facial Nerve Injury

Recovery of mimic function after facial nerve transection is poor. The successful regrowth of regenerating motor nerve fibers to reinnervate their targets is compromised by (i) poor axonal navigation and excessive collateral branching, (ii) abnormal exchange of nerve impulses between adjacent regrowing axons, namely axonal crosstalk, and (iii) insufficient synaptic input to the axotomized facial motoneurons. As a result, axotomized motoneurons become hyperexcitable but unable to discharge. We review our findings, which have addressed the poor return of mimic function after facial nerve injuries, by testing the hypothesized detrimental component, and we propose that intensifying the trigeminal sensory input to axotomized and electrophysiologically silent facial motoneurons improves the specificity of the reinnervation of appropriate targets. We compared behavioral, functional, and morphological parameters after single reconstructive surgery of the facial nerve (or its buccal branch) with those obtained after identical facial nerve surgery, but combined with direct or indirect stimulation of the ipsilateral infraorbital nerve. We found that both methods of trigeminal sensory stimulation, i.e., stimulation of the vibrissal hairs and manual stimulation of the whisker pad, were beneficial for the outcome through improvement of the quality of target reinnervation and recovery of vibrissal motor performance.

Ectopic stem cell niches sustain rainbow trout (Oncorhynchus mykiss) intestine absorptive capacity when challenged with a plant protein-rich diet

To develop more sustainable feed formulations, it is important to assess in detail their effect on gut function and health. We previously described the specific organization of the epithelial and stromal components of the intestinal stem cell niche (ISCN), in rainbow trout (RT) under actual farming conditions. In the present work, we used our previous observation, for performing a comparative analysis between a control diet (CF) and an experimental vegetable-based diet (CV) under a new perspective. We correlated diet-induced changes of the morphology and the absorptive capability of the RT mucosa with modifications of the ISCN. Histological analysis confirmed that CV diet caused a mucosa remodeling, characterized by the generation of accessory branches sprouting from the middle of the proximal intestine folds, determining a significant increase of the luminal surface. The newly-formed structures showed positivity for PepT1, Sglt-1, and Fabp2 indicating their active role in small molecule absorption. However, the cells lining the base of the new branches expressed both epithelial (sox9) and stromal (pdgfrα and foxl1) stem cell markers, rather than the expected markers of fully differentiated cells. Our results suggest that a nutritional challenge results in the formation of an ectopic ISNC at the middle of the intestinal folds that sustains the formation of functional collateral branches, presumably to compensate for the reduced intestinal absorption. Overall, these data highlight, for the first time, the plasticity of the ISCN and its possible role in compensating intestinal functions in response to challenging conditions.

Femoral tripod arteries: Surgical anatomic variants.

To describe the surgical anatomy of the femoral tripod arteries and their anatomical variants. Patients who underwent vascular surgery by external arciform approach of the Scarpa between May 2022 and July 2022 were selected. The surgical anatomy was assessed by direct observation. The origin and the course of major branches of the femoral artery (FA) were studied. Diameters and the distance of the origin of the femoral profunda artery (FPA) from the midpoint of the inguinal ligament was measured in millimeters and recorded. The observed anatomical variations were photographed and compared to those in the literature. A total of 40 patients (34 men, 85%) were included. The median diameter of the common femoral artery (CFA) was 9mm (IQR: 7-12mm). The Modal bifurcation was noted in 95% of cases. The collateral branches of the CFA were found to be distributed as follows: the superficial circumflex iliac artery (SCIA) in 34 cases (85%), the superficial epigastric artery (SEA) in 22 cases (55%), the deep external pudic artery in 16 cases (40%), and the superficial external pudic artery in 18 cases (45%). The median diameter of the FPA was 5mm (IQR: 4-6mm). The FPA originated from the posterolateral side of the CFA in 90% of cases, from the posterior side in 5% of cases and from the medial side in 5% of cases. The median diameter of the SFA was 6mm (IQR: 4-9mm). The anatomic variants of the femoral tripod arteries are extremely frequent. Therefore, it is important to recognize the anatomy in order to avoid possible diagnostic errors and to minimize the risk of per and post procedural complications.