Distinct Body Regions Research Articles

The Square-Plus Flap: A Modification to Release Long Postburn Scar Contractures.

The square flap method has been successful in releasing contracture bands at various body regions. However, the original square flap method alone may not be efficient in releasing long contracture bands. We, therefore, proposed an extended design to the traditional design, which is called the "square-plus flap." A 4-year-old girl presented with a postburn web-like contracture band over the right axilla. We marked a square flap technique at the center of the contracture band and then two additional Z-plasties were placed on both edges of the flap. After the release and securing of the square flap, the adjacent distal Z-plasty was then transposed and sutured in their new locations. We do not need to incise the proximal Z-plasty as we could achieve complete relaxation of the contracture band. This novel modification can be added to the plastic surgeon's armamentarium for releasing long postburn contracture bands involving distinct body regions.

Improvement of muscle strength in specific muscular regions in nusinersen-treated adult patients with 5q-spinal muscular atrophy

Real-world data have shown mild improvement of overall motor function in adult patients treated with nusinersen, the first approved therapy for 5q-spinal muscular atrophy (SMA). However, knowledge about preferably targeted muscle functions is sparse. The aim of this study was to evaluate strength of distinct muscles and body regions in adult SMA patients in the early course of nusinersen therapy. 72 muscles of 15 patients were tested on the Medical Research Council (MRC) 0–10 scale (translated into MRC %) from nusinersen start to 14 months of treatment. The whole body muscular strength improved slightly or remained stable in 80% of SMA patients with a median improvement of + 2%. However, relevant increases of muscle strength of distinct regions were identified in the proximal upper limbs and shoulder girdle (median + 8%) and in muscle groups with a preserved function pre-treatment, even in more advanced diseased SMA patients. MRC grading was additionally performed in seven patients enrolled during ongoing treatment. Here, further improvement of muscle strength until month 18–26 was seen with the highest increases in the proximal upper and lower limbs. Our findings suggest that sole evaluation of the overall muscle strength might underestimate nusinersen therapy benefits.

Complications of cochlear implants with MRI scans in different body regions: type, frequency and impact

ObjectivesThe aim was to assess the type, frequency and impact of MRI-related complications in patients with cochlear implants (CI) and MRI indications in different body regions.MethodsFor that purpose, the institutional radiology database of a single tertiary hospital was searched for patients with a CI who underwent MRI between 2001 and 2018. The number of MRI examinations and complications were retrieved from the patient record. Examinations were categorized into five distinct body regions or combinations thereof. Records of CI artifacts in the head also included basic information on diagnostic image quality.ResultsOut of 1017 MRI database entries (examinations) of patients with a CI, 91 records were after implantation (71 patients) and 66 were attempted (no contraindications, 49 patients). In four cases (4/66, 6.1%), the magnet was dislocated and had to be replaced surgically. Three out of four severe complications occurred for examination regions outside the head. Thirteen MRI examinations were aborted due to pain (19.7%) and one because of artifacts—resulting in 48 scans (72.7%) completed successfully (36 patients). All cranial scans featured device artifacts in all sequences, but the majority of them did not affect proper imaging diagnostics in the respective region.ConclusionThis retrospective, single-center analysis of patients with MRI-conditional cochlear implants shows that MRI-related complications were common, at least in models with a fixed magnet, despite appropriate precautions and compliance with the manufacturers’ guidelines. MRI examinations of CI patients should therefore be indicated strictly until the exact causes have been clarified.

Development and validation of bioelectrical impedance prediction equations estimating regional lean soft tissue mass in middle-aged adults.

Bioelectrical impedance (BIA) whole-body and regional raw parameters have been used to develop prediction models to estimate whole-body lean soft tissue (LSTM), with less attention being given to the development of models for regional LSTM. Therefore, we aimed to develop and validate BIA-derived equations predicting regional LSTM against dual x-ray absorptiometry (DXA) in healthy adults. 149 adults were included in this cross-sectional investigation. Whole-body and regional LSTM were assessed by DXA, and raw bioelectrical parameters of distinct body regions were measured using a 50 kHz phase sensitive BIA analyzer. BIA-derived equations were developed using a stepwise multiple linear regression approach in 2/3 of the sample and cross-validated in the remaining sample. Slopes and intercepts of predicted LSTM and DXA measured LSTM did not differ from 1 and 0, respectively, for each region (p ≥ 0.05), with the exception for the trunk (p < 0.05). The BIA-derived equations exhibited a strong relationship (p < 0.001) between the predicted and measured LSTM for each of the following body regions: right and left arms (R = 0.94; R = 0.96), right and left legs (R = 0.88; R = 0.88), upper body (R = 0.96), lower body (R = 0.89), right and left sides of the body (R = 0.94; R = 0.94), and trunk (R = 0.90). Agreement analyses revealed no associations between the differences and the means of the predicted and DXA-derived LSTM. The developed BIA-derived equations provide a valid estimate of regional LSTM in middle-aged healthy adults, representing a cost-effective and time-efficient alternative to DXA for the assessment and identification of LSTM imbalances in both clinical and sport-specific contexts.

Novel Mg-0.5Ca-xMn Biodegradable Alloys Intended for Orthopedic Application: An In Vitro and In Vivo Study.

Mg-based biodegradable materials, used for medical applications, have been extensively studied in the past decades. The in vitro cytocompatibility study showed that the proliferation and viability (as assessed by quantitative MTT-assay—3-(4,5-dimethyltiazol-2-yl)-2,5-diphenyl tetrazolium bromide) were not negatively affected with time by the addition of Mn as an alloying element. In this sense, it should be put forward that the studied alloys don’t have a cytotoxic effect according to the standard ISO 10993-5, i.e., the level of the cells’ viability (cultured with the studied experimental alloys) attained both after 1 day and 5 days was over 82% (i.e., 82, 43–89, 65%). Furthermore, the fibroblastic cells showed variable morphology (evidenced by fluorescence microscopy) related to the alloy sample’s proximity (i.e., related to the variation on the Ca, Mg, and Mn ionic concentration as a result of alloy degradation). It should be mentioned that the cells presented a polygonal morphology with large cytoplasmic processes in the vicinity of the alloy’s samples, and a bipolar morphology in the remote region of the wells. Moreover, the in vitro results seem to indicate that only 0.5% Mn is sufficient to improve the chemical stability, and thus the cytocompatibility; from this point of view, it could provide some flexibility in choosing the right alloy for a specific medical application, depending on the specific parameters of each alloy, such as its mechanical properties and corrosion resistance. In order to assess the in vivo compatibility of each concentration of alloy, the pieces were implanted in four rats, in two distinct body regions, i.e., the lumbar and thigh. The body’s reaction was followed over time, 60 days, both by general clinical examinations considering macroscopic changes, and by laboratory examinations, which revealed macroscopic and microscopic changes using X-rays, CT(Computed Tomography), histology exams and SEM (Scanning Electron Microscopy). In both anatomical regions, for each of the tested alloys, deformations were observed, i.e., a local reaction of different intensities, starting the day after surgery. The release of hydrogen gas that forms during Mg alloy degradation occurred immediately after implantation in all five of the groups examined, which did not affect the normal functionality of the tissues surrounding the implants. Imaging examinations (radiological and CT) revealed the presence of the alloy and the volume of hydrogen gas in the lumbar and femoral region in varying amounts. The biodegradable alloys in the Mg-Ca-Mn system have great potential to be used in orthopedic applications.

Trauma Team Activation: Which Surgical Capability Is Immediately Required in Polytrauma? A Retrospective, Monocentric Analysis of Emergency Procedures Performed on 751 Severely Injured Patients.

There has been an ongoing discussion as to which interventions should be carried out by an “organ specialist” (for example, a thoracic or visceral surgeon) or by a trauma surgeon with appropriate general surgical training in polytrauma patients. However, there are only limited data about which exact emergency interventions are immediately carried out. This retrospective data analysis of one Level 1 trauma center includes adult polytrauma patients, as defined according to the Berlin definition. The primary outcome was the four most common emergency surgical interventions (ESI) performed during primary resuscitation. Out of 1116 patients, 751 (67.3%) patients (male gender, 530, 74.3%) met the inclusion criteria. The median age was 39 years (IQR: 25, 58) and the median injury severity score (ISS) was 38 (IQR: 29, 45). In total, 711 (94.7%) patients had at least one ESI. The four most common ESI were the insertion of a chest tube (48%), emergency laparotomy (26.3%), external fixation (23.5%), and the insertion of an intracranial pressure probe (ICP) (19.3%). The initial emergency treatment of polytrauma patients include a limited spectrum of potential life-saving interventions across distinct body regions. Polytrauma care would benefit from the 24/7 availability of a trauma team able to perform basic potentially life-saving surgical interventions, including chest tube insertion, emergency laparotomy, placing external fixators, and ICP insertion.

Patterns of skeletal integration in birds reveal that adaptation of element shapes enables coordinated evolution between anatomical modules.

Birds show tremendous ecological disparity in spite of strong biomechanical constraints imposed by flight. Modular skeletal evolution is generally accepted to have facilitated this, with distinct body regions showing semi-independent evolutionary trajectories. However, this hypothesis has received little scrutiny. We analyse evolutionary modularity and ecomorphology using three-dimensional data from across the entire skeleton in a phylogenetically broad sample of extant birds. We find strongly modular evolution of skeletal element sizes within body regions (head, trunk, forelimb and hindlimb). However, element shapes show substantially less modularity, have stronger relationships to ecology, and provide evidence that ecological adaptation involves coordinated evolution of elements across different body regions. This complicates the straightforward paradigm in which modular evolution facilitated the ecological diversification of birds. Our findings suggest the potential for undetected patterns of morphological evolution in even well-studied groups, and advance the understanding of the interface between evolutionary integration and ecomorphology.

Palaeoniscoid remains from the Lower Permian Pedra de Fogo Formation (Parnaíba Basin): Insights from general morphology and histology

ABSTRACT Fossil fish remains from the Pedra de Fogo Formation in Brazil are abundant and diversified, yet studies of fossils from this lithostratigraphic unit in the Tocantins State remain scarce. Here we describe the general morphology and histology of actinopterygian remains collected in Filadelfia municipality, Tocantins State. These new records comprise isolated teeth and scales found at about the same biostratigraphic level. Our morphologic analysis of scales reveals five distinct body regions. Comparative and histological analysis of the ganoid scales point to the palaeoniscoid type, confirming a palaeonisciform contribution. Additionally, teeth histology confirms the presence of simplexodont plicidentine, indicating a possible morphofunctional adaptation to predatory life. The discovery of more complete specimens is necessary to refine taxonomic assignment.

A review and new insights to antimicrobial action of local anesthetics.

Local anesthetics (LAs) are medications which can provide analgesia in distinct body regions through the blockade of voltage-gated sodium channels. Besides pain management, the supplemental role of LAs as antimicrobial agents has been documented in several studies. Different databases including PubMed, Scopus, and Web of Science with the name of different local anesthetics and related names for antimicrobial keywords were searched without time limitation. This review summarized different in vitro and in vivo studies regarding antimicrobial effects of different LAs with focuses on antimicrobial applications of most studied LAs, interaction with different agents which combined with LAs, and mechanisms of action and structural dependence of LAs antibacterial effects. Among different LAs, lidocaine is the most studied preparation. Reduction of the incidence of endophthalmitis after intravitreal injection, prophylaxis for surgical wound infections, prevention of the incidence of catheter-associated infections, oral biofilm reduction on the buccal mucosa, and prevention against bacteria that produced nosocomial infection are some examples of lidocaine antimicrobial application. Studies showed that different factors including structure, concentration, duration of exposure, type of microorganism tested, and temperature affect the degree of LA antimicrobial activity. In addition, various agents such as antibiotics, preservatives, opioids, epinephrine, and propofol can combine with LAs and affect their antimicrobial properties through synergistic or antagonistic action. Due to antibacterial activities, LAs could be applied in a clinic for prophylaxis of surgical site infection. In the application of LAs prior to diagnostic procedures caution should be needed; otherwise, when culturing the specimen, they could lead to false negative results.

A Deep Structure of Person Re-Identification Using Multi-Level Gaussian Models

Person re-identification is being widely used in the forensic, and security and surveillance system, but person re-identification is a challenging task in real life scenario. Hence, in this work, a new feature descriptor model has been proposed using a multilayer framework of Gaussian distribution model on pixel features, which include color moments, color space values and Schmid filter responses. An image of a person usually consists of distinct body regions, usually with differentiable clothing followed by local colors and texture patterns. Thus, the image is evaluated locally by dividing the image into overlapping regions. Each region is further fragmented into a set of local Gaussians on small patches. A global Gaussian encodes, these local Gaussians for each region creating a multi-level structure. Hence, the global picture of a person is described by local level information present in it, which is often ignored. Also, we have analyzed the efficiency of earlier metric learning methods on this descriptor. The performance of the descriptor is evaluated on four public available challenging datasets and the highest accuracy achieved on these datasets are compared with similar state-of-the-arts, which demonstrate the superior performance.

Growth Plate Injuries of the Lower Extremity: Case Examples and Lessons Learned.

Background:The presence of growth plates at the ends of long bones makes fracture management in children unique in terms of the potential risk of developing angular deformities and growth arrest.Materials and Methods:We discuss three distinct cases depicting various aspects of physeal injury of the lower extremity in children.Results:The case illustrations chosen represent distinct body regions and different physeal injuries: Salter–Harris II fracture of the distal femur, Salter–Harris VI perichondrial injury of the medial aspect of the knee region, and Salter–Harris III fracture of the distal tibia. The clinical presentation, pertinent history and physical findings, imaging studies, management, and subsequent course are presented.Conclusions:Growth plate injuries of the lower extremity require a high index of suspicion and close monitoring during skeletal growth. Early recognition and proper management of these injuries can minimize long term morbidity. The treatment plan should be individualized after a comprehensive analysis of the injury pattern in each patient. Establishing a long term treatment plan and discussing the prognosis of these injuries with the child's caretakers is imperative.

Role of MEKK1 in the anterior-posterior patterning during planarian regeneration.

Planarians have established a unique body pattern along the anterior-posterior (AP) axis, which consists of at least four distinct body regions arranged in an anterior to posterior sequence: head, prepharyngeal, pharyngeal (containing a pharynx), and tail regions, and possess high regenerative ability. How they reconstruct the regional continuity in a head-to-tail sequence after amputation still remains unknown. We use as a model planarian Dugesia japonica head regeneration from tail fragments, which involves dynamic rearrangement of the body regionality of preexisting tail tissues along the AP axis, and show here that RNA interference of the gene D.japonica mek kinase 1 (Djmekk1) caused a significant anterior shift in the position of pharynx regeneration at the expense of the prepharyngeal region, while keeping the head region relatively constant in size, and accordingly led to development of a relatively longer tail region. Our data suggest that DjMEKK1 regulates anterior extracellular signal-regulated kinase (ERK) and posterior β-catenin signaling pathways in a positive and negative manner, respectively, to establish a proper balance resulting in the regeneration of planarian's scale-invariant trunk-to-tail patterns across individuals. Furthermore, we demonstrated that DjMEKK1 negatively modulates planarian β-catenin activity via its serine/threonine kinase domain, but not its PHD/RING finger domain, by testing secondary axis formation in Xenopus embryos. The data suggest that Djmekk1 plays an instructive role in the coordination between the establishment of the prepharyngeal region and posteriorizing of pharynx formation by balancing the two opposing morphogenetic signals along the AP axis during planarian regeneration.

Functional diversity of the lateral line system among populations of a native Australian freshwater fish.

Fishes use their mechanoreceptive lateral line system to sense nearby objects by detecting slight fluctuations in hydrodynamic motion within their immediate environment. Species of fish from different habitats often display specialisations of the lateral line system, in particular the distribution and abundance of neuromasts, but the lateral line can also exhibit considerable diversity within a species. Here, we provide the first investigation of the lateral line system of the Australian western rainbowfish (Melanotaenia australis), a species that occupies a diversity of freshwater habitats across semi-arid northwest Australia. We collected 155 individuals from eight populations and surveyed each habitat for environmental factors that may contribute to lateral line specialisation, including water flow, predation risk, habitat structure and prey availability. Scanning electron microscopy and fluorescent dye labelling were used to describe the lateral line system in M. australis, and to examine whether the abundance and arrangement of superficial neuromasts (SNs) varied within and among populations. We found that the SNs of M. australis were present in distinct body regions rather than lines. The abundance of SNs within each body region was highly variable, and also differed among populations and individuals. Variation in SN abundance among populations was best explained by habitat structure and the availability of invertebrate prey. Our finding that specific environmental factors explain among-population variation in a key sensory system suggests that the ability to acquire sensory information is specialised for the particular behavioural needs of the animal.

Additivity in perception of affect from limb motion

In this study, the notion of additivity in perception of affect from limb motion is investigated. Specifically, we examine whether the impact of multiple limbs in perception of affect is equal to the sum of the impacts of each individual limb. Several neutral, happy, and sad walking sequences are first aligned and averaged. Four distinct body regions or limbs are defined for this study: arms and hands, legs and feet, head and neck, and torso. The three average walks are used to create the stimuli. The motion of each limb and combination of limbs from the neutral sequence are replaced with those of the happy and sad sequences. Through collecting perceptual ratings for when individual limbs contain affective features, and comparing the sums of these ratings to instances where multiple limbs of the body simultaneously contain affective features, additivity is investigated. We find that while the results are highly correlated, additivity does not hold in the classical sense. Based on the results, a mathematical model is proposed for describing the observed relationship.

Avaliação da região corpórea e dose da tuberculina no diagnóstico imunoalérgico em ovinos (Ovis aries) experimentalmente sensibilizados com inóculo inativado de Mycobacterium bovis

O objetivo foi a investigação do local de aplicação do derivado proteico purificado (PPD) bovino, empregado no teste imunoalérgico da tuberculose, em 15 ovinos (Ovis aries) experimentalmente sensibilizados com Mycobacterium bovis AN5. A partir da melhor resposta obtida na fase de identificação da região corpórea, avaliou-se a dose de PPD bovino a ser aplicada. Decorridos 60 dias da sensibilização, o PPD bovino foi aplicado em cinco distintas regiões corpóreas (cervical média, torácica dorsal, abdominal dorsal, prega da cauda e face medial proximal do membro pélvico - face interna da coxa) com a mensuração da espessura da dobra de pele e da reação através de cutímetro de mola, nos momentos antes (0h) e após aplicação (12h, 24h, 48h, 72h e 96h). A análise dos resultados obtidos foi significante, em ordem decrescente, para as regiões: torácica dorsal, cervical média e abdominal dorsal às 48 e 72h após aplicação do PPD bovino. Elegeu-se a região torácica dorsal como melhor local de aplicação. Recomenda-se que a leitura da reação tuberculínica em ovinos deve ser efetuada às 72h da aplicação do PPD, utilizando-se a dose de 0,1 mL.

Microstructural morphology in early dermal denticles of hammerhead sharks (Elasmobranchii: Sphyrnidae) and related taxa

AbstractMello, W.C., de Carvalho, J.J., Brito, P.M.M. 2011. Microstructural morphology in early dermal denticles of hammerhead sharks (Elasmobranchii: Sphyrnidae) and related taxa. —Acta Zoologica (Stockholm) 00: 1–7.This study uses scanning electron microscopies to investigate and describe the microstructural diversity of dermal denticles in the family Sphyrnidae, which comprises all living hammerhead shark species, comparing them to other related taxa (i.e. Carcharhinus dussumieri, Carcharhinus plumbeus, Carcharhinus acronotus, Rhizoprionodon acutus, Negaprion brevirostris and Hemigaleus microstoma). The results reveal that sphyrnids present noticeable microstructures in the dermal denticles, distinguishing them from the other related species investigated. Additionally, scale patterns are the same in three distinct body regions (i.e. cephalic, branchial and dorsal fin). Species of Sphyrnidae that reach bigger total lengths and that are widely distributed (i.e. Sphyrna lewini and Sphyrna mokarran) presented more, smaller and nearly hexagonal microstructures that do not cover the entire scale surface, unlike species reaching smaller sizes and restricted to coastal habits (i.e. Sphyrna tiburo, Sphyrna tudes, Sphyrna media and Eusphyra blochii). The sphyrnid scales are similar to R. acutus and C. dussumieri rather than to the other species, but it is not possible to identify the sphyrnid species only by scale features. It is clear that a similar morphology of scales is not necessarily related to similar life habits, and that they are candidates to provide new characters in phylogenetical studies among sphyrnids.

Local and overall thermal comfort in an aircraft cabin and their interrelations

In this study the interrelation between local and overall thermal comfort of passengers in aircraft cabins was investigated by thirteen simulated flights. For each of the tests forty test persons filled out questionnaires concerning their perceived overall and local thermal comfort at temperatures of 20 °C–25 °C, which were measured at every second seat. With these physical and subjective data PMV (Predicted Mean Vote) and TSMV (Thermal Sensation Mean Vote) of test persons as well as PPD (Predicted Percentage of Dissatisfied) and PD (Percentage of Dissatisfied) were compared. The PMV was consistently similar to the TSMV, while the thermal dissatisfaction in tests was always higher than PPD. The hypothesis at the beginning of this study was that the high ratio of thermal dissatisfaction in the aircraft cabin reported in literature might be caused by local discomfort. Therefore statistical analyses about the interrelations between local and overall thermal comfort were performed and models indicating such interrelations were developed. Some local perceptions are significantly different from overall thermal perception and these body segments alter in dependence of the overall thermal environment. Also body segments rated similarly were detected and these segments were pooled to distinct body regions using principal component analysis. Under the same overall thermal sensation the local thermal perception on a certain body region predominantly influenced the overall thermal comfort. Therefore weighting factors of local body regions on the overall thermal comfort were determined in dependence of the overall thermal sensation by means of multiple linear regression models.

Perineal body anatomy in living women: 3-dimensional analysis using thin-slice magnetic resonance imaging

The objective of the study was to describe a framework for visualizing the perineal body's complex anatomy using thin-slice magnetic resonance (MR) imaging. Two millimeter thick MR images were acquired in 11 women with normal pelvic support and no incontinence/prolapse symptoms. Anatomic structures were analyzed in axial, sagittal, and coronal slices. Three-dimensional (3-D) models were generated from these images. Three distinct perineal body regions are visible on MR imaging: (1) a superficial region at the level of the vestibular bulb, (2) a midregion at the proximal end of the superficial transverse perineal muscle, and (3) a deep region at the level of the midurethra and puborectalis muscle. Structures are best visualized on axial scans, whereas craniocaudal relationships are appreciated on sagittal scans. The 3-D model further clarifies interrelationships. Advances in MR technology allow visualization of perineal body anatomy in living women and development of 3-D models that enhance our understanding of its 3 different regions: superficial, mid, and deep.

Comparative larval myogenesis and adult myoanatomy of the rhynchonelliform (articulate) brachiopods Argyrotheca cordata, A. cistellula, and Terebratalia transversa

BackgroundDespite significant methodological progress, Brachiopoda remains one of the lophotrochozoan phyla for which no recent ontogenetic data employing modern methodologies such as fluorescence labelling and confocal microscopy are available. This is particularly astonishing given the ongoing controversy concerning its phylogenetic position. In order to contribute new morphogenetic data for phylogenetic and evolutionary inferences, we describe herein the ontogeny and myoanatomy of larvae and adults of the rhynchonelliform brachiopods Argyrotheca cordata, A. cistellula, and Terebratalia transversa using fluorescence F-actin labelling combined with confocal laserscanning microscopy.ResultsFully grown larvae of A. cordata and T. transversa consist of three distinct body regions, namely an apical lobe, a mantle lobe with four bundles of setae, and a pedicle lobe. Myogenesis is very similar in these two species. The first anlagen of the musculature develop in the pedicle lobe, followed by setae muscles and the mantle lobe musculature. Late-stage larvae show a network of strong pedicle muscles, central mantle muscles, longitudinal muscles running from the mantle to the pedicle lobe, setae pouch muscles, setae muscles, a U-shaped muscle, serial mantle muscles, and apical longitudinal as well as apical transversal muscles. Fully developed A. cistellula larvae differ from the former species in that they have only two visible body lobes and lack setae. Nevertheless, we found corresponding muscle systems to all muscles present in the former two species, except for the musculature associated with the setae, in larvae of A. cistellula. With our survey of the adult myoanatomy of A. cordata and A. cistellula and the juvenile muscular architecture of T. transversa we confirm the presence of adductors, diductors, dorsal and ventral pedicle adjustors, mantle margin muscles, a distinct musculature of the intestine, and striated muscle fibres in the tentacles for all three species.ConclusionOur data indicate that larvae of rhynchonelliform brachiopods share a common muscular bodyplan and are thus derived from a common ancestral larval type. Comparison of the muscular phenotype of rhynchonelliform larvae to that of the other two lophophorate phyla, Phoronida and Ectoprocta, does not indicate homology of individual larval muscles. This may be due to an early evolutionary split of the ontogenetic pathways of Brachiopoda, Phoronida, and Ectoprocta that gave rise to the morphological diversity of these phyla.

Distribution of Spinal and Associated Injuries in Multiple Trauma Patients.

Injury to the spinal column and cord are often part of life-threatening multiple trauma. Epidemiological data could help to establish an evidence-based assessment and therapy of these patients. We present a retrospective chart analysis of 590 multiple traumatized patients admitted within a 4-year-period. Patients suffering from injuries of the spinal column were analysed regarding mechanism and distribution of their injuries to all body regions. Thirty-one percent (n = 183) of polytraumatized patients displayed a spine injury. Distribution analysis showed peaks in the cervical spine and the thoraco-lumbar junction. The risk of relevant associated injuries is mainly influenced from anatomical vicinity to the injured spinal segment. Injuries to the spinal column are frequent in the multiple trauma patients population. Diagnosed injuries to distinct body regions should make the trauma team suspicious of injury to the nearby spinal column. Appropriate treatment includes thorough assessment of all injuries to clarify the damage and carry on special protection of these spinal regions preventing from deterioration.