Important Anatomical Area Research Articles

Changes in Hippocampal Plasticity in Depression and Therapeutic Approaches Influencing These Changes.

Depression is a common neurological disease that seriously affects human health. There are many hypotheses about the pathogenesis of depression, and the most widely recognized and applied is the monoamine hypothesis. However, no hypothesis can fully explain the pathogenesis of depression. At present, the brain-derived neurotrophic factor (BDNF) and neurogenesis hypotheses have highlighted the important role of plasticity in depression. The plasticity of neurons and glial cells plays a vital role in the transmission and integration of signals in the central nervous system. Plasticity is the adaptive change in the nervous system in response to changes in external signals. The hippocampus is an important anatomical area associated with depression. Studies have shown that some antidepressants can treat depression by changing the plasticity of the hippocampus. Furthermore, caloric restriction has also been shown to affect antidepressant and hippocampal plasticity changes. In this review, we summarize the latest research, focusing on changes in the plasticity of hippocampal neurons and glial cells in depression and the role of BDNF in the changes in hippocampal plasticity in depression, as well as caloric restriction and mitochondrial plasticity. This review may contribute to the development of antidepressant drugs and elucidating the mechanism of depression.

CT Scan Evaluation of Prevalence of Paradoxical Middle Turbinate In Adult Population of Bihar

Introduction: Middle turbinate overlying the middle meatus is the most important anatomic area in the lateral wall of the nose. It is a thinsheet of bone which curves in different planes very similar to a dried leaf. Paradoxical Middle Turbinate (PMT) is the abnormal curvatureof middle turbinate, where the convex surface faces laterally instead of its usual medial curvature and may block the drainage pathway ofmiddle meatus. The present study aimed at observing the prevalence of the paradoxical middle turbinate in the adult population of Bihar. Subjects and Methods: This was a retrospective study being conducted on 150 patients who presented to the Department of Radiodiagnosis. Their CT scans were analysed for the presence of paradoxical middle turbinate. The results were analysed as percentage and ‘p’ value was calculated using Fischer’s Exact Test. Results: Prevalence of Paradoxical Middle Turbinate was observed in 28 cases i.e. 18.6% cases; 16 in males and 12 in females. ‘p’ value was 0.677 on applying Fisher’s Exact test. Conclusion: Anatomical variations of the paranasal sinus region like paradoxical middle turbinate are quite common cause of diseases involving paranasal sinuses and they must be searched for by the surgeons planning any endoscopic sinus surgery. This study attempted to provide the prevalence of the paradoxical middle turbinate which will definitely help the FESS surgery and its outcomes.

A morphovolumetric study of head malposition in proximal humeral fractures based on 3-dimensional computed tomography scans: the control volume theory

This study regards a volumetric analysis of proximal humeral fractures. The main purpose was to investigate the head displacement in relation to the shaft and its link to volume reductions ("bone loss") of the anatomic segments interposed between the head and the shaft: the tuberosities and the calcar. We call this area "control volume." In 20 fractures, we used 3-dimensional virtual reconstruction to create a reference system that divides geometrically the control volume and allows the evaluation of displacement angles of the humeral head. We calculated the volumetric reduction of control volume segments for each fracture through a specific mathematical protocol. The measurement of the head displacement angles in 20 fractures led to following results: in the coronal plane, 10 varus, 6 valgus, 4 neutral; in the sagittal plane, 6 anterior tilt, 9 posterior tilt, 5 neutral position. There was a reduction of control volume in 19 of 20 fractures. Only in 1 fracture was the control volume intact and the fracture was nonimpacted. In 19 impacted fractures, the volume reduction was variable (4% minimum loss, 98% maximum loss). In head varus position, loss was greater in the medial area than in the lateral area. There was generally a clear correspondence between the positions assumed by the head and the volumetric losses of the respective control volume segments. The control volume is an important anatomic and functional area of the proximal humerus. A morphovolumetric 3-dimensional approach improves knowledge about pathomorphology of proximal humeral fractures.

Surgical management of nonmelanomatous malignant cutaneous lesions of the face

Objective The aim of the present study was to evaluate the esthetic and functional outcomes after surgical excision of nonmelanomatous malignant lesions of the face, followed by a suitable tool of reconstruction. Background Neoplasm of the skin is found most often on the face. Cosmetically, the face is the most important anatomic area for most patients. Because of this, malignant tumors of the facial skin pose a great challenge in treatment, prohibiting compromises between oncologically responsible surgery and functional and cosmetic outcomes. Patients and methods This prospective study included 25 patients, all of them suffering from nonmelanomatous skin cancer and managed at Menoufia University Hospitals and Damanhur Oncology Center by different modalities of reconstruction during the period from April 2012 to December 2014. The appropriate technique was selected for every patient, taking in consideration the location and size of the lesion. Results Eighteen cases had reconstructive procedures with local flaps only, five cases had more combined reconstructive tools in the form of local flaps (rotational flaps) plus split-thickness graft to close the secondary defect, and two cases required reconstruction with a full-thickness graft. Conclusion Our experience showed that the postoperative defects gave the best cosmetic results when reconstructed by using a nearby tissue, fulfilling all patient and surgeon expectations with a minimum rate of morbidity. Clear guidelines and a multidisciplinary approach for the treatment of skin cancer are important to ensure that patients receive optimal care with satisfactory end results for tumor control as well as reconstructive esthetic outcome.

Exploring the safety range via the transoral approach to the craniovertebral junction.

Surgeries via the transoral approach are widely used to deal with lesions near the craniovertebral junction. For this approach, the pharyngeal tubercle is an important landmark to identify the midline. The foramen lacerum, another important anatomic area where some crucial structures pass, is close to the pharyngeal tubercle. In the current study, we measured relevant distances and angles on 120 adults without brain diseases to estimate the safety range of the transoral approach. Distances between the pharyngeal tubercle and the foramen lacerum were expressed as mean (SD) and 95% confidence interval. Angles between the straight lines, which pass through the pharyngeal tubercle and the foramen lacerum, and the sagittal plane, as well as the horizontal plane, were also presented as mean (SD) and 95% confidence interval. As regards the 95% confidence intervals of the angles and the distances, which were used to define the safety range, no differences were observed between the right side and the left side. During such surgeries, if the midline is defined as a datum line, it is less likely for surgeons to destroy adjacent structures when moving within 36.30 degrees on the sagittal plane and 45.00 degrees on the horizontal plane once they find the pharyngeal tubercle. It is also safe to move within 16.20 mm from the pharyngeal tubercle. With these data, we have successfully defined the safety range of the surgery, which may help operators choose proper instruments in surgery and avoid injuries to important structures. Moreover, operators may use these data to position the pharyngeal tubercle so as not to deviate from the midline.

A Simple and Effective Way to Protect the Nipple-Areolar Complex During Operation: A Clinical Tip

The nipple-areolar complex is a unique and important anatomical area in breast surgery. Areolar access incisions are common1-5 because in that area, the desired plane can be dissected easily and directly. Varying degrees of injury to the nipple-areolar complex have been reported, such as dehiscence or abrasion due to implant insertion and distraction of the skin hook, especially when the diameter of the …

Appearance Is a Function of the Face

Increasingly, third-party insurers deny coverage to patients with posttraumatic and congenital facial deformities because these are not seen as "functional." Recent facial transplants have demonstrated that severely deformed patients are willing to undergo potentially life-threatening surgery in search of a normal physiognomy. Scant quantitative research exists that objectively documents appearance as a primary "function" of the face. This study was designed to establish a population-based definition of the functions of the human face, rank importance of the face among various anatomical areas, and determine the risk value the average person places on a normal appearance. Voluntary adult subjects (n = 210) in three states aged 18 to 75 years were recruited using a quota sampling technique. Subjects completed study questionnaires of demography and bias using the Gamble Chance of Death Questionnaire and the Rosenberg Self-Esteem Scale. The face ranked as the most important anatomical area for functional reconstruction. Appearance was the fifth most important function of the face, after breathing, sight, speech, and eating. Normal facial appearance was rated as very important for one to be a functioning member of American society (p = 0.01) by 49 percent. One in seven subjects (13 percent) would accept a 30 to 45 percent risk of death to obtain a "normal" face. Normal appearance is a primary function of the face, based on a large, culturally diverse population sample across the lifespan. Normal appearance ranks above smell and expression as a function. Restoration of facial appearance is ranked the most important anatomical area for repair. Normal facial appearance is very important for one to be a functional member of American society.

Perforation of the inferior alveolar nerve by the maxillary artery: An anatomical study

The infratemporal fossa is a clinically important anatomical area for the delivery of local anaesthetic agents in dentistry and maxillofacial surgery. We studied the infratemporal fossas in white cadavers, and in particular the topographical relations of the inferior alveolar nerve and the maxillary artery. In 3 of the 50 fossas dissected the maxillary artery passed through the inferior alveolar nerve, splitting it into superficial and deep divisions. Entrapment of the maxillary artery may cause numbness or headache and may interfere with injection of local anaesthetics into the infratemporal fossa.

Access ostoetomies: an extended role of oral and maxillofacial surgeon

Background and objectives: Adequate access to the skull base, an important anatomical area associated with many vital structures has long been a surgical challenge. The maxillofacial surgeon by nature of training and expertise is in an advantageous position in the management of patients by providing surgical access to the base of skull lesions in the anterior and middle cranial fossa, retro-orbital and periorbital areas and retro maxillary space. Inaccessibility of these areas has been a great surgical problem.

Quantitation of transverse maxillary dimensions using computed tomography: a methodological and reproducibility study.

The present investigation was a methodological study of a new method of quantification of a series of factors in the transverse dimension of the maxilla including the nose, maxillary bones and dental arches, based on computer tomographic (CT) scanning. The aim was to investigate a series of parameters thought to be relevant in the differential diagnosis of discrepancies in the morphology of this area and probably affected by orthodontic appliances. Based on a standardized CT scanning registration of 10 subjects, a series of points on the scans were identified and then measured in a special cephalometric computer system (linear and angular values). The quantitation was repeated by each observer and inter- and intra-observer differences were calculated. The results demonstrated that virtually all the parameters showed a high degree of reproducibility at both levels and confirmed the statistical suitability of the method described. The method will be used in a series of ongoing studies regarding the morphology and treatment of discrepancies of the midface and therefore supplement the relatively sparse information based on quantitative reports concerning this important anatomical area.

Cochlear Hook Anatomy: Evaluation of the Spatial Relationship of the Basal Cochlear Duct to Middle Ear Landmarks

The cochlear hook is an important anatomical area for the otologist performing cochlear implants and other otological procedures, who requires knowledge of the basal cochlea. A total of 15 human temporal bones were dissected and the spatial relationship of the hook segment of the cochlear duct to the stapes, round window, cochleariform process and ductus reuniens were evaluated. Inter-individual variability was noted for widths of scala tympani (average width 1.36 +/- 0.25 mm) and scala vestibuli (average width 1.18 +/- 0.18 mm) in the region of typical cochlear implant placement, with the scala vestibuli occasionally being wider than the scala tympani. The cochlear duct was in closest proximity to the stapes at the midportion of the footplate, with an average distance of 1.23 mm at this narrowest width. A fibrous anchor, not previously described in otology literature, was identified securing the most basal end of the cochlear duct. Knowing the spatial relationship of the cochlear duct to the middle and inner ear structures could prevent damage to the basilar membrane in procedures around or involving the basal cochlear, such as cochlear implantation, stapedotomy, or implantable hearing devices.

Ankle impingement syndromes

The ankle impingement syndrome is a frequent condition in both athletes and the normal population. We investigated this painful syndrome from both a clinical and a diagnostic viewpoint. Depending on what ankle tissue impinges on the other, it is possible to distinguish bone impingement, soft tissue impingement and peripheral nerve entrapment. For each of these pathologic conditions we investigated the diagnostic role of conventional radiography, Computed Tomography and Magnetic Resonance Imaging. The evidence of osteophytes, exostosis and presence of the os trigonum on plain films make clinical diagnosis easy in both anterior and posterior bone impingement. CT can provide useful information about the component of the posterior ankle. MRI always adds important information about chondral or subchondral bone injuries, synovial reaction and adjacent soft tissue involvement. The anterolateral impingement syndrome is caused by repeated injuries in plantar flexion and ankle intrarotation. MRI well detects the meniscoid injury thanks to high contrast sequences; it can also distinguish this syndrome from painful chondral and/or bony lesions at this level. MRI is also the method of choice to study sinus tarsi impingement, especially thanks to fat suppression sequences which increase MR diagnostic capabilities in this important anatomic area. Deep peroneal nerve entrapment, the medial plantar nerve entrapment syndrome and the tarsal tunnel syndrome are the most important entrapment neuropathies of the ankle. US and MRI are very useful to study the tendon and soft tissue abnormalities causing the anterior tarsal tunnel syndrome. CT and particularly MRI can easily detect many pathologic conditions causing the medial plantar nerve entrapment and the tarsal tunnel syndromes.

Symposium. ENT for nonspecialists. The nose: structure and function.

The structural relationships of the upper lateral cartilage and the septum form an important anatomic area called the liminal valve, one of three known paired valves of the nose. A small deformity in the region of the liminal valve may cause significant airway obstruction that usually can be relieved by surgery. Eighty percent of the population has alternating congestion and decongestion of the nasal turbinates, a phenomenon know as the nasal cycle. The exact function of this cycle is unknown, although it probably allows the two nasal chambers to act in unison and function as one nose. It is important to recognize the cycle as a normal phenomenon and to differentiate it from pathologic causes of nasal obstruction.