Lateral Area Research Articles

Japanese quails (Coturnix Japonica) show keel bone damage during the laying period-a radiography study.

Keel bone damage is an important welfare issue in laying hens and can occur with a high prevalence of up to 100% of hens within one flock. Affected hens suffer from pain. Although multiple factors contribute to the prevalence and severity of keel bone damage, selection for high laying performance appears to play a key role. With up to 300 eggs/year, Japanese quails show a high laying performance, too, and, thus, may also show keel bone damage. However, to our knowledge, there are no scientific results on keel bone damage in Japanese quails to date. Therefore, the aim of this study was to assess whether keel bone fractures and deviations occur in Japanese quails and to obtain more detailed information about the development of their keel bone during the production cycle. A group of 51 female quails were radiographed at 8, 10, 15, 19, and 23weeks of age. The X-rays were used to detect fractures and deviations and to measure the lateral surface area, length, and radiographic density of the keel bone. In addition, the length of the caudal cartilaginous part of the keel bone was measured to learn more about the progress of ossification. At 23weeks of age, quails were euthanized and their macerated keel bones assessed for fractures and deviations. Both keel bone deviations and keel bone fractures were detected in the Japanese quails. In the 23rd week of age, 82% of the quails had a deviated keel bone as assessed after maceration. Furthermore, there was a decrease in radiographic density, lateral surface area, and length of the keel bone between weeks of age 8 and 19. This could indicate a general loss of bone substance and/or demineralization of the keel bone. Our study shows that keel bone damage is not only a problem in laying hens but also affects female Japanese quails.

Evaluation and comparison of functional and esthetic outcomes of pectoralis major myocutaneous flap with or without removal of sternocleidomastoid muscle following neck dissection in patients being operated for oral squamous cell carcinoma

India comprising the burden of oral squamous cell carcinoma which grow locally and then spreads to the cervical lymph nodes. Neck dissection is a beneficial procedure for addressing metastases in the neck arising from head and neck cancers. This surgical technique aims to remove lymph nodes on one side of the neck where cancer cells may have spread. However, this procedure can significantly impact a patient's appearance and cause distortion in the cervical area, particularly when it involves the removal of the sternocleidomastoid muscle, leading to a flattening effect in the lateral neck area. Reconstructing tissue defects following extensive surgeries in the head and neck region presents a distinct challenge for surgeons. They have the option to use either pedicled or free tissue transfer for this purpose. We compared and evaluated functional and esthetics outcomes of pectoralis major myocutaneous flap with or without removal of sternocleidomastoid muscle following neck dissection. We concluded that lack of notable distinction between the MRND type II and III groups. Both groups exhibited restricted range of motion in flexion, abduction, and external rotation. Notably, there was a significant impact on neck circumference, while shoulder functionality demonstrated gradual improvement over time. Interestingly, no substantial variances were observed between the groups in terms of drainage and wound healing. The quality of life reported by participants was generally favorable, with composite scores, social-emotional sub-scores, and average physical function aligning with acceptable standards. It's important to note that achieving a more substantial sample size is imperative to obtain results of greater significance and reliability.

Stereotactic Electroencephalogram Recordings in Temporal Lobectomy Patients Demonstrates the Predictive Value of Interictal Cross-Frequency Correlations: A Retrospective Study.

Positive correlations between low- and high-frequency spectra from stereotactic electroencephalogram (SEEG) recordings have been implicated in pathological brain activity interictally and have been used for ictal detection in both focal and network models. We evaluated SEEG signals in patients who ultimately underwent temporal lobectomy to evaluate their utility in seizure localization and prediction of seizure freedom post-resection. We retrospectively analyzed cross-frequency correlations between beta and high gamma (HG) interictal SEEG signals from 22 patients. We compared signals based on temporal versus extra-temporal locations, seizure-free (SF) versus non-seizure-free (NSF) outcomes, and mesial (M) versus mesial temporal-plus (M+) onset. Positive cross-correlations were increased in temporal areas. NSF patients showed a higher proportion of positive electrodes in temporal areas. SF patients had a greater proportion of significant channels in mesial versus lateral temporal areas. HG/Beta correlations in mesial versus lateral temporal areas predicted seizure freedom better than ictal SEEG seizure onset localization to M or M+ locations. We present preliminary data that local HG/Beta correlations may predict epilepsy focus and surgical outcome and may have utility as adjunct methods to conventional SEEG analysis. Further studies are needed to determine strategies for prospective studies and clinical use.

Ganglia-Induced Tarsal Tunnel Syndrome.

Tarsal tunnel syndrome (TTS) is a common entrapment neuropathy that is sometimes elicited by ganglia in the tarsal tunnel. Between August 2020 and July 2022, we operated on 117 sides with TTS. This retrospective study examined data from 8 consecutive patients (8 sides: 5 men, 3 women; average age 67.8 years) with an extraneural ganglion in the tarsal tunnel. We investigated the clinical characteristics and surgical outcomes for these patients. The mass was palpable through the skin in 1 patient, detected intraoperatively in 1 patient, and visualized on MRI scanning in the other 6 patients. Symptoms involved the medial plantar nerve area (n = 5), lateral plantar nerve area (n = 1), and medial and lateral plantar nerve areas (n = 2). The interval between symptom onset and surgery ranged from 4 to 168 months. Adhesion between large (≥20 mm) ganglia and surrounding tissue and nerves was observed intraoperatively in 4 patients. Of the 8 patients, 7 underwent total ganglion resection. There were no surgery-related complications. On their last postoperative visit, 3 patients with a duration of symptoms not exceeding 10 months reported favorable outcomes. Because ganglia eliciting TTS are often undetectable by skin palpation, imaging studies may be necessary. Early surgical intervention appears to yield favorable outcomes.

Ultrasonographic characterization of parametrial endometriosis: a prospective study

ObjectiveTo study the ultrasonographic diagnostic accuracy and characteristics of parametrial endometriosis comprehensively. DesignThis prospective study enrolled patients with suspected deep endometriosis scheduled for laparoscopic surgical treatment. Preoperative ultrasonographic examinations were performed following the International Deep Endometriosis Analysis criteria. The study aimed to evaluate the presence of parametrial endometriosis and its ultrasonographic characteristics, using surgical diagnosis as the reference standard. Additionally, indirect signs of deep endometriosis and concomitant deep endometriosis nodules associated with parametrial involvement were identified, assessing their predictive significance in anterior, lateral, and posterior parametrial areas. SubjectsPatients with suspected deep endometriosis scheduled for surgical treatment. Intervention/ExposureStandardized preoperative ultrasonographic examination. Main Outcome MeasuresThe diagnostic accuracy of transvaginal ultrasound in identifying parametrial endometriosis, including sensitivity and specificity. Ultrasonographic characteristics of parametrial nodules, prevalence in distinct parametrial areas, and associations with indirect deep endometriosis signs and concomitant nodules. ResultsSurgical confirmation of parametrial nodules was observed in 105 out of 545 patients (18.5% left, 17.0% right). Transvaginal ultrasound demonstrated a sensitivity of 77.1% (95% CI 68.0–84.8%) and specificity of 99.1% (95% CI 67.7–99.8%). Parametrial nodules typically exhibited characteristics such as a mild hypoechoic appearance (83.6%), starry morphology (74.7%), irregular margins (70.2%), and low vascularization. The posterior parametrium was the most common location (52.2%), followed by the lateral (41.0%) and anterior parametrium (6.8%). Concomitant deep nodules in the rectum (63.5%) and infiltrating the rectovaginal septum (56.5%) were significantly more prevalent in patients with parametrial involvement (both p<0.001). Indirect signs of deep endometriosis, such as ovaries fixed to the uterine wall (71.8%) and the absence of a posterior sliding sign (51.8%), were also more common in women with parametrial DE nodules (both p<0.001). Hydronephrosis, though relatively uncommon in patients with parametrial involvement (8.2%), was largely detected in lateral parametrial nodules (70.0%). ConclusionThis study represents a systematic ultrasonographic characterization of parametrial endometriosis, comprehensively assessing the diagnostic accuracy of transvaginal ultrasound in identifying parametrial involvement within a sizable cohort of patients with preoperative suspicion of deep endometriosis.

Tunnel construction in shallow soft rock using the pipe shed support

In order to clarify the impact mechanism of shallow buried soft rock tunnel excavation on the upper existing highway, as well as the mechanism of pipe shed reinforcement, a combination of theoretical analysis and on-site monitoring was used to conduct in-depth research on the Diantou Tunnel Crossing the existing highway project of Dayong Expressway. The impact of shallow buried soft rock tunnel crossing construction on the existing highway and safety control issues were studied, a new deformation control index, namely deformation difference rate, was introduced. The results show that the main lateral area of influence of rock deformation is within a distance of one diameter, and the overall area of influence is within a distance of twice the diameter. From the perspective of axial tunnel deformation, the deformation of surrounding rock tends to be stable when the excavation face passes through the monitoring section about twice the tunnel diameter. Effectively controlling rock deformation depends on the total amount of settlement deformation, the change rate of deformation, and the difference rate of deformation. For V-class shallow buried tunnel surrounding rock, in order to prevent cracks on the surface, the cumulative deformation of the surrounding rock needs to be less than 50 mm, the change rate needs to be less than 3 mm/day, and the difference rate needs to be less than 5 mm/m. Finally, the proposed control standard for surface subsidence is given for similar engineering reference.

Distribution of calcium-binding proteins immunoreactivity in the bottlenose dolphin entorhinal cortex.

The entorhinal cortex has been shown to be involved in high-level cognitive functions in terrestrial mammals. It can be divided into two main areas: the lateral entorhinal area (LEA) and the medial entorhinal area (MEA). Understanding of its structural organization in cetaceans is particularly important given the extensive evidence for their cognitive abilities. The present study describes the cytoarchitectural and immunohistochemical properties of the entorhinal cortex of the bottlenose dolphin (Tursiops truncatus, Montagu, 1821), perhaps the most studied cetacean species and a paradigm for dolphins and other small cetaceans. Four bottlenose dolphins' entorhinal cortices were processed. To obtain a precise overview of the organization of the entorhinal cortex we used thionin staining to study its laminar and regional organization, and immunoperoxidase technique to investigate the immunohistochemical distribution of three most commonly used calcium-binding proteins (CBPs), calbindin D-28k (CB), calretinin (CR) and parvalbumin (PV). Entorhinal cortex layers thickness were measured, morphological and morphometric analysis for each layer were conducted and statistically compared. Six layers in both the LEA and MEA were identified. The main difference between the LEA and the MEA is observed in layers II and III: the neurons in layer II of the LEA were denser and larger than the neurons in layer II of MEA. In addition, a relatively cell-free zone between layers II and III in LEA, but not in MEA, was observed. The immunohistochemical distribution of the three CBPs, CB, CR and PV were distinct in each layer. The immunostaining pattern of CR, on one side, and CB/PV, on the other side, appeared to be distributed in a complementary manner. PV and CB immunostaining was particularly evident in layers II and III, whereas CR immunoreactive neurons were distributed throughout all layers, especially in layers V and VI. Immunoreactivity was expressed by neurons belonging to different morphological classes: All CBPs were expressed in non-pyramidal neurons, but CB and CR were also found in pyramidal neurons. The morphological characteristics of pyramidal and non-pyramidal neurons in the dolphin entorhinal cortex are similar to those described in the entorhinal cortex of other species, including primates and rodents. Interestingly, in primates, rodents, and dolphins, most of the CBP-containing neurons are found in the superficial layers, but the large CR-ir neurons are also abundant in the deep layers. Layers II and III of the entorhinal cortex contain neurons that give rise to the perforant pathway, which conveys most of the cortical information to the hippocampal formation. From the hippocampal formation, reciprocal projections are directed back to the deep layer of the entorhinal cortex, which distributes the information to the neocortex and subcortical area. Our data reveal that in the dolphin entorhinal cortex, the three major CBPs label morphologically heterogeneous groups of neurons that may be involved in the information flow between entorhinal input and output pathways.

Altered functional connectivity in default mode network maintains attention task performance in school-age children with frontal lobe tumor

This study examines functional brain network changes in children with frontal lobe tumors (FLT). Ten pediatric FLT patients from Beijing Tiantan Hospital and 20 healthy children were compared in terms of cognitive performance and resting-state functional magnetic resonance imaging (rs-fMRI) connectivity. The FLT group showed lower cognitive performance, particularly in visual and working memory domains, but had comparable attention abilities to the healthy controls. There were notable differences in connectivity between the default mode network (DMN) and sensorimotor network (SMN) in both groups. The FLT group also displayed a significant reduction in local efficiency in the left lateral parietal area within the DMN. Importantly, reduced DMN-SMN connections and increased DMN-lateral prefrontal cortex connectivity may facilitate maintaining attention and memory tasks in FLT children. This study sheds light on how the brains of children with FLT adapt, preserving “normal” attention functions despite frontal lobe damage.

Morphology of ctenostome bryozoans: 7. Hislopia, Echinella andTimwoodiellina.

Ctenostome bryozoans are a small group of gymnolaemates comprising less than 400 recent species. They are paraphyletic and ctenostome-grade ancestors gave rise to Cheilostomata, the most dominant and speciose taxon of Bryozoa in the present day. Investigations into ctenostomes are important for reconstructing character evolution among Gymnolaemata. As a continuation of studies on a morphological series of ctenostome bryozoans, we herein investigate six species of hislopiids, a small clade of threegenera occurring in freshwater habitats. The general morphology of all species is similar in having primarily uniserial chains of encrusting zooids, which are mostly oval to ellipsoid and have a flattened frontobasal axis. Hislopia prolixa and Echinella placoides often have more slender zooids with a higher frontobasal axis. Apertures of hislopiids are quadrangular, lined by a thickened cuticle. Apertural spines are present in various lengths in E. placoides, Hislopia lacustris and Hislopia corderoi. The remaining cuticle is rather thin except at lateral areas, close to the pore-plates which are prominent in hislopiids because of abundant special and limiting cells. All species except H. corderoi and Timwoodiellina natans have a prominent collar obstructing the vestibulum, whereas the latter two species instead have an 'external collar' as cuticular, outer folds projecting over the aperture. Hislopiid lophophores carry eight, or more commonly 12-18 tentacles. The digestive tract is distinguished by an often highly elongated esophagus and/or cardia, with the latter always having a prominent bulbous part in the form of a proventriculus-or gizzard in E. placoides. The caecum is extensive in all species. In Hislopia the intestine is characteristically two-chambered with a proximal and distal part before entering an anal tube of various length. The latter is present in all species except T. natans and terminates in mid-lophophoral area. Oocytes in E. placoides are large and macrolecithal indicating brooding and the production of lecithotrophic larvae. Hislopia species produce small, oligolecithal ones, which suggests zygote spawning and planktotrophy. In general, the morphology is similar among the different hislopiids with characters of the gut aiding in delineating the genera Echinella and Timwoodiellina.

A matching and localization study of iliac bone graft for repair of talar cartilage injury secondary to lateral ankle instability.

Background: To investigate the search for an Iliac-Talar Grafts on the iliac bone that is morphologically matched to a multiplanar injury lesion of the talus; while utilizing a bone-harvesting guide to ensure precise positioning of the Iliac-Talar Grafts. Methods: A total of twenty-two cases with both talar CT data and iliac CT data were collected from January 2019 to June 2023. One case each of talar deformity injury and bone disease were excluded, resulting in a selection of 20 cases. The medial and lateral target repair areas of the talus were formulated, and virtual surgery was performed by using digital orthopedic technology to locate an iliac-talar restoration on the iliac bone that matched the morphology of the multiplanar injury lesion of the talus. 3D chromatographic deviation analysis was used to assess the accuracy of Iliac-Talar Grafts in terms of morphometric matching and positioning, while personalized iliac bone extraction guides were designed to ensure accurate positioning of the Iliac-Talar Grafts. Results: The best fitting point for repairing the medial talar lesion is determined to be medial to the anterior iliac crest, specifically 2.935 ± 0.365cm posterior to the anterior superior iliac spine, and 2.550 ± 0.559cm anterior to the valgus-iliac crest point (VICP). Similarly, for the repair of the lateral talar lesion, the ideal position is found to be lateral to the posterior iliac crest, approximately 2.695 ± 0.640cm posterior to the valgus-iliac crest point (VICP). Utilizing bone extraction guides enables precise positioning for iliac bone extraction. Conclusion: This study utilizes virtual surgery, 3D chromatographic deviation analysis, and guide plate techniques in digital orthopedics to precisely locate the Iliac-Talar Graft on the iliac bone, matching the morphology of the talar lesion; it provides a new solution for cutting the iliac bone implant that matches the the multifaceted talar lesion to be repaired.

Cone Beam Computed Tomography in observing the presence and location of canalis sinuosus.

Cone Beam Computed Tomography (CBCT) was used to observe and describe the distribution of canalis sinuosus (CS) in the Chinese population and the location of CS in the maxillary alveolar bone, so as to help oral surgeons evaluate the intraoperative risk and prognosis before maxillary surgery and reduce the complications caused by the injury of this structure in anterior surgery. CBCT images of 600 patients admitted from 2021 to 2022 were collected to observe the anatomical structure of CS in the maxillary region. The following parameters were recorded: age, sex, number of CS, left and right distribution of CS, CS diameter, and location. Statistical analysis was performed on all of the collected data. The discovery rate of CS in this study was 59.75%, and it is commonly found in the lateral incisor area (64.82%). No significant difference can be found in the presence and number of CS in different gender and age groups (p>0.05). The use of high-resolution CBCT before implantation is of irreplaceable significance in the diagnosis and analysis of CS, which is conducive to reducing implantation complications and failure rate. The incidence of CS was independent of age or sex, while the location of CS was statistically significant.

Endoscopic ear surgery -- Discipline establishment and technological innovation

The application of microscope is a milestone in the history of otosurgery, which makes otologists deal with middle ear lesions more clearly and finely, and helps otologists expand the scope of treatment to the lateral skull base area, which greatly promotes the development of otosurgery. In the past 20 years, with the continuous improvement of endoscopic equipment research and development and the gradual improvement of endoscopic technology, the application of endoscopic technology in China has shown an explosive development, and Chinese otolaryngologists have experienced from the initial attempts of endoscopic technology, to the widespread popularization of innovative and applicable technology, and then to the feasibility of exploring the future innovative concepts. Endoscopic technology is another revolutionary push for the development of otosurgery after the microscope.

Interpositional bone graft with cortical and cancellous calvarial bone for addressing the bone gap after reduction malarplasty: a case report

Asians typically exhibit prominent zygomas; therefore, several attempts have been made to reduce these structures to achieve a softer appearance. The intraoral approach is preferred because of its shorter surgical duration and lower invasiveness; however, it is associated with serious complications, such as nonunion. In revisional surgery, the intraoral approach poses limitations in accessing the upper part of the zygoma and the lateral orbital rim area due to its restricted operative field. Therefore, we developed an intraoral interpositional bone graft technique that enabled almost complete reconstruction. A 40-year-old woman presented with persistent depression in the left infraorbital and cheek regions after two revision operations after reduction malarplasty. Based on computed tomography (CT) scan findings, reconstruction using bone grafts was planned. Calvarial bone was harvested and divided into cortical and cancellous parts. The cortical bone was sculpted into an L-shape and inserted into the gap between the maxilla and the lower zygoma body. The hard-to-reach lateral orbital rim area was filled with cancellous bone without fixation. Follow-up CT scans showed that the cortical bone grafts were well-maintained and stabilized with titanium plates, while the cancellous bone had undergone significant resorption and was replaced by new bone, indicative of successful natural healing.

Identifying cortical structure markers of resilience to adversity in young people using surface-based morphometry.

Previous research on the neurobiological bases of resilience in youth has largely used categorical definitions of resilience and voxel-based morphometry methods that assess gray matter volume. However, it is important to consider brain structure more broadly as different cortical properties have distinct developmental trajectories. To address these limitations, we used surface-based morphometry and data-driven, continuous resilience scores to examine associations between resilience and cortical structure. Structural MRI data from 286 youths (Mage = 13.6 years, 51% female) who took part in the European multi-site FemNAT-CD study were pre-processed and analyzed using surface-based morphometry. Continuous resilience scores were derived for each participant based on adversity exposure and levels of psychopathology using the residual regression method. Vertex-wise analyses assessed for correlations between resilience scores and cortical thickness, surface area, gyrification and volume. Resilience scores were positively associated with right lateral occipital surface area and right superior frontal gyrification and negatively correlated with left inferior temporal surface area. Moreover, sex-by-resilience interactions were observed for gyrification in frontal and temporal regions. Our findings extend previous research by revealing that resilience is related to surface area and gyrification in frontal, occipital and temporal regions that are implicated in emotion regulation and face or object recognition.

Corticocortical connections of the rostral forelimb area in rats: a quantitative tract-tracing study.

The rostral forelimb area (RFA) in the rat is a premotor cortical region based on its dense efferent projections to primary motor cortex. This study describes corticocortical connections of RFA and the relative strength of connections with other cortical areas. The goal was to provide a better understanding of the cortical network in which RFA participates, and thus, determine its function in sensorimotor behavior. The RFA of adult male Long-Evans rats (n= 6) was identified using intracortical microstimulation techniques and injected with the tract-tracer, biotinylated dextran amine (BDA). In post-mortem tissue, locations of BDA-labeled terminal boutons and neuronal somata were plotted and superimposed on cortical field boundaries. Quantitative estimates of terminal boutons in each region of interest were based on unbiased stereological methods. The results demonstrate that RFA has dense connections with primary motor cortex and frontal cortex medial and lateral to RFA. Moderate connections were found with insular cortex, primary somatosensory cortex (S1), the M1/S1 overlap zone, and lateral somatosensory areas. Cortical connections of RFA in rat are strikingly similar to cortical connections of the ventral premotor cortex in non-human primates, suggesting that these areas share similar functions and allow greater translation of rodent premotor cortex studies to primates.

Prediction of Pharyngeal 3D Volume Using 2D Lateral Area Measurements During Swallowing.

This study evaluated the validity of pharyngeal 2D area measurements acquired from the lateral view for predicting the actual 3D volume in healthy adults during swallowing. Seventy-five healthy adults (39 females, 36 males; mean age 51.3years) were examined using 320-row area detector computed tomography (320-ADCT). All participants swallowed a 10mL honey-thick barium bolus upon command while seated in a 45° semi-reclining position. Multi-planar reconstruction images and dynamic 3D-CT images were obtained using Aquilion ONE software. Pharyngeal 2D area and 3D volume measurements were taken before swallowing and at the frame depicting maximum pharyngeal constriction. Pharyngeal volume before swallowing (PVhold) was accurately predicted by 2D area (R2 = 0.816). Adding height and sex to the model increased R2 to 0.836. Regarding pharyngeal volume during maximum constriction (PVmax), 2D area also exhibited acceptable predictive power (R2 = 0.777). However, analysis of statistical residuals and outliers revealed a greater tendency for prediction errors when there is less complete constriction of the pharynx as well as asymmetry in bolus flow or movement. Findings highlight the importance of routinely incorporating anterior-posterior views during VFSS exams. Future work is needed to determine clinical utility of pharyngeal volume measurements derived from 320-ADCT.

Polygon model for solution of non-linear velocity gradient of interface and asymmetric break-up of droplet

In this study, a novel model is proposed to accurately depict the changes in the droplet-matrix interface as a function of the velocity gradient at different times. Using the iteration method and drawing the droplet shape, the interface velocity gradient-matrix shear rate non-linear equation is simultaneously solved. The initial droplet shape is assumed to be a polygon, with each side independently undergoing modifications under stress. By sequentially adjusting each side at different time points, the overall shape of the droplet is reconstructed. The experimental section examines droplets consisting of alcohols (polyvinyl alcohol and polyethylene glycol) in water-soluble form with different concentrations and glycerol. The matrix material used is poly dimethyl siloxane. The viscosity ratio between the droplet and matrix falls within the range of 0.18–3.08. The experimental findings show two types of droplet breakup: a single-end bulb and two non-uniform end bulbs of different sizes. The simulation results from the model align well with the experimental observations, accurately capturing the dimensions and volume of the droplets and the aspect ratio of the bulbs. The model also predicts the aspect ratio, lateral area, and rotation of the droplets before breakup with minimal deviation from the experimental data.

Odontogenıc Keratocyst: A Case Report

Odontogenic keratocyst was first mentioned in the literature by Mikulicz in 1876, and described by Philipsen in 1956. These cysts are developmental odontogenic cysts arising from dental laminate remnants. Generally, these cysts can be seen in the second or third decade of life, in both mandibular and maxillary jaws; but most often they are localized in the mandibular jaw. A 23-year-old male patient who came to our clinic complaining of swelling in the lower jaw and did not have a systemic disease had a radiolucent lesion measuring about 4 * 2 cm in the mandible and lateral tooth area in the maxilla. Enucleation of radiolucent lesions which are localized in maxillary and mandibular jaws was performed. Both lesions were sent to the pathology laboratory for detailed examination. Extraction of the impacted right mandibular canine was made. According to the pathology report, a diagnosis of odontogenic keratocyst was made to both lesions. In this case keratocysts were seen as multiocular, and it was suspected that there could be Gorlin Goltz syndrome. According to the medical genetic report of the patient, who does not have any systemic diseases, Multilocular Odontogenic Keratocysts could not be associated with Gorlin Goltz syndrome.

Determination of Sensitivity and Positive Predictive Value for Handheld Doppler in the Assessment of Thoracodorsal Artery Perforators and Literature Review

Abstract Background: Hand-held Doppler (HHD) is still a very useful tool in the reconstructive surgeon’s armamentarium. One hundred percent specificity in detecting perforators can be achieved with HHD when a perforator compression test is applied. The study aimed to determine the sensitivity and positive predictive value (PPV) for HHD in the assessment of thoracodorsal artery perforators, by applying the perforator compression test, using the color Doppler ultrasound (CDU) as the standard. Materials and Methods: This was a cross-sectional study. The Plastic Surgeon assessed for perforators using HHD on both lateral thoracic areas for each patient, with a re-evaluation of the same locations by a Consultant Radiologist using the CDU. The data generated were analysed using the Statistical Package for the Social Sciences (SPSS) software version 20, and results were presented in charts and tables. The sensitivity and PPV for HHD were then calculated. Results: A total of 70 patients were included, 58 males (82.9%) and 12 females (17.1%). The age range was 18–65 years, with a mean of 31.77 years ± 11.72 years. Overall, 247 perforators were identified by HHD. The true positive, false-positive, and false-negative values for HHD were 127 (51.4%), 120 (48.6%), and 20 (8.1%), respectively. The sensitivity and PPV for the HHD were calculated as 86.3% and 51.4%, respectively. Conclusion: The sensitivity of HHD was high while the PPV was much lower compared to other studies. This implies that for patients with positive HHD signals, the probability of having perforators intraoperative is low.

Innovative Stress-responsive Liner Design for Lower Limb Disability

After lower limb amputation or disability, prosthetic limbs are essential for regaining mobility, but skin integrity often degrades due to mechanical stresses at the stump–prosthesis interface. In this study, the finite element method was utilized to predict the areas at the stump–prosthetic interface experiencing the highest levels and distributions of mechanical stresses. The empirical results of the finite element analysis (FEA) delineated the stress concentration sites. Consequently, we devised an innovative liner design tailored to these stress patterns, which was subsequently implemented. The simulation outcomes validated the effectiveness of the liner, demonstrating significant reductions in stress levels at the junction of the residual limb and the prosthetic socket. The results demonstrated that the designed liner was highly effective in reducing stress, particularly in three critical areas: the lateral area of the tibia head (LTH), the tibia end area (TE), and the fibular end (FE). Stress values at the LTH were reduced from 55 to 10 kPa, at the TE from 60 to 28 kPa, and at the FE from 72.3 to 14 kPa. In essence, this liner represents a bespoke intervention, with the FEA serving as a predictive tool that not only identifies critical stress points but also guides the design of personalized prosthetic liners. These findings will improve the structural and functional compatibility of the prosthesis, thereby enhancing wearer comfort and reducing the risk of skin-related complications for persons with disabilities.