Ligament Area Research Articles

Changes in Cross-sectional Area and Signal Intensity of Healing Anterior Cruciate Ligaments and Grafts in the First 2 Years After Surgery

Background: The quality of a repaired anterior cruciate ligament (ACL) or reconstructed graft is typically quantified in clinical studies by evaluating knee, lower extremity, or patient performance. However, magnetic resonance imaging of the healing ACL or graft may provide a more direct measure of tissue quality (ie, signal intensity) and quantity (ie, cross-sectional area). Hypotheses: (1) Average cross-sectional area or signal intensity of a healing ACL after bridge-enhanced ACL repair (BEAR) or a hamstring autograft (ACL reconstruction) will change postoperatively from 3 to 24 months. (2) The average cross-sectional area and signal intensity of the healing ligament or graft will correlate with anatomic features of the knee associated with ACL injury. Study Design: Cohort study; Level of evidence, 2. Methods: Patients with a complete midsubstance ACL tear who were treated with either BEAR (n = 10) or ACL reconstruction (n = 10) underwent magnetic resonance imaging at 3, 6, 12, and 24 months after surgery. Images were analyzed to determine the average cross-sectional area and signal intensity of the ACL or graft at each time point. ACL orientation, stump length, and bony anatomy were also assessed. Results: Mean cross-sectional area of the grafts was 48% to 98% larger than the contralateral intact ACLs at all time points (P < .01). The BEAR ACLs were 23% to 28% greater in cross-sectional area than the contralateral intact ACLs at 3 and 6 months (P < .02) but similar at 12 and 24 months. The BEAR ACLs were similar in sagittal orientation to the contralateral ACLs, while the grafts were 6.5° more vertical (P = .005). For the BEAR ACLs, a bigger notch correlated with a bigger cross-sectional area, while a shorter ACL femoral stump, steeper lateral tibial slope, and shallower medial tibial depth were associated with higher signal intensity (R2 > .40, P < .05). Performance of notchplasty resulted in an increased ACL cross-sectional area after the BEAR procedure (P = .007). No anatomic features were correlated with ACL graft size or signal intensity. Conclusion: Hamstring autografts were larger in cross-sectional area and more vertically oriented than the native ACLs at 24 months after surgery. BEAR ACLs had a cross-sectional area, signal intensity, and sagittal orientation similar to the contralateral ACLs at 24 months. The early signal intensity and cross-sectional area of the repaired ACL may be affected by specific anatomic features, including lateral tibial slope and notch width—observations that deserve further study in a larger cohort of patients. Registration: NCT02292004 (ClinicalTrials.gov identifier)

The role of the anterior talofibular ligament area as a morphological parameter of the chronic ankle sprain

BackgroundRepetitive microtrauma can result in a hypertrophied ATFL. Previous studies have found that the anterior talofibular ligament thickness (ATFLT) is correlated with lateral ankle sprains, ligament injuries and chronic stroke in patients, and thickened anterior talofibular ligament (ATFL) has been considered to be a major morphologic parameter of hypertrophied ATFL. However, hypertrophy is different from thickness. Thus, we devised the anterior talofibular ligament area (ATFLA) as a new morphological parameter to evaluate the hypertrophy of the whole ATFL. MethodsATFL samples were collected from 53 patients with sprain group and from 50 control subjects who underwent magnetic resonance imaging (MRI) of the ankle and revealed no evidence of lateral ankle injury. Axial T1-weighted MRI images were collected at the ankle level from all subjects. We measured the ATFLA and ATFLT at the anterior margin of the fibular malleolus to the talus bone on the MRI using a picture archiving and communications system. The ATFLA was measured as the whole cross-sectional ligament area of the ATFL that was most hypertrophied in the axial MR images. The ATFLT was measured as the thickest point between the lateral malleolus and the talus of the ankle. ResultsThe average ATFLA was 25.0 ± 6.0 mm2 in the control group and 47.1 ± 10.4 mm2 in the sprain group. The average ATFLT was 2.3 ± 0.6 mm in the control group and 3.8 ± 0.6 mm in the hypertrophied group. Patients in sprain group had significantly greater ATFLA (p < 0.001) and ATFLT (p < 0.001) than the control subjects. A Receiver Operator Characteristics curve analysis showed that the best cut-off point of the ATFLA was 34.8 mm2, with 94.3% sensitivity, 94.0% specificity, and an AUC of 0.97 (95% CI, 0.94–1.00). The optimal cut-off point of the ATFLT was 3.1 mm, with 86.8% sensitivity, 86.0% specificity, and AUC of 0.95 (95% CI, 0.92–0.99). ConclusionATFLA is a new morphological parameter for evaluating chronic ankle sprain, and may even be more sensitive than ATFLT.

Value of Anterior Band of the Inferior Glenohumeral Ligament Area as a Morphological Parameter of Adhesive Capsulitis

Objective Thickened inferior glenohumeral ligament (IGHL) is considered as one of the major morphological parameters of adhesive capsulitis (AC). Previous studies reported that the anterior band of inferior glenohumeral ligament thickness (aIGHLT) is correlated with shoulder capsular contracture, luxatio erecta humeri, and AC. However, the thickness varies from the measured angle. To reduce this measurement error, we devised a new morphological parameter, called the anterior band of inferior glenohumeral ligament area (aIGHLA). Methods The aIGHL samples were collected from 54 patients with AC and from 50 control subjects who underwent shoulder magnetic resonance imaging (MRI) without any evidence of AC. Coronal T2-weighted MRI images were obtained at the shoulder level from each patient. We measured the aIGHLA and aIGHLT at the maximal view of the IGHL in the coronal plane using our picture archiving and communication system. The aIGHLA was measured at the whole cross-sectional area of the IGHL in the most hypertrophied segment of the coronal MR images. The aIGHLT was measured at the thickest point of the IGHL. Results The average aIGHLA was 55.58 ± 14.16 mm2 in the control group and 83.71 ± 28.45 mm2 in the AC group. The average aIGHLT was 3.47 ± 0.99 mm in the control group and 4.52 ± 1.02 mm in the AC group. AC patients showed significantly greater aIGHLA (p < 0.001) and aIGHLT (p < 0.001) than control subjects. Receiver operating characteristic (ROC) curve analysis showed that the optimal cut-off score of the aIGHLA was 63.37 mm2, with 79.6% sensitivity, 80.0% specificity, and AUC of 0.84 (95% CI, 0.76–0.92). The optimal cut-off point of the IGHLT was 3.81 mm, with 74.1% sensitivity, 74.0% specificity, and AUC of 0.77 (95% CI, 0.68–0.86). Conclusions Although the aIGHLA and aIGHLT were both significantly associated with AC, the aIGHLA was a more sensitive diagnostic parameter.

Numerical modeling of essential work of fracture on ductile polymeric films

Essential work of fracture method has been successfully used to characterize the fracture behavior of ductile polymeric films. The observed essential and non-essential fracture process zones are related to the toughness of the films. Three-dimensional finite element method (FEM) modeling has been carried out in this study to elucidate the film fracture process based on the essential work of fracture concept. Experimental observation on a model linear low-density polyethylene (LLDPE) blown film was used to validate the FEM model. The numerical model facilitates an in-depth understanding of the development of stress and strain fields and the fracture process zones at different loading steps. The FEM findings show that film thickness and ligament length have significant influence on the development of stress and strain fields at and around the ligament area. Furthermore, the numerical analysis reveals how various material properties, such as yield stress and strain hardening slope, can influence the development of fracture process zones. Usefulness of FEM modeling for developing tough polymeric films is discussed.

Revision of the British Lower Jurassic Arcoidea (Bivalvia): palaeobiological, palaeoecological and evolutionary implications

ABSTRACT The majority of species of the Arcoidea identified from the British Lower Jurassic are taxa within the Grammatodontinae. Although this study has further partitioned the Grammatodontinae fossils into the genera Grammatodon, Cosmetodon and Catella based on distinct defining characters, it is clear that differentiation at a species level becomes problematic as adults exhibit characters that grade between two distinct end states. Additionally, there is variability in characters between the juvenile and adult shells within species and the two valves of individuals. These factors have led to an over-splitting of British Lower Jurassic arcoid species, with implications in the study of marine environmental change and extinction events. After revision of the taxonomy of Lower Jurassic Arcoidea, it is clear that there was a gradual change in arcoid form through this epoch, moving from sulcate Cosmetodon to sulcate-free Grammatodon s.s. Arcoid species that survived the Toarcian extinction event in the UK were non-sulcate. This study concurs with previous research suggesting the Parallelodontidae, via the Grammatodontinae, led to the Cucullaeidae. Indeed, hinge dentition and ligament area gradational end states of some British Late Jurassic Grammatodon appear very Cucullaea-like. Dynamic environmental conditions through the Early Jurassic appear to have helped drive this evolutionary change.

Facilitation of Chemotaxis Activity of Mesenchymal Stem Cells via Stromal Cell-Derived Factor-1 and Its Receptor May Promote Ectopic Ossification of Human Spinal Ligaments.

Mesenchymal stem cells (MSCs) have been used to elucidate the pathogenesis of numerous diseases. Our recent study showed that MSCs may conduce to the ossification of spinal ligaments. Stromal cell-derived factor-1 (SDF-1) and CXC chemokine receptor 4 (CXCR4) regulate MSC migration. Moreover, their expression is elevated in sites of damage and remodeling in pathologic states. We explored the possible role of the SDF-1/CXCR4 axis in the chemotactic behavior of MSCs in the ossification of spinal ligaments. Specimens of thoracic vertebra ossified ligamentum flavum (OLF) and non-OLF plaques were received from patients in whom we had performed spine surgery. Paraffin-embedded tissue sections were prepared for immunohistochemical staining. Cultured MSCs from the ligamentum flavum were prepared for in vitro analyses. We observed SDF-1 and CXCR4 localization immunohistochemically in the perivascular area and collagenous matrix of ligaments and in chondrocytes near the ossification front of OLF. And then, immunohistochemical staining showed a close relationship between MSCs and the SDF-1/CXCR4 axis. In the in vitro analyses, expression of the SDF-1/CXCR4 and the migratory capacity of MSCs in OLF were remarkably higher compared with non-OLF MSCs. Furthermore, the migration of MSCs was upregulated by SDF-1 and downregulated by treatment with AMD3100 (C28H54N88HCl), a specific antagonist for CXCR4. All in vitro test data showed a significant difference in MSCs from OLF compared with non-OLF MSCs. Our results reveal that the SDF-1/CXCR4 axis may contribute to an MSC-mediated increase in the ossification process, indicating that the SDF-1/CXCR4 axis may become a potential target for a novel therapeutic strategy for ossification of spinal ligaments.

Mensuração ultrassonográfica dos ligamentos colaterais da articulação interfalangeana distal de equinos da raça Crioula

Criollo horses were used in the past only for field services, especially countryside work. However, currently, they have been used as sports animals in several modalities involving turns in legs and exercises on irregular terrain, predisposing them to injuries in the distal extremity. Among the alterations recognized as cause of lameness in this region are the conditions related to collateral ligaments of the distal interphalangeal joint (CL-DIPJ), which in horses are structures that help to maintain joint stability and suffer a high pressure due to the high body weight, especially when it is not equally distributed at the stance phase. Considering the importance of the ultrasound anatomical knowledge of this structure for the early diagnosis of locomotive affections in the digit of Criollo horses, this study aimed to standardize CL-DIPJ measurements in healthy horses of this breed. We used 25 adult Criollo horses not submitted to sports practice. For ultrasonographic evaluation, after a trichotomy of the region, an ultrasound Chison 8300VET and a 6.0 MHz linear probe were used with a standoff pad. This technique uses a cross-sectional view, in which CL-DIPJ is visualized in the distal concavity portion of the middle phalanx, being a standard for the measurements. For ligament measurements, the variables dorsopalmar diameter (DPD), latero-medial diameter (LMD), and cross-sectional area (CSA) of ligaments were used. Three measurements were performed for each variable and average values were obtained, which were compared to each other and did not present significant differences (p &gt; 0.05). The average measurements of diameter and area of collateral ligaments of the distal interphalangeal joint in Criollo horses were 9.04 mm for DPD, 7.55 mm for LMD, and 0.52 mm2 for CSA. This was the first study that standardized the size of this structure in this breed.

Poor sensitivity of transvaginal ultrasound markers in diagnosis of superficial endometriosis of the uterosacral ligaments

Introduction: This study aims to evaluate the use of transvaginal ultrasound in predicting superficial endometriosis near the uterosacral ligaments, in women with symptoms of endometriosis. Methods: This was a prospective observational pilot study in which women with symptoms of endometriosis underwent detailed pre-operative transvaginal ultrasound to assess the uterosacral ligament area for thickening (‘white line sign’), tenderness and small hypoechoic nodules. Women with deep infiltrating endometriosis were excluded. The test characteristics of transvaginal ultrasound were reported using histologically or visually proven endometriosis near the ipsilateral uterosacral ligament as a reference standard. Results: In 81 patients who underwent pre-operative transvaginal ultrasound and laparoscopy, no marker had appropriate test characteristics for a diagnostic or screening test for endometriosis near the ipsilateral uterosacral ligament when used alone. The presence of a small hypoechoic nodule on the white line had the highest specificity of the three markers, at 82% (95% confidence interval 66%–92%). Quantitative measurement of the white line also achieved a high specificity of ≥96% using a cut-off of 5.8 and 6.1 mm, on the left and right sides, respectively. Conclusion: Transvaginal ultrasound of the uterosacral ligament area using the three proposed markers is not a clinically useful screening test for superficial endometriosis near the uterosacral ligaments. A grossly thickened white line (≥5.8 mm) and/or the presence of small hypoechoic nodules are highly specific findings for superficial endometriosis near the uterosacral ligaments and may prompt surgical management.

Characterization of nanoporous silver mechanical properties by molecular dynamics simulation

Nanoporous metals (NPMs) have great potential applications in many technological areas, such as catalysis, sensing, actuation, and fuel cells, because of their unique physical and chemical properties. The cognition of related mechanical properties is one of the important bases for achieving functionalized applications. A series of large-scale molecular dynamics (MD) simulations is performed to study the mechanical properties of nanoporous sliver (NPS) under uniaxial tension. Three different topology architectures of NPS, including cube, gyroid and diamond structures, are constructed and investigated. The effects of topology architecture and relative density on the mechanical properties are discussed. The LAMMPS is used to perform MD simulations and the embedded atom method potential is utilized to describe the interatomic interactions. The applied strain rate is 109 s-1 and the applied strain increment is 0.001 in each loading step. The results show that the plastic properties of NPS mainly depend on those of ligaments and the breakage of NPS mainly occurs in ligament areas. Meanwhile, the gyroid structure has better plasticity than other structures, due to the existence of ligament in spiral form. For one structure, the ultimate strength and the Young's modulus increase with the increase of relative density. Analysis shows that the basic mechanical properties of NPS largely depend on the relative density, similar to those of porous materials. The modulus as a function of relative density displays a power-law relation and the exponents depend on the topology architectures. The exponents of three structures are in a range between 1 and 2, showing that the bending of ligament and the tension of ligament are both included during the deformation. The variation trends of modulus of diamond and gyroid structures are similar to the variation of relative density, whose possible reason is that diamond and gyroid structures are both constructed by triply periodic minimal surfaces. With the same relative density, the modulus of diamond structure is in good agreement with that of gyroid structure, and the modulus of cube structure is the minimum. The strength shows a linear relation with the relative density, indicating that the yielding behavior of NPS is dominated by the axial yielding of ligament. When three types of NPSs have the same relative density, the strength of diamond structure is the maximum, cube structure second, and gyroid structure is the minimum. In diamond structure NPS, the structure of triangular framework is formed between ligaments, resulting in a relatively higher strength. The present study will provide an atomistic insight into the understanding of deformation mechanisms of nanoporous metals, and it will provide data support for designing NPMs with optimal mechanical properties by controlling geometric structure.

Ultrasonographic evaluation of cross-sectional area of tarsal ligaments in Standardbred Trotter Horses

ABSTRACTUltrasound evaluations of the cross-sectional area (CSA) in the tarsal region of Standardbred Trotter Horses (STH) have been previously reported for tendons but not for ligaments. The objective of this study was to identify normal ultrasonographic CSAs in the tarsal ligaments of STH. Transverse echographic scans of ligaments at five tarsal levels from proximal to distal direction were recorded in 25 healthy STH. All images were recorded, and the CSA measurements (mean ± SD) were determined. The widest structure resulted in the long plantar ligament (LPL) at distal portion of the astragalus, and the smallest was the long medial collateral ligament (LMCL) at the medial malleolus of the tibia. Long collateral ligaments (LCL) increased their CSA at the level of their distal insertions, while LPL reached the maximum CSA in the middle of its length. Although this report was limited due to its retrospective design, it is the opinion of the authors that the normal CSAs investigated in this paper could function as a reference guide when tarsal pathological conditions are suspected in STH.

MRI Assessment of Changes in Swelling of Wrist Structures Following OMT in Patients With Carpal Tunnel Syndrome

Abstract We treated patients with carpal tunnel syndrome using OMT. Treatments were focused on the upper thoracic spine, lower cervical spine, and tenderpoints in the forearm muscles. OMT was not applied to the wrist in an attempt to stretch the transverse carpal ligament. MRI images were used to assess changes in fluid content in both the carpal tunnel and median nerve after OMT treatment. MRI measurements of median nerve area, carpal tunnel area and length of the transverse carpal ligament were also obtained. These measurements were correlated with changes in nerve conduction velocities (NCVs), pain ratings, wrist motion measurements, and somatic dysfunction information. The numeric data were compared and contrasted using Hest statistics. Significance probabilities of P &amp;lt; 0.05 were computed. Statistically significant changes were noted in pain ratings, wrist motions and nerve conduction (sensory amplitude). Five patients responded with improvement in symptoms and one did not. The responder group demonstrated a decrease in the amount of swelling of both the median nerve and carpal tunnel. The nonresponder demonstrated increased swelling in both the median nerve and carpal tunnel. Changes in the swelling of both the median nerve and carpal tunnel appear to more closely parallel changes in hand symptoms than nerve conduction results.1 No statistically significant increases occurred in the length of the transverse carpal ligament or the carpal tunnel area. Minimal changes in both the length of the transverse carpal ligament and carpal tunnel area did occur despite no active attempts to stretch this region. All six patients had a predominance of acute changes in the upper thoracic spine and upper ribs. Most patients had tension in the flexor muscles of the forearm. Treatment of the upper thoracic spine, upper ribs, and forearms are all important in the management of carpal tunnel syndrome.

Structural Inheritance and Redox Performance of Nanoporous Electrodes from Nanocrystalline Fe85.2B10-14P0-4Cu0.8 Alloys.

Nanoporous electrodes have been fabricated by selectively dissolving the less noble α-Fe crystalline phase from nanocrystalline Fe85.2B14–xPxCu0.8 alloys (x= 0, 2, 4 at.%). The preferential dissolution is triggered by the weaker electrochemical stability of α-Fe nanocrystals than amorphous phase. The final nanoporous structure is mainly composed of amorphous residual phase and minor undissolved α-Fe crystals and can be predicted from initial microstructure of nanocrystalline precursor alloys. The structural inheritance is proved by the similarity of the size and outlines between nanopores formed after dealloying in 0.1 M H2SO4 and α-Fe nanocrystals precipitated after annealing of amorphous Fe85.2B14−xPxCu0.8 (x = 0, 2, 4 at.%) alloys. The Redox peak current density of the nanoporous electrodes obtained from nanocrystalline Fe85.2B10P4Cu0.8 alloys is more than one order higher than those of Fe plate electrode and its counterpart nanocrystalline alloys due to the large surface area and nearly-amorphous nature of ligaments.

APPROACH TO 3D ANALYSIS OF GRAVITY PTOSIS

Abstract. The assessment of ptosis degree for rejuvenation procedures, the choice of following operation technique and evaluation of surgery result are based on subjective visual examination and surgeon’s experience. The photogrammetric scans of 25 female patients of age 20 to 55 in vertical and supine (horizontal) position of body with placing the regular marker points on the face were analyzed. For 5 patients, also the CT data was acquired and segmentation of soft tissue was performed. Four of these patients underwent SMAS-lifting, the photogrammetry scanning was repeat 6 months after the operation. Computer vision algorithms was used for markers detection on the 3D model texture, marker were projected from texture to triangular mesh. 3D mesh models were registered with user defined anatomy points and pair selection based on markers location was done. Pairs of points on vertical and horizontal 3D models were analyzed for surface tissue mobility examination. The migration vectors of each side of the face are uniformly directed upwards and laterally. The vectors are projected at the areas of so-called ligaments demonstrate no evidence in deviation from row sequences. The volume migration is strongly correlates with the age of examined patients, on the contrary the point migration moderately correlates with age in patients of 30 to 50 years old. The analysis of migration vectors before and after the SMAS-lifting revealed no significant changes in surface points’ migration. The described method allows to assess the mechanical conditions of individual face and evaluate efficacy of surgery. This approach can be used for the classification of face ptosis grade.

Semi-automated detection of anterior cruciate ligament injury from MRI

Background and objectives: A radiologist’s work in detecting various injuries or pathologies from radiological scans can be tiresome, time consuming and prone to errors. The field of computer-aided diagnosis aims to reduce these factors by introducing a level of automation in the process. In this paper, we deal with the problem of detecting the presence of anterior cruciate ligament (ACL) injury in a human knee. We examine the possibility of aiding the diagnosis process by building a decision-support model for detecting the presence of milder ACL injuries (not requiring operative treatment) and complete ACL ruptures (requiring operative treatment) from sagittal plane magnetic resonance (MR) volumes of human knees.Methods: Histogram of oriented gradient (HOG) descriptors and gist descriptors are extracted from manually selected rectangular regions of interest enveloping the wider cruciate ligament area. Performance of two machine-learning models is explored, coupled with both feature extraction methods: support vector machine (SVM) and random forests model. Model generalisation properties were determined by performing multiple iterations of stratified 10-fold cross validation whilst observing the area under the curve (AUC) score.Results: Sagittal plane knee joint MR data was retrospectively gathered at the Clinical Hospital Centre Rijeka, Croatia, from 2007 until 2014. Type of ACL injury was established in a double-blind fashion by comparing the retrospectively set diagnosis against the prospective opinion of another radiologist. After clean up, the resulting dataset consisted of 917 usable labelled exam sequences of left or right knees. Experimental results suggest that a linear-kernel SVM learned from HOG descriptors has the best generalisation properties among the experimental models compared, having an area under the curve of 0.894 for the injury-detection problem and 0.943 for the complete-rupture-detection problem.Conclusions: Although the problem of performing semi-automated ACL-injury diagnosis by observing knee-joint MR volumes alone is a difficult one, experimental results suggest potential clinical application of computer-aided decision making, both for detecting milder injuries and detecting complete ruptures.

Finite element analysis of the maxillary central incisor with traditional and modified crown lengthening surgery and post-core restoration in management of crown-root fracture

To construct three-dimensional finite element models with modified crown lengthening surgery and post-core restoration in management of various crown-root fracture types, to investigate the intensity and distribution of stressin models mentioned above, and to compare and analyze the indications of traditional and modified crown lengthening surgeries from the mechanic point of view. Nine three-dimensional finite element models with modified crown lengthening surgery and post-core restoration were established and analyzed by micro-CT scanning technique, dental impression scanner, Mimics 10.0, Geomagic studio 9.0 and ANSYS 14.0 software. The von Mises stress of dentin, periodontal ligament, alveolar bone, post and core, as well as the periodontal ligament area and threshold limit value were calculated and compared with the findings of traditional crown lengthening models which had been published earlierby our research group. The von Mises stress intensity of modified crown lengthening models were: dentin>post>core>alveolar bone>periodontal ligament. The maximum von Mises stress of dentin(44.37-80.58 MPa)distributed in lingual central shoulder. The periodontal ligament area of the modified crown lengthening surgery was reduced by 6% to 28%, under the same crown-root fracture conditions, the periodontal ligament area of modified crown lengthening models was larger than that of the traditional crown lengthening models. In modified crown lengthening surgery models, the von Mises stress of periodontal ligament of B3L1m, B3L2m, B3L3m models exceeded their limit values, however, the von Mises stress of periodontal ligament of the B2L2c, B2L3c, B3L1c, B3L2c, B3L3c models exceeded their limit values in traditional crown lengthening surgery models. The modified crown lengthening surgery conserves more periodontal supporting tissues, which facilitates the long-term survival of teeth. The indication of modified crown lengthening surgery is wider than traditional method. The maxillary central incisors with labial fracture at gingival margin level and with palatal fracture at or below the alveolar crest level are not the indication of the crown lengthening surgery.

Huncalotis, an enigmatic new pectinoid genus (Bivalvia, Late Jurassic) from South America

The extensive outcrops of the Late Jurassic–Early Cretaceous Vaca Muerta Formation black shales and marls in the Neuquen Basin have yielded very few bivalves, and these are not well known. The material described here was collected in central Neuquen, from late Tithonian calcareous levels within the black shales, between beds with Substeueroceras sp. and with Argentiniceras noduliferum (Steuer). The material is referred to the new genus Huncalotis and to the new species H. millaini. The strongly inequivalve shells, the ligamental area with a triangular slightly prosocline resilifer, the right valve with ctenolium and a very deep byssal notch, and the lack of radial ornamentation make the shell of this new genus strikingly similar to the Triassic pectinid Pleuronectites. This resemblance may be due to either phylogenetic relationships or convergence. Obliquipecten peruanum Rivera from central Peru is tentatively referred to Huncalotis. The Neuquen specimens are found in two main preservation types. Most of the material occurs in shell pavements, with equally abundant right and left valves and wide size range, within “beef” or “sandwich concretions”. These specimens are commonly complete but disarticulated, and show radial fractures orientated at right angles to the shell margins. A few specimens were found on the outside of large calcareous concretions within black shales; these are often articulated, complete shells, which preserve the original convexity of the valves. In some cases these articulated shells seem to be associated with large ammonite shells, suggesting an epibyssate (possibly also pseudoplanktonic) lifestyle.

Effect of manual therapy and neurodynamic techniques vs ultrasound and laser on 2PD in patients with CTS: A randomized controlled trial

Study DesignRandomized controlled trial. IntroductionTwo-point discrimination (2PD) test can be used to assess both clinical condition and the effects of therapy in carpal tunnel syndrome (CTS) patients. Purpose of the StudyTo determine whether there are specific differences in 2PD between symptomatic and asymptomatic hands in CTS patients and to evaluate the impact of 2 therapy regimes on 2PD in patients with CTS. MethodsTherapy for the neurodynamic mobilization group was based on manual therapy and neurodynamic techniques. Therapy for the electrophysical modalities group was based on red and infrared laser and ultrasound therapy using a contact method applied in the transverse ligament area. Therapeutic cycle consisted of 20 therapy sessions delivered at twice-weekly intervals. ResultsAfter therapy, 2PD in the symptomatic limbs in the neurodynamic mobilization and electrophysical modalities groups significantly improved (p < .001). However, there was no statistically significant difference between the treatment groups. ConclusionsBoth therapy programs used in this study were beneficial for improving 2PD. Level of evidence2.

INFLUENCE OF STRUCTURAL FEATURES OF MAGNETITE CRYSTALS ON THE PROCESS OF AGGLOMERATE SINTERING

Abstract. Regarding to the iron ore agglomerates of various (CaO / SiO2 ) basicity the authors have investigated the formation of ferriferous silicate melt during sintering of sinter ore with magnetite crystals of different structures – homogeneous and heterogeneous. Magnetite crystals of homogeneous structure, with close to stoichiometry composition, take an active part in the formation of ferriferous silicate melt. The ore grains ligaments in the form of iron and calcium containing olivine are locally formed on the place of the melt in the agglomerates of low basicity. With the growth of the agglomerates basicity and increasing the oxidation potential of the gas phase instead of silicate the high-iron ligaments of aluminum silicoferrite appear to form a frame structure of the agglomerates. Magnetite crystals of heterogeneous structure, as a product of decomposition of the solid solution, impede the transition of magnetite iron into the ferriferous silicate melt. Low content of iron oxide in the melt expands the range of crystallization of silicate ligaments and reduces the area of ferritic ligaments in the agglomerate. Failure of magnetite of heterogeneous structure to participate in formation of a melt excludes the possibility of appearance of high-iron aluminum silicoferrite in agglomerates ligament. As a result, the process of ferrite formation in the agglomerates of high basicity begins with the appearance of high-calcium ferrites.

The patterns of lymph node metastasis in adenocarcinoma of esophagogastric junction : a reference for target volume delineation in radical radiotherapy

Objective To analyze the patterns and distribution of lymph node metastasis in patients with adenocarcinoma of the esophagogastric junction(AEG). Methods The pathological data of 393 patients with AEG from 2006 to 2009 were analyzed. The patterns and distribution of lymph node metastasis were analyzed in patients with different Siewert subtypes, depths of tumor invasion, and maximum diameters of the tumor, and the high-risk lymphatic drainage areas were investigated. Between-group comparison was performed by χ2 test. Results The metastatic rate and ratio of abdominal lymph nodes in AEG were 69. 2% and 31. 31%, respectively. The incidence rates of lymph node metastasis in the cardia, lesser curvature, left gastric artery, splenic artery, splenic hilum, mesenteric root, and abdominal aorta were the highest. The metastatic rate and ratio of mediastinal lymph nodes were 16.4% and 8.3%, respectively. The incidence rates of lymph node metastasis in the lower paraesophageal, esophageal hiatus, and superior diaphragmatic areas were the highest. Compared with Siewert type Ⅱ and type Ⅲ AEG, Siewert type I AEG had a significantly higher mediastinal lymph node metastatic rate(P = 0. 003)and a significantly lower abdominal lymph node metastatic ratio(P=0. 002).The metastatic ratios of lymph nodes in multiple abdominal regions were higher in patients with stage T3+T4 AEG and a maximum tumor diameter of cm than in the control group, while the metastatic ratios of mediastinal lymph nodes in groups with different maximum tumor diameters were similar. The metastatic ratios of lymph nodes in the greater curvature, hepatoduodenal ligament, and inferior diaphragmatic areas were lower than 10% in all groups. Conclusions In radiotherapy for AEG, the abdominal high-risk lymphatic drainage areas involve the cardia, lesser curvature, left gastric artery, splenic artery, splenic hilum, mesenteric root, and abdominal aorta, while the mediastinal high-risk lymphatic drainage areas involve the lower paraesophageal, esophageal hiatus, and superior diaphragmatic areas. In addition, the personalized target volume design should be based on the patterns of lymph node metastasis with different Siewert subtypes and clinical pathological characteristics. Key words: Esophagogastric junction neoplasm/radiotherapy; Target delineation; Lymph node metastasis

Influence of the meniscofemoral ligaments on the morphology of the posterior cruciate ligaments ‐ an MRI assisted morphometric analysis of different phases in life.

PurposeThe morphology of the meniscofemoral ligaments and the posterior cruciate ligament varies during different stages of life. This study shows those alterations and highlights the age in which the change to the anatomy occurs.Material and methodsRetrospective study of 342 knee MRIs. The patients were allocated to five age groups depending on their respective age at the date of examination. The main focus laid on the incidences, the length and the cross‐sectional area of the meniscofemoral ligaments and their relationship to the posterior cruciate ligament in different phases of life.ResultsThe MFLs are present in the vast majority of people and can be seen as part of the normal human anatomy. Above the age of 10 years, there is no significant difference in the incidence of the MFLs. Length growth of the MFLs is concluded below the age of 11 years, but the MFLs still keep increasing in cross‐sectional area. Single MFLs are significantly larger in cross‐sectional area than the same MFL in knees with both MFLs present. The cross‐sectional area of the PCL is significantly larger if the pMFL is missing.ConclusionThe MFLs of the human knee are non‐dispensable structures working in synergy with other elements of the knee joint, especially the PCL. Absence is compensated by the other, present MFL or by the PCL through larger than average morphometrics. Further studies need to be conducted to ascertain if simple absence of the MFLs without compensation may be correlated with pathologies of the knee joint.