Long-term Morphological Changes Research Articles

Changes in Upper Airway Space in a Patient with Pycnodysostosis Following Primary Surgery and Orthodontic Treatment: A 12-Year Follow-Up Case Report

Pycnodysostosis (PDS) is an autosomal recessive form of osteosclerotic skeletal dysplasia characterized by craniofacial anomalies, a high-arched palate, and a narrowed pharyngeal space due to mandibular and maxillary deficiencies. These structural anomalies in the upper airway predispose PDS patients to obstructive sleep apnea (OSA). OSA can be managed in PDS patients using either a conservative (non-surgical and multidisciplinary) approach or surgical interventions. Given the craniofacial anomalies associated with PDS, orthodontic treatment aims to address the maxillary transverse deficit and retrognathia. Currently, there is no evidence regarding the impact of orthodontic therapy on OSA levels among PDS patients. This study reports the long-term morphological and functional changes in the upper airway of a PDS patient following adenotonsillectomy and uvulopalatoplasty at an early age (3.6 years) and orthodontic camouflage in late mixed dentition (10 years). Polysomnographies (PSGs), nuclear magnetic resonance (NMR), and lateral cephalograms taken before and after ENT surgery and orthodontic treatment were analyzed. Lateral X-rays were evaluated for changes in the posterior airway space (PAS), while polysomnographies provided the apnea–hypopnea index (AHI). The NMR scans were segmented to measure the perimeter and radius of the upper airway. The findings of this study indicate that improvements following uvulopalatoplasty (UPP) were partial and temporary. Nonetheless, orthodontic therapy and the use of elastics did not appear to influence the PAS or AHI. Future studies with larger cohorts are needed to evaluate the long-term effectiveness of the UPP procedure. This study was conducted in accordance with the CARE guidelines.

Dating drainage reversal using mineral provenance along the Yangsan Fault, South Korea.

Tectonics is broadly accepted as one of the main factors controlling long-term landscape evolution. The impact of tectonics on short timescales is most often observed through earthquake rupturings that produce localized, metric-scale deformations. Although these deformations significantly affect the landscape, it remains challenging to precisely correlate major landscape changes with these localized earthquake deformations. Therefore, linking instantaneous deformation to long-term morphological changes often involves a thought experiment with potentially limited temporal resolution. At a paleoseismological site along the slow-moving strike-slip Yangsan Fault in South Korea, we employed optically stimulated luminescence (OSL) dating and detrital zircon analysis on all exposed unconsolidated layers in trench walls. The results reveal a significant provenance shift in the sediments accumulating in the trench, indicating a major reorganization of the drainage network. Based on our OSL and detrital zircon data, we estimate that this change occurred around 70ka. We propose that this drastic drainage reorganization was caused by a combination of very slow, yet continuous, earthquake activity and a temporary reduction in river erosion during the onset of the cold, dry spell characteristic of the MIS4 stage across the Korean Peninsula.

Glucose-Free Solutions Mediated Inhibition of Oxidative Stress and Oxidative Stress-Related Damages in Peritoneal Dialysis: A Promising Solution.

Oxidative stress (OxSt) and inflammation are common in end-stage renal disease and dialysis patients; they are known risk factors for cardiovascular disease and mortality. In peritoneal dialysis (PD), OxSt and inflammation are even further increased compared to the already increased oxidative stress of their pre-dialysis phase. This is due to the high glucose-based solutions currently used, whose continuous contact with the peritoneal membrane can induce significant long-term morphological and functional changes (mesothelial to mesenchymal transition, thickening, neo-angiogenesis and fibrosis) of the peritoneal membrane. Oxidative stress plays a very important role in these processes, which may compromise the peritoneal dialysis procedure. There is, therefore, the need for more biocompatible dialysis fluids with polymers other than glucose to prevent and treat OxSt and inflammation. The most known and used of such glucose-free and more biocompatible peritoneal dialysis solutions is icodextrin, which has shown a protective effect from oxidative stress. This has supported the consideration of the use of glucose-free-based peritoneal dialysis fluids in order to reduce oxidative stress and improve peritoneal membrane survival. Studies investigating peritoneal dialysis with the use of osmo-metabolic agents (L-carnitine, xylitol and their combination) in peritoneal fluids replacing glucose-based fluids are, in fact, ongoing. They represent a promising strategy to reduce OxSt, preserve the peritoneal membrane's integrity and improve patients' outcome.

Experimental evaluation of an artificial anal sphincter based on biomechanical compatibility.

The artificial anal sphincter is a device used to treat patients with fecal incontinence who are unable to control their bowel movements on their own. Long-term morphological changes in the tissue surrounding the artificial anal sphincter can cause biomechanical compatibility problems, which seriously affect the clinical application of the artificial anal sphincter. In this paper, the superelasticity of shape memory alloys was utilized to design and fabricate a biomechanically compatible constant force clamping artificial anal sphincter. An invitro simulation system was constructed to verify the effectiveness, safety, and constant force characteristics of the artificial anal sphincter. The experimental results demonstrated that the artificial anal sphincter could be effectively closed with no leakage of the liquid-like intestinal contents, which are most likely to leak. The pressure of the artificial anal sphincter on the intestinal tube gradually increased and eventually became constant during closure, and the pressure value was always less than the intestinal blood supply pressure threshold. In this paper, we designed an artificial anal sphincter based on biomechanical compatibility and the corresponding invitro simulation experimental program and preliminarily verified the effectiveness, safety, and constant force characteristics of the artificial anal sphincter.

Quantifying Spatio-Temporal River Morphological Change and Its Consequences in the Vietnamese Mekong River Delta Using Remote Sensing and Geographical Information System Techniques

The evolution of delta and riverbank erosion within the river basin can significantly impact the environment, ecosystems, and lives of those residing along rivers. The Vietnamese Mekong Delta (VMD), counted among the world’s largest deltas, has undergone significant morphological alterations via natural processes and human activities. This research aims to examine these morphological alterations and their impacts on local economic and social conditions in the VMD. This study utilized satellite data from 1988 to 2020, coupled with population density and land use/land cover (LULC) maps from 2002, 2008, and 2015. The findings reveal that the VMD experienced widespread erosion over the past three decades, covering an area of 66.8 km2 and affecting 48% of the riverbank length (682 km). In contrast to riverbanks, islets showed an accretion trend with an additional area of 13.3 km2, resulting in a decrease in river width over the years. Riverbank and islet erosion has had a profound impact on the LULC, population, and economy of the provinces along the VMD. From 2002 to 2020, eight different land use types were affected, with agricultural land being the most severely eroded, constituting over 86% of the total lost land area (3235.47 ha). The consequences of land loss due to erosion affected 31,273 people and resulted in substantial economic damages estimated at VND 19,409.90 billion (USD 799.50 million) across nine provinces along the VMD. Notably, even though built-up land represented a relatively small portion of the affected area (6.58%), it accounted for the majority of the economic damage at 70.6% (USD 564.45 million). This study underscores the crucial role of satellite imagery and GIS in monitoring long-term morphological changes and assessing their primary impacts. Such analysis is essential for formulating effective plans and strategies for the sustainable management of river environments.

Long-term morphological and sedimentological changes caused by bottom trawling on the northern Catalan continental shelf (NW Mediterranean)

Bottom trawling is a fishing method that involves towing of nets along the seafloor to catch demersal species. The dragging of trawling gears along the seafloor results in scraping and ploughing of the surficial sediments, leading to the formation of turbid plumes of resuspended sediments and causing measurable changes in the seabed morphology. High-resolution multibeam data, side scan sonar, sediment grain size and vessel tracking data have been used to investigate the impact of bottom trawling on the seafloor morphology and surficial sediments of the northern Catalan continental shelf (NW Mediterranean), providing new insights into the impact of this anthropogenic activity on the seafloor. Multibeam data evidenced the occurrence of large-scale erosive features as a consequence of repeated scouring by fishing gears in localized areas. They are characterized by elongated (70-300 m wide and up to 8 km long) channelized areas of high backscatter with variable incision (from 0.2 m to 1.2 m). The spatial distribution of these morphologies shows a similar pattern to that observed in the fishing intensity, with maximum values in the areas of increased trawling intensity, corresponding to the main fishing grounds. Side scan sonar data also shows higher densities of trawl marks in these areas than in the surroundings. Sediment cores collected on these features show an upward-coarsening trend in the first 4-5 cm of the core, suggesting that part of the finer fraction resuspended by trawling is winnowed, increasing the sand content of the surface sediment. The identification of such large erosive morphologies in the main fishing grounds evidences that repeated trawling over the same fishing ground during decades can result in deep excavation of the seafloor, leading to permanent large-scale morphological changes. Furthermore, the evolution of these erosive features over a 13-year interval points towards long recovery periods after the cessation of trawling activities.

Remote effects of temporal lobe epilepsy surgery: Long-term morphological changes after surgical resection.

Epilepsy surgery is an effective treatment for drug-resistant patients. However, how different surgical approaches affect long-term brain structure remains poorly characterized. Here, we present a semiautomated method for quantifying structural changes after epilepsy surgery and compare the remote structural effects of two approaches, anterior temporal lobectomy (ATL), and selective amygdalohippocampectomy (SAH). We studied 36 temporal lobe epilepsy patients who underwent resective surgery (ATL = 22, SAH = 14). All patients received same-scanner MR imaging preoperatively and postoperatively (mean 2 years). To analyze postoperative structural changes, we segmented the resection zone and modified the Advanced Normalization Tools (ANTs) longitudinal cortical pipeline to account for resections. We compared global and regional annualized cortical thinning between surgical treatments. Across procedures, there was significant cortical thinning in the ipsilateral insula, fusiform, pericalcarine, and several temporal lobe regions outside the resection zone as well as the contralateral hippocampus. Additionally, increased postoperative cortical thickness was seen in the supramarginal gyrus. Patients treated with ATL exhibited greater annualized cortical thinning compared with SAH cases (ATL: -0.08 ± 0.11 mm per year, SAH: -0.01 ± 0.02 mm per year, t = 2.99, P = 0.006). There were focal postoperative differences between the two treatment groups in the ipsilateral insula (P = 0.039, corrected). Annualized cortical thinning rates correlated with preoperative cortical thickness (r = 0.60, P < 0.001) and had weaker associations with age at surgery (r = -0.33, P = 0.051) and disease duration (r = -0.42, P = 0.058). Our evidence suggests that selective procedures are associated with less cortical thinning and that earlier surgical intervention may reduce long-term impacts on brain structure.

Evaluation of the potential stranding risk for aquatic organisms according to long-term morphological changes and grain size in alpine rivers impacted by hydropeaking

Hydropeaking is one of the major hydropower-related disturbances of natural processes in river systems. The artificial flow fluctuations that are caused by the on-demand production of electricity are known for their severe impacts on aquatic ecosystems. These particularly affect those species and life stages that are not able to adjust their habitat selection to rapid up- and downramping rates. To date, the stranding risk has both experimentally and numerically mainly been investigated with variable hydropeaking graphs over stable river bathymetries. There is a lack of knowledge on how single, discrete peaking events vary concerning their impact on the stranding risk when the river morphology changes in the long-term perspective. The present study precisely addresses this knowledge gap by investigating morphological changes on the reach scale over a period of 20 years and the related variability of the lateral ramping velocity as a proxy for stranding risk. Two alpine gravel bed rivers impacted by hydropeaking over decades were tested by applying a one-dimensional and two-dimensional unsteady modelling approach. Both the Bregenzerach River and the Inn River exhibit alternating gravel bars on the reach scale. The results of the morphological development, however, showed different developments in the period 1995–2015. The Bregenzerach River displayed continuous aggradation (uplift of river bed) over the various selected submonitoring periods. In contrast, the Inn River showed continuous incision (erosion of river bed). The stranding risk exhibited high variability on a single cross-sectional basis. However, on the reach scale, no significant changes in stranding risk were calculated for either river reach. In addition, the impacts of river incision on the substrate composition were investigated. Here, in line with preceding studies, the results show that the coarsening of substrate increases the stranding risk and that especially the d90 (90 % finer of the grain size distribution) must be considered. The present study reveals that the quantified stranding risk of aquatic organisms is a function of the general morphological (bar) characteristics of the impacted river and both the morphological and grain size development have an impact on the potential stranding risk of aquatic organisms and should be considered in the revision of licences in the management of multi-stressed river systems.

Morphology of proximal and distal human semitendinosus compartments and the effects of distal tendon harvesting for anterior cruciate ligament reconstruction.

The human semitendinosus muscle is characterized by a tendinous inscription separating proximal and distal neuromuscular compartments. As each compartment is innervated by separate nerve branches, potential exists for independent operation and control of compartments. However, the morphology and function of each compartment have not been thoroughly examined in an adult human population. Further, the distal semitendinosus tendon is typically harvested for use in anterior cruciate ligament reconstruction surgery, which induces long-term morphological changes to the semitendinosus muscle-tendon unit. It remains unknown if muscle morphological alterations following anterior cruciate ligament reconstruction are uniform between proximal and distal semitendinosus compartments. Here, we performed magnetic resonance imaging on 10 individuals who had undergone anterior cruciate ligament reconstruction involving an ipsilateral distal semitendinosus tendon graft 14 ± 4 months prior, extracting morphological parameters of the whole semitendinosus muscle and each individual compartment from both the (non-injured) contralateral and surgical legs. In the contralateral leg, volume and length of the proximal compartment were smaller than the distal compartment. No between-compartment differences in volume or length were found for anterior cruciate ligament reconstructed legs, likely due to greater shortening of the distal compared to the proximal compartment after anterior cruciate ligament reconstruction. The maximal anatomical cross-sectional area of both compartments was substantially smaller on the anterior cruciate ligament reconstructed leg but did not differ between compartments on either leg. The absolute and relative between-leg differences in proximal compartment morphology on the anterior cruciate ligament reconstructed leg were strongly correlated with the corresponding between-leg differences in distal compartment morphological parameters. Specifically, greater between-leg morphological differences in one compartment were highly correlated with large between-leg differences in the other compartment, and vice versa for smaller differences. These relationships indicate that despite the heterogeneity in compartment length and volume, compartment atrophy is not independent or random. Further, the tendinous inscription endpoints were generally positioned at the same proximodistal level as the compartment maximal anatomical cross-sectional areas, providing a wide area over which the tendinous inscription could mechanically interact with compartments. Overall, results suggest the two human semitendinosus compartments are not mechanically independent.

Median Nerve Recovery and Morphological Change on MRI at 24 Months after Open Carpal Tunnel Release.

Background: This study aimed to investigate the relationship between postoperative clinical results and long-term morphological changes in patients with carpal tunnel syndrome (CTS) as observed on magnetic resonance imaging (MRI) before and after open carpal tunnel release (OCTR). Methods: We retrospectively analysed data for 28 hands that had undergone OCTR with at least 24 months of follow-up data. Two-point discrimination (2PD) test results were examined for the first three fingers, as were the distal motor latency (DML) and sensory conduction velocity (SCV) of the median nerve. We also calculated the cross-sectional area (CSA) of the carpal tunnel and the distance from the median nerve to the volar carpal bone at the hamate and the pisiform levels using MRI images. Variables were compared before and 24 months after OCTR. Results: Significant improvements in all variables were observed, including average 2PD scores (Finger I: 13.1 ± 6.2 vs. 7.7 ± 4.3, p < 0.01, Finger II: 11.9 ± 6.6 vs. 7.0 ± 3.5, p < 0.01, Finger III: 13.6 ± 6.1 vs. 7.8 ± 4.5, p < 0.01), average DML (8.3 ± 3.3 vs. 4.3 ± 0.6 m/s, p < 0.01), average SCV (30.8 ± 11.0 vs. 41.3 ± 5.3 m/s, p < 0.01), CSA of the carpal tunnel (hamate level: 194.9 ± 30.6 vs. 254.2 ± 47.6 mm2, p < 0.01, pisiform level: 244.2 ± 46.5 vs. 274.7 ± 75.1 mm2, p = 0.01) and the distance between the median nerve and volar carpal bone (hamate level: 8.7 ± 1.4 vs. 11.2 ± 1.6 mm, p < 0.01, pisiform level: 11.8 ± 1.7 vs. 13.8 ± 2.5 mm, p < 0.01). Conclusions: Our results demonstrate that OCTR is successful in achieving long-term decompression and recovery of the median nerve in patients with CTS. Level of Evidence: Level III (Therapeutic).

Research on biomechanical compatibility for a novel artificial anal sphincter with constant force.

Existing artificial anal sphincter studies have shown that biomechanical compatibility problem between artificial anal sphincter and rectum caused by long-term morphological changes of the tissue surrounding the implanted prosthesis can lead to device failure or tissue ischemic necrosis. In this article, a mechanical artificial anal sphincter with constant force clamping is designed based on the superelasticity of shape memory alloys, which improved the biomechanical compatibility of implantable artificial anal sphincter. Firstly, the anatomical structure and the biomechanical properties of the rectum are analyzed to obtain the size parameters and material parameters of the rectal model. Secondly, a novel artificial anal sphincter with constant force is designed to improve the biomechanical compatibility between the artificial sphincter and the rectum. Thirdly, the static analysis of artificial anal sphincter is carried out by finite element analysis. The simulation results show that the artificial anal sphincter can maintain a constant clamping force of 4N within a certain variation range of intestinal tissue thickness, which verifies the constant force characteristic of the artificial anal sphincter. The constant clamping force of the artificial anal sphincter to the rectum is 4N that is greater than the clamping force 3.99 N required to close the rectum, which verifies the effectiveness the artificial anal sphincter. The surface contact stress and the minimum principal stress of the rectum in the clamping state are less than the pressure threshold, which verifies the safety of the artificial anal sphincter. The novel artificial anal sphincter has better biomechanical compatibility and improves the mechanical match between artificial sphincter and intestinal tissue. This study may provide more reasonable and effective simulation data for in vivo experiments of artificial anal sphincter in future, which may provide theoretical and technical support for further research about clinical application of artificial anal sphincter.

LONG-TERM MORPHOLOGIC CHANGES IN MACULAR NEOVASCULARIZATION UNDER AFLIBERCEPT TREATMENT WITH A TREAT-AND-EXTEND REGIMEN.

To examine the morphologic changes in macular neovascularization (MNV) secondary to age-related macular degeneration after 2 years of aflibercept treatment under a treat-and-extend (T&E) regimen. This retrospective study analyzed the medical records for 26 eyes of 25 patients diagnosed with treatment-naive neovascular age-related macular degeneration and treated with aflibercept under a treat-and-extend regimen for 2 years. The areas of the MNV and vascular structures were assessed using swept-source optical coherence tomography angiography at baseline and after 2 years of treatment. The mean MNV area increased significantly from 0.65 ± 0.42 mm 2 at baseline to 0.78 ± 0.45 mm 2 at 2 years. At 2 years, the mean change in the MNV area from baseline was 22% (interquartile range: 4%-60%). The baseline MNV area was negatively correlated with the change ratio of the MNV areas at 2 years and baseline ( R = -0.68, P < 0.001). Nine of the 26 eyes (34.6%) showed newly formed mature vessels, and 7 eyes (26.9%) showed prominently developing preexisting mature vessels. Macular neovascularization expanded and showed vascular maturation under aflibercept treatment with a treat-and-extend regimen. The smaller the MNV at baseline, the greater is its expansion in 2 years.

Ray-tracing analysis on the far-red induced light-capturing ability of kale

Far-red (FR, 700–800 nm) light has recently been used to regulate phytochrome-mediated morphological responses in vertical farms. Long-term morphological changes in different FR intensities are well known, but changes in photosynthetic capacity have not been sufficiently investigated. The objectives of this study were to quantitatively analyze the growth, photosynthetic responses, and light interception of kale (Brassica oleracea L. var. acephala) depending on the FR fraction. The plants were cultivated at a photosynthetic photon flux density (PPFD) of 240 μmol m−2 s−1 under red and white LEDs with FR LED (peak at 730 nm) for 16 h. The FR fractions determined as FR/R+FR were FR0.07 (control), FR0.28, FR0.60, and FR0.72. To evaluate the morphological and physiological responses in each FR fraction, the growth, chlorophyll content, chlorophyll fluorescence, P700 absorbance change, and photosynthetic rate were measured. Light interception was quantitatively calculated using 3D-scanned plant models with physiological changes and ray-tracing simulations. The dry weight of shoot and root, total petiole length, and leaf area increased with increasing FR fractions. As a result of ray-tracing analysis, the light interception and canopy photosynthetic rate increased with high FR fraction treatment. As the FR fraction increased, the effective quantum yield of photosystem II [Y(II)], the parameters of the JIP test that is related to quantum yield and efficiency for electron transport in photosystem II and photosystem performance indices decreased. Despite the decreased electron transport efficiency, the canopy photosynthetic rate increased in relation to the FR fraction. In conclusion, the increase in the FR fraction increased the yield of kale because of the synergistic improvement in morphological change and canopy photosynthesis.

Short-Term, Voluntary Exercise Affects Morpho-Functional Maturation of Adult-Generated Neurons in Rat Hippocampus.

Physical exercise is a well-proven neurogenic stimulus, promoting neuronal progenitor proliferation and affecting newborn cell survival. Besides, it has beneficial effects on brain health and cognition. Previously, we found that three days of physical activity in a very precocious period of adult-generated granule cell life is able to antedate the appearance of the first GABAergic synaptic contacts and increase T-type Ca2+ channel expression. Considering the role of GABA and Ca2+ in fostering neuronal maturation, in this study, we used short-term, voluntary exercise on a running wheel to investigate if it is able to induce long-term morphological and synaptic changes in newborn neurons. Using adult male rats, we found that: (i) three days of voluntary physical exercise can definitively influence the morpho-functional maturation process of newborn granule neurons when applied very early during their development; (ii) a significant percentage of new neurons show more mature morphological characteristics far from the end of exercise protocol; (iii) the long-term morphological effects result in enhanced synaptic plasticity. Present findings demonstrate that the morpho-functional changes induced by exercise on very immature adult-generated neurons are permanent, affecting the neuron maturation and integration in hippocampal circuitry. Our data contribute to underpinning the beneficial potential of physical activity on brain health, also performed for short times.

Inhibition of RANKL and Sema4D improves residual ridge resorption in mice

Residual ridge resorption (RRR) is a chronic and progressive bone resorption following tooth loss. It causes deterioration of the oral environments and leads to the pathogenesis of various systemic diseases. However, the molecular mechanisms and risk factors for RRR progression are still unclear and controversial. In this study, we developed a tooth extraction model using mice for analyzing long-term morphological and gene expression changes in the alveolar bone. We further applied ovariectomy to this model to elucidate the effects of osteoporosis on RRR progression. As a result, the alveolar bone loss was biphasic and consisted of rapid loss in the early stages and subsequently slow and sustained bone loss over a long period. Histological analysis indicated that ovariectomy prolonged the activation of osteoclasts in the alveolar bone. Furthermore, the expressions of Tnfsf11 and Sema4d kept increasing for a long time in OVX mice. Administration of neutralization antibodies for receptor activator of NF-κB ligand (RANKL) effectively suppressed RRR. Similarly, inhibition of Semaphorin 4D (Sema4D) also improved alveolar bone loss. This study demonstrated that reduced ovarian function may be a risk factor for RRR and that RANKL and Sema4D suppression are potential treatments.

Statistical Analysis for Tidal Flat Classification and Topography Using Multitemporal SAR Backscattering Coefficients

Coastal zones are very dynamic natural systems that experience short-term and long-term morphological changes. Their highly dynamic behavior requires frequent monitoring. Tidal flat topography for a large spatial coverage has been generated mainly by the waterline extraction method from multitemporal remote sensing observations. Despite the efficiency and robustness of the waterline extraction method, the waterline-based digital elevation model (DEM) is limited to representing small scale topographic features, such as localized tidal tributaries. Tidal flats show a rapid increase in SAR backscattering coefficients when the tide height is lower than the tidal flat topography compared to when the tidal flat is covered by water. This leads to a tidal flat with a distinct statistical behavior on the temporal variability of our multitemporal SAR backscattering coefficients. Therefore, this study aims to suggest a new method that can overcome the constraints of the waterline-based method by using a pixel-based DEM generation algorithm. Jenks Natural Break (JNB) optimization was applied to distinguish the tidal flat from land and ocean using multitemporal Senitnel-1 SAR data for the years 2014–2020. We also implemented a logistic model to characterize the temporal evolution of the SAR backscattering coefficients along with the tide heights and estimated intertidal topography. The Sentinel-1 DEM from the JNB classification and logistic function was evaluated by an airborne Lidar DEM. Our pixel-based DEM outperformed the waterline-based Landsat DEM. This study demonstrates that our statistical approach to intertidal classification and topography serves to monitor the near real-time spatiotemporal distribution changes of tidal flats through continuous and stable SAR data collection on local and regional scales.

Long-term Morphological Changes of the Velum and the Nasopharynx in Patients With Cleft Palate.

To investigate long-term morphological changes in the soft palate length and nasopharynx in patients with cleft palate. We hypothesized that there would be differences in the morphological development of the soft palate and nasopharynx between patients with and without cleft palate and that these developmental changes would negatively affect the soft palate length to pharyngeal depth ratio involved in velopharyngeal closure for patients with cleft palate. Retrospective, case-control study. Institutional practice. Ninety-two patients (Group F) with unilateral cleft lip, alveolus, and palate and 67 patients (Group CLA) with unilateral cleft lip and alveolus not requiring palatoplasty were included. The soft palate length, nasopharyngeal size, and soft palate length to pharyngeal depth ratio were measured via lateral cephalograms obtained at three different periods. Group F showed a shorter soft palate length and smaller nasopharyngeal size than Group CLA at all periods. Both these parameters increased with age, but the increase in amount was significantly less in Group F compared with that in Group CLA. The soft palate length to pharyngeal depth ratio in Group F decreased with age. In patients with cleft palate, the soft palate length to pharyngeal depth ratio, which is involved in velopharyngeal closure, can change with age. Less soft palate length growth and unfavorable relationship between the soft palate and nasopharynx may be masked in early childhood but can manifest later on with age.

Onyx™ Cast Fragmentation After Embolization of Endoleaks

Purpose: Endoleaks are common following endovascular aneurysm repair (EVAR), and the liquid embolic material Onyx has been widely used in their treatment. We report our experience of long-term morphological changes of Onyx casts on surveillance imaging. Materials and Methods: We identified 10 patients over 10 years who underwent Onyx embolization in our institution. Morphological changes of Onyx casts were assessed on surveillance radiographs and computed tomography (CT) scans. Relevant outcome data and sequelae were obtained via electronic patient records. Results: Twelve procedures were performed on 10 cases, 9 for type 2, and 1 for a type 1a endoleak. Five cases showed evidence of Onyx fragmentation on follow-up imaging ranging from a single fracture to gross fragmentation with migration of fragments. Of these 5, 3 had achieved primary success but 2 went on to develop recurrence of endoleak. Onyx volume ranged from 4 to 46.5 ml (median 10.5 ml) per patient with larger volumes demonstrating the most marked fragmentation on follow-up. Follow-up ranged from 9 months to 8 years (median 2.25 years). Conclusion: To our knowledge, this is the first report of Onyx fragmentation after endoleak embolization. If long-term morphological stability of the Onyx cast is necessary to maintain aneurysm seal, then Onyx may not offer a permanent solution to some patients with post-EVAR endoleaks. Our study cannot ascertain whether the observed changes were the cause or the effect of ongoing aneurysm growth, persistent endoleak, and/or other forces acting on the solidified polymer, but it raises important questions on the use of Onyx in this setting.

Decellularized adipose tissue: A key factor in promoting fat regeneration by recruiting and inducing mesenchymal stem cells

BackgroundDecellularized adipose tissue (DAT) has attracted much attention due to its wide range of sources and adipose regeneration capacity. However, the lipogenic efficiency of DAT is still controversial due to its unclear mechanism. To this point, it is crucial to clarify the mechanism of DAT in promoting adipose regeneration Objective: This study aims to explore the mechanism of DAT promoting adipose regeneration and survival mechanism of DAT transplantation in vivo. MethodsDAT preparation by repeated freeze-thaw, enzymatic digestion, and isopropanol degreasing. Histology, DAPI, immunohistochemistry, immunofluorescence and scanning electron microscopy confirmed the efficacy and reproducibility of these approaches. BM-MSCs, ADSCs and UCMSCs were cocultured with DAT for 14 days and then stained with oil red O. Adipogenic genes of three MSCs were detected by RT-PCR. DAT and adipose tissue were transplanted subcutaneously into the back of nude mice to observe medium and long-term morphological changes, vascularization, and lipid-forming efficiency. Mass spectrometry (MS)-based proteomic to analyze the adipogenic protein contents of DAT and adipose tissue. ResultsThe DAT without any cellular components but with an abundance of collagen; neither DNA nor lipids were detected. Seeding experiments with MSCs indicated that the DAT provided an inductive microenvironment for adipogenesis, supporting the expression of the master regulators PPARγ. Within four months after transplantation, HE morphology of DAT was identical to adipose cells. Immunofluorescence markers CD31 and perilipin were increased in DAT, while the retention rate gradually decreased over time, eventually accounting for 33.7% of the original volume. MS-based proteomic analyses identified 1013 types of proteins in adipose tissue and 29 proteins in the DAT. Analyses of GO and KEGG databases suggested that DAT contained a variety of proteins involved in fat metabolism. ConclusionsDAT can interact with different types of MSCs and ultimately achieve adipose regeneration. The presence of multiple adipogenic proteins in DAT make it play a vital role in adipose regeneration. DAT is expected to be an ideal bio-derived scaffold for adipose tissue engineering.

Current asymmetry and its implications for morphological changes in Vembanad Lake, the second largest wetland ecosystem in India

Flow dynamics are a key part of the physical processes that drive the sediment transport in an aquatic system, affecting depositional processes and leading to landform evolution. The current asymmetry (CA) noted in Vembanad Lake (VL), India, have a particularly strong influence on the sediment budget and thus shape its geomorphology. In the present study the Coastal Ocean Model - Finite Volume Coastal Ocean Model (FVCOM) was used to compute the lateral current asymmetries and their implications for the long-term morphological changes in VL during different tidal phases. Model results were utilised to calculate the CA using two criteria: (1) Peak flood/ebb velocities with duration, and (2) Asymmetry Index (AIDV). AIDV values suggest the prevalence of ebb dominance over the entire system except at Cherai and Vallarpadam. However, several isolated pockets were noted on the right/eastern bank (shallow depth) of the system where the peak flood velocity exceeded the ebb, favouring accretion.Contrary to the concept of ebb asymmetry, mean velocity and duration asymmetries were prevalent in the asymmetry index (AIDV); hence we adopted peak flood/ebb velocity and its duration asymmetries to improve our understanding of the sediment transport dynamics. Typical flood asymmetry was identified on the right bank and at many of the lateral stations in VL, which switched to the modified ebb asymmetry during substantial river discharge. Analysis of CA enables understanding of the process that influences selective morphological changes, as explained by the model results. This conclusion was well corroborated by results obtained over the past three decades (1973–2008) from analysis of Landsat satellite imagery. Flood/ebb dominance in VL is explicitly substantiated with regions of accretion/erosion derived from satellite imageries. A holistic approach encompassing modelling, observations, remote sensing, and GIS techniques were used to address the erosion-accretion process in VL.