Medial Portion Research Articles

The Gut Microbiota of Farmed and Wild Brook Trout (Salvelinus fontinalis): Evaluation of Feed-Related Differences Using 16S rRNA Gene Metabarcoding.

The gut microbiota has become a topic of increasing importance in various fields, including aquaculture. Several fish species have been the subject of investigations concerning the intestinal microbiota, which have compared different variables, including the intestinal portions, the environment, and diet. In this study, the microbiota of farmed and wild brook trout (Salvelinus fontinalis) were analyzed, in which the wall and content of the medial portion of the intestine were considered separately. A total of 66 fish (age class 2+) were sampled, of which 46 were wild and 20 were farmed brook trout, in two different years. Microbiota data were obtained using a 16S metabarcoding approach by analyzing the V3-V4 hypervariable regions of the corresponding 16S rRNA. The data showed that the core microbiota of these species consist of Proteobacteria (Alpha- and Gammaproteobacteria), Actinobacteria, Firmicutes (Bacilli and Clostridia), and, only for farmed animals, Fusobacteria. The latter taxon's presence is likely related to the fishmeal-based diet administered to farmed brook trout. Indeed, alpha and beta diversity analysis showed differences between wild and farmed fish. Finally, statistically significant differences in the microbiota composition were observed between the intestinal walls and contents of wild fish, while no differences were detected in reared animals. Our work represents the first study on the intestinal microbiota of brook trout with respect to both farmed and wild specimens. Future studies might focus on the comparison of our data with those pertaining to other fish species and on the study of other portions of the brook trout intestine.

Successful Surgical Treatment of Anterior Fusion Cage Dislocation into the Cervical Esophagus

We report on a 50-year-old patient’s case, who underwent ventral and dorsal cervical fusion for polytrauma due to car accident. The patient suffered very rare complication of the surgery-cage dislocation into the cervical esophagus. He underwent multiple surgical interventions: ventral and dorsal cervical fusion, laminectomy, tracheostomy, epicystostomy, gastrostomy. The surgical treatment was divided into two stages. At the first stage, open cholecystectomy and gastrostomy correction were performed and at the second stage, extraction of the cage and closure of the esophageal wall defect were performed. To prevent failure of the sutures placed on the wound of the esophagus, the method of covering the suture line with a pedicled flap cut from the medial portion of the sternocleidomastoid muscle was used. The control X-Ray examination was performed at 6th p/o day, which reveals no extravasation and free passage of contrast to the stomach. The patient after almost a three-year break began peroral eating and was discharged the hospital at 10th p/o day. We consider, that the method of covering the suture line by pedicled flap from sternocleidomastoid muscle in cases of difficult suturing of defects of the cervical esophagus, is a good surgical option. Surgeons should be aware of the risk of cage dislocation of cervical fusion procedure.

Differentiation of strains in the lateral and medial bands of the iliofemoral ligament: A segmental approach.

Iliofemoral ligament strains have been assessed in a circumscribed portion, limiting the information regarding the strains in the proximal, mid and distal portions. The purpose of this study is to describe the longitudinal and transversal strain within the proximal, mid and distal portions of the lateral and medial bands of the iliofemoral ligament. Ten fresh cadaveric specimens were assessed. The iliofemoral ligaments were divided into medial and lateral bands. Hemispherical beads (2.6 mm) were placed on the lateral and medial borders of each band. Four positions were assessed: abduction, extension, internal and external rotations combined with extension. The hemispherical beads were scanned at the end range of motion using a laser scanner. The three-dimensional position of each bead was used to estimate longitudinal and transversal strains. A three-factor ANOVA was used to compare movements, borders, and portions within each ligament for longitudinal strains. A one-way ANOVA was used to compare transversal strains between portions. This technique showed mean reliability (ICC: 2, 1) of 0.90 ± 0.06. The external rotation showed the highest strains in both ligaments (p < 0.05). Abduction showed a significant difference between the lateral and medial borders in both bands (p = 0.001). Eight movement-border combinations showed a significant difference between proximal, medial, and lateral portions (p < 0.005). According to our results, there is a clear effect of portions (proximal, mid and distal) within the ligament and movements. Abduction shows the lowest strains longitudinally but the largest strains transversally. Although we do not know the impact of this phenomenon, future studies should assess the strains following hip arthroscopies. The latter might improve the impact of this procedure on hip biomechanics. Lastly, the iliofemoral ligament should be assessed using a segmental approach rather than as a complete unit.

Function and form of the shoulder in congenital and untreated growth hormone deficiency.

The shoulder is the most mobile joint in the entire human body. During arm elevation, it requires the integrity of a set of muscles, bones, and tendons. Individuals with short stature often need to raise their arms above the shoulder girdle and may have functional restriction or shoulder injuries. The impact of isolated GH deficiency (IGHD) on joints remains not well defined. The purpose of this work is to evaluate the function and structure of the shoulder in short-statured adult individuals with untreated IGHD due to the same homozygous mutation in the GHRH receptor gene. A cross-sectional study (evidence 3) was carried out in 20 GH-naive IGHD subjects and 20 age-matched controls. They completed the disabilities of the arm, shoulder, and hand (DASH) questionnaire and shoulder ultrasound (US). Thickness of the anterior, medial, and posterior portions of the supraspinatus tendon and of subacromial space was measured, and the number of individuals with tendinosis or tearing of the supraspinatus tendon was registered. DASH score was similar between IGHD and controls, but IGHD subjects complained less of symptoms (p = 0.002). The number of individual with tears was higher in the controls (p = 0.02). As expected, the absolute US measurements were lower in IGHD, but the magnitude of the reduction was most pronounced in the thickness of the anterior portion of the supraspinatus tendon. Adults with lifetime IGHD do not have functional shoulder restrictions, complain less of problems in performing upper extremity activities, and have fewer tendinous injuries than controls.

Unusual Presentation of Juvenile Rhabdomyosarcoma in the Temporomandibular Area: A Case Report

Rhabdomyosarcoma frequently affects the craniofacial region with a rapid growing pattern that usually results in swelling of the interested area. The present paper describes a peculiar occurrence of rhabdomyosarcoma in a 12-year-old boy and the importance of a careful evaluation of clinical history to choose the correct diagnostic strategy. The patient was evaluated in the orthodontics section of the Dental School of the University of Bologna by an orofacial pain specialist, with a compliance of excruciating pain around the right ear that occurred 4 months earlier after a sports trauma. The patient had been previously evaluated by a pediatrician and an ENT specialist who requested a computerized tomography that did not show pathological conditions in the head/neck district. The drug therapy for pain control was not effective. The clinical examination showed a severe limitation of mouth opening, periauricular paresthesia and mandibular hyperalgesia on the right side. The patient reported intermittent, very intense stabs of pain occurring every 5 min, with a continuous dull pain in the temporal area. A nuclear magnetic resonance was requested and showed the presence of a solid expansive lesion in the right pterygoid area that eroded the cranial base and the medial portion of the mandibular condyle. An incisional biopsy led to the diagnosis of embryonal rhabdomyosarcoma. This case report emphasizes the importance of not underestimating the presence of pain in young subjects, suggesting a proper approach to apparently simple clinical cases.

AIUM Practice Parameter for the Performance and Interpretation of Diagnostic Ultrasound of the Thyroid and Extracranial Head and Neck.

AIUM Practice Parameter for the Performance and Interpretation of Diagnostic Ultrasound of the Thyroid and Extracranial Head and Neck.

An anatomical study of the suboccipital cavernous sinus and its relationship with the myodural bridge complex.

The suboccipital cavernous sinus (SCS) and the myodural bridge complex (MDBC) are both located in the suboccipital region. The SCS is regarded as a route for venous intracranial outflow and is often encountered during surgery. The MDBC consists of the suboccipital muscles, nuchal ligament, and myodural bridge and could be a power source for cerebrospinal fluid circulation. Intracranial pressure depends on intracranial blood volume and the cerebrospinal fluid. Since the SCS and MDBC have similar anatomical locations and functions, the aim of the present study was to reveal the relationships between them and the detailed anatomical characteristics of the SCS. The study involved gross dissection, histological staining, P45 plastination, and three-dimensional visualization techniques. The SCS consists of many small venous sinuses enclosed within a thin fibrous membrane that is strengthened by a fibrous arch closing the vertebral artery groove. The venous vessels are more abundant in the lateral and medial portions of the SCS than the middle portion. The middle and medial portions of the SCS are covered by the MDBC. Type I collagen fibers arranged in parallel and originating from the MDBC terminate on the SCS either directly or indirectly via the fibrous arch. The morphological features of SCS revealed in this research could serve as an anatomical basis for upper neck surgical procedures. There are parallel arrangements of type I collagen fibers between the MDBC and the SCS. The MDBC could change the blood volume in the SCS by pulling its wall during the head movement.

Gametogenesis in two-year-old Siberian sturgeon hybrids in industrial fish farming

The paper presents a comparison of gonad development of two-yearold Siberian sturgeon × Amur sturgeon interspecific hybrid and Siberian sturgeon × Kaluga fish interspecific hybrid bred using a combination technology with a twoyear cycle in a recirculating aquaculture system of the Experimental Selection and Breeding Farm “Yakot” and in flow-through tanks at the Konakovo Division of the Branch for Freshwater Fisheries of the Federal State Budget Scientific Institution “Russian Federal Research Institute of Fisheries and Oceanography” (VNIIPRKH). To determine the synchronism of gonad development, a histological analysis of cranial, medial, and caudal portions of the testes and ovaries was performed at the end of breeding, with a thermal constant of 12,217 degree days. The study of gametogenesis in SS×KF and SS×AS hybrids showed that gonad maturity in the two-yearold hybrids corresponded to early maturity stage II. An examination of germ cell development in the left and right gonads during the early stages of gametogenesis revealed a similar pattern. The hybrids showed normal gonad development early in maturity. In females, the main parameter is cytological sex determination: the presence of zygotene oocytes and single-layer follicle basophilic oocytes. In males, secondary sperm cell multiplication occurs in the forming cysts. Early spermatogenic wave is observed in some cases, which suggests normal germ cell development in the studied hybrids. The studies show normal reproductive system development in females and males of the studied SS×KF and SS×AS hybrids at the age of two years.

The Spiral Lift: A Novel Twist on Body Contouring

Abstract Goals/Purpose Thigh lifts historically have been performed using a vertical excision to correct the horizontal laxity.1However, this leaves an unsightly scar when wearing shorts or a bikini bottom. More recently the horizontal scar saving thighplasty has been described, but this only addresses a limited medial portion of the thigh laxity.2While plastic surgeons perform abdominoplasty concurrently with medial thigh lifts,3 there is no described technique of this type of spiral lift in the literature. The spiral lift does not use liposuction of the medial thighplasty portion of the procedure as is used in many of the published techniques.4 Moreover, compared to other described horizontal thigh lift techniques, which use a much smaller horizontal incision,5 the spiral lift extends this incision in the groin crease and into the inferior gluteal crease, resulting in a longer but very well hidden incision. This provides maximal lift of the entire thigh while avoiding a vertical scar. Our goal was to develop a technique to lift the medial and lateral aspect of the leg and the buttock skin while also minimizing visible scarring. Methods/Technique The lower abdominoplasty/belt lipectomy incision is designed in the pre-operative area such that the post-operative incision will be hidden in a pair of underwear of choice. The thighplasty incisions are designed in the groin crease, continuing into the lower abdominoplasty incision, and extend posteromedially around into the inferior gluteal crease. A pinch test is used to determine the appropriate amount of tissue that can be excised. The patient is intubated on the stretcher, then flipped into the prone position on an OR bed. Excision is performed to the level of the thoracolumbar fascia on the back and Scarpa’s fascia for the thighs to avoid the posterior cutaneous nerve. Two drains are left in the back. Following closure, the patient is flipped supine onto a second OR bed. A standard abdominoplasty is then performed in continuation with the back incision to complete the belt lipectomy. The anterior medial thigh excision is again performed at the level of Scarpa’s fascia, staying superficial in the region of the femoral vessels and lymphatics. Two drains are placed anterior in the abdomen. Results/Complications A total of 12 pts have undergone a full belt lipectomy with the spiral lift thighplasty since it first was performed in July 2019. This technique has shown good cosmetic results (Figures 1&amp;2), providing a circumferential vertical lift of the buttock and entire thigh while also addressing the abdomen and back. We have had good success in both men and women. This procedure is especially beneficial for massive weight loss patients, but we have also done the spiral thigh lift with abdominoplasties not requiring circumferential body lift. Five patients also underwent additional concurrent procedures involving the breast (mastopexy, augmentation, etc). Some patients had same day surgery (7), while five were observed overnight. The patients do tend to get some mild swelling of the mons. Scrotal swelling can be minimized with scrotal elevation and compression. Three patients had dehiscence of the thigh wounds, two of which were minor and were managed with dressing changes. One was caused by a fall at home and required return to the operating room for repair, but also had subsequent dehiscence requiring dressing changes. This was one of two patients that were re-admitted following the procedure, the other being a patient admitted for UTI sepsis 10 days after surgery. Forty-two percent of patients have had minor revisions following the procedure, 80% of which are performed concurrently with another primary surgery (eg. brachioplasty, cervicoplasty). One patient experienced transient lymphedema of the bilateral thighs. We have experienced no major infections. Some patients have experienced descent of the anterior medial thigh incision, visible in bikini bottoms. Conclusion The spiral lift is a technique that can successfully achieve a full body lift and address the thigh laxity circumferentially while completely hiding the scars in the underwear lines or natural skin creases.

V10-01 A COMPREHENSIVE REVIEW OF NEUROANATOMY, PROSTATE ANATOMY AND PERI-PROSTATIC STRUCTURES

You have accessJournal of UrologyCME1 Apr 2023V10-01 A COMPREHENSIVE REVIEW OF NEUROANATOMY, PROSTATE ANATOMY AND PERI-PROSTATIC STRUCTURES Sneha Parekh and Ashutosh Tewari Sneha ParekhSneha Parekh More articles by this author and Ashutosh TewariAshutosh Tewari More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003328.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: We aim to present the most revised anatomy of prostate, surrounding structures and its neuroanatomy in the form a 3D animated video. METHODS: We searched the PubMed database to identify original and review articles that addressed the anatomy of the prostate and relevant surrounding structures, with an emphasis on work published from July 2002 to January 2022. Understanding the findings in literature, we applied this knowledge and created a 3D animation video. RESULTS: Laterally the prostate is surrounded by the Endopelvic fascia, which has Parietal and medially has prostatic fascia. Ventrally prostatic capsule attached to Anterior Fibromuscular Stroma (AFMS), reaches postero-lateral prostate embracing Neurovascular bundle (NVB) medially and becomes pararectal fascia covering the rectum. The detrusor apron is an extension of anterior wall of bladder towards posterior area of pubic bone and contributes to AFMS. The urethral sphincter complex consists of external rhabdosphincter, inner lissosphincter and membranous urethra. Seminal Vesicles(SV) and Vas Deferens (VD) are extra peritoneal tubular structures, located at base of prostate, surrounded by major nerves posterolaterally, associations with Proximal neurovascular plate (PNP). Prostate with surrounding structures is supplied by autonomic and somatic branches originating from lower (T11-L2) and (S2-S4). Nerve fibers from centers coalesce to form pelvic plexus, aka PNP.The autonomic fibers from PNP are distributed into NVB and ANP (Accessory Neural Pathway) in a spray like pattern, with 60% of fibers on postero-lateral and 40% on antero-lateral prostate.DVC is composed of nerve fibers, dorsal veins and prostatic arteries. The puboprostatic ligamentous complex comprises of puboprostatic ligaments, arcus tendineus, and puboperinealis muscle. The puboprostatic ligaments are dense pyramid-shaped medial portions of distal endopelvic fascia. The puboperinealis is a paired muscle that originates from pubis, flanks prostatic-urethral junction, terminates at perineal body. CONCLUSIONS: Prostate is a dense fibromuscular gland, situated in the true pelvis surrounded by a compact multi-layered fascia with intermingling nerves and vessels.The nerves from the lumbar and sacral roots along with somatic supply form the pelvic plexus, further giving the prostatic neural hammock. This forms the basis of nerve sparing and its grades. Puboprostatic ligamentous complex along with peri-prostatic fascia and detrusor apron support the prostate and has a role in erectile and continence. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e926 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sneha Parekh More articles by this author Ashutosh Tewari More articles by this author Expand All Advertisement PDF downloadLoading ...

The regenerative treatment of costal osteochondral graft implantation for partial growth arrest using a rabbit model

PurposeTo investigate the feasibility of cylindrical costal osteochondral graft transplantation as a novel regenerative treatment in growth arrest. MethodsThe medial portion of the proximal tibial growth plate of 6-week-old male New Zealand White rabbits was resected to establish an experimental model of partial growth plate injury. The rabbits were divided into four groups: no-treatment, bone wax transplantation, costal chondral graft, and costal osteochondral graft groups. Radiographic and micro-computed tomography scan results were analyzed to evaluate angular deformity of the tibia and bony bridge formation at the injury site. In addition, repair of the injured growth plate cartilage was assessed histologically at 4, 8, and 12 weeks postoperatively. ResultsRadiographic examination revealed that bone wax transplantation continuously decreased the medial proximal tibial angle (MPTA) while the costal chondral graft implantation reduced the decrease of MPTA at 12 weeks postoperatively. The costal osteochondral graft implantation recovered the MPTA, close to the normal. Histologically, the costal osteochondral grafts retained the MPTA in the injured site compared to costal chondral grafts. Additionally, hypertrophic chondrocytes were observed at the graft site in the costal osteochondral graft group at 12 weeks, suggesting that endochondral ossification may occur at the graft site similar to normal ossification. The fluorescence in situ hybridization analysis of osteochondral grafts transplanted from male to female rabbits indicated that they were replaced by cells of host origin. ConclusionThe costal osteochondral graft can achieve regeneration without bony bridge formation in partial growth plate injury.

Semantic cognition in healthy ageing: Neural signatures of representation and control mechanisms in naming typical and atypical objects

Effective use of conceptual knowledge engages semantic representation and control processes to access information in a goal-driven manner. Neuropsychological findings of patients presenting either degraded knowledge (e.g., semantic dementia) or disrupted control (e.g., semantic aphasia) converge with neuroimaging evidence from young adults, and delineate the neural segregation of representation and control mechanisms. However, there is still scarce research on the neurofunctional underpinnings of such mechanisms in healthy ageing. To address this, we conducted an fMRI study, wherein young and older adults performed a covert naming task of typical and atypical objects. Three main age-related differences were found. As shown by age group and typicality interactions, older adults exhibited overactivation during naming of atypical (e.g., avocado) relative to typical concepts in brain regions associated to semantic representation, including anterior and medial portions of left temporal lobe (respectively, ATL and MTG). This provides evidence for the reorganization of neural activity in these brain regions contingent to the enrichment of semantic repositories in older ages. The medial orbitofrontal gyrus was also overactivated, indicating that the processing of atypical concepts (relative to typical items) taxes additional control resources in the elderly. Increased activation in the inferior frontal gyrus (IFG) was observed in naming typical items (relative to atypical ones), but only for young adults. This suggests that naming typical items (e.g., strawberry) taxes more on control processes in younger ages, presumably due to the semantic competition set by other items that share multiple features with the target (e.g., raspberry, blackberry, cherry). Together, these results reveal the dynamic nature of semantic control interplaying with conceptual representations as people grow older, by indicating that distinct neural bases uphold semantic performance from young to older ages. These findings may be explained by neural compensation mechanisms coming into play to support neurocognitive changes in healthy ageing.

A Postsynaptic Density Immediate Early Gene-Based Connectome Analysis of Acute NMDAR Blockade and Reversal Effect of Antipsychotic Administration.

Although antipsychotics' mechanisms of action have been thoroughly investigated, they have not been fully elucidated at the network level. We tested the hypothesis that acute pre-treatment with ketamine (KET) and administration of asenapine (ASE) would modulate the functional connectivity of brain areas relevant to the pathophysiology of schizophrenia, based on transcript levels of Homer1a, an immediate early gene encoding a key molecule of the dendritic spine. Sprague-Dawley rats (n = 20) were assigned to KET (30 mg/kg) or vehicle (VEH). Each pre-treatment group (n = 10) was randomly split into two arms, receiving ASE (0.3 mg/kg), or VEH. Homer1a mRNA levels were evaluated by in situ hybridization in 33 regions of interest (ROIs). We computed all possible pairwise Pearson correlations and generated a network for each treatment group. Acute KET challenge was associated with negative correlations between the medial portion of cingulate cortex/indusium griseum and other ROIs, not detectable in other treatment groups. KET/ASE group showed significantly higher inter-correlations between medial cingulate cortex/indusium griseum and lateral putamen, the upper lip of the primary somatosensory cortex, septal area nuclei, and claustrum, in comparison to the KET/VEH network. ASE exposure was associated with changes in subcortical-cortical connectivity and an increase in centrality measures of the cingulate cortex and lateral septal nuclei. In conclusion, ASE was found to finely regulate brain connectivity by modelling the synaptic architecture and restoring a functional pattern of interregional co-activation.

Three Zone Scanning Protocol For Lung Ultrasound: An Anatomical Basis.

Lung ultrasound is rapidly gaining popularity based on point of care ease of use, diagnostic fidelity and lack of ionizing radiation. This was particularly notable at the beginning of the COVID-19 pandemic, where concerns of contamination of the x-ray department led to a reluctance to order frequent chest x-rays. Early COVID-19 lung involvement is of a bronchopneumonia, and patches of consolidation adjacent to the chest wall were easily detectable by ultrasound. A large number of proposed scanning protocols were advocated and are often complex and largely based on traditional stethoscope examination or access points on the chest wall rather than the underlying lung anatomy. A surgical understanding of lung anatomy and related surface anatomy has led us to develop a simplified three zone scanning protocol in 2013. The anterior zone corresponds to the upper lobe, and the posterior zone is divided between upper lobe and lower lobe. The relationship between lung lobes and the surface of the chest wall provides the anatomical basis for a simple three scanning zone lung ultrasound protocol.

A New Giant Petrel (Macronectes, Aves: Procellariidae) from the Pliocene of Taranaki, New Zealand

A new species of giant petrel, Macronectes tinae sp. nov., is described from the Pliocene deposits of South Taranaki, New Zealand. The holotype is a near complete skull and the paratype a fragmentary left humerus; both come from the Tangahoe Formation, dating from the late Pliocene (Piacenzian or “Waipipian”; age estimated as ca. 3.36–3.06 Ma). The new species of giant petrel is the first fossil Macronectes ever reported. It is morphologically similar to the two present-day Macronectes spp., but it was a smaller bird. The skull is diagnosed by its overall smaller size, a proportionately longer apertura nasi ossea, and potentially by a shorter os supraocciptale. The humerus is diagnosed from both species by a proportionately less deep shaft, a more prominent medial portion of the epicondylus ventralis, and a larger and fusiform fossa medialis brachialis. The Tangahoe Formation is proving to be a remarkable source of marine vertebrate fossils and an important piece of the puzzle in understanding the evolution and biogeography of seabirds.

Multiportal Combined Endoscopic Endonasal and Transorbital Pathways: Qualitative and Quantitative Anatomic Studies of the "Connection" Skull Base Areas.

Combined endonasal and transorbital multiportal surgery has been recently described for selected skull base pathologies. Nevertheless, a detailed anatomic description and a quantitative comprehensive anatomic study of the skull base areas where these 2 endoscopic routes converge, a so-called connection areas, are missing in the scientific literature. To identify all the skull base areas and anatomic structures where endonasal and transorbital endoscopic avenues could be connected and combined. Five cadaveric specimens (10 sides) were used for dissection. Qualitative description and quantitative analysis of each connection areas were performed. At the anterior cranial fossa, the connection area was found at the level of the sphenoid planum; in the middle cranial fossa, it was at the Mullan triangle; finally, in the posterior cranial fossa, the connection area was just behind the medial portion of the petrous apex. The average extradural working areas through the transorbital approach were 4.93, 12.93, and 1.93 cm 2 and from the endonasal corridor were 7.75, 10.45, and 7.48 cm 2 at the level of anterior, middle, and posterior cranial fossae, respectively. The combined endonasal and transorbital endoscopic approach is an innovative entity of skull base neurosurgery. From the anatomic point of view, our study demonstrated the feasibility of this combined approach to access the entire skull base, by both corridors, identifying a working connection area in each cranial fossa. These data could be extremely useful during the surgical planning to predict which portion of a lesion could be removed through each route and to optimize patients' care.

JS-NG-3: UNIQUE IMAGING FINDINGS IN RENAL ARTERY FIBROMUSCULAR DYSPLASIA

A 35-year-old female patient with fluctuating blood pressure was referred to hypertension department for investigation of possible secondary hypertension. Computed tomographic angiography (CTA) of the renal arteries was performed, demonstrating abnormal right renal artery at the medial portion of the vessel with complete tubular narrowing and right kidney atrophy (right 79*35 mm, left 109*45 mm) (Panel A). Subsequent renal arteriography confirmed the long tubular narrowed right renal artery (Panel C) and the established severe tortuosity collateral vessel from the abdominal aorta (Panel B). The etiological diagnosis of the renal artery stenosis in this young woman was challenging and was supposed to be congenital renal dysplasia. Catheter-based angioplasty was not recommended. However, intravascular ultrasound (IVUS) revealed that it was not congenital narrowed artery, but concentric intimal-medial thickening caused stenosis of the vessel (Panel E). Therefore, renal artery fibromuscular dysplasia (FMD) was diagnosed and considered to be intimal type. Balloon angioplasty was performed, and IVUS showed that the lesion lumen was dilated successfully (Panel F). However, a bailout stent had to be placed because of intimal dissection during angioplasty, and renal blood flow was restored after procedure (Panel D). One month after the procedure, the patient was normotensive without any antihypertensive medication. At 1 year follow-up, the 99mTc-glomerular filtration rate of the right kidney increased from 19.7 to 40.4 ml/min. FMD is a nonatherosclerotic, noninflammatory vascular disease that most commonly affects renal arteries and is recommended to be classified according to angiographic finding as multifocal FMD or focal FMD. Compared with multifocal FMD, focal FMD is less often seen, and the diagnosis of some cases is challenging. In the present case, such a long tubular stenosis of renal artery is rare, and the diagnosis was confirmed by IVUS. IVUS may be a useful tool for the diagnosis of focal FMD.

Disrupted topological organization of functional brain networks in Alzheimer’s disease patients with depressive symptoms

BackgroundDepression is a common symptom of Alzheimer’s disease (AD), but the underlying neural mechanism is unknown. The aim of this study was to explore the topological properties of AD patients with depressive symptoms (D-AD) using graph theoretical analysis.MethodsWe obtained 3-Tesla rsfMRI data from 24 D-AD patients, 20 non-depressed AD patients (nD-AD), and 20 normal controls (NC). Resting state networks were identified using graph theory analysis. ANOVA with a two-sample t-test post hoc analysis in GRETNA was used to assess the topological measurements.ResultsOur results demonstrate that the three groups show characteristic properties of a small-world network. NCs showed significantly larger global and local efficiency than D-AD and nD-AD patients. Compared with nD-AD patients, D-AD patients showed decreased nodal centrality in the pallidum, putamen, and right superior temporal gyrus. They also showed increased nodal centrality in the right superior parietal gyrus, the medial orbital portion of the right superior frontal gyrus, and the orbital portion of the right superior frontal gyrus. Compared with nD-AD patients, NC showed decreased nodal betweenness in the right superior temporal gyrus, and increased nodal betweenness in medial orbital part of the right superior frontal gyrus.ConclusionsThese results indicate that D-AD is associated with alterations of topological structure. Our study provides new insights into the brain mechanisms underlying D-AD.

In vitro anthelmintic activity of Lippia alba essential oil chemotypes against Haemonchus contortus

The aim of the present study was to evaluate the effects of the essential oils of Lippia alba chemotypes carvone and citral on H. contortus. Chemical characterization was performed by means of gas chromatography coupled to mass spectrometry (GC/MS). The anthelmintic effects of the essential oils were assessed through the egg hatch test (EHT) and the adult worm motility test (AWMT) using a multidrug-resistant H. contortus Kokstad isolate. Confocal laser scanning microscopy (CLSM) of eggs and adults of H. contortus and scanning electron microscopy (SEM) of adults were performed after treatment with oils for qualitative observations of their effects. The carvone chemotype of L. alba (LaCV) presented 70% carvone, and the citral chemotype of L. alba (LaCT) presented 29.4% geranial and 20.4% neral, respectively. In the EHT, the EC50 values of LaCV and LaCT were 0.2 and 0.3 mg/mL, respectively. In AWMT, after 12 h of exposure to 2 mg/mL LaCV and 2 mg/mL LaCT, 100% of adult nematodes were immobile. CLSM showed changes in larval motility inside the egg caused by LaCV, while LaCT promoted changes in larval formation. In adults exposed to both chemotypes, alterations in the anterior portion of the oesophagus were observed. In SEM, morphological changes were observed in the buccal capsule and in the medial portion of H. contortus adults. It is concluded that the two essential oils of L. alba, the chemotypes carvone and citral, caused morphological changes and inhibited the hatching of eggs and the motility of adult H. contortus nematodes.

Morphological Analysis of the Sylvian Fissure Stem to Guide a Safe Trans-sylvian Fissure Approach.

The sylvian fissure stem and its deep cisternal part (SDCP) consist mainly of the orbital gyrus (OG) and anterior medial portion of the temporal lobe. SDCP's adhesion has been found to make a trans-sylvian approach difficult due to the various patterns of adhesion. Thus, in this study, we aim to clarify the morphological features of the SDCP, and to guide a safe trans-sylvian approach. We retrospectively classified the morphology of the SDCP in 81 patients into 3 types (tight, moderate, loose type) according to the degree of adhesion of the arachnoid membrane and analyzed the morphological features of the OG and the temporal lobe using intraoperative video images. In addition, we have retrospectively measured each width of the SDCP's subarachnoid space at the three points (Point A, lateral superior portion; Point B, downward portion; Point C, medial inferior portion of SDCP) and analyzed their relationship to the degree of adhesion using the preoperative coronal three-dimensional computed tomography angiography (3D-CTA) images of 44 patients. As per the results, SDCP's adhesions were determined to be significantly tighter in cases with large OG and young cases. The temporal lobe had four surfaces (posterior, middle, anterior, and medial) that adhered to the OG in various patterns. The tighter the adhesion between the OG and each of the three distal surfaces of the temporal lobe, the narrower the width of the subarachnoid space at each point (A, B, C). Understanding of the morphological features of the SDCP, and estimating its adhesion preoperatively are useful in developing a surgical strategy and obtaining correct intraoperative orientation in the trans-sylvian approach.