Sagittal Thickness Research Articles

Diagnostic value and efficacy evaluation value of transvaginal color doppler ultrasound parameters for uterine scar pregnancy and sub-type after cesarean section

ObjectiveWe aimed to probe the diagnostic value of transvaginal color Doppler ultrasound (TV-CDU) parameters in cesarean scar pregnancy (CSP) and CSP sub-types, and the relevant factors affecting patients’ surgical effects.MethodsSeventy-five CSP patients (all requested termination of pregnancy) were selected as the observation group, and 75 normal pregnant women with a history of cesarean section were selected as the control group. All the study subjects underwent TV-CDU and their cesarean scar muscle (CSM) thickness, minimum sagittal muscle thickness and resistance index (RI) of blood flow in the anterior wall of the lower uterine segment were calculated. The diagnostic value of CSM, minimum sagittal muscle thickness, and RI for CSP and CSP sub-types was analyzed. The patients in the observation group were grouped into the effective group and the ineffective group according to whether the surgical treatment was effective or not, and the independent factors affecting CSP efficacy were analyzed.ResultsThe observation group had lower CSM, minimum sagittal muscle thickness and RI than the control group. CSM, RI, and minimum sagittal thickness in patients with type II CSP were lower than those in patients with type I, and these indicators in patients with type III were lower than those in patients with type II. The area under the curve (AUC) of CSM, RI and minimum sagittal muscle thickness in combination for CSP diagnosis and the AUC for CSP sub-types were higher than those of each indicator alone. Gestational sac size and CSM were independent factors affecting CSP treatment.ConclusionChanges in TV-CDU parameters facilitates CSP diagnosis after cesarean section. CSM, minimum sagittal muscle thickness changes, and RI in combination possesses high value for CSP diagnosis and CSP sub-types. Gestational sac size and CSM are independent factors affecting CSP treatment.

The study of the number and localization of the nutrient foramen on the clavicle and its relationship with other clavicle parameters.

Nutrient foramen (NF) is a hole on the long bones that allows the passage of the nutrient artery. The vasculature of the bone is very important for fracture healing and vascularized bone grafting. Therefore, information about the location and number of NFs is important for surgical and clinical practice. The clavicle is the most commonly fractured bone. The aim of this study was to analyze the relationship between the location and number of NFs on the clavicle and other clavicle parameters. This study was performed on 86 dry clavicles of contemporary adult individuals without age and gender records. Some clavicle parameters and NF parameters were measured and the relationship between them was analyzed. Measurements were performed using a digital caliper. Most of the clavicles had a single NF. There was a positive correlation between DFant/DFpost (distance between NF and anterior border/distance between NF and posterior border) and vertical thickness of sternal end (VTs), vertical thickness of thinnest point (VTt) and clavicular thinnest point index (CIt) in all cases (p < 0.05). Sagittal thickness of acromial end (STa), vertical thickness of clavicle (VTc), sagittal thickness of clavicle (STc) and sagittal thickness of thinnest point (STt) were associated with NF counts. The most common localization of NFs was type 2. The NFs were mostly located in the inferior position. Relationships between the number and morphometric characteristics of NFs and some clavicle parameters were determined. It was suggested that the knowledge of the number and morphometric characteristics of NFs is important for the protection of the nutrient artery in orthopedic surgery applications.

Optical development in the murine eye lens of accelerated senescence-prone SAMP8 and senescence-resistant SAMR1 strains

The eye lens is responsible for focusing objects at various distances onto the retina and its refractive power is determined by its surface curvature as well as its internal gradient refractive index (GRIN). The lens continues to grow with age resulting in changes to the shape and to the GRIN profile. The present study aims to investigate how the ageing process may influence lens optical development. Murine lenses of accelerated senescence-prone strain (SAMP8) aged from 4 to 50 weeks; senescence-resistant strain (SAMR1) aged from 5 to 52 weeks as well as AKR strain (served as control) aged from 6 to 70 weeks were measured using the X-ray interferometer at the SPring-8 synchrotron Japan within three consecutive years from 2020 to 2022. Three dimensional distributions of the lens GRIN were reconstructed using the measured data and the lens shapes were determined using image segmentation in MatLab. Variations in the parameters describing the lens shape and the GRIN profile with age were compared amongst three mouse strains. With advancing age, both the lens anterior and posterior surface flattens and the lens sagittal thickness increase in all three mouse strains (Anterior radius of curvature increase at 0.008 mm/week, 0.007 mm/week and 0.002 mm/week while posterior radius of curvature increase at 0.002 mm/week, 0.007 mm/week and 0.003 mm/week respectively in AKR, SAMP8 and SAMR1 lenses). Compared with the AKR strain, the SAMP8 samples demonstrate a higher rate of increase in the posterior curvature radius (0.007 mm/week) and the thickness (0.015 mm/week), whilst the SAMR1 samples show slower increases in the anterior curvature radius (0.002 mm/week) and its thickness (0.013 mm/week). There are similar age-related trends in GRIN shape in the radial direction (in all three types of murine lenses nr2 and nr6 increase with age while nr4 decrease with age consistently) but not in the axial direction amongst three mouse strains (nz1 of AKR lens decrease while of SAMP8 and SAMR1 increase with age; nz2 of all three models increase with age; nz3 of AKR lens increase while of SAMP8 and SAMR1 decrease with age). The ageing process can influence the speed of lens shape change and affect the GRIN profile mainly in the axial direction, contributing to an accelerated decline rate of the optical power in the senescence-prone strain (3.5 D/week compared to 2.3 D/week in the AKR control model) but a retardatory decrease in the senescence-resistant strain (2.1 D/week compared to the 2.3D/week in the AKR control model).

Dimensional changes of Hoffa’s fat pad related to aging: evaluation by MRI

BackgroundHoffa's fat pad is an intra-capsular extra-sinovial structure of the knee joint that has a significant biomechanical and metabolic role, minimizing the influence of stresses created by loading and generating cytokines. Changes in its size can lead to variations in the homeostasis of the knee in elderly patients. This work intends to assess the dimensional variations of Hoffa's fat pad associated to aging in both sexes, using MRI sagittal sequences acquired from the OAI (Osteoarthritis Initiative) database.MethodsWe examined the Hoffa's fat pad sagittal thickness in 217 men and women with knee osteoarthritis who were grouped into four age groups for the study: 40–49; 50–59; 60–69; and 70–80. 3T sagittal IW 2D TSE Fat-suppressed MRI sequences, taken from the OAI (Osteoarthritis Initiative) database, were examined.ResultsHoffa’s fat pad thickness was shown to differ significantly between groups in both men and women, decreasing in the older individuals' groups (R = − 0.46; p 0.0001). By dividing the patients into ten-year age groups and by sex, the thickness of both the right knee and the left knee was examined. In fact, the average thickness of Hoffa's fat pad of the right knee was reported to be, in males, 33.6+/− 3 mm in subjects aged between 40 and 49 years, 31+/− 2.4 mm for patients aged between 50 and 59, 30.3 ± 1.8 mm in the group between 60 and 69 years and 28.7+/− 1.8 mm between 70 and 80 years. In women the values obtained were the following: 29+/− 1.6 mm between 40 and 49 years; 28.9+/− 2.6 mm in the group between 50 and 59 years, 25.3+/− 1.9 mm for patients aged 60 and 69 years and 26+/− 2 mm between 70 and 80 years. Similar results were obtained for the left knee.ConclusionsHoffa’s fat pad gradually thins with aging in both male and female patients with knee osteoarthritis, and this can be detected by evaluating the thickness of the fat pad on sagittal MRI sequences.

Quadriceps Tendon Autograft in Pediatric Anterior Cruciate Ligament Reconstruction: Graft Dimensions and Prediction of Size on Preoperative Mri

Background:There has been a growth of interest in quadriceps autograft anterior cruciate ligament (ACL) reconstruction in the pediatric population.Hypothesis/Purpose:The goal of this study was to evaluate children and adolescents who underwent ACL reconstruction using a quadriceps autograft to determine the properties of the harvested graft and to assess the value of demographic, anthropometric, and MRI measurements in predicting the graft size preoperatively.Methods:A retrospective IRB-approved database search was performed from January 2018 through October 2020 for patients undergoing ACL reconstruction. Patients <18 years old at the time of surgery in whom a quadriceps tendon autograft was used were selected. Demographic data and anthropometric measurements were recorded and graft measurements were abstracted from the operative note. Knee magnetic resonance images (MRI) were reviewed to measure the quadriceps tendon thickness on sagittal cuts (Figure 1). Graft length and diameter were then correlated with anthropometric and radiographic data.Results:A total of 169 patients (98 male) were included in the final analysis, with a median age of 15 years (range, 9-17). A tendon length of 65mm or more was harvested in 159 (94%) patients. The mean final graft diameter was 8.4 ± 0.7mm (range, 7 – 11mm) (Table 1). All patients had a graft diameter of 7mm or more, and 139 (82%) had a diameter of 8mm or larger. Preconditioning decreased the graft diameter by a mean of 0.68 ± 0.23mm. Age (P=0.04) and quadriceps thickness on MRI (P<0.001) were significant predictors of the final graft diameter. An MRI sagittal thickness of >6.7mm was 97.4% sensitive for obtaining a graft of ≥8mm in diameter.Conclusion:Our findings suggest that tendon-only quadriceps autograft is a reliable graft source in the pediatric ACL reconstruction, yielding a graft of ≥8mm in diameter in 82% of pediatric patients. Furthermore, preoperative MRI measurements can be reliably used to predict a graft of adequate diameter in children and adolescents undergoing ACL reconstruction, with a sagittal thickness of >6.7mm being highly predictive of a final graft size ≥8mm.Table 1.Univariable and multivariable logistic regression models predicting a final graft diameter of 8mm or more. Significant predictors are indicated in bold. 95%CI: 95% Confidence interval, BMI: body mass index.Figure 1.Preoperative knee sagittal proton density-weighted MRI of a 13-year-old boy with ACL tear. Quadriceps tendon sagittal thickness was measure 1cm above the patella. The three layers of the quadriceps tendon (vastus medialis/lateralis, rectus, intermedius) are also visible in this image.

Quadriceps Tendon Autograft in Pediatric ACL Reconstruction: Graft Dimensions and Prediction of Size on Preoperative MRI

Background:There is increased interest in quadriceps autograft anterior cruciate ligament (ACL) reconstruction in the pediatric population.Purpose:To evaluate children and adolescents who underwent ACL reconstruction using a quadriceps autograft to determine the properties of the harvested graft and to assess the value of demographic, anthropometric, and magnetic resonance imaging (MRI) measurements in predicting the graft size preoperatively.Study Design:Cross-sectional study; Level of evidence, 3.Methods:A retrospective database search was performed from January 2018 through October 2020 for patients undergoing ACL reconstruction. Patients <18 years old at the time of surgery in whom a quadriceps tendon autograft was used were selected. Demographic data and anthropometric measurements were recorded, and graft measurements were abstracted from the operative notes. Knee MRI scans were reviewed to measure the quadriceps tendon thickness on sagittal cuts. Graft length and diameter were then correlated with anthropometric and radiographic data.Results:A total of 169 patients (98 male) were included in the final analysis, with a median age of 15 years (range, 9-17 years). A tendon length ≥65 mm was harvested in 159 (94%) patients. The final graft diameter was 8.4 ± 0.7 mm (mean ± SD; range, 7-11 mm). All patients had a graft diameter ≥7 mm, and 139 (82%) had a diameter ≥8 mm. Preconditioning decreased the graft diameter by a mean 0.67 ± 0.23 mm. Age (P = .04) and quadriceps thickness on MRI (P = .003) were significant predictors of the final graft diameter. An MRI sagittal thickness >6.7 mm was 97.4% sensitive for obtaining a graft ≥8 mm in diameter.Conclusion:Our findings suggest that tendon-only quadriceps autograft is a reliable graft source in pediatric ACL reconstruction, yielding a graft diameter ≥8 mm in 82% of pediatric patients. Furthermore, preoperative MRI measurements can be reliably used to predict a graft of adequate diameter in children and adolescents undergoing ACL reconstruction, with a sagittal thickness >6.7 mm being highly predictive of a final graft size ≥8 mm.

On the contribution of the nucleus and cortex to human lens shape and size

BackgroundThe shape of the human lens changes from almost spherical at birth to ellipsoid due to a decrease in sagittal thickness and an increase in equatorial diameter during the first two decades of life. Both dimensions increase thereafter. This study was undertaken to determine the reason for the change.MethodsPublished refractive index gradients, from 20 lenses aged from seven to 82 years, were used to calculate the protein contents of concentric shells of fibre cells in human lenses. The boundaries of nuclear cores containing from 2.5 to 45 mg, in 2.5 mg increments, were determined from the isoindicial shells. Cortex thickness was determined from the distance between the 30 mg nuclear boundary and the capsule.ResultsThe sagittal thickness of every nuclear core decreased until age 40 years and remained constant thereafter. Over the same time frame, the equatorial diameter of the cores containing up to 30 mg of protein increased, while those of cores larger than 30 mg decreased. The volumes of the cores decreased and their shapes changed from near spherical to spheroidal. Equatorial and sagittal cortex thickness increased linearly with age at 0.0082 mm per year. The anterior sagittal cortex was 0.23 mm larger than the posterior and the equatorial cortex was 0.62 mm greater.ConclusionsChanges in lens shape observed during the first two decades of life are due to remodelling and compaction of the 30 mg nuclear core. Cortex growth is linear throughout life.

Cross Sectional Area of the Achilles Tendon in a Prospective Cohort of an Elite Military Population

Category: Ankle, Hindfoot Introduction/Purpose: The prevalence of Achilles tendon pathology is common in many sports and daily activities. From ruptures to overuse injuries resulting in tendonopathies, AT dysfunction can result in disability and reduced productively. Continued research that increases our knowledge base of normal Achilles tendon properties can improve our ability to reduce and prevent future AT injuries. In this study, we examined the cross-sectional area (CSA) of the Achilles tendon (AT) at multiple levels in an asymptomatic population of elite American military service members that participate in greater than 20 hours of intense training per week. Methods: We conducted a prospective cohort study composed of 41 active duty United States Army Rangers. The Rangers are a specialized infantry organization that participates in extensive military training and rigorous combat missions. The service members were voluntarily recruited to participate while deployed in a combat theater. All subjects were members of the Ranger Regiment participating in greater than 20 hours of intense bipedal non-sport weekly training with no history of AT pathology. In a standing position, each subject had bilateral Achilles insertion marked along with additional skin markings made at 2 cm, 4 cm, and 6 cm above the AT insertion. At all four levels, the AT was measured in the coronal and sagittal plains using ultrasound. Results: In 41 subjects, a total of 82 Achilles tendons were examined. The mean age of the cohort was 26 years, 70 inches tall, with a mean weight of 187 pounds. The mean sagittal thickness of the AT at the insertion was 4.3 mm, 2 cm above the insertion is was 4.3 mm, 4 cm above the insertion is was 4.2 mm, and at 6 cm above the insertion it was 4 mm. In the coronal plain was 19.1 mm, 14.3 mm, 13.5 mm, and 14.4 mm respectively. The cross-sectional area was calculated at each respective level: 0.65 cm2, 0.48 cm2, 0.44 cm2 and 0.45 cm2. The non-dominant ankle was slightly larger at each level but was not found to be statistically significant. Conclusion: These results provide the mean sagittal and coronal diameters of the Achilles tendon as measured by ultrasound throughout the watershed area of a young active adult male population. Our data also suggest that increased non-sport activity may not increase the cross-sectional area of the Achilles tendon. Identifying the normal diameter at multiple levels throughout the most commonly injured area can potentially improve the provider’s ability to identify early disease processes and apply targeted interventions to help slow or prevent progression and possible rupture.

Foramen arcuale: a rare morphological variation located in atlas vertebrae.

To investigate the incidence of foramen arcuale in dry atlas vertebrae which may cause clinical problems. Eighty-one dry human cervical vertebrae were examined. The evaluated parameters of two atlas vertebrae including foramen arcuale were as follows: maximum antero-posterior, transverse diameters and areas of the right and left superior articular facets and transverse foramina; maximum antero-posterior diameters, heights, areas and central sagittal thickness of bony arch forming roof of foramen arcuale, respectively. All parameters were measured with caliper in milimeters. Thirteen of eighty-one cervical vertebrae specimens (13/81, 16.05%) were atlas and the two of thirteen atlas vertebrae (2/13, 15.38%) had macroscopically complete foramen arcuale. Each of the two atlas vertebrae was including one foramen arcuale (one on the left and one on the right side). There was a statistically significant difference (p = 0.04) between the mean antero-posterior diameter of superior articular facet located on each side of atlas vertebrae, whereas not (p = 0.51) between mean antero-posterior diameter of transverse foramina. There was not any significant difference between the mean transverse diameters and areas of superior articular facets and transverse foramina located on each side of atlas vertebrae, respectively. Each of the areas of transverse foramina located on the same sides with foramen arcuale in two atlas vertebrae was less than the mean areas of transverse foramina located ipsilateral side with each foramen arcuale in thirteen atlas vertebrae. The present study provides additional information about the incidence and topography of the atlas vertebrae including foramen arcuale.

Morphometric study of the true S1 and S2 of the normal and dysmorphic sacralized sacra.

This study aimed to generate data for the S1 and S2 alar pedicle and body and the alar orientations for both dysmorphic and normal sacra. The study comprised two groups: Group N consisted of 53 normal sacra and Group D included 10 dysmorphic sacra. Various features such as alar pedicle circumference; anterior, middle, and posterior axis of the sacral ala; sacral body height and width; and sagittal thickness were measured. In group N, the median anterior axis of the alae was observed to be 30° on the right and 25° on the left, the median midline axis was found to be 20° on the right and 15° on the left, and the median posterior alar axis was -15° on the right and -20° on the left. The true S1 and S2 alar pedicle circumferences were observed to be significantly smaller in group D, which demonstrated a shorter S1 alar pedicle mean circumference, significantly narrower S1 body mean width, and considerably tapered sagittal thickness. Our analysis indicated that dysmorphic sacra have a lower sagittal thickness and width of bodies and smaller alar pedicles, which explains the difficulties in their percutaneous fixation.

Efficacy and safety of hyaluronic acid (500-730kDa) Ultrasound-guided injections on painful tendinopathies: a prospective, open label, clinical study.

Tendinopathies are conditions characterized by activity-induced pain, local tenderness and swelling for which a gold standard treatment is not established yet. Hyaluronic Acid (HA) is a key-molecule in several cellular activities and it is normally present in the extra-cellular matrix of tendons and ligaments. Amongst its properties, HA injections may reduce pain and determine disease-modifying effects. This study is an investigator-initiated open-label trial conducted to investigate the efficacy and safety of HA (500-730 kDa) peritendinous injections on pain reduction in patients affected by lateral elbow, Achilles or patellar tendinopathy. A total of 71 tendons (34 with Achilles tendinopathy, 26 with lateral elbow tendinopathy, 11 with patellar tendinopathy) of 62 patients with painful tendinopathy were treated with a cycle of ultrasound-guided peritendinous injections one injection per week for three consecutive weeks. Efficacy assessments included changes in pain intensity measured by Visual Analogue Scale (VAS) at follow-up evaluations were performed 7 (V2), 14 (V3) and 56 days aften first treatment. An Ultrasound (US) assessment was also performed to evaluate changes in tendon thickness and neovascularization. Adverse events were recorded for safety analysis throughout the study. All results were analyzed with descriptive statistics appropriate to the nature of the variables. Significant reduction in VAS (p<0.001) from baseline was observed in Achilles (-6.16 ± 0.45 cm), patellar (-6.16 ± 0.72 cm) and lateral elbow (-5.33 ± 0.43 cm) tendinopathies. The sagittal thickness decreased significantly from baseline at each endpoint (V3 day 14 and V4 day 56) in each type of tendinopathy analyzed (p<0.05). Neovascularization decreased for each tendons at V3 and V4, except for patellar tendon at V3 V1 (p=0.125). Nevertheless, reduction at V4 compared to baseline remained significant (p=0.016). US-guided HA (500-730 kDa) peritendinous injections determine significant pain relief and reduction in tendon thickness and neovascularization in US evaluations. The effect of HA did not show differences regarding the site of affected tendon. The treatment proved to be safe and very well tolerated. 4.

Nonhuman Primate Ocular Biometry.

PurposeTo examine ocular growth in nonhuman primates (NHPs) from measurements on ex vivo eyes.MethodsWe obtained NHP eyes from animals that had been killed as part of other studies or because of health-related issues. Digital calipers were used to measure the horizontal, vertical, and anteroposterior globe diameters as well as corneal horizontal and vertical diameters of excised globes from 98 hamadryas baboons, 551 cynomolgus monkeys, and 112 rhesus monkeys, at ages ranging from 23 to 360 months. Isolated lens sagittal thickness and equatorial diameter were measured by shadowphotogrammetry. Wet and fixed dry weights were obtained for lenses.ResultsNonhuman primate globe growth continues throughout life, slowing toward an asymptotic maximum. The final globe size scales with negative allometry to adult body size. Corneal growth ceases at around 20 months. Lens diameter increases but thickness decreases with increasing age. Nonhuman primate lens wet and dry weight accumulation is monophasic, continuing throughout life toward asymptotic maxima. The dry/wet weight ratio reaches a maximum of 0.33.ConclusionsNonhuman primate ocular globe and lens growth differ in several respects from those in humans. Although age-related losses of lens power and accommodative amplitude are similar, lens growth and properties are different indicating care should be taken in extrapolating NHP observations to the study of human accommodation.

The eye lens: age-related trends and individual variations in refractive index and shape parameters.

The eye lens grows throughout life by cell accrual on its surface and can change shape to adjust the focussing power of the eye. Varying concentrations of proteins in successive cell layers create a refractive index gradient. The continued growth of the lens and age-related changes in proteins render it less able to alter shape with loss of capacity by the end of the sixth decade of life. Growth and protein ageing alter the refractive index but as accurate measurement of this parameter is difficult, the nature of such alterations remains uncertain. The most accurate method to date for measuring refractive index in intact lenses has been developed at the SPring-8 synchrotron. The technique, based on Talbot interferometry, has an X-ray source and was used to measure refractive index in sixty-six human lenses, aged from 16 to 91 years. Height and width were measured for forty-five lenses. Refractive index contours show decentration in some older lenses but individual variations mask age-related trends. Refractive index profiles along the optic axis have relatively flat central sections with distinct micro-fluctuations and a steep gradient in the cortex but do not exhibit an age-related trend. The refractive index profiles in the equatorial aspect show statistical significance with age, particularly for lenses below the age of sixty that had capacity to alter shape in vivo. The maximum refractive index in the lens centre decreases slightly with age with considerable scatter in the data and there are age-related variations in sagittal thickness and equatorial height.

Reliability of Superficial Male Pelvic Floor Structural Measurements Using Linear-Array Transperineal Sonography

This study evaluated reliability of measures for superficial structures of the male pelvic floor (PF) obtained via transperineal sonography. Two embalmed cadavers were dissected to identify positioning of muscles on and around the bulb of the penis and to confirm the PF protocol. Cross-sectional area (CSA) and linear thickness of the bulb of the penis, urethra, bulbospongiosus (BS) muscles, and ischiocavernosus (IC) muscles were measured on 38 transverse images from 20 male patients by three raters with varied study knowledge and sonographic experience. Intra- and inter-rater reliability were calculated with two-way, mixed effects intra-class correlation coefficients. Measures of the bulb of the penis had the best reliability. CSA of all muscles and sagittal thickness of the BS near the central tendon had good reliability. Reliability varied for rater-identified thickest muscle region and measures of the urethra. Our study suggests that structures of the male PF can be reliably evaluated using a transperineal sonographic approach.

Force–Deformation Properties of the Human Heel Pad during Barefoot Walking

The plantar heel pad is a specialized fibroadipose tissue that attenuates and, in part, dissipates the impact energy associated with heel strike. Although a near-maximal deformation of the heel pad has been shown during running, an in vivo measurement of the deformation and structural properties of the heel pad during walking remains largely unexplored. This study used a fluoroscope, synchronized with a pressure platform, to obtain force-deformation data for the heel pad during walking. Dynamic lateral foot radiographs were acquired from 6 male and 10 female adults (mean ± SD; age = 45 ± 10 yr, height = 1.66 ± 0.10 m, and weight = 80.7 ± 10.8 kg) while walking barefoot at preferred speeds. The inferior aspect of the calcaneus was digitized, and the sagittal thickness and deformation of the heel pad relative to the support surface were calculated. A simultaneous measurement of the peak force beneath the heel was used to estimate the principal structural properties of the heel pad. Transient loading profiles associated with walking induced rapidly changing deformation rates in the heel pad and resulted in irregular load-deformation curves. The initial stiffness (32 ± 11 N·mm) of the heel pad was 10 times lower than its final stiffness (212 ± 125 N·mm), and on average, only 1.0 J of energy was dissipated by the heel pad with each step during walking. Peak deformation (10.3 mm) approached that predicted for the limit of pain tolerance (10.7 mm). These findings suggest that the heel pad operates close to its pain threshold even at speeds encountered during barefoot walking and provides insight as to why barefoot runners may adopt "forefoot" strike patterns that minimize heel loading.

Comparative Study of the Nasopharyngeal Airway Dimensions in Class II Individuals using Cone-beam Computed Tomography

Objectives: The aims of our study were to use cone-beam computed tomography (CBCT) to assess the dimensional changes in the nasopharyngeal soft-tissue characteristics in Indian patients with Class II malocclusion and to compare the results with patients with ideal occlusion. Materials and methods: A sample of 20 patients (10 girls, 10 boys) with Class II malocclusion due to true mandibular retrognathism was selected. None of the subjects had a history of upper airway disease, adenoidectomy, or pathology in the pharynx. Cone-beam computed tomography scans were taken to measure the nasopharyngeal airway changes in terms of linear measurements, and sagittal cross-sectional areas. Error analysis was performed to prevent systematic or random errors. Independent mean t-tests and Pearson correlation analysis were used to evaluate sex differences and the correlations among the variables. Results: Nasopharyngeal soft-tissue characteristics in Class II subjects were different in male and female subjects. Men with Class II malocclusion have larger adenoid width areas than do women. Men also had greater sagittal thickness of the lower airway. The retroglossal and the total airway area were significantly greater in the control group. Conclusion: This study suggests new lines of investigation about the relationship between skeletal and dental anomalies and airway obstruction, and possible specific respiratory characteristics for each type of malocclusion.

Some features of the developmental uterus in human fetuses

Proper development of each component of the reproductive tract is imperative for successful natural reproduction. The aim was to investigate some morphological features of the fetal uterus in early phases of its development. The uteruses of 65 fetuses of different gestational age were included and each of them was measured in three dimensions: uterine length (UL), uterine width (BC) and the antero-posterior (sagittal) thickness of the uterine fundus (FT) using ImageJ computer program. It was observed that the most intense fetal uterus growth occurred between seventh and eighth month of gestational age (between week 25 and 31). The most intense rate of uterine growth had UL and it showed steeper growth curve from the fourth month of gestational age. The values of UL, BC, FT showed statistically highly positive Pearson’s linear correlation with values of CRL, and GA, and among themselves. The strongest correlation was between UL and gestational age. Contrary to proved rising linear trends of UL/FT and UL/BC, BC/FT performed linear trend of decline. However, two divergent linear trends, one ascending (UL/FT), and other declining (BC/FT) have similar descent in values during the early gestational age, from week 12 to 15. Fetal uteruses did not grow at the same rate by all three measured dimensions, and each of measured dimensions has noticeable standard deviations during gestational periods, even with a resolution of a week, suggesting individuality of each human development/growth even during prenatal life.

The sagittal pelvic thickness: a determining parameter for the regulation of the sagittal spinopelvic balance.

Objective. To propose and validate a dimensional parameter, the sagittal pelvic thickness (SPT) (distance between the middle point of the upper sacral plate and the femoral heads axis, expressed as a ratio with the length of the upper plate of S1: (SPT/S1) for the analysis of the sagittal balance of the pelvispinal unit. Methods. The parameters were analysed on standing radiographic imaging and compared for normal, low back pain, children, and spondylolysis cases. Results. Values of SPT/S1 were observed significantly higher in high grade spondylolysis populations and in children (3,5 and 3,7) than in normal population (3,3). A geometrical connection with the classical angular parameters validated SPT/S1. Conclusion. SPT/S1 was considered reflecting the lever arm of action of spinopelvic muscles and ligaments and describing the ability of a subject to compensate a sagittal unbalance. It was proposed as an anatomical and functional pelvic parameter.

DEFORMATION OF THE HUMAN HEEL PAD DURING WALKING APPROACHES PREDICTED LIMITS OF PAIN TOLERANCE

BackgroundThe plantar heel pad is a specialised fibroadipose tissue that attenuates and dissipates, in part, the impact energy associated with heel strike. Although near maximal deformation of the heel pad...

Alterations of the Transverse Ligament: An MRI Study Comparing Patients With Acute Whiplash and Matched Control Subjects

The objective of our study was to evaluate whether there is injury to the transverse ligament of the atlas in patients with acute whiplash. Ninety patients with an acute (< 48 hours) symptomatic whiplash-associated injury and 90 healthy age- and sex-matched asymptomatic control subjects (mean age of patients and control subjects, 36 years) were included. The maximal sagittal thickness of the transverse ligament was measured on midsagittal T1 volumetric interpolated breath-hold examination (VIBE) images and transverse reformatted VIBE images. The signal intensity of the transverse ligament was measured on transverse STIR images and on transverse reformatted T1 VIBE images before and after IV administration of gadoterate. Contrast between the transverse ligament and CSF and alterations of contrast after gadoterate injection were calculated. Patients had a minimally thicker transverse ligament (posttraumatic swelling) than control subjects, and the difference in thickness was significant in men only (p = 0.03). In patients, a significant signal alteration of the transverse ligament (p = 0.03) was seen on STIR (posttraumatic edema) and native VIBE sequences. The contrast between the transverse ligament and the CSF on VIBE images was significantly (p = 0.005) lower in patients than in control subjects. With the application of a contrast agent, the contrast difference between the transverse ligament and CSF in patients and control subjects was less pronounced (p = 0.038). There was no abnormal uptake of contrast agent by the transverse ligament or CSF. The results of our study indicate possible involvement of the transverse ligament in whiplash injury. Although MRI may be helpful to study injury-related changes of anatomic structures in cohorts, it is not suited for individual diagnosis because the alterations are too small.