Transverse Diameter Research Articles

Characterization of granulation in citrus “Harumi” fruit during postharvest storage

Granulation is a serious physiological disorder in citrus fruit, which impairs the fruit quality and causes economic losses to the citrus industry. ‘Harumi’ ((Citrus unshiu × C. sinensis) × C. reticulate), a mandarin-type variety, is prone to granulation, especially after long-term storage. In the present study, to elucidate the molecular mechanism of granulation, physiochemical changes were investigated in the juice sacs of ‘Harumi’ during the granulation process. The results showed that large size fruit (L fruit, transverse diameter of 8.5 - 10.0 cm) was prone to granulation, while small size fruit (S fruit, transverse diameter of 5.0 - 6.5 cm) was not. In L fruit, lignin content increased rapidly, which was accompanied by the reduction of the content of sugars (fructose and glucose) and organic acid (citric acid) during the granulation process. Moreover, the occurrence of granulation inhibited carotenoid biosynthesis in the ‘Harumi’ fruit. In L fruit, the content of the major carotenoids, β-cryptoxanthin, all-trans-violaxanthin, and 9-cis-violaxanthin, were decreased during the granulation process, and as a result, total carotenoid content in L fruit was 75.8% lower than that in S fruit in the fifth month after harvest. The real-time PCR results showed that the expression of carotenoid biosynthetic genes (CitPSY, CitPDS, CitZDS, CitLCYb2, and CitHYb) was down-regulated, while the expression of carotenoid catabolic genes (CitNCED2 and CitNCED3) was up-regulated in L fruit during the granulation process. This study is the first to investigate the carotenoid metabolism during the granulation process, which will provide new insights into exploring the causes of granulation in citrus fruit.

Partially Lacerated Digital Flexor Tendons: A Cadaveric Study Determining the Intact Cross-sectional Area and Biomechanical Analysis.

The extent of injury in partially lacerated tendons has conventionally been expressed as a percentage of the total tendon, to justify surgical repair. We propose a more objective method to estimate the cross-sectional area of the remnant intact tendon and to determine if the remaining tendon fibers can withstand the tensile forces of early active mobilization against resistance. The study was done on 20 cadaveric specimens, which were randomly assigned to receive a laceration of 25%, 50%, or 75% of the measured transverse tendon diameter. The circumference of the remaining intact portion of the partially lacerated tendon was measured and converted using a formula to determine the derived cross-sectional area (D-CSA). These D-CSA values were then validated by comparing them to digitally measured cross-sectional areas using a computer software program (computer-measured cross-sectional area, C-CSA). In addition, the ultimate tensile strength (UTS) of these partially lacerated tendons was analyzed to determine if a threshold exists beyond which surgical repair of a partially lacerated tendon is indicated. We found that the D-CSAs matched moderately with C-CSAs, with 0.622 of Pearson correlation coefficient. The UTSs of tendons with CSAs above 8 mm in circumference were consistently above 150 N. Measurement of the circumference of the partially lacerated tendon to obtain the D-CSA could be an accurate and practical method to benchmark residual tendon strength in the management of partially lacerated tendons.

Phenology, production, and fruit quality of blackberry cultivars under greenhouse in southern Brazil

Knowing the phenology, production, and fruit quality of blackberry cultivars grown in greenhouses enables growers to develop and/or improve assertive orchard management. The aim of this study was to investigate whether phenology, production, and fruit quality differ among blackberry cultivars grown under greenhouse. The treatments were four blackberry cultivars (‘BRS Cainguá’, ‘BRS Tupy’, ‘BRS Xavante’, and ‘BRS Xingu’), arranged in a randomized block design, with four replications and three plants per plot. Phenology, production, and fruit quality were assessed. ‘BRS Xingu’ had an earlier start than all the phenological stages assessed, proving to be the earliest to achieve fruit harvest stage. ‘BRS Cainguá’ was the latest to harvest. ‘BRS Xingu’ showed the highest total production values, followed by ‘BRS Cainguá’, with the largest longitudinal diameter, and ‘BRS Tupy’, with the largest transverse diameter. Fruit quality was not influenced by the cultivars. In conclusion, the four blackberry cultivars differ in terms of phenology and fruit production potential under greenhouse. This allows production to be staggered around 15 days in terms of the start and end of the harvest.

Radiological characteristics and diagnostic clues for persistent descending mesocolon in patients with rectal cancer.

Persistent descending mesocolon (PDM) increases the difficulty and colonic ischemia in the surgery of colorectal cancer, but the preoperative diagnostic criteria have not yet been clearly demonstrated. This study explored the MR imaging features and diagnostic criteria of PDM to improve the preoperative diagnostic rate. The clinical data of 54 patients with PDM and 270 patients without PDM who underwent rectal surgery at the Department of Colorectal Surgery, Fujian Medical University Union Hospital, from March 2018 to December 2022 were analyzed, retrospectively. The radiological parameters of PDM from MRI were analyzed. On MRI T2WI axial image, the left edge of the abdominal aorta was defined as the reference line. The shortest vertical distance between the right edge of the descending colon and this line (dN) and the maximum transverse diameter of the peritoneal cavity (dA) at the same level and the maximum vertical distance between the right edge of the descending colon and this line (dW) were measured. There were significant statistical differences in dN, dW, dN/dW, and dN/dA between the PDM group and the non-PDM group. dN, dN/dW, and dN/dA have high diagnostic performance for the PDM. dN < 4.16cm, dN/dW < 0.52, and dN/dA < 0.15 can all be used as clues to diagnose PDM. We propose a feasible set of diagnostic criteria for PDM based on abdominal MRI, which can quickly and accurately diagnose PDM, and provide some reference for preoperative planning and surgical decision-making.

The Influence of Anthropometrics on Cardiac Mechanics in Healthy Women With Opposite Obesity Phenotypes (Android vs Gynoid).

The possible influence exerted by mechanical factors and/or compressive phenomena on myocardial strain parameters in healthy individuals with opposite obesity phenotypes (android vs gynoid) has never been previously investigated. Accordingly, we aimed at evaluating the relationship between anthropometrics, such as the waist-to-hip ratio (WHR), modified Haller index (MHI, the ratio of chest transverse diameter over the distance between sternum and spine), and epicardial adipose tissue (EAT), and left ventricular (LV)-global longitudinal strain (GLS), in healthy women with opposite obesity phenotypes (android vs gynoid). Forty healthy women with obesity (body mass index (BMI) ≥30 Kg/m2)and WHR ≥0.85 ("android group") (52.5±13.2 yrs), 40 age- and BMI-matched healthy women with obesityand WHR <0.78 ("gynoid group") (49.8±13.4 yrs) and 40 age-matched healthy women without obesity (BMI <30 Kg/m2) (controls) (50.3±12.5 yrs) were retrospectively analyzed. All women underwent transthoracic echocardiography implemented with echocardiographic strain analysis of all cardiac chambers. Correlation between LV-GLS and anthropometrics (WHR, MHI, and EAT) was assessed in both groups of obese women. Age, WHR, homeostasis model assessment for insulin resistance (HOMA-IR), and left ventricular mass index (LVMi) were included in the logistic regression analysis performed for evaluating the independent predictors of reduced LV-GLS magnitude (less negative than -20%) in women with android obesity. Compared to the other groups of women, those with android obesity were found with significantly greater LVMi, higher LV filling pressures, and lower biventricular and biatrial deformation indices. A strong inverse correlation between LV-GLS and all anthropometrics (WHR, MHI, and EAT) was demonstrated in both groups of women with obesity. Univariate logistic regression analysis revealed that WHR (OR 1.58, 95%CI 1.22-2.03, p<0.001) and LVMi (OR 1.09, 95%CI 1.02-1.16, p=0.006) were independently correlated with LV-GLS impairment in women with android obesity. On multivariate logistic regression analysis, the WHR maintained a statistically significant association with the above-mentioned outcome (OR 1.68, 95%CI 1.14-2.48, p=0.009). Receiver operating characteristic (ROC) curve analysis showed that a WHR value ≥1.01 had 93% sensitivity and 100% specificity for detecting LV-GLS impairment in women with android obesity (AUC=0.98; 95%CI 0.96-1.00). Anthropometrics may strongly influence cardiac mechanics in healthy women with obesity. The WHR is associated with reduced LV-GLS magnitude in healthy women with android obesity, independent of age, glycometabolic status, and LV size.

Application of contrast-enhanced ultrasound in the diagnosis of tuberous vas deferens tuberculosis.

To assess the value of contrast-enhanced ultrasound (CEUS) in the diagnosis of tuberous vas deferens tuberculosis (VD TB) and improve the positive diagnostic rate of VD TB. CEUS and routine ultrasound (US) images of 17 patients with tuberous VD TB confirmed by surgery, pathology, or laboratory semen examination were retrospectively analyzed and summarized, and the positive rates of both imaging techniques were compared. The 19 VD lesions of the 17 patients were divided into two types according to the CEUS findings: Type I and Type II, and type II was divided into Types IIa, IIb, and IIc. Of the nodules with transverse diameters > 1cm, 100% presented as type II. Of the nodules with transverse diameters < 1cm, 37.5% (3/8) presented as type I and 62.5% (5/8) presented as type II. The sonographic manifestations of tuberous VD TB were hypoechoic and mixed echoic. The positive diagnostic rate was 89.5% for CEUS and 68.4% for US, but the difference was not significant (χ2 = 2.533; P = 0.111). CEUS was able to show the blood supply characteristics of tuberous VD TB, the internal necrosis of nodules was more easily observed by CEUS than by routine US, which is helpful for the diagnosis of tuberous VD TB.

Prenatal diagnosis of pontocerebellar hypoplasia with postnatal follow-up.

To describe the MR features enabling prenatal diagnosis of pontocerebellar hypoplasia (PCH). This was a retrospective single monocentre study. The inclusion criteria were decreased cerebellar biometry on dedicated neurosonography and available fetal Magnetic Resonance Imaging (MRI) with PCH diagnosis later confirmed either genetically or clinically on post-natal MRI or by autopsy. The exclusion criteria were non-available MRI and sonographic features suggestive of a known genetic or other pathologic diagnosis. The collected data were biometric or morphological imaging parameters, clinical outcome, termination of pregnancy (TOP), pathological findings and genetic analysis (karyotyping, chromosomal microarray, DNA sequencing targeted or exome). PCH was classified as classic, non-classic, chromosomal, or unknown type. Forty-two fetuses were diagnosed with PCH, of which 27 were referred for decreased transverse cerebellar diameter at screening ultrasound. Neurosonography and fetal MRI were performed at a mean gestational age of 29+4 and 31+0weeks, respectively. Termination of pregnancy occurred. Pregnancy was terminated in 24 cases. Neuropathological examination confirmed the diagnosis in 24 cases and genetic testing identified abnormalities in 29 cases (28 families, 14 chromosomal anomaly). Classic PCH is associated with pontine atrophy and small MR measurements decreasing with advancing gestation. This is the first large series of prenatally diagnosed PCHs. Our study shows the essential contribution of fetal MRI to the prenatal diagnosis of PCH. Classic PCHs are particularly severe and are associated with certain MR features.

Morphological and Morphometric Variations of Fovea Capitis Femoris: A Cross-sectional Study from Kolkata, West Bengal, India

Introduction: The proximal end of the femur is an important anatomical modification in humans, widely explored to acquire detailed knowledge that aids in determining the exact size of hip prosthesis and minimising postoperative complications. However, thorough analysis of the various parameters of the Fovea Capitis Femoris (FCF) is frequently overlooked, yet it is also important during reconstructive surgery of the ligamentum teres femoris, radiographic evaluation of hip dysplasia, or as an anatomical landmark in hip arthroscopy. Detailed morphological and morphometric measurements of the FCF in the West Bengal population would help bridge this gap, as there are few Indian studies regarding the fovea. Aim: To determine the morphological and morphometric measurements of the FCF in the West Bengal population. Materials and Methods: A cross-sectional study was conducted among 297 dry femora from the Department of Anatomy at Kolkata Medical College, Kolkata, West Bengal, India from October 2023 to February 2024. The position and shape of the fovea were recorded. Morphometric measurements of the fovea (depth, transverse diameter, and vertical diameter) and the head of the femur (transverse and vertical diameters) were taken using a vernier caliper. The collected data were compiled in a Microsoft Excel sheet and analysed using Jamovi software (free version). The Pearson’s correlation formula was used to determine the correlation between various parameters of the fovea and femoral head. A p-value of &lt;0.05 was considered statistically significant. Results: All femora had a single distinct fovea. The most frequent shape of the fovea was oval 135 (45.45%), and its most common position was in the posterior-inferior quadrant 263 (88.55%) of the femoral head. Regarding morphometric measurements, the mean values of the transverse diameter, vertical diameter, and Depth of the Fovea (DF) were 1.53±0.367 cm, 1.28±0.303 cm, and 0.304±0.141 cm, respectively. A positive correlation was found between the transverse and vertical diameters of the fovea (Pearson’s correlation r=0.239), and a significant p-value (p&lt;0.001) was also found between them. Conclusion: Knowledge of these variations may be useful for anatomists, radiologists, anthropologists, forensic experts, and orthopaedic surgeons when planning and executing hip replacement surgeries.

A retrospective study of 3D measurement and analysis applied in the morphological evaluation of achalasia cardia.

Achalasia cardia (AC) is defined as a disorder of esophageal motility whose diagnostic gold standard depends on high-resolution manometry (HRM). The invasiveness of HRM can cause difficulties in diagnosis, treatment, and follow-up for patients with AC. Thus, we aimed to investigate the function of 3D reconstruction and measurement to prove the wide application of this alternative non-invasive approach for AC. A total of 126 patients with AC and 40 healthy subjects in Tianjin Medical University General Hospital from January 2018 to October 2022 were enrolled in this retrospective study. Chest CT images of these subjects were used to reconstruct the 3D models of the esophagus, stomach, spine, left crus, and right crus. Measurements of esophagus length, volume of esophagus, gastroesophageal insertion angle (His angle), max thickness of esophageal wall, esophagus maximum transverse and longitudinal diameter, esophagus-spine angle, and spine-lower esophageal sphincter (LES) angle were applied based on the models. Retrocardiac esophagus length, volume of esophagus, max thickness of esophageal wall, esophagus maximum transverse and longitudinal diameter, thoracic esophagus-spine angle, and spine-LES angle in the AC group were higher than those in the control group (all P values <0.05). Among the three subtypes of AC, thoracic esophagus length, intra-abdominal LES length, volume of esophagus, His angle, esophagus maximum transverse and longitudinal diameter, and thoracic esophagus-spine angle all presented statistical differences (all P values <0.05). Correlation analysis revealed that manometric types were positively associated with His angle [r=0.196; 95% confidence interval (CI): 0.009, 0.372; P=0.028] but negatively associated with volume of esophagus (r=-0.480; 95% CI: -0.639, -0.310; P<0.001), esophagus maximum transverse diameter (r=-0.551; 95% CI: -0.679, -0.400; P<0.001), esophagus maximum longitudinal diameter (r=-0.518; 95% CI: -0.649, -0.366; P<0.001), and thoracic esophagus-spine angle (r=-0.324; 95% CI: -0.479, -0.157; P<0.001). This study successfully presented the differences in esophageal length, volume, thickness, and angles between healthy subjects and different AC subtypes on the basis of 3D reconstruction and measurement. Thus, 3D model and measurement can be regarded as a good support for further research and make a valuable contribution to developing non-invasive approaches for AC management.

Morphological and Morphometric Study of Greater Palatine Foramen in Dry Skulls of Eastern Indian Population

Abstract Background: Greater palatine foramen (GPF) transmits important neurovascular structures which may get injured during different operative procedures such as intraoral maxillary nerve block, cleft palate repair, and operative procedures involving maxillary sinus and maxillary molars. Hence, proper knowledge about the GPF is very essential. The aim of this study was to study the shape of GPF and its location in relation to molar tooth, measure the diameters of GPF, and measure the distances of GPF from different landmarks of palate. Methodology: A dry bone-based study was conducted on dry human skulls of Eastern Indian population using digital Vernier caliper. At first location of GPF in relation to maxillary molars was noted, followed by anteroposterior (AP) and transverse diameter of GPF and distance of GPF from incisive fossa, posterior border of hard palate (PBHP) and interpalatine suture was measured. Results: In 69.64% of cases, GPF was present medial to the maxillary molar tooth and most common shape is oval type which is found in 44.64% of cases. AP diameter was almost same in both the sides which is 5.13 mm in average and transverse diameter is 2.91 mm. The mean distance of GPF from incisive fossa, PBHP, and interpalatine suture (IPS) is as follows in sequence, 37.24 mm, 3.21 mm, and 13.68 mm. Conclusion: The findings from the present study can be used as a guide for locating GPF during different operative procedures such as palatal reconstruction in cleft palate, maxillary surgeries, and intraoral maxillary nerve block. GPF is located about 3 mm in front of PBHP, most commonly medial to the third maxillary molar, about 15 mm lateral to IPS in the present study among Eastern Indian population.

Feasibility of ultrasound measurement of tracheal diameter in patients undergoing severe scoliosis orthopedic surgery: A randomized trial

Objective To explore the feasibility of ultrasound measurement of the transverse diameter of the cervical trachea at its narrowest point in patients undergoing severe scoliosis orthopedic surgery. Methods A total of 110 patients, aged 18-65, who scheduled for elective orthopedic surgery for severe scoliosis were included. Prior to surgery, all patients underwent two types of tracheal inner diameter measurements: (1) CT measurement of the anteroposterior diameter (Dmin,AP) and transverse diameter (Dmin,T) of the cervical trachea at its narrowest point; and (2) ultrasound measurement of Dmin,T. Based on the measurement results, the patients were randomly divided into two groups, the CT group ( n = 55) and the ultrasound group ( n = 55). We compared the Dmin,AP and Dmin,T measured by CT for all patients. Then, we compared CT and ultrasound measurements of Dmin,T. Furthermore, we conducted an analysis to determine the correlation and consistency between the two methods. Additionally, we examined the success rate of first-attempt tracheal intubation and the occurrence rate of tracheal tube being too wide or too narrow between the two groups, and assessed the occurrence of postoperative 24-h pharyngeal pain and hoarseness. Results When comparing the Dmin,AP and Dmin,T measured by CT in all patients, a statistically significant difference was observed ( p &lt; .001). When comparing the measurements of Dmin,T between CT and ultrasound in all patients, no statistically significant differences were found ( p &gt; .05). The correlation coefficient (r) between CT and ultrasound measurements of Dmin,T was 0.849 ( p &lt; .001). The mean difference in Dmin,T was 0.19 mm, and the limits of agreement (LoA) were −2.24 mm to 2.62 mm. Conclusions Ultrasound measurement of Dmin,T in severe scoliosis patients is feasible and provides valuable guidance for the selection of endotracheal tube sizes. It serves as a non-invasive and bedside auxiliary examination method for perioperative airway assessment.

Systematic Review on Morphometric Study of Suprascapular Notch

Suprascapular notch roofed by STSL is located in the lateral part of the superior border of scapula and medial to the base of the coracoids process. The suprascapular nerve (SN) is entrapped due to anatomical variation of the notch. The SN injury is the main cause of shoulder pain and weakness. Detailed anatomical knowledge of the SSN is necessary to manage entrapment neuropathy and interventional techniques. Therefore, in this study, we will measure the anatomical knowledge of various types of SSNs and the morphology of these structures. We searched multiple computerised databases from 2012 to 2022. Morphometry-based studies of the SSN were included in this systematic review. Those studies have information on various dimensions of SSN. The SSN can be classified into six anatomical types. These include Type I (wide depression), Type II (wide blunted V shape), Type III (symmetric U shape), Type IV (small V shape), Type V (partial ossified STSL), and Type VI (fully ossified STSL). Throughout the review, SSN was categorised as stated by Rengachary classification. There were five types of SSNs in the present review, the most predominant being type III (41.43%). Type III notch has a higher superior transverse diameter (STD) and middle transverse diameter (MTD) than any other notches, while type V notch has the lowest STD and MTD. Based on the outcomes of our review, we can conclude that type III SSN accounted for the most prevalence, followed by the other types of SSN. Type III notch (U-shaped notch through symmetrical and parallel lateral borders) has a higher STD and MTD than any other notch. At the same time, the type V notch has been found to have the lowest STD and MTD.

Condições meteorológicas afetam o desenvolvimento sazonal e a produção de frutos de coqueiro-anão-verde

ABSTRACT Understanding the green dwarf coconut palm development is essential to improve its management. This study aimed to characterize and understand the seasonality of the green dwarf coconut palm development and yield under rainfed and irrigated conditions in the northeastern region of the Pará state, Brazil. The longitudinal and transverse diameters, fruit mass and yield, in addition to the number of live leaves, live bunches, fruits of the bunches nº 11 and 14 and female fowers were monitored. The coconuts between the bunches nº 20 and 22 showed larger dimensions and biomass (fresh and dry). The partition of the production components varies according to the time of the year, with the liquid albumen mass, which is a component of greater commercial focus, being higher in the rainy season, with lower percentage losses in the irrigated cultivation. The meteorological seasonality plays a key role in fower dropping and fruit abortion, directly contributing to the amount of produced fruits.

Determination of the embryotoxic effects of propofol injected into eggs on the cerebellum and spinal cord using histologic methods: an animal study.

This study aims to determine the possible embryotoxic effects of propofol on the cerebellum and spinal cord using fertile chicken eggs. A total of 430 fertile eggs were divided into 5 groups: control, saline, 2.5 mg.kg-1, 12.5 mg.kg-1, and 37.5 mg.kg-1 propofol. Injections were made immediately before incubation via the air chamber. On the 15th, 18th, and 21st day of incubation, 6 embryos from each group were evaluated. Serial paraffin sections taken from the cerebellum and spinal cord were stained with hematoxylin-eosin, Kluver-Barrera, toluidine blue, and periodic acid-Schiff's reaction. The outer granular layer and total cortex thickness were measured, and the linear density of the Purkinje cells was determined. The ratios of the substantia grisea surface area to the total surface area of the spinal cord were calculated. The transverse and longitudinal diameters of the canalis centralis were also assessed. No structural malformation was observed in any embryos examined macroscopically. No significant difference was observed between the groups in terms of development and histologic organization of the cerebellum and spinal cord. However, on the 15th, 18th, and 21st day, the outer granular layer (p < 0.001 for all days) and the total cortex thickness (p < 0.01, p < 0.001, and p < 0.001, respectively) decreased significantly in different propofol dose groups in varying degrees in the cerebellum. Similarly, in the spinal cord, there were significant changes in the ratios of the substantia grisea surface area to the total surface area (p < 0.01 and p < 0.001, respectively). It was concluded that the in-ovo-administered propofol given immediately before incubation has adverse effects on the developing cerebellum and spinal cord. Therefore, it is important for anesthesiologists always to remain vigilant when treating female patients of childbearing age.

Contralateral approach using microscope and tubular retractor system for ipsilateral decompression of lumbar degenerative lateral recess stenosis associated with narrow spinal canal.

To summarize the clinical effect of a single-center retrospective analysis of the contralateral approach with a microscope and tubular retractor system for ipsilateral decompression in patients with lumbar lateral recess stenosis and a narrow spinal canal. A total of 25 patients who underwent ipsilateral decompression surgery via a contralateral approach with microscope and tubular retractor system, performed by one surgeon at a single center were retrospectively examined. The width of the lamina fenestration was compared with the preoperative distance from the root of the spinous process to the dorsal articular facet, the bilateral articular facet change in the suprapedicle notch section on CT scan, and with the changes in transverse and sagittal diameters of the canal area on MRI. Clinical efficacy was assessed using the Japanese Orthopedic Association (JOA), Visual Analog Scale (VAS), and Oswestry Disability Index (ODI) scores. In total, 25 patients were treated and the mean intraoperative time was 82.04 ± 12.48 min. There was no nerve injury, cerebrospinal fluid leakage, and infection complications. The postoperative CT revealed that the width of the contralateral laminar fenestration was less than the distance from the root of the spinous process to the dorsal articular facet. The residual widths of the ipsilateral articular facet and contralateral articular facet were greater than 2/3 of the preoperative articular facet width. The transverse and sagittal diameter of canal were significantly increased. The mean follow-up period was 12-16 months, and no recurrence or reoperation incidence were found at the last follow-up. When compared to pre-surgery, the ODI, VAS, and JOA scores were significantly improved after surgery (p < 0.05). Based on our single-center retrospective observation of 25 cases and combined with previous literature, the contralateral approach with a microscope and tubular retractor system for ipsilateral decompression in patients with lumbar lateral recess stenosis and a narrow spinal canal can reduce damage to the articular processes, and probably more conducive to the postoperative stability of the lumbar spine. This was a single center retrospective analysis with a small sample size and lacked randomized controlled trials (RCTs). However, larger-scale, multicenter RTCs are required for additional validation.

Ultrasound evaluation and grading of neuromuscular disease in lower extremities among diabetic patients.

To explore the clinical utility of ultrasound in evaluating and grading neuromuscular diseases in the lower extremities of patients with diabetes mellitus. A total of 126 inpatients from the Department of Diabetes at Zhangzhou Affiliated Hospital of Fujian Medical University, China, were recruited from June 2020 to December 2022. The cohort included 69 patients with type 2 diabetes mellitus (T2DM) and diabetic peripheral neuropathy (DPN group) and 57 patients with T2DM but without DPN (non-DPN group). Additionally, 80 healthy controls were included. High-frequency ultrasound was used to scan the common peroneal, sural, and tibial nerves, measuring their transverse (D1) and anteroposterior (D2) diameters, and calculating the cross-sectional area (CSA). Changes in the internal echo of the extensor digitorum brevis (EDB) muscle, including maximum thickness and CSA, were also recorded. The DPN group was further subdivided based on disease duration to assess ultrasonic changes over time and the statistical significance of these variations. Ultrasonic changes such as uneven internal echo reduction, ill-defined epineurial boundaries, and obscured cribriform structures were most prevalent in the DPN group. Significant differences in ultrasound parameters (D1, D2, CSA) were observed among the groups (all P<0.05), with the most pronounced changes in the DPN group. In patients with a disease duration of over 15 years, a significant increase in CSA of lower extremity nerves and a decrease in CSA of the EDB were noted compared to those in the 5-10 years subgroup (19.89±0.98 vs 19.00±0.94; 5.25±0.74 vs 5.93±0.94; all P<0.05). High-frequency ultrasound provides a valuable imaging basis for diagnosing and monitoring DPN, demonstrating significant changes in nerve and muscle parameters among diabetic patients.

Fontes alternativas de fósforo na produção de beterraba visando ao sistema orgânico

ABSTRACT The demand for beet produced in the organic system has increased. This study aimed to evaluate the beet production with the use of different proportions of phosphorus sources. A randomized block design was used. The treatments were established in a 6 x 2 + 1 factorial arrangement, corresponding to 6 proportions of the phosphorus fertilizers Yoorin® thermophosphate (YT) and bone meal (BM) (100 % of P2O5 with YT; 80 % of P2O5 with YT + 20 % of P2O5 with BM; 60 % of P2O5 with YT + 40 % with BM; 40 % of P2O5 with YT + 60 % with BM; 20 % of P2O5 with YT + 80 % with BM; and 100 % of P2O5 with BM), 2 doses of P2O5 (180 - recommended - and 360 kg ha-1) and 1 control without these phosphorus fertilizers. The plant height, number of leaves, root and shoot fresh and dry weight, transverse and longitudinal root diameter and total root yield were evaluated. The recommended fertilizer dose resulted in higher values, when compared to twice the recommendation. The proportion of 0 % of thermophosphate and 100 % of bone meal provided the highest mean values for the evaluated parameters. High phosphorus doses showed to be harmful to beet production.

Incisional lumbar hernias: Current role of laparoscopic approach with intraperitoneal onlay mesh procedure

Abstract PURPOSE: Lumbar incisional hernias are a defect of the posterolateral region on the abdominal wall that originated from previous surgical incisions in the area. A surgical approach is challenging due to low incidence and the lack of enough publications on the topic, which generates controversies among surgeons. The purpose of this paper is to show our laparoscopic approach experience using the intraperitoneal onlay mesh (IPOM) and IPOM Plus procedures for the treatment of lumbar incisional hernias. MATERIALS AND METHODS: This was a retrospective descriptive study, including 10 patients with lumbar/posterolateral incisional hernias, diagnosed by computerized tomography scan and surgically treated with the IPOM laparoscopic technique in one case and IPOM Plus in nine cases from 2014 to 2021. Demographic data and baseline characteristics of enrolled patients were assessed, as well as perioperative data, surgical time, length of hospital stay, and recurrence during an average 38.6-month follow-up. RESULTS: In the series assessed, the defect size ranged between 24 and 72 cm2, with mean longitudinal and transversal diameters of 7.9 and 5.8 cm, respectively. The surgery lasted 120–180 min. There were no cases of conversion or intraoperative visceral lesions. Nine patients were discharged on an average of 37.8 ± 8.9 h after admission, and one patient stayed for 64 h due to extra analgesic demand. Postoperative morbidity was a case of hematoma. There was one case of recurrence. CONCLUSION: The results of our experience have shown the benefits of the laparoscopic approach with the IPOM Plus method for the treatment of lumbar incisional hernias, including short hospital stays and low incidence of postoperative complications. Accordingly, this mainstream technique, which has shown good outcomes both in the short and the long term, appears to be a simple and safe procedure.

Anthropometric evaluation of the distal end of the femur in the South Indian population with its clinical implications

Introduction: The femur is known as the longest weight-bearing bone in the body. Its length is around 45 cm in an average adult. The morphometric studies related to the distal end of the femur in the South Indian population are sparse. The present morphometric study was undertaken to compare and contrast the various measurements of the distal end of the femur in the South Indian population. Materials and Methods: In this study, 111 adult dry femora (56 from the right and 55 from the left side) were used for distal anthropometric measurements. Bicondylar width, medial condylar anteroposterior diameter, lateral condylar anteroposterior diameter, medial condylar transverse diameter, lateral condylar transverse diameter, width of intercondylar notch, and diameter of femur were measured using digital Vernier caliper. Results: The mean bicondylar width on the right and left sides were 70.43 mm, respectively. The average medial condylar anteroposterior distance for the right and left sides were 53.87 mm and 54.84 mm, whereas, the lateral condylar anteroposterior distance for the right and left sides was 55.33 mm and 55.44 mm. The medial condylar transverse distance for the right and left sides were 25.35 mm and 25.52 mm, and that of the lateral condylar transverse distance on the right and left sides were 26.87 mm and 26.71 mm. The intercondylar notch width was measured to be 18.26 mm and 18.43 mm on the right and left femora, respectively. The differences in the bilateral measurements were found to be statistically not significant between the right and left femora. Conclusion: The morphometric evaluation of the lower end of the femur would help the orthopedic surgeon, radiologist, and anthropology practitioner to a great extent, especially in dealing with knee joint-related disorders, and placing various implants in the reconstruction of femoral fragments among South Indian populations.

Determination of Sexual Dimorphism from Foramen Magnum in an Eastern Indian Population

Human identification is an important arena of forensic investigation, it includes sex determination which becomes extremely difficult in fragmented skeletal remains. Skull dimensions are measured for the purpose of sexual dimorphism which vary in different populations. In this study, we attempted to analyse the measurements from adult human skulls and employ discriminant function to predict sex accurately. A manual vernier calliper was used to measure the antero-posterior (AP) diameter and transverse diameter of foramen magnum of 88 skulls (49 males, 39 females) from the collection housed at the department of Anatomy, RG KAR medical college and Calcutta medical college. The Wilk's lambda for the model is 0.795. The discriminant function equation is, Df= 3.342× (APdiameter of foramen magnum) +0.725× (Transverse diameter of foramen magnum) -13.641(constant). The cut-off point is 0.505. So above this value 0.505, the cases are male and below it, the cases are female. On comparing the measurements, we found that antero-posterior dimensions and transverse dimensions of foramen magnum were greater in males than females. Collectively, all the results indicate that dimensions of foramen magnum can be used as a moderate indicator for sex determination in regional populations.