Evaluation of the anterolateral ligament of the knee by magnetic resonance imaging in patients with chronic anterior cruciate ligament rupture

ObjectiveThe purpose of this study was to evaluate the visibility of the anterolateral ligament (ALL) by magnetic resonance imaging (MRI) in patients with chronic anterior cruciate ligament (ACL) rupture.Materials and methodsThis retrospective case – control study compared 1.5 - T MRI scans for 50 patients with a chronic ACL rupture with those of a control group of 50 patients with an intact ACL. The ALL was evaluated in three portions: femoral, meniscal, and tibial. The status of each portion was classified as visualized or non-visualized. Two radiologists separately reviewed all the MRI scans to evaluate interobserver reliability.ResultsAt least one portion of the ALL was visualized in 100% of the control group and 72% of the chronic ACL rupture group. All three portions of the ALL were identified in 72% of the control group but only 10% of the chronic ACL rupture group. In both groups, the most commonly visualized portion was the meniscal portion and the least visualized was the tibial portion. In 18% of the chronic ACL rupture group, no portion of the ALL was visualized.ConclusionsThe visibility of the ALL of the knee was significantly lower in patients with a chronic ACL rupture than in those with an intact one.     

Increased activation of the fear neurocircuitry in children exposed to violence

Most studies investigating the effect of childhood trauma on the brain are retrospective and mainly focus on maltreatment, whereas different types of trauma exposure such as growing up in a violent neighborhood, as well as developmental stage, could have differential effects on brain structure and function. The current magnetic resonance imaging study assessed the effect of trauma exposure broadly and violence exposure more specifically, as well as developmental stage on the fear neurocircuitry in 8‐ to 14‐year‐old children and adolescents (N = 69). We observed reduced hippocampal and increased amygdala volume with increasing levels of trauma exposure. Second, higher levels of violence exposure were associated with increased activation in the amygdala, hippocampus, and ventromedial prefrontal cortex during emotional response inhibition. This association was specifically observed in children younger than 10 years. Finally, increased functional connectivity between the amygdala and brainstem was associated with higher levels of violence exposure. Based on the current findings, it could be hypothesized that trauma exposure during childhood results in structural changes that are associated with later risk for psychiatric disorders. At the same time, it could be postulated that growing up in an unsafe environment leads the brain to functionally adapt to this situation in a way that promotes survival, where the long‐term costs or consequences of these adaptations are largely unknown and an area for future investigations.     

Instrument-based Tests for Measuring Anterior Chamber Cells in Uveitis: A Systematic Review

ABSTRACT

Purpose

New instrument-based techniques for anterior chamber (AC) cell counting can offer automation and objectivity above clinician assessment. This review aims to identify such instruments and its correlation with clinician estimates.     

胫前动脉踝上穿支皮瓣修复足踝部软组织缺损19例

目的探讨胫前动脉踝上穿支皮瓣修复足踝部软组织缺损的临床疗效。方法回顾性研究2018年4月至2019年6月采用胫前动脉踝上穿支皮瓣修复足踝部软组织缺损19例的资料,其中男11例,女8例;年龄为21~75岁,平均39岁。根据前踝上穿支皮瓣解剖学基础,按照足踝部软组织缺损大小和形状,在小腿下端前外侧设计并切取皮瓣转位修复创面。切取胫前动脉踝上穿支皮瓣面积为6.0 cm×5.0 cm^14.0 cm×8.0 cm,均为带蒂皮瓣转位。根据皮瓣成活、感染控制、弹性色泽、外观形态、供区瘢痕、皮肤感觉、患者认可等情况,对患者足踝部软组织缺损的修复情况进行综合评价。结果本组19例皮瓣全部成活,软组织缺损、肌腱、骨质及钢板外露均得以修复。供区均I期愈合。术后门诊随访2~16个月,皮瓣血运良好,颜色接近周围正常皮肤,臃肿不明显,患者对外观表示满意;供区皮片愈合良好,无明显增生、挛缩及溃疡,踝关节功能良好。结论胫前动脉踝上穿支皮瓣是修复足踝部软组织缺损较为理想的方法之一,手术操作简便,穿支较恒定,血供可靠,具有一定的临床应用价值。     

Interaction of nicotinic acetylcholine receptors with dopamine receptors in synaptic plasticity of the mouse insular cortex

The insular cortex plays essential roles in nicotine addiction. However, much is still unknown about its cellular and synaptic mechanisms responsible for nicotine addiction. We have previously shown that in layer 5 pyramidal neurons of the mouse insular cortex, activation of the nicotinic acetylcholine receptors (nAChRs) suppresses synaptic potentiation through enhancing GABAergic synaptic transmission, although it enhances both glutamatergic and GABAergic synaptic transmission. In the present study, we examined whether dopamine receptors might contribute to the nicotine‐induced inhibition of synaptic potentiation. The nicotine‐induced inhibition of synaptic potentiation was decreased in the presence of a D1 dopamine receptor antagonist SCH23390 irrespective of the presence of a D2 dopamine receptor antagonist sulpiride, suggesting that D1 dopamine receptors are involved in nicotine‐induced inhibition. We also investigated how dopamine receptors might contribute to the nAChR‐induced enhancement of glutamatergic and GABAergic synaptic transmission. The nAChR‐induced enhancement of GABAergic synaptic transmission was decreased in the presence of SCH23390 irrespective of the presence of sulpiride, whereas that of glutamatergic synaptic transmission was not altered in the presence of SCH23390 and sulpiride. These results suggest that D1 dopamine receptors are involved in the nAChR‐induced enhancement of GABAergic synaptic transmission while dopamine receptors are not involved in that of glutamatergic synaptic transmission. These observations indicate that the interaction between nAChRs and D1 dopamine receptors plays critical roles in synaptic activities in layer 5 pyramidal neurons of the mouse insular cortex. These insular synaptic changes might be associated with nicotine addiction.     

学龄期儿童前房深度发育状况分析

目的了解7~14岁学龄期儿童前房深度发育情况。探索其与屈光度数间的关系。方法收集2012年6月至2014年6月眼科门诊7~14岁儿童为研究对象，共计521例（1042只眼）。采用IOLMaster人工晶状体生物测量仪测量各屈光参数，同时测量身高、体重。散瞳后验光测得静态屈光度。分析前房深度发育情况及不同屈光状态的学龄期儿童前房深度发育情况。结果（1）随着年龄的增长，7~14岁学龄期的儿童前房深度随之增长，差异具有统计学意义（P＜0.01）。同一年龄段儿童的左右眼之间的均值相近，且生长发育趋势相近（均P＞0.05）。（2）随着年龄的增长，男女的前房深度均逐渐增大，同一年龄段男性前房深度大于女性前房深度（均P＜0.01）。（3）儿童前房深度与身高正相关（P＜0.01）。（4）前房深度随近视度数增高而增大，低度近视组与中度近视组及高度近视组差异有统计学意义（P＜0.05）。结论学龄期儿童的前房深度的发育受到身高、性别及屈光度数的影响，与身高呈正相关，同一年龄段，男性前房深度大于女性。双眼前房深度发育同步。低中度近视的儿童前房深度增大。     

CT三维重建模型下模拟髋臼前柱2种经皮置钉方法的比较

目的对比CT三维重建模型下模拟髋臼前柱2种经皮置钉方法的效果。方法选取55例正常成人骨盆CT资料构建三维模型,共110侧髋臼前柱,调整模型透明度使其类似常规X线片,分别用2种置钉方法进行置钉,A组利用出口闭孔位和入口髂骨位引导置钉,B组利用髋臼前柱轴位引导置钉,置钉完成后恢复图像为不透明状态,记录螺钉是否进入髋关节及与耻骨支的位置关系。结果55例110侧髋臼,4侧未能找到髋臼前柱轴位影像予以剔除,106侧髋臼前柱纳入研究。2组模型均无螺钉进入髋臼。A组螺钉置入优秀、良好、尚可率分别为59.4%、17.0%、23.6%,B组分别为59.4%、22.6%、17.9%,2组总体置钉质量差异无统计学意义(Z=-0.829,P=0.407)。A组女性骨盆置钉优秀、良好、尚可率分别为7.1%、21.4%、71.4%,B组分别为28.6%、21.4%、50.0%,B组置钉质量显著高于A组(Z=-3.000,P=0.003)。A组男性骨盆置钉优秀率78.2%,良好率15.4%,尚可率6.4%,B组分别为70.5%、23.1%、6.4%,2组差异无显著性(Z=-0.969,P=0.333)。结论髋臼前柱轴位可以作为引导置钉的一种手段,尤其适用于女性患者,对于男性患者,2种方法均可实现较好的置钉。