3D Computer graphics simulation to obtain optimal surgical exposure during microvascular decompression of the glossopharyngeal nerve

The affected artery in glossopharyngeal neuralgia (GPN) is most often the posterior inferior cerebellar artery (PICA) from the caudal side or the anterior inferior cerebellar artery (AICA) from the rostral side. This technical report describes two representative cases of GPN, one with PICA as the affected artery and the other with AICA, and demonstrates the optimal approach for each affected artery. We used 3D computer graphics (3D CG) simulation to consider the ideal transposition of the affected artery in any position and approach. Subsequently, we performed microvascular decompression (MVD) surgery based on this simulation. For PICA, we used the transcondylar fossa approach in the lateral recumbent position, very close to the prone position, with the patient’s head tilted anteriorly for caudal transposition of PICA. In contrast, for AICA, we adopted a lateral suboccipital approach with opening of the lateral cerebellomedullary fissure, to visualize better the root entry zone of the glossopharyngeal nerve and to obtain a wide working space in the cerebellomedullary cistern, for rostral transposition of AICA. Both procedures were performed successfully. The best surgical approach for MVD in patients with GPN is contingent on the affected artery—PICA or AICA. 3D CG simulation provides tailored approach for MVD of the glossopharyngeal nerve, thereby ensuring optimal surgical exposure.     

Coil embolization of a large,wide-necked aneurysm using a double coil-delivered microcatheter technique in combination with a balloon-assisted technique

Abstract

The present paper describes a double coil-delivered microcatheter technique used in combination with a balloon-assisted technique to treat a patient with a large, wide-necked basilar tip aneurysm with detachable coil treatment. The aneurysm was completely occluded using this technique. There was no recanalization or any neurological deterioration within 12 months of embolization. [Neurol Res 1999; 21: 324-326]     

Hip range‐of‐motion (ROM) is less than normal after rotational acetabular osteotomy for developmental dysplasia of the hip: A simulated ROM analysis

The optimal reorientation of the acetabulum for developmental dysplasia of the hip (DDH) is unknown in terms of hip range‐of‐motion (ROM). The simulated ROMs of 52 DDHs after rotational acetabular osteotomy (RAO) with several patterns of femoral head coverage and those of 73 normal hips were analyzed using computer models reconstructed from CT images. After RAO with a lateral center edge angle (LCEA) of 30° and an anterior center edge angle (ACEA) of 55° producing coverage similar to that of normal hips, the maximal flexion and maximal internal rotation at 110° flexion with 20° adduction were significantly smaller than those of the normal group. To achieve ROMs after RAO similar to those of the normal group, an LCEA of 30° with an ACEA of 45°, an LCEA of 25° with an ACEA of 45° to 50°, and an LCEA of 20° with an ACEA of 50° could be preferred angles to target, even though they provided smaller coverage than that of normal hips. After RAO producing femoral head coverage similar to that of normal hips, the maximal flexion and the maximal internal rotation at 110° flexion with 20° adduction were significantly smaller than those of the normal group. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:217–223, 2016.     

A study on craniofacial morphology of Japanese subjects with normal occlusion and esthetic profile

This study was designed to properly characterize the cephalometric values of Japanese individuals with both normal occlusion and esthetic profiles. Multivariate statistics were applied to analyze the collected data. Cephalometric values identified are expected to help in the simplification of orthodontic diagnosis. Lateral cephalometric radiographs from 50 men and 50 women with normal occlusion were traced and the dimensions of hard and soft tissues recorded. The corresponding values were classified by cluster analysis, and selected representative values were subjected to principal component analysis. From these values, characteristics of hard and soft tissue morphology were extracted. The subjects were grouped by sex, and subdivided into esthetic and unesthetic profile groups. The principal component scores from each group were plotted on a scattergram and the characteristics of each group investigated. The hard tissue characteristics in men with esthetic profiles were primarily vertical factors, including a tendency for smaller lower facial heights, a smaller mandibular plane angle, and a larger Nasion-ANS/ANS-Menton (N-ANS/ANS-Me). Soft tissue features included a more posteriorly placed maxilla and a high nasal crest. These features yield a less marked maxillary prognathism and a greater nose prominence. In females, hard tissue characteristics associated with esthetic profiles primarily involved the cranial base and posterior facial area. These included a smaller saddle angle, larger articulare angle, and smaller Sella-Articulare/Articlare-Gonion (S-Ar/Ar-Go). Female soft tissue characteristics primarily included retracted upper and lower lips, a shallow inferior sulcus with a smaller lower lip-Frankfort plane angle, and a shorter mentolabial sulcus and subnasale perpendicular-upper lip.     

Comparison of visual field defect progression in secondary Glaucoma due to anterior uveitis caused by three types of herpes viruses

Graefe's Archive for Clinical and Experimental Ophthalmology - To clarify the prevalence of secondary glaucoma (SG) and its speed of progression in patients with herpes simplex virus...     

Two-step photomechanical motion of a dibenzobarrelene crystal

Photomechanical crystals are interesting from both basic and applied perspectives, and thus it is important to develop new examples. We investigated the photomechanical bending behaviour of a photochromic crystal of a dibenzobarrelene derivative. When a plate-like crystal was irradiated with ultraviolet (UV) light at 365 nm, two-step bending was observed. In the first step, the crystal quickly bent away from the light source, with an accompanying crystal colour change from colourless to purple. In the second step, under prolonged UV light, the bending returned slowly and then the crystal bent up towards the opposite direction, accompanied by an additional colour change to light yellow. Spectroscopic measurements and X-ray crystallographic analysis suggested that a long-lived biradical species is generated immediately upon UV light irradiation via a Norrish type II intramolecular hydrogen abstraction, and then the final photoproducts are formed under continuous UV exposure. X-ray crystallographic analysis before and after UV light irradiation for a few seconds revealed that the longitudinal axis (a axis) of the crystal elongated slightly after irradiation, which is consistent with the direction of the first-step bending. Based on these results, we propose that first-step bending could be induced by a biradical species, generated via a Norrish type II intramolecular hydrogen abstraction, and the second-step bending could originate from the formation of a mixture of final photoproducts under prolonged light irradiation.

Upon light irradiation, a dibenzobarrelene crystal quickly bent, and then slowly bent towards the opposite direction.     

Influence of laparoscopy-aided gastrostomy on gastroesophageal reflux in neurologically impaired patients using multichannel intraluminal impedance pH measurements

Esophagus - Development of gastroesophageal reflux disease (GERD) after gastrostomy remains debatable. Therefore, this study aimed to evaluate whether laparoscopy-aided gastrostomy (LAG) influence...     

Important role of the hepatic vagus nerve in glucose uptake and production by the liver

We examined the role of the hepatic vagus nerve in hepatic and peripheral glucose metabolism. To assess endogenous glucose production (EGP), hepatic uptake of first-pass glucose infused intraportally (HGU), and the metabolic clearance rate of glucose (MCR), rats were subjected to hepatic vagotomy (HV, n = 7) or sham operation (SH, n = 8), after 10 days, they were then subjected to a euglycemic-hyperinsulinemic clamp together with a portal glucose load in the 24-hour fasting state. Metabolic parameters were determined by the dual-tracer method using stable isotopes. During the experiment, [6,6-2H2]glucose was continuously infused into the peripheral vein. To maintain euglycemia (4.5 mmol/L), insulin (54 pmol x kg(-1) x min(-1)) and glucose were infused peripherally after the 90-minute tracer equilibration and 30-minute basal periods, and glucose containing 5% enriched [U-13C]glucose was infused intraportally (50 micromol x kg(-1) x min(-1)) for 120 minutes (clamp period). EGP was significantly higher in HV rats versus SH rats during the basal period (64.3 +/- 7.6 v 43.6 +/- 5.3 micromol x kg(-1) x min(-1), P < .005)) and was comparable to EGP in SH rats during the clamp period (9.3 +/- 21.5 v 1.1 +/- 11.7 micromol x kg(-1) x min(-1)). HGU was reduced in HV rats compared with SH rats during portal glucose infusion (5.9 +/- 2.4 v 10.1 +/- 3.2 micromol x kg(-1) x min(-1)). The MCR in HV rats was significantly higher than in SH rats in the basal period (11.0 +/- 2.0 v 7.9 +/- 0.8 mL x kg(-1) x min(-1), P < .01)) and was comparable to the MCR in SH rats during the clamp period (41.9 +/- 10.0 and 36.6 +/- 5.7 mL x kg(-1) x min(-1)). We conclude that innervation of the hepatic vagus nerve is important for the regulation of hepatic glucose production in the postabsorptive state and HGU in the postprandial state.