Age and sex effects on brain morphology

1. 1. Brain morphology can be assessed readily in vivo using magnetic resonance imaging (MRI).

2. 2. In this study, the effects of age and sex on whole-brain morphology were examined using an operator-controlled computer-segmentation protocol.

3. 3. Results indicated that age was associated with gray-matter volume reduction.

4. 4. Brain-size differences between males and females were primarily attributable to whitematter volume.

5. 5. This study confirms the importance of controlling for age and sex in brain-morphology studies.

     

Recurrent peripheral embolism following nonunion of the clavicle

Vascular complications in closed clavicular fractures are uncommon, with an incidence of only 0.4%. Subclavian artery injury can present acutely or can have a delayed presentation with arm ischemia. We report the case of an undetected subclavian pseudoaneurysm in a patient with a nonunion fracture clavicle who was referred with persistent ischemia following attempted brachial embolectomy at another center, along with a review of literature to support the hypothesis that in addition to repair of the aneurysm, treatment of the psuedarthrosis by fixation of the clavicle is essential.     

Post-infectious irritable bowel syndrome:Mechanistic insights into chronic disturbances following enteric infection

Irritable bowel syndrome(IBS)is a commonly encountered chronic functional gastrointestinal(GI)disorder.Approximately 10%of IBS patients can trace the onset of their symptoms to a previous a bout of infectious dysentery.The appearance of new IBS symptoms following an infectious event is defined as post-infectiousIBS.Indeed,with the World Health Organization estimating between 2 and 4 billion cases annually,infectious diarrheal disease represents an incredible international healthcare burden.Additionally,compounding evidence suggests many commonly encountered enteropathogens as unique triggers behind IBS symptom generation and underlying pathophysiological features.A growing body of work provides evidence supporting a role for pathogen-mediated modifications in the resident intestinal microbiota,epithelial barrier integrity,effector cell functions,and innate and adaptive immune features,all proposed physiological manifestations that can underlie GI abnormalities in IBS.Enteric pathogens must employ a vast array of machinery to evade host protective immune mechanisms,and illicit successful infections.Consequently,the impact of infectious events on host physiology can be multidimensional in terms of anatomical location,functional scope,and duration.This review offers a unique discussion of the mechanisms employed by many commonly encountered enteric pathogens that cause acute disease,but may also lead to the establishment of chronic GI dysfunction compatible with IBS.     

Utilizing cystic plate for safe and rapid liver retraction at laparoscopic cholecystectomy: A useful technique

Nowadays, laparoscopic cholecystectomy for gallstone disease is considered not only the gold standard but an essential component of surgical training. In this regard, liver retraction plays an important role during cholecystectomy and also after specimen extraction. We describe a simple technique for liver retraction that achieves rapid, safe and steady exposure of the cystic fossa along with the subhepatic region for tackling any inadvertent bile leaks or bleeding. It is especially useful for diseased livers which are otherwise prone to iatrogenic laceration during haphazard and uncontrolled hepatic manipulation. Nonetheless, it may be easily mastered by surgical trainees, and thus reduce their learning curve.