Arterial supply of the temporo-medial region of the brain significance for preoperative vascular occlusion testing

The mesiobasal limbic system is of particular significance in the surgical treatment of temporo-medial tumors and epilepsy. It consists of the uncus, amygdaloid body, hippocampus, dentate gyrus, subiculum, fasciolar gyrus and the parahippocampal gyrus. Knowledge of the vascular microanatomy is a key to the surgical treatment of pathologies in the region. The anterior choroidal artery was selectively injected in fresh brain specimens 50 specimens with a gelatinous ink mixture to demonstrate vascular territories in stereotactic brain slices, and 50 with a Biodur resin to obtain casts for microanatomical evaluation. The cast technique was also applied to 35 specimens injected into the posterior cerebral artery. The rostral third of the temporomedial region is mainly supplied by branches of the anterior choroidal artery. The occipital two thirds are supplied by hippocampal branches, the posteromedial choroidal artery and the inferior temporal branches of the posterior cerebral artery. Important vessel variations with significant implications for the preoperative Wada-test are presented     

The failed repressor: EEG asymmetry as a moderator of the relation between defensiveness and depressive symptoms

This study assessed the joint effects of defensiveness and frontal asymmetry in predicting symptoms of depression and anxiety. Depression symptoms were measured with the Beck Depression Inventory (BDI) and anxiety symptoms with the Taylor Manifest Anxiety Scale (TMAS). Defensiveness was assessed with both the Marlowe Crowne Social Desirability Scale (MCSD) and the Eysenck Personality Questionnaire L scale (EPQL). Participants completed two EEG recording sessions 3 weeks apart. Six baselines, three eyes open and three eyes closed, were recorded in each session. Alpha power (8–13 Hz) was computed and log transformed. R–L asymmetry was computed at eight pairs of homologous sites for aggregated data. Defensiveness (EPQL and MCSD scores) and depression symptoms (BDI) were assessed at the beginning of the first session. L and MCSD correlated positively with anterior R–L asymmetries. For both scales, the highest correlations were observed at F8–F7. L interacted with F8–F7 asymmetry to predict depressive symptoms. Among left frontally active individuals, there was trend toward a negative correlation between L and BDI. Among the right frontally active individuals, the correlation between L and the BDI was positive. MCSD did not moderate the relation between F8–F7 asymmetry and BDI. The results are consistent with the hypothesis that defensiveness protects against symptoms of depression in the context of left frontal activity, and serves as a diathesis for depression in the context of right frontal activity. High-defensive individuals who are right frontally active may represent “failed repressors,” i.e. individuals for whom defensiveness does not protect against depression, and may even exacerbate it.     

Does a torn anterior cruciate ligament lead to change in the central nervous drive of the knee extensors?

Summary Integrated surface electromyograms of the three superficial parts of the quadriceps and isokinetic knee extensor maximum torque and power production were recorded simultaneously and at different angular velocities in both legs in 11 male subjects with unilateral tear of the anterior cruciate ligament. The cross-sectional area (CSA) of the thigh and its muscular components were measured by computerized tomography. The principal findings were a small but significant decrease in quadriceps CSA on the affected side; a decreased active, but not passive, range of movement; decreased mechanical output, whether or not corrected for differences in CSA; and decreased electrornyographic activity — particularly in rectus femoris. These findings suggest that the reason for the decreased maximum and total knee extensor performance seen in these patients is a change in knee joint receptor afferent inflow.     

Gait speed is more challenging than cognitive load on the stride-to-stride variability in individuals with anterior cruciate ligament deficiency

Background

Several investigations have studied gait variability of individuals with anterior cruciate ligament (ACL) deficiency; however, the effect of dual-tasking on the gait variability of these individuals remained unclear. The aim of the present study was to determine the effect of gait speed and dual-tasking on knee flexion–extension variability in subjects with and without ACL deficiency.

Length-dependent activation and sensitivity in arterial ring segments

This study examines the effect of length on the dose-response (D-R) relationship and the effect of agonist concentration on the length-tension (L-T) relationship in vascular smooth muscle. The experiments used 2-mm rings from isolated segments of the dog anterior tibial artery. In D-R experiments the length (internal ring circumference) for maximum active force (L_max) was determined first. D-R relationships were obtained from cumulative responses to increasing concentrations of norepinephrine (NE) or potassium (K⁺). L-T relationships were obtained from individual responses to a specific concentration of agonist as the ring was stretched in increments of L₀ (the initial length for resting force). Dimensions of the arterial rings were measured with a video caliper. For NE and K⁺ stimulations at lengths equal to and less than L_max: (a) The concentration for half maximal response (ED₅₀) was lowest (most sensitive) at L_max and increased significantly as length decreased from L_max; (b) When the direction of length change was reversed, the direction of change in ED₅₀ was reversed; and (c) The ED₅₀ of repeated dose-response experiments at L_max was not significantly different. For NE: (a) the ED₅₀ decreased significantly when length was increased from L_max; and (b) the ED₅₀ increased significantly when length was decreased to L_max. The results of L-T experiments show L_max is significantly longer for a low concentration of NE (10⁻⁶ M) than for a high concentration (10⁻⁵ M). With force normalized to the maximum force, the L-T curve is significantly lower, and the initial length for an active response was 80% longer for 10⁻⁶ M than for 10⁻⁵ M NE. It may be concluded that vascular smooth muscle has a length-dependent dose-response relationship and a concentration-dependent length-tension relationship.     

Anterior tibial artery and its actual projection on the lateral aspect of the tibia: a cadaveric study

The anterior tibial artery (ATA) is at risk of injury during high tibial osteotomy, Ilizarov wire placement, pin placement in external fixation, or proximal locking screw insertion, as the artery is not visualized intraoperatively. The ATA is anchored to the oval foramen of the interosseous membrane on the proximal tibia by the deep fascia and recurrent genicular vascular branches. Segment 1 (from the bifurcation of the popliteal artery to the level of the interosseous foramen) and the proximal part of segment 2 (from the interosseous foramen to the level where the artery crosses the anterior border of the tibia) may be damaged when pin, wire or screw placement is directed posterolaterally at that level. Distally, a straight mediolateral pin or Ilizarov wires may lacerate the artery. Segment 2 of the ATA descends against the interosseous membrane in its proximal part, which is projected on the posterior third of the tibia relative to the sagittal plane; in its middle part, it runs close to the lateral cortex of the tibia, it is projected on the middle third of the tibia; in its distal part it runs gradually towards the anterior third of the tibia and contacts with the anterior third of the tibial cortical surface. This information may help reduce risk of injury to the ATA during high tibial osteotomy, external fixation and pin placement or insertion of locking screws.     

CD34+ stromal cells and hyalinized vascular changes in the anal fibroepithelial polyps

AIMS: To elucidate the pathogenesis of the anal fibroepithelial polyp, we examined surgically resected lesions histopathologically. METHODS AND RESULTS: Twenty-seven surgically resected anal fibroepithelial polyps were investigated histologically with an additional immunohistochemical examination using anti-CD34. For a control study, the surgical specimens of the anal canal showing non-polypoid lesions, obtained from haemorrhoidectomy (18 specimens) and rectectomy (five specimens) due to rectal cancer without anal canal involvement, were also analysed. We demonstrated characteristic spindle or stellate cells immunohistochemically positive for CD34 in the anal fibroepithelial polyps (24/27, 89%). The number of CD34+ cells was statistically related to the size of anal fibroepithelial polyps, although CD34+ stromal cells were recognized in the non-polypoid anal submucosa and haemorrhoids. We also found hyalinized vascular changes in the base of six anal fibroepithelial polyps examined. These features were not detected in the non-polypoid anal canal. CONCLUSIONS: An increase in CD34+ stromal cells may play a role in the enlargement of anal fibroepithelial polyps. CD34+ stromal cells are suggested to be distinctive mesenchymal cells with a capability for tissue repair and overgrowth. The vascular impairment could be secondary change associated with localized tissue damage by abnormal traction.     

脊髓型颈椎病前路减压与内固定手术治疗

目的 评估脊髓型颈椎病前路战压与内固定手术的疗效。方法 对17例脊髓型颈椎病患者采用颈前入路环锯或开槽扩大，显微镜下对致压物施行潜行性减压，植骨后钢板内固定，随访6～48个月。结果 术后症状消失或明显缓解15例，好转2例，无死亡或症状加重。植骨块融合满意，钢板固定无松动，螺钉无松脱。结论 本术式治疗脊髓型颈椎病减压彻底，植骨块融合，内固定钢板稳定可靠。     

Chondral separation in the trochlear groove - a definite clinical entity

Four patients with unusual femoro-patellar chondral defects are presented. We were unable to find their particular lesion described adequately in the literature. The patients all gave a history of relatively minor non-contact injury and presented with anterior knee pain and persistent swelling. The main features on clinical examination were moderate effusion and marked patello-femoral crepitus. Plain X-rays of the knee were unhelpful. At arthroscopy large full thickness chondral defects were seen on the femoral side of the patello-femoral articulation at the site of patellar contact with the knee in about 60° of flexion. The synovium was found to be prolific and vascular. Multiple 1.6-mm drill holes were made in the defect and chondral debris was washed out. Two patients underwent associated lateral patellar release. When a clear cut mechanical patello-femoral disorder presents unexpectedly with associated effusion and a normal radiograph, we suggest that arthroscopy be advised with particular attention to the femoral trochlea.     

Ultrastructure and histochemistry of human anterior lingual salivary glands (glands of blandin and nuhn)

Background: Speciamens of human anterior lingual salivary glans obtained by surgery and by dissection of cadavers were studied ultrastructurally and histochemically. Methods: Specimens were obtained by surgery for ultrastructural study. Other specimens for histochemistry were obtained by dissection of fresh cadavers. Tissues for electron microscopy were fixed and processed by conventional mesns. Formalin-fixed cadaver specimens were subjected to a battery of tests for glycoconjugates. Results: The anterior lingual salivary glands are composed predominantly of mucous tubules (which come in two distinct sizes: large and small), seromucous demilunes, and rare seromucous acini. Regardless of tubule size, mucous cells are typically in appearance and, like mucous cells in other human salivary glands, contain filamentous bodies. Histochemically, the larger tubules contain neutral glycoproteins, low concentrations of sialoglycoproteins, and large amounts of sulfated glycoproteins. The small mucous tubules contain neutral glycoproteins, much sialoglycoprotein, and relatively small amounts of sulfated glycoprotein. The seromucous cells, whether demilunar or acinar, are identical. They contain numerous secretory granules, which show a spectrum of internal patterns from one individual to another. These cells have considerable concentrations of neutral- and sialoglycoproteins and lower concentrations of sulfated gly-coproteins. Countrary to previously published reports, we could find no differences in the ratio of mucous to seromucous cells along the anteriorposterior lingual axis: there was no gradient of seromucous cells in our specimens. The ducts in the anterior lingual salivary glands are not precise counterparts of those in the major salivary glands, since the former have no capsules, hence lack lobulation. Without these familiar structural landmarks, the only duct that can be identified with certainty is the intercalated duct, and then only if it is in continuity with or lies close to a secretory endpiece. Such ducts consist of simple cuboidal epithelium of prosaic appearance. The ductular epithelium gradually thickens and gives rise to what appear to be excretory ducts consisting of columnar cells with few mitochondria. Scattered within the walls of the walls of the larger ducts are patches of typical striated ducts wherein the taller cells display basal striations resulting from highly folded basal plasma membranes and numerous, vertically oriented, virgulate mitochondria. In other atypical regions of the excretory duct, basal cells may have a primary cilium that juts into the intercellular space. Conclusions: There is a high degree of structural variability in human anterior lingual salivary glands. Because of the technical difficulties in collecting pristine saliva from these glands, the precise functions(s) of these organs remains unknown. © 1994 Wiley-Liss, Inc.