A systematic approach to reconstruction of neglected tears of the patellar tendon. A case report

Neglected tears of the patellar tendon due to loss of active extension remain a difficult therapeutic endeavor. The goals in the approach to this diagnosis include restoration of both structural and functional integrity of the extensor mechanism. A procedure has been developed utilizing Z-shortening of the patellar tendon, Z-lengthening of the quadriceps tendon, and the semitendinosis gracilis as a biologic splint. This technique allows establishment of preoperative goals, including restoration of the muscle-tendon complex in its anatomic position, restoration of quadriceps function, preservation of vascularity of the reconstructed tendon, and splinting of the patellar tendon. This reconstruction allows early mobilization and rehabilitation.     

Anaerobes and short-chain fatty acids in crevicular fluid from adults with chronic periodontitis

Pathogeny of adult chronic periodontitis is still unclear. Bacteriological and chemical analysis of crevicular fluid have shown, in active sites of the disease, a simultaneous presence of anaerobes and their major by-product: short-chain fatty acids. The last can decrease "in vitro" the neutrophil intracellular pH, whenever these cells are incubated in an acid medium. Clinical investigations are scarce which hold out data useful to attempt verifying this possible physiopathological mechanism. This work shows the presence of anaerobes in the active periodontal pockets, together with the presence of short-chain fatty acids likely to reach a concentration level comparable to that used for inhibiting neutrophils "in vitro". Forthcoming studies should investigate about a possible intracellular pH drop in the neutrophils and other cells of the inflamed periodontium.     

Timing of in-vitro fertilization of cumulus-free and cumulus-enclosed human oocytes

In humans, in contrast to other species, sperm capacitationrequires a very short time, as in-vitro fertilization has beenobtained after only 45 mm of contact between oocytes and spermatozoacapacitated for 1 h. No fertilization occurred, whatever theduration of sperm capacit.ation, when gamete mixing did notexceed 30 mim. On the contrary, 85% of cumulus-free mature oocytesexposed to sperm for 1–4 h were fertilized. The presenceof the pre-ovulatory, fully-expanded or compact cumulus massdid not represent a physical barrier to sperm progression, aswe observed no delay in fertilization when oocytes were enclosedin the cumulus. The use of a short insemination protocol (1–4h instead of 17–20 h) did not reduce the fertilizationrate of denuded or cumulus-enclosed oocytes and had no significanteffect on the morphological appearance of the embryos or theircleavage rates.     

Endogenous animal models of intracranial aneurysm development: a review

Neurosurgical Review - The pathogenesis and natural history of intracranial aneurysm (IA) remains poorly understood. To this end, animal models with induced cerebral vessel lesions mimicking human...     

Numerical Architecture

The idea that there is a “Number Sense” (Dehaene, 1997) or “Core Knowledge” of number ensconced in a modular processing system (Carey, 2009) has gained popularity as the study of numerical cognition has matured. However, these claims are generally made with little, if any, detailed examination of which modular properties are instantiated in numerical processing. In this article, I aim to rectify this situation by detailing the modular properties on display in numerical cognitive processing. In the process, I review literature from across the cognitive sciences and describe how the evidence reported in these works supports the hypothesis that numerical cognitive processing is modular. I outline the properties that would suffice for deeming a certain processing system a modular processing system. Subsequently, I use behavioral, neuropsychological, philosophical, and anthropological evidence to show that the number module is domain specific, informationally encapsulated, neurally localizable, subject to specific pathological breakdowns, mandatory, fast, and inaccessible at the person level; in other words, I use the evidence to demonstrate that some of our numerical capacity is housed in modular casing.     

Sequential Swallowing of Liquid in Elderly Adults: Cup or Straw?

This article describes the study of the characteristics of sequential swallowing of 100 ml of liquid (dyed water) in two swallowing trials, directly from a cup and through a straw, in healthy elderly individuals. The aim of the study was to determine whether differences in the swallowing pattern are influenced by the type of utensil used. The subjects were subjected to clinical assessment and fiberoptic endoscopic evaluation of swallowing. The research found that intake from the cup showed a significantly lower median as regards time to drink the total volume. The final intake volume was significantly larger from the cup. A statistically significant difference was found in the oral spillage of liquid, which was notably higher in the cup trial. Despite the presence of residue in the valleculae and pyriform sinuses, in neither trial was there penetration or aspiration of liquid. The straw has a favorable influence on the quality of the sequential swallowing of liquid in regard to bolus containment within the oral cavity, which was better with that utensil. The cup provides a higher final volume in a shorter time for intake but there is more fluid spillage.     

Aneurysmal remodeling in the circle of Willis after carotid occlusion in an experimental model

Carotid occlusions are associated with de novo intracranial aneurysm formation in clinical case reports, but this phenomenon is not widely studied. We performed bilateral carotid ligation (n=9) in rabbits to simulate carotid occlusion, and sham surgery (n=3) for control. Upon euthanasia (n=3 at 5 days, n=6 at 6 months post ligation, and n=3 at 5 days after sham operation), vascular corrosion casts of the circle of Willis (CoW) were created. Using scanning electron microscopy, we quantified gross morphologic, macroscopic, and microscopic changes on the endocasts and compared findings with histologic data. At 5 days, CoW arteries of ligated animals increased caliber. The posterior communicating artery (PCom) increased length and tortuosity, and the ophthalmic artery (OA) origin presented preaneurysmal bulges. At 6 months, calibers were unchanged from 5 days, PComs further increased tortuosity while presenting segmental dilations, and the OA origin and basilar terminus presented preaneurysmal bulges. This exploratory study provides evidence that flow increase after carotid occlusion produces both compensatory arterial augmentation and pathologic remodeling such as tortuosity and saccular/fusiform aneurysm. Our findings may have considerable clinical implications, as these lesser-known consequences should be considered when managing patients with carotid artery disease or choosing carotid ligation as a therapeutic option.