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Sample records for partial medial meniscectomy

  1. Joint space narrowing after partial medial meniscectomy in the anterior cruciate ligament-intact knee.

    PubMed

    Shelbourne, K Donald; Dickens, Jonathan F

    2007-09-01

    Osteoarthritis of the knee is common after total medial meniscectomy. In anterior cruciate ligament-intact knees, the reported outcomes of partial medial meniscectomy are variable. Radiographic assessment using a posteroanterior weight-bearing view is a reliable tool for detecting minor medial joint space narrowing, which may be an early sign of osteoarthritis. Studies that assessed the effect of partial medial meniscectomy found a low percentage of patients with >50% joint narrowing at 10 to 15 years after surgery. Digital radiography, using a posteroanterior weight-bearing view, is a highly sensitive method for observing minor joint space narrowing in the involved knee. A recent study showed that 88% of patients who underwent partial medial meniscectomy had joint space narrowing of <2 mm, and none had narrowing >or=2 mm, at a mean follow-up of 12 years. Subjective results after partial medial meniscectomy are favorable, with 88% to 95% of patients reporting good to excellent results.

  2. Effects of strength and neuromuscular training on functional performance in athletes after partial medial meniscectomy

    PubMed Central

    Zhang, Xiaohui; Hu, Min; Lou, Zhen; Liao, Bagen

    2017-01-01

    The aims of this study were to determine an effective knee function rehabilitation program for athletes undergoing partial medial meniscectomy. Participants were randomly assigned to neuromuscular training (NT) or strength training (ST) group and subjected to functional assessments before surgery and again at 4, and 8 weeks post hoc. Functional knee assessment, such as Lysholm knee scoring, star excursion balance, and BTE PrimusRS isokinetic performance tests were evaluated in each group. All postoperational symptoms were significantly improved after 4 and 8 weeks of NT and ST. Both NT and ST programs showed effective knee function recovery seen as an increase in muscular strength and endurance. However, the NT program showed the most significant functional improvement of dynamic balance and coordination. PMID:28349042

  3. The effects of neuromuscular exercise on medial knee joint load post-arthroscopic partial medial meniscectomy: ‘SCOPEX’ a randomised control trial protocol

    PubMed Central

    2012-01-01

    Background Meniscectomy is a risk factor for knee osteoarthritis, with increased medial joint loading a likely contributor to the development and progression of knee osteoarthritis in this group. Therefore, post-surgical rehabilitation or interventions that reduce medial knee joint loading have the potential to reduce the risk of developing or progressing osteoarthritis. The primary purpose of this randomised, assessor-blind controlled trial is to determine the effects of a home-based, physiotherapist-supervised neuromuscular exercise program on medial knee joint load during functional tasks in people who have recently undergone a partial medial meniscectomy. Methods/design 62 people aged 30–50 years who have undergone an arthroscopic partial medial meniscectomy within the previous 3 to 12 months will be recruited and randomly assigned to a neuromuscular exercise or control group using concealed allocation. The neuromuscular exercise group will attend 8 supervised exercise sessions with a physiotherapist and will perform 6 exercises at home, at least 3 times per week for 12 weeks. The control group will not receive the neuromuscular training program. Blinded assessment will be performed at baseline and immediately following the 12-week intervention. The primary outcomes are change in the peak external knee adduction moment measured by 3-dimensional analysis during normal paced walking and one-leg rise. Secondary outcomes include the change in peak external knee adduction moment during fast pace walking and one-leg hop and change in the knee adduction moment impulse during walking, one-leg rise and one-leg hop, knee and hip muscle strength, electromyographic muscle activation patterns, objective measures of physical function, as well as self-reported measures of physical function and symptoms and additional biomechanical parameters. Discussion The findings from this trial will provide evidence regarding the effect of a home-based, physiotherapist

  4. Sural artery injury with arteriovenous fistula: case report about a rare complication following arthroscopic medial meniscectomy

    PubMed Central

    In den Kleef, Nick J.H.M.; Konings, Peer C.; Smeets, Luuk

    2015-01-01

    This case report presents a patient with hematoma and pain after a knee arthroscopy with partial medial meniscectomy. A lesion of the sural artery was treated by endovascular coiling. The level of evidence is IV. PMID:25656167

  5. The Role of Arthroscopic Partial Meniscectomy in the Management of Degenerative Meniscus Tears: A Review of the Recent Literature

    PubMed Central

    Azam, Mohsin; Shenoy, Ravi

    2016-01-01

    Background: The use of arthroscopic partial meniscectomy for middle aged to older adults with knee pain is one of the most common surgical procedures with approximately 150,000 knee arthroscopies being carried out in the United Kingdom each year, and about five times that number in the United States. Despite this, the procedure remains controversial. The aim of this paper is to provide a comprehensive review of the role of arthroscopic meniscectomy in patients with degenerative meniscus tears and suggest recommendations for clinical practice. Methods: A thorough literature search was performed using available databases, including Pubmed, Medline, EMBASE and the Cochrane Library to cover important randomised control trials surrounding the use of arthroscopic partial meniscectomy. Results: The majority of randomised control trials suggest that arthroscopic partial meniscectomy is not superior to conservative measures such as exercise programmes. Furthermore, one randomised control trial found that arthroscopic partial meniscectomy was not even superior to sham surgery. Conclusion: There is significant overtreatment of knee pain with arthroscopic partial meniscectomy when alternative, less invasive and less expensive treatment options are equally effective. First-line treatment of degenerative meniscus tears should be non-operative therapy focused on analgesia and physical therapy to provide pain relief as well as improve mechanical function of the knee joint. Arthroscopic partial meniscectomy should be considered as a last resort when extensive exercise programmes and physiotherapy have been tried and failed. PMID:28217206

  6. Simple arthroscopic partial meniscectomy associated with anterior cruciate-deficient knees.

    PubMed

    Marshall, S; Levas, M G; Harrah, A

    1985-01-01

    Twenty-five patients with combined tears of the meniscus and anterior cruciate ligament in the same knee were evaluated for the results of a simple arthroscopic meniscectomy that preserved the meniscal rim. These patients, classified as "recreational athletes," were analyzed to determine their postoperative functional capabilities. Using the presence or absence of the pivot shift sign as the most important indicator of functional capability, we found that partial meniscectomy was effective in allowing patients to regain a high degree of normal functional ability and in permitting forward motion activities. However, all patients were left with an anterior cruciate-deficient knee that caused laxity in the anterior plane and frequently in the rotatory plane. Rotatory laxity markedly limits activities, and those patients unable to adjust to their instability are considering further surgery.

  7. A multi-scale finite element model for investigation of chondrocyte mechanics in normal and medial meniscectomy human knee joint during walking.

    PubMed

    Tanska, Petri; Mononen, Mika E; Korhonen, Rami K

    2015-06-01

    Mechanical signals experienced by chondrocytes (articular cartilage cells) modulate cell synthesis and cartilage health. Multi-scale modeling can be used to study how forces are transferred from joint surfaces through tissues to chondrocytes. Therefore, estimation of chondrocyte behavior during certain physical activities, such as walking, could provide information about how cells respond to normal and abnormal loading in joints. In this study, a 3D multi-scale model was developed for evaluating chondrocyte and surrounding peri- and extracellular matrix responses during gait loading within healthy and medial meniscectomy knee joints. The knee joint geometry was based on MRI, whereas the input used for gait loading was obtained from the literature. Femoral and tibial cartilages were modeled as fibril-reinforced poroviscoelastic materials, whereas menisci were considered as transversely isotropic. Fluid pressures in the chondrocyte and cartilage tissue increased up to 2MPa (an increase of 30%) in the meniscectomy joint compared to the normal, healthy joint. The elevated level of fluid pressure was observed during the entire stance phase of gait. A medial meniscectomy caused substantially larger (up to 60%) changes in maximum principal strains in the chondrocyte compared to those in the peri- or extracellular matrices. Chondrocyte volume or morphology did not change substantially due to a medial meniscectomy. Current findings suggest that during walking chondrocyte deformations are not substantially altered due to a medial meniscectomy, while abnormal joint loading exposes chondrocytes to elevated levels of fluid pressure and maximum principal strains (compared to strains in the peri- or extracellular matrices). These might contribute to cell viability and the onset of osteoarthritis.

  8. Early in situ changes in chondrocyte biomechanical responses due to a partial meniscectomy in the lateral compartment of the mature rabbit knee joint.

    PubMed

    Fick, J M; P Ronkainen, A; Madden, R; Sawatsky, A; Tiitu, V; Herzog, W; Korhonen, R K

    2016-12-08

    We determined the biomechanical responses of chondrocytes to indentation at specific locations within the superficial zone of cartilage (i.e. patellar, femoral groove, femoral condylar and tibial plateau sites) taken from female New Zealand white rabbits three days after a partial meniscectomy in the lateral compartment of a knee joint. Confocal laser scanning microscopy combined with a custom indentation system was utilized to image chondrocyte responses at sites taken from ten contralateral and experimental knee joints. Cell volume, height, width and depth changes, global, local axial and transverse strains and Young׳s moduli were determined. Histological assessment was performed and proteoglycan content from the superficial zone of each site was determined. Relative to contralateral group cells, patellar, femoral groove and lateral femoral condyle cells in the experimental group underwent greater volume decreases (p < 0.05), due to smaller lateral expansions (with greater decreases in cell height only for the lateral femoral condyle cells; p < 0.05) whereas medial femoral and medial tibial plateau cells underwent smaller volume decreases (p < 0.05), due to less deformation in cell height (p < 0.05). Proteoglycan content was reduced in the patellar (p > 0.05), femoral groove, medial femoral condyle and medial tibial plateau experimental sites (p < 0.05). The findings suggest: (i) cell biomechanical responses to cartilage loading in the rabbit knee joint can become altered as early as 3 days after a partial meniscectomy, (ii) are site-specific, and (iii) occur before alterations in tissue mechanics or changes detectable with histology.

  9. The effects of Rumalon, a glycosaminoglycan peptide complex, in a partial meniscectomy model of osteoarthritis in rabbits.

    PubMed

    Moskowitz, R W; Reese, J H; Young, R G; Fein-Krantz, D; Malemud, C J; Caplan, A I

    1991-02-01

    The effects of Rumalon, a glycosaminoglycan peptide complex (GP-C), were evaluated in a partial meniscectomy model of osteoarthritis (OA). When rabbits were treated with Rumalon, 0.25 ml/kg 3 times/week for 12 weeks after partial meniscectomy, the proportion of animals that developed cartilage ulceration was lower than that in untreated meniscectomized rabbits (p less than 0.05). At 6 weeks sacrifice, the same dose of Rumalon was associated with a trend toward reduction in the number of animals with ulcerations. Rumalon administered at a dose of 0.5 ml/kg for 12 weeks reduced the number of animals with ulcers, although not at the p less than 0.05 level of significance. Semiquantitative histologic evaluations revealed no differences between control and treatment groups either in the thickness of articular cartilage, density of cells present, safranin-O stain or ratio of DNA/protein. Increased proteoglycan synthesis characteristic of OA was modulated toward normal in association with Rumalon therapy. Diminished OA changes in response to Rumalon are consistent with an ameliorative response to this agent in the partial meniscectomy model in the rabbit.

  10. Exercise therapy versus arthroscopic partial meniscectomy for degenerative meniscal tear in middle aged patients: randomised controlled trial with two year follow-up

    PubMed Central

    Kise, Nina Jullum; Risberg, May Arna; Stensrud, Silje; Ranstam, Jonas; Engebretsen, Lars; Roos, Ewa M

    2016-01-01

    Objective To determine if exercise therapy is superior to arthroscopic partial meniscectomy for knee function in middle aged patients with degenerative meniscal tears. Design Randomised controlled superiority trial. Setting Orthopaedic departments at two public hospitals and two physiotherapy clinics in Norway. Participants 140 adults, mean age 49.5 years (range 35.7–59.9), with degenerative medial meniscal tear verified by magnetic resonance imaging. 96% had no definitive radiographic evidence of osteoarthritis. Interventions 12 week supervised exercise therapy alone or arthroscopic partial meniscectomy alone. Main outcome measures Intention to treat analysis of between group difference in change in knee injury and osteoarthritis outcome score (KOOS4), defined a priori as the mean score for four of five KOOS subscale scores (pain, other symptoms, function in sport and recreation, and knee related quality of life) from baseline to two year follow-up and change in thigh muscle strength from baseline to three months. Results No clinically relevant difference was found between the two groups in change in KOOS4 at two years (0.9 points, 95% confidence interval −4.3 to 6.1; P=0.72). At three months, muscle strength had improved in the exercise group (P≤0.004). No serious adverse events occurred in either group during the two year follow-up. 19% of the participants allocated to exercise therapy crossed over to surgery during the two year follow-up, with no additional benefit. Conclusion The observed difference in treatment effect was minute after two years of follow-up, and the trial's inferential uncertainty was sufficiently small to exclude clinically relevant differences. Exercise therapy showed positive effects over surgery in improving thigh muscle strength, at least in the short term. Our results should encourage clinicians and middle aged patients with degenerative meniscal tear and no definitive radiographic evidence of osteoarthritis to consider supervised

  11. Intra-articular injection of hyaluronic acid following arthroscopic partial meniscectomy of the knee.

    PubMed

    Thein, Rafael; Haviv, Barak; Kidron, Amos; Bronak, Shlomo

    2010-10-11

    The short-term recovery period post-arthroscopic meniscectomy is characterized by pain and impaired function most likely related to the irrigation of synovial fluid from the knee intraoperatively. Consequently, along with removal of harmful debris, the irrigation fluid dilutes the hyaluronic acid layer covering the joint tissues. Hyaluronic acid contributes to the homeostasis of the joint environment and is an important component of synovial fluid and cartilage matrix. Hence, the instillation of hyaluronic acid after the procedure may relieve symptoms. This prospective, single-blind, randomized, controlled study evaluated clinical outcome after hyaluronic acid injection to patients who underwent arthroscopic meniscectomy of the knee. Patients with ligamentous injuries or severe chondral damage were excluded. Fifty-six patients with a mean age of 34 years (range, 17-44 years) were injected with Viscoseal (TRB Chemedica International S.A., Geneva, Switzerland) or normal saline immediately post-arthroscopy and divided into the Viscoseal group or control group, respectively. Patients were evaluated for pain, swelling, and function at 1, 4, and 12 weeks postoperatively. Patients in the control group reported more pain at week 1, with a mean visual analog score (VAS) of 43, than did patients in the Viscoseal group, with a mean VAS of 28 (P=.006). At 4 weeks postoperatively, none of the Viscoseal patients had consumed analgesics, where 9 (of 28) in the control group reported acetaminophen intake (P=.039). No significant difference in knee function was found between groups. Intra-articular injection of Viscoseal after arthroscopic meniscectomy reduced pain in the short-term recovery period.

  12. Exercise therapy versus arthroscopic partial meniscectomy for degenerative meniscal tear in middle aged patients: randomised controlled trial with two year follow-up

    PubMed Central

    Risberg, May Arna; Stensrud, Silje; Ranstam, Jonas; Engebretsen, Lars; Roos, Ewa M

    2016-01-01

    Objective To determine if exercise therapy is superior to arthroscopic partial meniscectomy for knee function in middle aged patients with degenerative meniscal tears. Design Randomised controlled superiority trial. Setting Orthopaedic departments at two public hospitals and two physiotherapy clinics in Norway. Participants 140 adults, mean age 49.5 years (range 35.7-59.9), with degenerative medial meniscal tear verified by magnetic resonance imaging. 96% had no definitive radiographic evidence of osteoarthritis. Interventions 12 week supervised exercise therapy alone or arthroscopic partial meniscectomy alone. Main outcome measures Intention to treat analysis of between group difference in change in knee injury and osteoarthritis outcome score (KOOS4), defined a priori as the mean score for four of five KOOS subscale scores (pain, other symptoms, function in sport and recreation, and knee related quality of life) from baseline to two year follow-up and change in thigh muscle strength from baseline to three months. Results No clinically relevant difference was found between the two groups in change in KOOS4 at two years (0.9 points, 95% confidence interval −4.3 to 6.1; P=0.72). At three months, muscle strength had improved in the exercise group (P≤0.004). No serious adverse events occurred in either group during the two year follow-up. 19% of the participants allocated to exercise therapy crossed over to surgery during the two year follow-up, with no additional benefit. Conclusion The observed difference in treatment effect was minute after two years of follow-up, and the trial’s inferential uncertainty was sufficiently small to exclude clinically relevant differences. Exercise therapy showed positive effects over surgery in improving thigh muscle strength, at least in the short term. Our results should encourage clinicians and middle aged patients with degenerative meniscal tear and no definitive radiographic evidence of osteoarthritis to consider

  13. Percutaneous Partial Medial Collateral Ligament Release (PPMCLR) Does Not Result in Residual Medial Collateral Laxity (MCL)

    PubMed Central

    Hinton, M. Alan

    2015-01-01

    Objectives: The intra-articular posterior medial knee can be difficult to approach during arthroscopy. This is especially true for medial meniscal tears, medial meniscal repairs or medial meniscal transplantation. Various methods and instruments have been proposed to help with this approach. PPMCLR is one of these methods. This study found that this is a safe technique and does not result in measurable laxity of the MCL. Methods: 50 consecutive patients took part in the study. The patients were then randomized into a control or partial percutaneous release group (25 in each group). Prior to arthroscopy each patient had standardized 30 degree valgus stress radiograph performed. The MCL was stressed with the Telos Stress Device GA/III at 30 degrees of flexion; utilizing 150 Newton's of stress. The stress radiographs were measured independently for the maximal separation at the medial compartment. At six weeks the stress radiographs were repeated and the results again recorded. The postoperative care for each group was the same. Results: The results were then statistically evaluated using the, finding no radiographic evidence of residual laxity P<.005. There was also no difference in the control and PPMCLR group p<.0005. No patient complained of residual laxity. Patient follow up will be discussed. Conclusion: PPMCLR is an effective and safe method to reach the intra-articular posterior aspect of the knee during arthroscopy. PPMCLR does not result in measurable laxity of the MCL.

  14. Changes in Joint Contact Mechanics in a Large Quadrupedal Animal Model After Partial Meniscectomy and a Focal Cartilage Injury.

    PubMed

    Heckelsmiller, David J; James Rudert, M; Baer, Thomas E; Pedersen, Douglas R; Fredericks, Douglas C; Goetz, Jessica E

    2017-05-01

    Acute mechanical damage and the resulting joint contact abnormalities are central to the initiation and progression of post-traumatic osteoarthritis (PTOA). Study of PTOA is typically performed in vivo with replicate animals using artificially induced injury features. The goal of this work was to measure changes in a joint contact stress in the knee of a large quadruped after creation of a clinically realistic overload injury and a focal cartilage defect. Whole-joint overload was achieved by excising a 5-mm wedge of the anterior medial meniscus. Focal cartilage defects were created using a custom pneumatic impact gun specifically developed and mechanically characterized for this work. To evaluate the effect of these injuries on joint contact mechanics, Tekscan (Tekscan, Inc., South Boston, MA) measurements were obtained pre-operatively, postmeniscectomy, and postimpact (1.2-J) in a nonrandomized group of axially loaded cadaveric sheep knees. Postmeniscectomy, peak contact stress in the medial compartment is increased by 71% (p = 0.03) and contact area is decreased by 35% (p = 0.001); the center of pressure (CoP) shifted toward the cruciate ligaments in both the medial (p = 0.004) and lateral (p = 0.03) compartments. The creation of a cartilage defect did not significantly change any aspect of contact mechanics measured in the meniscectomized knee. This work characterizes the mechanical environment present in a quadrupedal animal knee joint after two methods to reproducibly induce joint injury features that lead to PTOA.

  15. Medial and Lateral Discoid Menisci of Both Knees

    PubMed Central

    Kan, Hiroyuki; Arai, Yuji; Nakagawa, Shuji; Inoue, Hiroaki; Minami, Ginjiro; Ikoma, Kazuya; Fujiwara, Hiroyoshi; Kubo, Toshikazu

    2016-01-01

    Discoid menisci on both the medial and lateral sides are rare, and there are very few reports on cases involving both sides. We report a case of a 52-year-old female with medial and lateral discoid menisci in both knees. Arthroscopy revealed the lateral menisci of both knees were complete discoid menisci, and partial meniscectomy was performed. The medial menisci were incomplete discoid menisci, but there were no findings of abnormal mobility or injury; therefore, the medial menisci were observed without treatment. At six months postoperatively, her pain and range of motion restrictions disappeared. PMID:27894182

  16. Editorial Commentary: Chondrocytes Trump Ligaments! Partial Release of the Medial Collateral Ligament During Knee Arthroscopy Protects Chondrocytes.

    PubMed

    Leland, J Martin

    2016-10-01

    With knee arthroscopy being the most common orthopaedic procedure performed in the United States, it is crucial to be able to access the entire knee without iatrogenic injury. Frequently orthopaedic surgeons encounter tight medial compartments, creating difficulty in accessing the posterior horn of the medial meniscus without damaging the articular cartilage. Partial release of the medial collateral ligament during knee arthroscopy protects chondrocytes.

  17. Patellofemoral osteoarthritis coexistent with tibiofemoral osteoarthritis in a meniscectomy population

    PubMed Central

    Englund, M; Lohmander, L

    2005-01-01

    Objectives: To evaluate the frequency of patellofemoral osteoarthritis and its relevance to symptoms and function in a meniscectomy population. Methods: 317 patients with no cruciate ligament injury were evaluated (mean (SD) age, 54 (11) years). They had undergone meniscal resection 15 to 22 years earlier (follow up rate 70%). Standing tibiofemoral and skyline patellofemoral radiographs were graded according to the OARSI atlas. The Knee Injury and Osteoarthritis Outcome Score (KOOS) was used to quantify symptoms and function. Controls were 68 unoperated subjects identified from national population records. Results: Patellofemoral osteoarthritis (isolated or coexisting with tibiofemoral osteoarthritis) was present in 66 of 317 index knees (21%) and 21 of 263 unoperated contralateral knees (8%, p<0.001). In 57/66 (86%) of these index knees, tibiofemoral osteoarthritis was present (mixed osteoarthritis). In a model adjusted for age, sex, and body mass index, the odds ratio for patellofemoral osteoarthritis (alone or in combination with tibiofemoral osteoarthritis) was 2.6 (95% confidence interval, 1.1 to 6.6) after medial meniscectomy and 5.3 (1.9 to 15.0) after lateral meniscectomy, using controls as the reference. Individuals with a mixed knee osteoarthritis pattern had more symptoms, lower function in sports and recreation, and worse knee related quality of life than subjects with isolated tibiofemoral osteoarthritis. Conclusions: Mixed patellofemoral and tibiofemoral osteoarthritis is common in a meniscectomy population. Patellofemoral osteoarthritis is a contributing cause of knee symptoms and reduced knee related quality of life and is relevant to the management of knee complaints of this group of patients. PMID:15843446

  18. Evaluation of electrosurgical meniscectomy in rabbits.

    PubMed

    Schosheim, P M; Caspari, R B

    1986-01-01

    Recently, electrosurgical cutting instruments utilizing radiofrequency energy have been designed as arthroscopic devices for cutting meniscal tissue. This study attempted to determine the in vivo gross and microscopic effects of radiofrequency energy on meniscal tissue in rabbits. Twelve adult New Zealand white rabbits (48 menisci) underwent bilateral knee arthrotomies. Ten rabbits (40 menisci) underwent partial meniscectomies in which one half of each meniscus in the longitudinal plane was removed with the electrosurgical generator. Two control rabbits underwent arthrotomy without resection of meniscal tissue. At specific time intervals, the rabbits were killed, and the menisci were removed. The gross specimens were photographed, and microscopic sections of each meniscus were fixed and stained. Specimens were evaluated to determine the cellular and vascular response to the electrosurgical cut edge of each meniscus. The microscopic specimens revealed that the radiofrequency cutting instruments produced a small degree of direct thermal damage to the cut meniscus. A tissue response producing a hypercellular dense collagen matrix was present for approximately 3 months. The spontaneous repair of tissue was complete by 6 months, and the histologic 6-month specimens could not be distinguished from the 6-month control specimens except with respect to the overall width of the specimens.

  19. Protease inhibitors decrease rabbit cartilage degradation after meniscectomy

    SciTech Connect

    Caputo, C.B.; Sygowski, L.A.; Patton, S.P.; Wolanin, D.J.; Shaw, A.; Roberts, R.A.; DiPasquale, G.

    1988-01-01

    In vitro proteoglycan (PG) synthesis and release were measured on cartilage removed from rabbit knees within 1 week of meniscectomy. Three days following partial lateral meniscectomy, 72% of the femurs and 82% of the tibias had visible ulcers. Cartilage from the weight-bearing areas incorporated 2.0-2.9 times more /sup 35/S-sulfate in vitro than cartilage from the opposite, unoperated knees. /sup 3/H-thymidine incorporation was 2.5-3.4 times higher for surgical than control groups. /sup 35/S-sulfate incorporation by the surgical group was inhibited by 22% in the presence of 10(-4) M U24522, an inhibitor of rabbit chondrocyte metalloprotease (CMP). /sup 3/H-thymidine incorporation by the surgical group was inhibited by 28% by 10(-4) M U24522. In vitro PG release from cartilage removed 2 days after surgery was 1.6-3.7 times higher for the surgical than the control group. PG release by the surgical group after 22 h of incubation was reduced to the control level by three CMP inhibitors, U24278, U24279, and U24522. PG release by cartilage from the nonsurgical group was also reduced by these compounds at 22 h. These results suggest that both the anabolic and catabolic processes that are stimulated by surgery can be isolated in vitro and that CMP may be involved in the catabolic process.

  20. Medial entorhinal cortex lesions only partially disrupt hippocampal place cells and hippocampus-dependent place memory

    PubMed Central

    Hales, Jena B; Schlesiger, Magdalene I; Leutgeb, Jill K; Squire, Larry R; Leutgeb, Stefan; Clark, Robert E

    2014-01-01

    SUMMARY Entorhinal cortex provides the primary cortical projections to the hippocampus, a brain structure critical for memory. However, it remains unclear how the precise firing patterns of medial entorhinal cortex (MEC) cells influence hippocampal physiology and hippocampus-dependent behavior. We found that complete bilateral lesions of MEC resulted in a lower proportion of active hippocampal cells. The remaining active cells had place fields, but with decreased spatial precision and decreased long-term spatial stability. In addition, MEC rats were as impaired at acquiring the watermaze as hippocampus rats, while rats with combined MEC and hippocampal lesions had an even greater deficit. However, MEC rats were not impaired on other hippocampus-dependent tasks, including those in which an object location or context was remembered. Thus, MEC is not necessary for all types of spatial coding, nor for all types of hippocampus-dependent memory, but is necessary for the normal acquisition of place memory. PMID:25437546

  1. Phasic-like stimulation of the medial forebrain bundle augments striatal gene expression despite methamphetamine-induced partial dopamine denervation.

    PubMed

    Howard, Christopher D; Pastuzyn, Elissa D; Barker-Haliski, Melissa L; Garris, Paul A; Keefe, Kristen A

    2013-05-01

    Methamphetamine-induced partial dopamine depletions are associated with impaired basal ganglia function, including decreased preprotachykinin mRNA expression and impaired transcriptional activation of activity-regulated, cytoskeleton-associated (Arc) gene in striatum. Recent work implicates deficits in phasic dopamine signaling as a potential mechanism linking methamphetamine-induced dopamine loss to impaired basal ganglia function. This study thus sought to establish a causal link between phasic dopamine transmission and altered basal ganglia function by determining whether the deficits in striatal neuron gene expression could be restored by increasing phasic dopamine release. Three weeks after pretreatment with saline or a neurotoxic regimen of methamphetamine, rats underwent phasic- or tonic-like stimulation of ascending dopamine neurons. Striatal gene expression was examined using in situ hybridization histochemistry. Phasic-like, but not tonic-like, stimulation induced immediate-early genes Arc and zif268 in both groups, despite the partial striatal dopamine denervation in methamphetamine-pretreated rats, with the Arc expression occurring in presumed striatonigral efferent neurons. Phasic-like stimulation also restored preprotachykinin mRNA expression. These results suggest that disruption of phasic dopamine signaling likely underlies methamphetamine-induced impairments in basal ganglia function, and that restoring phasic dopamine signaling may be a viable approach to manage long-term consequences of methamphetamine-induced dopamine loss on basal ganglia functions.

  2. AMECM/DCB scaffold prompts successful total meniscus reconstruction in a rabbit total meniscectomy model.

    PubMed

    Yuan, Zhiguo; Liu, Shuyun; Hao, Chunxiang; Guo, Weimin; Gao, Shuang; Wang, Mingjie; Chen, Mingxue; Sun, Zhen; Xu, Yichi; Wang, Yu; Peng, Jiang; Yuan, Mei; Guo, Quan-Yi

    2016-12-01

    Tissue-engineered meniscus regeneration is a very promising treatment strategy for meniscus lesions. However, generating the scaffold presents a huge challenge for meniscus engineering as this has to meet particular biomechanical and biocompatibility requirements. In this study, we utilized acellular meniscus extracellular matrix (AMECM) and demineralized cancellous bone (DCB) to construct three different types of three-dimensional porous meniscus scaffold: AMECM, DCB, and AMECM/DCB, respectively. We tested the scaffolds' physicochemical characteristics and observed their interactions with meniscus fibrochondrocytes to evaluate their cytocompatibility. We implanted the three different types of scaffold into the medial knee menisci of New Zealand rabbits that had undergone total meniscectomy; negative control rabbits received no implants. The reconstructed menisci and corresponding femoral condyle and tibial plateau cartilage were all evaluated at 3 and 6 months (n = 8). The in vitro study demonstrated that the AMECM/DCB scaffold had the most suitable biomechanical properties, as this produced the greatest compressive and tensile strength scores. The AMECM/DCB and AMECM scaffolds facilitated fibrochondrocyte proliferation and the secretion of collagen and glycosaminoglycans (GAGs) more effectively than did the DCB scaffold. The in vivo experiments demonstrated that both the AMECM/DCB and DCB groups had generated neomeniscus at both 3 and 6 months post-implantation, but there was no obvious meniscus regeneration in the AMECM or control groups, so the neomeniscus analysis could not perform on AMECM and control group. At both 3 and 6 months, histological scores were better for regenerated menisci in the AMECM/DCB than in the DCB group, and significantly better for articular cartilage in the AMECM/DCB group compared with the other three groups. Knee MRI scores (Whole-Organ Magnetic Resonance Imaging Scores (WORMS)) were better in the AMECM/DCB group than in the

  3. Cytotoxic lesion of the medial prefrontal cortex abolishes the partial reinforcement extinction effect, attenuates prepulse inhibition of the acoustic startle reflex and induces transient hyperlocomotion, while sparing spontaneous object recognition memory in the rat.

    PubMed

    Yee, B K

    2000-01-01

    The partial reinforcement extinction effect refers to the increase in resistance to extinction of an operant response acquired under partial reinforcement relative to that acquired under continuous reinforcement. Prepulse inhibition of the acoustic startle response refers to the reduction in startle reactivity towards an intense acoustic pulse stimulus when it is shortly preceded by a weak prepulse stimulus. These two behavioural phenomena appear to be related to different forms of attentional processes. While the prepulse inhibition effect reflects an inherent early attentional gating mechanism, the partial reinforcement extinction effect is believed to involve the development of acquired inattention, i.e. the latter requires the animals to learn about what to and what not to attend. Impairments in prepulse inhibition and the partial reinforcement extinction effect have been independently linked to the neuropsychology of attentional dysfunctions seen in schizophrenia. The proposed neural substrates underlying these behaviourial phenomena also appear to overlap considerably: both focus on the nucleus accumbens and emphasize the functional importance of its limbic afferents, including that originating from the medial prefrontal cortex, on accumbal output/activity. The present study demonstrated that cytotoxic medial prefrontal cortex lesions which typically damaged the prelimbic, the infralimbic and the dorsal anterior cingulate areas could lead to the abolition of the partial reinforcement extinction effect and the attenuation of prepulse inhibition. The lesions also resulted in a transient elevation of spontaneous locomotor activity. In contrast, the same lesions spared performance in a spontaneous object recognition memory test, in which the lesioned animals displayed normal preference for a novel object when the novel object was presented in conjunction with a familiar object seen 10 min earlier within an open field arena. The present results lend support to the

  4. McMurray Test: A Prediction of Arthroscopic Meniscectomy Outcomes in Patients with Knee Osteoarthritis.

    PubMed

    Ji, Cheng; Lin, Xiangjin; Zhu, Liulong; Li, Min

    2015-05-01

    The McMurray test is used to evaluate patients with meniscal tears of the knee. Analysis of the sensitivity and specificity of McMurray test and the correlation between McMurray sign and postoperative outcomes are helpful to screen the candidates for arthroscopic meniscectomy. The present study compares the results of McMurray test with arthroscopic examination in patients with knee osteoarthritis. We studied 149 patients diagnosed as meniscal lesion with osteoarthritis by radiology and had arthroscopic surgery. Our data show that positive McMurray sign implies good postoperative outcomes for the patients with meniscal tear associated with osteoarthritis. For patients with osteoarthritis, those whose positive McMurray signs are in line with their radiological findings indicate they are eligible candidates for arthroscopic meniscectomy. Our study suggests that McMurray sign can be used as an indication for both symptomatic meniscal tear and postoperative outcomes.

  5. The neural substrates for the rewarding and dopamine-releasing effects of medial forebrain bundle stimulation have partially discrepant frequency responses.

    PubMed

    Cossette, M-P; Conover, K; Shizgal, P

    2016-01-15

    Midbrain dopamine neurons have long been implicated in the rewarding effect produced by electrical brain stimulation of the medial forebrain bundle (MFB). These neurons are excited trans-synaptically, but their precise role in intracranial self-stimulation (ICSS) has yet to be determined. This study assessed the hypothesis that midbrain dopamine neurons are in series with the directly stimulated substrate for self-stimulation of the MFB and either perform spatio-temporal integration of synaptic input from directly activated MFB fibers or relay the results of such integration to efferent stages of the reward circuitry. Psychometric current-frequency trade-off functions were derived from ICSS performance, and chemometric trade-off functions were derived from stimulation-induced dopamine transients in the nucleus accumbens (NAc) shell, measured by means of fast-scan cyclic voltammetry. Whereas the psychometric functions decline monotonically over a broad range of pulse frequencies and level off only at high frequencies, the chemometric functions obtained with the same rats and electrodes are either U-shaped or level off at lower pulse frequencies. This discrepancy was observed when the dopamine transients were recorded in either anesthetized or awake subjects. The lack of correspondence between the psychometric and chemometric functions is inconsistent with the hypothesis that dopamine neurons projecting to the NAc shell constitute an entire series stage of the neural circuit subserving self-stimulation of the MFB.

  6. Posterolateral rotatory instability of the knee after arthroscopic subtotal lateral meniscectomy: a case report

    PubMed Central

    BULGHERONI, ERICA; BULGHERONI, PAOLO

    2014-01-01

    A 33-year-old Caucasian woman came to our attention complaining of lateral knee pain on the left side, severe external instability associated with varus malalignment, and difficulties in weight-bearing activities. The symptoms had appeared following two lateral meniscectomies on her discoid meniscus, performed elsewhere. The patient was initially submitted to an allograft meniscus transplantation exploiting the unloaded condition of lateral compartment and obtained pain relief. The posterolateral corner was reconstructed in combination with a valgus osteotomy to address the posterolateral rotatory instability. The follow-up assessment at two years after the last surgery showed no symptoms, maintenance of limb alignment and no evidence of joint degeneration. PMID:25606550

  7. Medial epicondylitis - golfer's elbow

    MedlinePlus

    ... page: //medlineplus.gov/ency/article/007638.htm Medial epicondylitis - golfer's elbow To use the sharing features on this page, please enable JavaScript. Medial epicondylitis is soreness or pain on the inside of ...

  8. Medial Collateral Ligament (MCL) Injuries

    MedlinePlus

    ... of Healthy Breakfasts Shyness Medial Collateral Ligament (MCL) Injuries KidsHealth > For Teens > Medial Collateral Ligament (MCL) Injuries ... Treatment Coping With an MCL Injury About MCL Injuries A torn medial collateral ligament (MCL) is a ...

  9. Arthroscopic contact Nd:YAG laser meniscectomy: basic science, surgical technique, and clinical follow up

    NASA Astrophysics Data System (ADS)

    O'Brien, Stephen J.; Fealy, Stephen V.; Gibney, Mary A.; Miller, Drew V.; Kelly, Anne M.

    1990-06-01

    Recent basic science studies (5) have provided a scientific foundation for the use of the Contact Nd:YAG Laser as an arthroscopic tool for xneniscal resection and acroxnioplasty of the shoulder in a saline medium. This study prospectively evaluates the results of a three stage laboratory investigation as well as the clinical results of arthroscopic xneniscal resection. Fifteen patients with meniscal tears underwent subtotal meniscectomies utilizing a Contact Nd:YAG Laser (Surgical Laser Technologies; Malvern, Pennsylvania) . This was done in a saline medium with an average laser wattage of 25 W, (range 20 W to 30 W). Patients were evaluated postoperatively with reference to subjective and objective parameters at one week and four weeks postoperatively. Patients were evaluated with regard to wound healing, intraarticular swelling and pain. Assessment of technical parameters such as ease of resection, time of resection and instrument access were compared to conventional instruments. All fifteen patients were rated as having clinically excellent results based on pain relief, wound healing and swelling. In addition, although there was increased time with setting up the laser and calibrating it, there was not an increase in time for meniscal resection. Little, or no, secondary "trimmuning" was necessary with the laser. Increased accessibility was noted due to the small size of the laser. Arthroscopic Contact Nd:YAG Laser surgery is a safe and effective tool for menisca]. resection and coagulation in arthroscopic acromioplasties. It provides significant advantages over conventional cutting instruments with regard to accessibility and reduced need for secondary instruments.

  10. Medial canthal support structures: the medial retinaculum: a review.

    PubMed

    Kang, Hyera; Takahashi, Yasuhiro; Nakano, Takashi; Asamoto, Ken; Ikeda, Hiroshi; Kakizaki, Hirohiko

    2015-04-01

    The medial canthus is supported by several structures with a complicated 3-dimensional arrangement in a narrow space. Although the medial canthal tendon occupies a major portion of the area, the medial canthal support structures include the following entities: Horner's muscle, the medial rectus capsulopalpebral fascia including the medial check ligament, the medial horn of the levator aponeurosis, the medial horn supporting ligament, the medial horn of the lower eyelid retractors, the preseptal part of the orbicularis oculi muscle, and 3 variations of the Lockwood's ligament. We named the composite of these structures the "medial retinaculum," which is similar to the "lateral retinaculum" of the lateral canthus. Profound comprehension and consideration of the medial retinaculum warrants safe and effective surgery in the medial canthal region.

  11. Chuave Medial Verbs

    ERIC Educational Resources Information Center

    Thurman, Robert C.

    1975-01-01

    This article discusses two syntactic processes known as chaining and linkage, insofar as they are relevant to Chuave, a Papuan language spoken in the East New Guinea Highlands. These processes are discussed in relation to Chuave medial verbs. (CLK)

  12. Medial plica syndrome.

    PubMed

    Sznajderman, Tal; Smorgick, Yossi; Lindner, Dror; Beer, Yiftah; Agar, Gabriel

    2009-01-01

    Synovial plicae are membranous inward folds of the synovial lining of the knee joint capsula. Such folds are regularly found in the human knee, but most are asymptomatic and of little clinical consequence. However, they can become symptomatic and cause knee pain. In this review, we will discuss medial plica syndrome. Medial plica irritation of the knee is a common source of anterior knee pain. The main complaint is an intermittent, dull, aching pain in the area medial to the patella above the joint line and in the supramedial patellar area. Pain increases with activity, especially when knee flexion and extension are required. Treatment includes physiotherapy, reducing activity, and rest. In cases that do not respond initially to an exercise program, corticosteroid injections and non-steroidal antiinflammatory medication are given. Results of conservative treatment seem to be more appropriate in young patients with a short duration of symptoms. If conservative treatment fails, surgical treatment using arthroscopy is appropriate. During arthroscopy, excision of the whole plica should be achieved.

  13. Association of Quadriceps Strength and Psychosocial Factors With Single-Leg Hop Performance in Patients With Meniscectomy

    PubMed Central

    Hsu, Chao-Jung; George, Steven Z.; Chmielewski, Terese L.

    2016-01-01

    Background: Clinicians use the single-leg hop test to assess readiness for return to sports after knee injury. Few studies have reported the results of single-leg hop testing after meniscectomy. Additionally, the contributions of impairments in quadriceps strength and psychosocial factors to single-leg hop performance are unknown. Purpose: To compare single-leg hop performance (distance and landing mechanics) between limbs and to examine the association of single-leg hop performance with quadriceps strength and psychosocial factors in patients with meniscectomy. Study Design: Descriptive laboratory study. Methods: A total of 22 subjects who underwent meniscectomy for traumatic meniscal tears received either standard rehabilitation alone or with additional quadriceps strengthening. Testing was conducted immediately postrehabilitation and at 1 year postsurgery. A single-leg hop test was performed bilaterally, and hop distance was used to create a hop symmetry index. Landing mechanics (peak knee flexion angle, knee extension moment, and peak vertical ground-reaction force) were analyzed with a motion-capture system and a force plate. An isokinetic dynamometer (60 deg/s) assessed knee extensor peak torque and rate of torque development (RTD0-200ms and RTD0–peak torque). Questionnaires assessed fear of reinjury (Tampa Scale for Kinesiophobia [TSK-11]) and self-efficacy (Knee Activity Self-Efficacy [KASE]). Results: Rehabilitation groups did not significantly differ in single-leg hop performance; therefore, groups were combined for further analyses. The mean hop symmetry index was 88.6% and 98.9% at postrehabilitation and 1 year postsurgery, respectively. Compared with the nonsurgical limb, the surgical limb showed decreased peak knee flexion angle at postrehabilitation and decreased knee extension moment at 1 year postsurgery. The hop symmetry index was positively associated with peak torque, RTD0-200ms, and the KASE score at postrehabilitation. Moreover, at

  14. Effect of lateral meniscectomy and osteochondral grafting of a lateral femoral condylar defect on contact mechanics: a cadaveric study in dogs

    PubMed Central

    2013-01-01

    Background Osteochondral autograft transfer (OAT) aims at restoring normal articular cartilage surface geometry and articular contact mechanics. To date, no studies have evaluated the contact mechanics of the canine stifle following OAT. Additionally, there are no studies that evaluated the role of the meniscus in contact mechanics following OAT in human or canine femorotibial joints. The objective of this study was to measure the changes in femorotibial contact areas (CA), mean contact pressure (MCP) and peak contact pressure (PCP) before and after osteochondral autograft transplantation (OAT) of a simulated lateral femoral condylar cartilage defect with an intact lateral meniscus and following lateral meniscectomy. Results With an intact lateral meniscus, creation of an osteochondral defect caused a decrease in MCP and PCP by 11% and 30%, respectively, compared to the intact stifle (p < 0.01). With an intact meniscus, implanting an osteochondral graft restored MCP and PCP to 96% (p = 0.56) and 92% (p = 0.41) of the control values. Lateral meniscectomy with grafting decreased CA by 54% and increased PCP by 79% compared to the intact stifle (p < 0.01). Conclusions OAT restored contact pressures in stifles with a simulated lateral condylar defect when the meniscus was intact. The lateral meniscus has a significant role in maintaining normal contact pressures in both stifles with a defect or following OAT. Meniscectomy should be avoided when a femoral condylar defect is present and when performing OAT. PMID:23522348

  15. Outcome of ACL Reconstruction for Chronic ACL Injury in Knees without the Posterior Horn of the Medial Meniscus: Comparison with ACL Reconstructed Knees with An Intact Medial Meniscus

    PubMed Central

    Syam, Kevin; Chouhan, Devendra K.; Dhillon, Mandeep Singh

    2017-01-01

    Purpose Cadaveric studies have shown that deficiency of the posterior horn of the medial meniscus (PHMM) increases strain on the anterior cruciate ligament (ACL) graft. However, its influence on the clinical and radiological outcome after ACL reconstruction is less discussed and hence evaluated in this study. Materials and Methods This study included 77 cases of ACL reconstruction with a minimum 18-month follow-up. Of the 77 cases, 41 patients with intact menisci were compared clinically and radiologically with 36 patients with an injury to the PHMM that required various grades of meniscectomy. The knees were evaluated using subjective International Knee Documentation Committee (IKDC) score and Orthopadische Arbeitsgruppe Knie (OAK) score. Results Cases with intact menisci showed better stability (p=0.004) at an average of 44.51 months after surgery. No significant differences were noted in the overall OAK score, subjective IKDC score, and functional OAK score (p=0.082, p=0.526, and p=0.363, respectively). The incidence of radiological osteoarthrosis was significantly higher in the posterior horn deficient knees (p=0.022). Conclusions The tendency toward relatively higher objective instability and increased incidence of osteoarthrosis in the group with absent posterior horn reinforces its importance as a secondary stabiliser of the knee. PMID:28231647

  16. Congenital dystrophic medial rectus muscles

    PubMed Central

    Murthy, Ramesh

    2017-01-01

    We report two patients, one with congenital dystrophic medial rectus muscles and one with absence of the medial rectus muscles; in addition, one of them had absence of the lateral rectus muscles. While absence of the superior oblique and superior rectus has been more commonly reported in literature, especially with craniofacial syndromes, our patients were nonsyndromic. Considering the risk of anterior segment ischemia, correction of the large-angle exotropia was performed by horizontal rectus muscle surgery where possible, along with transfer of the superior oblique tendon to the superior part of the normal medial rectus muscle insertion area to create a tethering effect with a good outcome. PMID:28300745

  17. Medial Patellofemoral Ligament Reconstruction

    PubMed Central

    Palacios, Jose Antonio; Yacuzzi, Carlos; Oñativia, Jose I.; Zicaro, Juan Pablo; Costa-Paz, Matias

    2017-01-01

    Objectives: Recurrent patellofemoral dislocation is usually a multifactorial pathology. Different surgical techniques have been described according to the etiology of dislocation. In absence of a severe malalignment or an anatomical patellofemoral dysplasia, reconstruction of Medial Patello-femoral Ligament (MPFL) can restore the normal tracking of the patella, avoiding lateral excursion. The purpose of this study was to evaluate clinical results and complications in patients who underwent a MPFL reconstruction. Methods: We retrospectively evaluated 19 patients who underwent an anatomic MPFL reconstruction using autologous semitendinosus graft between 2007 and 2012. Exclusion criteria were patients with less than three years of follow-up and those with an associated procedure such as distal realignment or trochleoplasty. Clinical outcomes were measured using Kujala score and return to sport rate. We registered the postoperative complications and recurrence rate. Results: Nine patients were men and 10 women with a mean age of 25 years. Average follow-up was 5.8 years. Nine patients (47.4%) returned to their previous sport level, 8 (42.1%) changed to another sport or decreased their level and 2 (10.5%) were unable to practice any sports at all. Kujala score improvement was from 62.8 preoperative to 88.8 postoperative. One patient decreased the Kujala score. Eighty-nine percent of patients were satisfied with their outcome. One patient had a patellar fracture and four developed an arthrofibrosis and required mobilization under anesthesia. No recurrences were registered. Conclusion: Isolated MPFL reconstruction for recurrent patellofemoral dislocation is an effective alternative in absence of severe malalignment or anatomical dysplasia. Although no recurrences where registered at minimum 3-year follow-up, almost half of the patients were not able to return to their previous sport level.

  18. Medial temporal lobe volume predicts elders' everyday memory.

    PubMed

    Bailey, Heather R; Zacks, Jeffrey M; Hambrick, David Z; Zacks, Rose T; Head, Denise; Kurby, Christopher A; Sargent, Jesse Q

    2013-07-01

    Deficits in memory for everyday activities are common complaints among healthy and demented older adults. The medial temporal lobes and dorsolateral prefrontal cortex are both affected by aging and early-stage Alzheimer's disease, and are known to influence performance on laboratory memory tasks. We investigated whether the volume of these structures predicts everyday memory. Cognitively healthy older adults and older adults with mild Alzheimer's-type dementia watched movies of everyday activities and completed memory tests on the activities. Structural MRI was used to measure brain volume. Medial temporal but not prefrontal volume strongly predicted subsequent memory. Everyday memory depends on segmenting activity into discrete events during perception, and medial temporal volume partially accounted for the relationship between performance on the memory tests and performance on an event-segmentation task. The everyday-memory measures used in this study involve retrieval of episodic and semantic information as well as working memory updating. Thus, the current findings suggest that during perception, the medial temporal lobes support the construction of event representations that determine subsequent memory.

  19. Medial Temporal Lobe Volume Predicts Elders' Everyday Memory

    PubMed Central

    Bailey, Heather R.; Zacks, Jeffrey M.; Hambrick, David Z.; Zacks, Rose T.; Head, Denise; Kurby, Christopher A.; Sargent, Jesse Q.

    2013-01-01

    Deficits in memory for everyday activities are common complaints among healthy and demented older adults. The medial temporal lobes and dorsolateral prefrontal cortex are both affected by aging and early-stage Alzheimer's disease, and are known to influence performance on laboratory memory tasks. We investigated whether the volume of these structures predicts everyday memory. Cognitively healthy older adults and older adults with mild Alzheimer's-type dementia watched movies of everyday activities and completed memory tests on the activities. Structural MRI was used to measure brain volume. Medial temporal but not prefrontal volume strongly predicted subsequent memory. Everyday memory depends on segmenting activity into discrete events during perception, and medial temporal volume partially accounted for the relationship between performance on the memory tests and performance on an event-segmentation task. The everyday-memory measures used in this study involve retrieval of episodic and semantic information as well as working memory updating. Thus, the current findings suggest that during perception, the medial temporal lobes support the construction of event representations that determine subsequent memory. PMID:23630222

  20. Bottom-up Visual Integration in the Medial Parietal Lobe.

    PubMed

    Pflugshaupt, Tobias; Nösberger, Myriam; Gutbrod, Klemens; Weber, Konrad P; Linnebank, Michael; Brugger, Peter

    2016-03-01

    Largely based on findings from functional neuroimaging studies, the medial parietal lobe is known to contribute to internally directed cognitive processes such as visual imagery or episodic memory. Here, we present 2 patients with behavioral impairments that extend this view. Both had chronic unilateral lesions of nearly the entire medial parietal lobe, but in opposite hemispheres. Routine neuropsychological examination conducted >4 years after the onset of brain damage showed little deficits of minor severity. In contrast, both patients reported persistent unusual visual impairment. A comprehensive series of tachistoscopic experiments with lateralized stimulus presentation and comparison with healthy participants revealed partial visual hemiagnosia for stimuli presented to their contralesional hemifield, applying inferential single-case statistics to evaluate deficits and dissociations. Double dissociations were found in 4 experiments during which participants had to integrate more than one visual element, either through comparison or formation of a global gestalt. Against the background of recent neuroimaging findings, we conclude that of all medial parietal structures, the precuneus is the most likely candidate for a crucial involvement in such bottom-up visual integration.

  1. The snapping medial antebrachial cutaneous nerve.

    PubMed

    Cesmebasi, Alper; O'driscoll, Shawn W; Smith, Jay; Skinner, John A; Spinner, Robert J

    2015-10-01

    Snapping elbow is a well-known condition where elbow flexion and extension elicits a painful, popping sensation. The most frequent etiology is anterior dislocation of the ulnar nerve over the medial epicondyle. Four patients (3 females and 1 male) presented with complaints of a popping sensation in the elbow, pain over the medial aspect of the forearm, and ulnar neuritis. All patients underwent preoperative dynamic ultrasound and surgical exploration of the medial elbow. Intraoperatively, snapping of the MABC over the medial epicondyle was discovered in all four patients. In three patients, there was abnormal displacement of the medial triceps and ulnar nerve: in two of these, both structures dislocated over the medial epicondyle and in one patient both structures subluxated. In each case, the MABC was decompressed (n = 1) and transposed (n = 3), and in three cases, the medial triceps and ulnar nerve were addressed as well. Symptomatic improvement was achieved in all cases. Retrospective review of the ultrasound revealed the snapping MABC, though it was less effective prospectively in the cases when snapping MABC was not suspected. In conclusion, snapping of the MABC broadens the spectrum of disorders that results in snapping elbow. To our knowledge, we are unaware of prior reports of this entity.

  2. Bipartite medial cuneiform: new frequencies from skeletal collections and a meta-analysis of previous cases.

    PubMed

    Burnett, S E; Case, D T

    2011-04-01

    Bipartition of the medial cuneiform is a malsegmentation defect of the foot characterized by separation of the normal cuneiform into dorsal and plantar segments. In many cases, these segments are held together by means of a cartilaginous or fibrocartilaginous bridge, resulting in a deep, lytic-like pit in dry bone reminiscent of those seen in cases of non-osseous tarsal coalition. Partial bipartition, where separation of the two segments is incomplete, may also occur. Though originally documented over 250 years ago, relatively little is known about the bipartite medial cuneiform. The purpose of this paper is to present thirteen new cases (ten complete, three partial) from Egypt, England, South Africa, Denmark, and the United States, and to analyze all known cases to investigate patterns in sex, laterality, frequency, and associated anomalies. Results suggest that bipartite medial cuneiforms are significantly more prevalent in males. Bipartite medial cuneiforms are also frequently bilateral, perhaps indicating a strong genetic component. Identification of this condition in multiple individuals from a cemetery could, therefore, suggest a familial relationship. Frequencies of this variant are consistently less than 1% in most large samples, and significant frequency differences among samples from around the world are rare. Several other minor congenital variations have been noted in individuals with bipartition of the medial cuneiform. However, additional systematic research is needed to elucidate further the prevalence of associated variants.

  3. Bilateral agenesis of the anterior cruciate ligament: MRI evaluation.

    PubMed

    Bedoya, Maria A; McGraw, Michael H; Wells, Lawrence; Jaramillo, Diego

    2014-09-01

    Bilateral agenesis of the anterior cruciate ligament (ACL) is extremely rare. We describe a 13-year-old girl who presented with bilateral knee pain without history of trauma; she has two family members with knee instability. Magnetic resonance imaging showed bilateral absence of the ACL, and medial posterior horn meniscal tears. Bilateral arthroscopic partial meniscectomy and anterior cruciate ligament reconstruction was performed.

  4. [Tibial periostitis ("medial tibial stress syndrome")].

    PubMed

    Fournier, Pierre-Etienne

    2003-06-01

    Medial tibial stress syndrome is characterised by complaints along the posteromedial tibia. Runners and athletes involved in jumping activities may develop this syndrome. Increased stress to stabilize the foot especially when excessive pronation is present explain the occurrence this lesion.

  5. Medial medullary infarction: abnormal ocular motor findings.

    PubMed

    Kim, J Soo; Choi, K-D; Oh, S-Y; Park, S-H; Han, M-K; Yoon, B-W; Roh, J-K

    2005-10-25

    In 20 consecutive patients with isolated medial medullary infarction, abnormal ocular motor findings included nystagmus (n = 8), ocular contrapulsion (n = 5), and contralesional ocular tilt reaction (n = 2). The nystagmus was ipsilesional (n = 4), gaze-evoked (n = 5), upbeating (n = 4), and hemiseesaw (n = 1). The ocular motor abnormalities may be explained by involvements of the nucleus prepositus hypoglossi, medial longitudinal fasciculus or efferent fibers from the vestibular nuclei, climbing fibers, and cells of the paramedian tracts.

  6. The medial sural artery perforator free flap.

    PubMed

    Cavadas, P C; Sanz-Giménez-Rico, J R; Gutierrez-de la Cámara, A; Navarro-Monzonís, A; Soler-Nomdedeu, S; Martínez-Soriano, F

    2001-11-01

    The medial sural artery supplies the medial gastrocnemius muscle and sends perforating branches to the skin. The possible use of these musculocutaneous perforators as the source of a perforator-based free flap was investigated in cadavers. Ten legs were dissected, and the topography of significant perforating musculocutaneous vessels on both the medial and the lateral gastrocnemius muscles was recorded. A mean of 2.2 perforators (range, 1 to 4) was noted over the medial gastrocnemius muscle, whereas in only 20 percent of the specimens was a perforator of moderate size noted over the lateral gastrocnemius muscle. The perforating vessels from the medial sural artery clustered about 9 to 18 cm from the popliteal crease. When two perforators were present (the most frequent case), the perforators were located at a mean of 11.8 cm (range, 8.5 to 15 cm) and 17 cm (range, 15 to 19 cm) from the popliteal crease. A series of six successful clinical cases is reported, including five free flaps and one pedicled flap for ipsilateral lower-leg and foot reconstruction. The dissection is somewhat tedious, but the vascular pedicle can be considerably long and of suitable caliber. Donor-site morbidity was minimal because the muscle was not included in the flap. Although the present series is short, it seems that the medial sural artery perforator flap can be a useful flap for free and pedicled transfer in lower-limb reconstruction.

  7. Medial Canthoplasty Combined with Conjunctivodacryocystorhinostomy for the Treatment of Delayed Medial Telecanthal Deformity

    PubMed Central

    Sun, Hua; Li, Yang; Huang, Qian; Ding, Jing-Wen; Hou, Zhi-Jia; Li, Dong-Mei

    2017-01-01

    Background: Rupture of the medial canthal ligament can be caused by many events. It remains a challenge to rebuild the drainage system and restore the function. The aim of this study was to evaluate the clinical efficacy of medial canthoplasty combined with conjunctivodacryocystorhinostomy (CDCR) in patients with medial telecanthal deformities and lacrimal drainage system damage. Methods: Twenty-two patients (22 eyes) treated with medial canthoplasty and CDCR during June 2012 to June 2014 were included in this retrospective study. For all patients, a self-tapping, titanium, low-profile head microscrew was drilled into the solid bone on the posterior aspect of the anterior lacrimal crest at the attachment position of the medial canthal ligament. Medpor-coated tear drainage tubes were applied. Distance of patient's lateral displacement before and after operation was recorded and compared. The complications of CDCR were described. Results: Before the surgery, distance of patient's canthal displacement was 4–6 mm. The canthal distance between two eyes of patients with surgery was 1 mm or less. Among patients with CDCR, four patients had proximal obstruction and two patients had distal obstruction. Five patients had tube malposition, for example, tube extrusion 1–3 months after surgery. Conclusions: Medial canthoplasty combined with CDCR is an effective surgical method for treatment of patients with medial telecanthal deformity and lacrimal drainage system obstruction. The study indicates that medial canthoplasty combined with CDCR surgery rebuilds normal appearance of eyelid and contour of the medial canthus and successfully repairs the function of the lacrimal drainage system. PMID:28303853

  8. Affective Aprosodia from a Medial Frontal Stroke

    ERIC Educational Resources Information Center

    Heilman, Kenneth M.; Leon, Susan A.; Rosenbek, John C.

    2004-01-01

    Background and objectives: Whereas injury to the left hemisphere induces aphasia, injury to the right hemisphere's perisylvian region induces an impairment of emotional speech prosody (affective aprosodia). Left-sided medial frontal lesions are associated with reduced verbal fluency with relatively intact comprehension and repetition…

  9. [SECOT consensus on medial femorotibial osteoarthritis].

    PubMed

    Moreno, A; Silvestre, A; Carpintero, P

    2013-01-01

    A consensus, prepared by SECOT, is presented on the management of medial knee compartment osteoarthritis, in order to establish clinical criteria and recommendations directed at unifying the criteria in its management, dealing with the factors involved in the pathogenesis of medial femorotibial knee osteoarthritis, the usefulness of diagnostic imaging techniques, and the usefulness of arthroscopy. Conservative and surgical treatments are also analysed. The experts consulted showed a consensus (agreed or disagreed) in 65.8% of the items considered, leaving 14items where no consensus was found, which included the aetiopathogenesis of the osteoarthritis, the value of NMR in degenerative disease, the usefulness of COX-2 and the chondroprotective drugs, as well as on the ideal valgus tibial osteotomy technique.

  10. Medial Cochlear Efferent Function: A Theoretical Analysis

    NASA Astrophysics Data System (ADS)

    Mountain, David C.

    2011-11-01

    Since the discovery of the cochlear efferent system, many hypotheses have been put forth for its function. These hypotheses for its function range from protecting the cochlea from over stimulation to improving the detection of sounds in noise. It is known that the medial efferent system innervates the outer hair cells and that stimulation of this system reduces basilar membrane and auditory nerve sensitivity which suggests that this system acts to decrease the gain of the cochlear amplifier. Here I present modeling results as well as analysis of published experimental data that suggest that the function of the medial efferent reflex is to decrease the cochlear amplifier gain by just the right amount so that the nonlinearity in the basilar membrane response lines up perfectly with the inner hair cell nonlinear transduction process to produce a hair cell receptor potential that is proportional to the logarithm of the sound pressure level.

  11. Masseter and medial pterygoid muscle hypertrophy.

    PubMed

    Guruprasad, R; Rishi, Sudhirkumar; Nair, Preeti P; Thomas, Shaji

    2011-09-26

    Hypertrophy refers to an enlargement caused by an increase in the size but not in the number of cells. Generalised masticatory muscle hypertrophy may affect the temporalis muscle, masseters and medial pterygoids in a variety of combinations. Masseteric hypertrophy may present as either unilateral or bilateral painless swelling of unknown origin in the region of angle of mandible. It is a relatively rare condition and presents a diagnostic dilemma. While the history and clinical examination are important in differentiating this benign condition from parotid or dental pathology, they cannot necessarily exclude rare malignant lesion within the muscle. Advanced imaging modalities like CT and MRI are essential to confirm the diagnosis. Here the authors are reporting a unique case of masseter muscle hypertrophy along with medial pterygoid hypertrophy which was missed clinically but confirmed using CT and MRI.

  12. Osteoligamentous injuries of the medial ankle joint.

    PubMed

    Lötscher, P; Lang, T H; Zwicky, L; Hintermann, B; Knupp, M

    2015-12-01

    Injuries of the ankle joint have a high incidence in daily life and sports, thus, playing an important socioeconomic role. Therefore, proper diagnosis and adequate treatment are mandatory. While most of the ligament injuries around the ankle joint are treated conservatively, great controversy exists on how to treat deltoid ligament injuries in ankle fractures. Missed injuries and inadequate treatment of the medial ankle lead to inferior outcome with instability, progressive deformity, and ankle joint osteoarthritis.

  13. Medial septal lesion enhances general anesthesia response.

    PubMed

    Leung, L Stan; Ma, Jingyi; Shen, Bixia; Nachim, Ilan; Luo, Tao

    2013-09-01

    Electrolytic lesion of the medial septum, a basal forebrain nucleus that projects to the hippocampus, prolonged the emergence from general anesthesia in rats. Septal lesioned rats required a longer time to recover from a loss of righting reflex (LORR) and a loss of tail-pinch response after injectable (20 mg/kg i.p. pentobarbital, 5mg/kg i.v. propofol) or volatile (1.5% halothane, 2% isoflurane) anesthetic. When incremental doses of propofol were given i.p., septal lesioned rats as compared to control rats showed LORR at a lower dose of propofol. Similarly, when the rats were exposed to increasing concentrations of isoflurane, the percent of rats showing LORR was leftward shifted for lesioned rats as compared to control rats. Septal lesioned rats as compared to control rats showed decreased locomotor activity when exposed to 1.5% halothane. Lesion of the medial septum was confirmed by thionin-stained histological sections as well as loss of acetylcholinesterase (AchE) staining in the hippocampus, indicating a depletion of septohippocampal cholinergic afferents. Medial septal lesion resulted in a near complete loss of hippocampal theta rhythm during walking and a general decrease in power of the hippocampal EEG at all frequencies (0-100 Hz), during walking or immobility. It is concluded that lesion of medial septum, in part through a loss of septohippocampal cholinergic afferents, increased the anesthesia response to volatile and injectable general anesthetics, during both induction and emergence. It is suggested that the septohippocampal system participates in many components of general anesthesia including hypnosis, immobility, and analgesia.

  14. Variations in the origin of the medial calcaneal nerve.

    PubMed

    Dellon, A Lee; Kim, Jaesuk; Spaulding, Cecily M

    2002-02-01

    Previous anatomic studies of the medial heel region were done on embalmed human cadavers. Here, the innervation of the medial heel region was studied by dissecting living tissue with the use of 3.5-power loupe magnification during decompression of the medial ankle for tarsal tunnel syndrome in 85 feet. The medial heel was found to be innervated by just one medial calcaneal nerve in 37% of the feet, by two medial calcaneal nerves in 41%, by three medial calcaneal nerves in 19%, and by four medial calcaneal nerves in 3%. An origin for a medial calcaneal nerve from the medial plantar nerve was found in 46% of the feet. This nerve most often innervates the skin of the posteromedial arch, where it is at risk for injury during calcaneal spur removal or plantar fasciotomy. Knowledge of the variations in location of the medial calcaneal nerves may prevent neuroma formation during surgery and provide insight into the variability of heel symptoms associated with tarsal tunnel syndrome.

  15. Persistently active neurons in human medial frontal and medial temporal lobe support working memory.

    PubMed

    Kamiński, Jan; Sullivan, Shannon; Chung, Jeffrey M; Ross, Ian B; Mamelak, Adam N; Rutishauser, Ueli

    2017-04-01

    Persistent neural activity is a putative mechanism for the maintenance of working memories. Persistent activity relies on the activity of a distributed network of areas, but the differential contribution of each area remains unclear. We recorded single neurons in the human medial frontal cortex and medial temporal lobe while subjects held up to three items in memory. We found persistently active neurons in both areas. Persistent activity of hippocampal and amygdala neurons was stimulus-specific, formed stable attractors and was predictive of memory content. Medial frontal cortex persistent activity, on the other hand, was modulated by memory load and task set but was not stimulus-specific. Trial-by-trial variability in persistent activity in both areas was related to memory strength, because it predicted the speed and accuracy by which stimuli were remembered. This work reveals, in humans, direct evidence for a distributed network of persistently active neurons supporting working memory maintenance.

  16. Management of medial-sided knee injuries, part 1: medial collateral ligament.

    PubMed

    Marchant, Milford H; Tibor, Lisa M; Sekiya, Jon K; Hardaker, William T; Garrett, William E; Taylor, Dean C

    2011-05-01

    The medial collateral ligament complex is a primary stabilizer that combines static and dynamic resistance to direct valgus stress while contributing significant restraints to rotatory motion and anterior-posterior translation. Varying opinions exist among investigators regarding injury classification and treatment algorithms. Whereas most agree that the majority of isolated medial collateral ligament complex injuries can be treated nonoperatively, isolated injuries with chronic instability and multiligament injuries may require operative intervention. Substantial confounding factors are present within published reports, making comparative analyses and systematic review challenging. This review focuses on the anatomy and biomechanics of the medial structures of the knee; it discusses the clinical evaluation of complex injuries; and it reviews nonoperative and operative treatment methods.

  17. Post-ablative reconstruction of the medial canthus and medial orbital wall using conchal cartilage graft with three illustrative cases.

    PubMed

    Dagregorio, G; Darsonval, V

    2005-12-01

    When the medial third of the upper or lower eyelid has to be reconstructed after full-thickness tumour excision, we usually use Hübner tarsomarginal grafts, but when medial canthal lesions spread to the medial orbital wall without invading the orbital margin, conchal graft becomes our first surgical option. Previously reported solutions to this difficult problem are few and concern more directly medial orbital wall fractures. We found no article dealing specifically with the use of conchal graft in post-ablative reconstruction of the medial orbital wall. Nevertheless the concha presents great advantages over bone grafting or rib cartilage, because it is more flexible and malleable. And it is less prone to extrusion or infection as may be allografts implants. It is a very effective way to repair medial orbital defects, but graft reorientation must be perfect to match exactly the medial orbital wall concavity.

  18. The lateral column lengthening and medial column stabilization procedures.

    PubMed

    Chi, T D; Toolan, B C; Sangeorzan, B J; Hansen, S T

    1999-08-01

    The results of medial column stabilization, lateral column lengthening, and combined medial and lateral procedures were reviewed in the treatment of adult acquired flatfoot secondary to posterior tibialis tendon insufficiency. All bony procedures were accompanied by transfer of the flexor digitorum longus tendon to the medial cuneiform or stump of the posterior tibialis tendon and tendoachilles lengthening or gastrocnemius recession. Medial column fusion was performed for naviculocuneiform and cuneiform first metatarsal sag; lateral column lengthening was performed for calcaneovalgus deformity with a flat pitch angle; and combined procedures were performed for complex combined deformities. At 1 to 4 year followup of 65 feet, 88% of the feet that had lateral column lengthening, 80% that had medial column stabilization, and 88% of the feet that had medial and lateral procedures had a decrease in pain or were pain free. The lateral talar first metatarsal angle improved by 16 degrees in the patients in the lateral column lengthening group, 20 degrees in the patients in the medial column stabilization group, and 24 degrees in the patients in the combined medial and lateral procedures group. The anteroposterior talonavicular coverage angle improved by 14 degrees in the patients in the lateral column lengthening group, 10 degrees in the patients in the medial column stabilization group, and 14 degrees in the patients in the combined medial and lateral procedures group. These techniques effectively correct deformity without disrupting the essential joints of the hindfoot and midfoot.

  19. Consensus Statement on Indications and Contraindications for Medial Unicompartmental Knee Arthroplasty.

    PubMed

    Berend, Keith R; Berend, Michael E; Dalury, David F; Argenson, Jean-Noel; Dodd, Chris A; Scott, Richard D

    2015-01-01

    Previous work, now nearly 30 years dated, is frequently cited as the "gold standard" for the indications and contraindications for medial unicompartmental knee arthroplasty (UKA). The purpose of this article is to review current literature on the indications and contraindications to UKA and develop a consensus statement based on those data. Six surgeons with a combined experience of performing more than 8,000 partial knee arthroplasties were surveyed. Surgeons then participated in a discussion, emerging proposal, collaborative modification, and final consensus phase. The final consensus on primary indications and contraindications is presented. Notably, the authors provide consensus on previous contraindications, which are no longer considered to be contraindications. The authors provide an updated and concise review of the current indications and contraindications for medial UKA using scientifically based consensus-building methodology.

  20. Microvascular medial femoral condylar flaps in 107 consecutive reconstructions in the head and neck.

    PubMed

    Brandtner, Christian; Hachleitner, Johannes; Bottini, Gian Battista; Buerger, Heinz; Gaggl, Alexander

    2016-07-01

    We have assessed the role of the medial femoral condylar flap in 107 patients who had reconstructions of the head and neck. We retrospectively reviewed their medical records for indications, complications, and outcomes. The flap was primarily used for coverage of alveolar ridge defects (n=67), secondly for defects of the facial bone, calvaria, or skull base (n=35), and thirdly for partial laryngeal defects (n=5). Two flaps were lost. One patient fractured a femur 5 weeks postoperatively. The duration of follow up ranged from 6 months to 12 years. The medial femoral condylar flap is well-suited to individual reconstructions of the alveolar ridge, midface, calvaria, skull base, and part of the larynx with poor recipient sites. The flap does not replace other wellknown flaps, but offers new solutions for solving special problems in head and neck surgery.

  1. Medial unicondylar knee arthroplasty: technical pearls

    PubMed Central

    BONIFORTI, FILIPPO

    2015-01-01

    Unicondylar knee arthroplasty implantation is extremely demanding as the prosthesis needs to be integrated in the natural anatomy of the knee. It ensures the integrity of the natural knee kinematic. Some studies and registries data have shown lower success rate in comparison with total knee arthroplasty, and patient-related factors may have an impact on outcome. While, better results have been published by high volume centres. The indications for surgery should be reconsidered critically, even if medial osteoarthritis of the knee remains the most common. This article sets out the diagnostic, and surgical steps in order to fine tuning the unicompartmental replacement of the knee. PMID:26605256

  2. Medial knee joint loading increases in those who respond to hyaluronan injection for medial knee osteoarthritis.

    PubMed

    Briem, Kristin; Axe, Michael J; Snyder-Mackler, Lynn

    2009-11-01

    Knee osteoarthritis (OA) is a cause of decline in function and the medial compartment is often affected. Intraarticular injection of hyaluronic acid (HA) is indicated as a symptom modifying treatment with at least 6 months passing between consecutive injection series. The effects of HA injection on gait variables have not been extensively examined. Therefore, our objective was to investigate the effects of HA injection on gait in people with medial knee OA. Twenty-seven subjects were included; each was tested prior to treatment (baseline), no later than 3 weeks following the last injection (post-HA), and again 5 months after treatment ended (follow-up). Responder criteria were defined to identify responders and non-responders. Subjects underwent 3D gait analysis, muscle activity was sampled, and co-contraction indices were calculated. Responders experienced increased peak knee adduction moments post-HA, whereas non-responders did not. Improved self-report scores were associated with increased knee adduction moments and increased medial co-contraction. Pain relief may result in higher loading onto the already vulnerable medial compartment due to changes in lower limb mechanics and muscle activation patterns. Eventually this may result in a more rapid progression of joint deterioration.

  3. Medial subluxation of the patella without previous lateral retinacular release.

    PubMed

    Richman, N M; Scheller, A D

    1998-07-01

    This case presented a 17-year-old patient with persistent complaints localized to the right patellofemoral joint. Clinical examination demonstrated increased medial translation of the patella on manual stress. In contrast to previous published reports on medial patellar subluxation, this patient had not undergone prior lateral retinacular release. Arthroscopic examination documented medial tracking of the patella as well as excess medial translation. Imbrication of the patient's lateral patellar retinaculum centralized patella tracking and diminished medial translation on stress testing as observed arthroscopically and clinically. This case illustrates that medial patellar subluxation is a subtle problem that may be overlooked in the patient presenting with patellofemoral complaints and should be included in the differential diagnosis.

  4. [Medial epicondylitis. Etiology, diagnosis, therapeutic modalities].

    PubMed

    Tschantz, P; Meine, J

    1993-01-01

    Medial epicondylitis is rather uncommon, less frequent than external epicondylitis. For this reason, the diagnosis is thought of rather late. While taking the history, one should try to find out the possible causative effects. Symptoms of irritation of the cubital nerve, which are present in one out of five cases should be looked for. Several sports such as baseball, javelin or weight throwing, volleyball, climbing, tennis, golf, which need a strong flexion of the hand and fingers can induce this condition. However, in more than half of our patients, sports or professional activities were not in cause. The majority were housewives and do-it-yourself enthusiasts. Among our 55 operated cases, out of which few had professional or sports activities, we did not encounter during the operation the macroscopic tendinous lesions that are sometimes described by some authors. The treatment should be conservative in all cases. This includes rest, anti-inflammatory drugs, physiotherapy, muscular stretching, immobilisation in a cast, steroid infiltrations. One patient out of ten will have to be operated on. The operative techniques differ on some details, but they all include the desinsertion of the flexor muscles on the medial epicondyle. When there are clinical signs of irritation of the cubital nerve, it should be transposed anteriorly. The result of these operations is good in more than 90 per cent of the cases. However, a come back to professional sport can take as long as 8 months.

  5. The medial tibial stress syndrome. A cause of shin splints.

    PubMed

    Mubarak, S J; Gould, R N; Lee, Y F; Schmidt, D A; Hargens, A R

    1982-01-01

    The medial tibial stress syndrome is a symptom complex seen in athletes who complain of exercise-induced pain along the distal posterior-medial aspect of the tibia. Intramuscular pressures within the posterior compartments of the leg were measured in 12 patients with this disorder. These pressures were not elevated and therefore this syndrome is a not a compartment syndrome. Available information suggests that the medial tibial stress syndrome most likely represents a periostitis at this location of the leg.

  6. Cartilage Delamination Flap Mimicking a Torn Medial Meniscus

    PubMed Central

    Bin Abd Razak, Hamid Rahmatullah; Amit Kanta, Mitra

    2016-01-01

    We report a case of a chondral delamination lesion due to medial parapatellar plica friction syndrome involving the medial femoral condyle. This mimicked a torn medial meniscus in clinical and radiological presentation. Arthroscopy revealed a chondral delamination flap, which was debrided. Diagnosis of chondral lesions in the knee can be challenging. Clinical examination and MRI have good accuracy for diagnosis and should be used in tandem. Early diagnosis and treatment of chondral lesions are important to prevent progression to early osteoarthritis. PMID:28070434

  7. Medial Prefrontal-Medial Temporal Theta Phase Coupling in Dynamic Spatial Imagery.

    PubMed

    Kaplan, Raphael; Bush, Daniel; Bisby, James A; Horner, Aidan J; Meyer, Sofie S; Burgess, Neil

    2017-03-01

    Hippocampal-medial prefrontal interactions are thought to play a crucial role in mental simulation. Notably, the frontal midline/medial pFC (mPFC) theta rhythm in humans has been linked to introspective thought and working memory. In parallel, theta rhythms have been proposed to coordinate processing in the medial temporal cortex, retrosplenial cortex (RSc), and parietal cortex during the movement of viewpoint in imagery, extending their association with physical movement in rodent models. Here, we used noninvasive whole-head MEG to investigate theta oscillatory power and phase-locking during the 18-sec postencoding delay period of a spatial working memory task, in which participants imagined previously learned object sequences either on a blank background (object maintenance), from a first-person viewpoint in a scene (static imagery), or moving along a path past the objects (dynamic imagery). We found increases in 4- to 7-Hz theta power in mPFC when comparing the delay period with a preencoding baseline. We then examined whether the mPFC theta rhythm was phase-coupled with ongoing theta oscillations elsewhere in the brain. The same mPFC region showed significantly higher theta phase coupling with the posterior medial temporal lobe/RSc for dynamic imagery versus either object maintenance or static imagery. mPFC theta phase coupling was not observed with any other brain region. These results implicate oscillatory coupling between mPFC and medial temporal lobe/RSc theta rhythms in the dynamic mental exploration of imagined scenes.

  8. [Material properties of meniscus tissue and the effect of the menisci on the compression behavior of the knee joint].

    PubMed

    Kohn, D; Mussack, T; Plitz, W

    1993-01-01

    Specimens of meniscus tissue were taken from different locations of the medial and lateral meniscus. They were tested to failure in the tensometer and force elongation diagrams were recorded. 28 meniscus specimens (14 medial, 14 lateral) gained at autopsy were available for testing. The posterior third of the medial meniscus and the middle third of the lateral meniscus were the strongest and stiffest parts of the meniscus. Yet local differences within one meniscus were only subtle. One clinical significance of these data is, that for replacement of the medial and lateral meniscus the same homogeneous material can be employed. Six tests under compression were carried out using six knee specimens gained at autopsy. Knee compression tests yielded different results after radial cutting of the meniscus, whereas partial meniscectomy had no effect on deformation and hysteresis. These biomechanical results support the concept of partial meniscectomy and preservation of the meniscal periphery. But they cannot be related to the problem of possible degenerative arthritis after partial meniscectomy.

  9. Medial perirhinal cortex disambiguates confusable objects.

    PubMed

    Kivisaari, Sasa L; Tyler, Lorraine K; Monsch, Andreas U; Taylor, Kirsten I

    2012-12-01

    Our brain disambiguates the objects in our cluttered visual world seemingly effortlessly, enabling us to understand their significance and to act appropriately. The role of anteromedial temporal structures in this process, particularly the perirhinal cortex, is highly controversial. In some accounts, the perirhinal cortex is necessary for differentiating between perceptually and semantically confusable objects. Other models claim that the perirhinal cortex neither disambiguates perceptually confusable objects nor plays a unique role in semantic processing. One major hurdle to resolving this central debate is the fact that brain damage in human patients typically encompasses large portions of the anteromedial temporal lobe, such that the identification of individual substructures and precise neuroanatomical locus of the functional impairments has been difficult. We tested these competing accounts in patients with Alzheimer's disease with varying degrees of atrophy in anteromedial structures, including the perirhinal cortex. To assess the functional contribution of each anteromedial temporal region separately, we used a detailed region of interest approach. From each participant, we obtained magnetic resonance imaging scans and behavioural data from a picture naming task that contrasted naming performance with living and non-living things as a way of manipulating perceptual and semantic confusability; living things are more similar to one another than non-living things, which have more distinctive features. We manually traced neuroanatomical regions of interest on native-space cortical surface reconstructions to obtain mean thickness estimates for the lateral and medial perirhinal cortex and entorhinal cortex. Mean cortical thickness in each region of interest, and hippocampal volume, were submitted to regression analyses predicting naming performance. Importantly, atrophy of the medial perirhinal cortex, but not lateral perirhinal cortex, entorhinal cortex or

  10. An unusually medial axillary arch muscle.

    PubMed Central

    Dharap, A

    1994-01-01

    In the left upper limb of an adult male cadaver a triangular muscular slip, 3.5 cm long and 2.5 cm wide, arose from the lower border of latissimus dorsi just proximal to its tendon of insertion. It was inserted by a slender 6 cm long tendon mainly into the coracoid process of the scapula. Three short fibrous strands radiated from this slender tendon to gain attachments to pectoralis minor and the common tendon of origin of the short head of biceps brachii and coracobrachialis. In addition 2 flat tendinous bands attached the margin of this muscular slip to teres major. The thoracodorsal nerve entered the main bulk of latissimus dorsi close to the muscular slip but did not supply a separate branch to the latter. This is an axillary arch muscle in an unusually medial location. Images Fig. 1 Fig. 2 PMID:7928652

  11. Motor unit organization of human medial gastrocnemius.

    PubMed Central

    Garnett, R A; O'Donovan, M J; Stephens, J A; Taylor, A

    1979-01-01

    1. The properties of fifty-seven motor units in human medial gastrocnemius have been studied using controlled intramuscular microstimulation, glycogen depletion and muscle biopsy. 2. Motor units could be divided into three classes on the basis of their mechanical properties. Type S units were slow, small and fatigue resistant. Type FR units were fast, intermediate in size, and fatigue resistant. Type FF units were fast, large and fatigable. 3. Glycogen depletion of a number of type S and FF units revealed them to be composed of type 1 and type 2b muscle fibres respectively. 4. The results suggest that during slowly increasing voluntary contractions where units are recruited in order of size, type 1 and 2a muscle fibres would be employed at low force levels followed by type 2b muscle fibres in stronger contractions. Images Fig. 5 Fig. 6 PMID:430414

  12. Motor unit organization of human medial gastrocnemius.

    PubMed

    Garnett, R A; O'Donovan, M J; Stephens, J A; Taylor, A

    1979-02-01

    1. The properties of fifty-seven motor units in human medial gastrocnemius have been studied using controlled intramuscular microstimulation, glycogen depletion and muscle biopsy. 2. Motor units could be divided into three classes on the basis of their mechanical properties. Type S units were slow, small and fatigue resistant. Type FR units were fast, intermediate in size, and fatigue resistant. Type FF units were fast, large and fatigable. 3. Glycogen depletion of a number of type S and FF units revealed them to be composed of type 1 and type 2b muscle fibres respectively. 4. The results suggest that during slowly increasing voluntary contractions where units are recruited in order of size, type 1 and 2a muscle fibres would be employed at low force levels followed by type 2b muscle fibres in stronger contractions.

  13. Medial septum regulates the hippocampal spatial representation

    PubMed Central

    Mamad, Omar; McNamara, Harold M.; Reilly, Richard B.; Tsanov, Marian

    2015-01-01

    The hippocampal circuitry undergoes attentional modulation by the cholinergic medial septum. However, it is unclear how septal activation regulates the spatial properties of hippocampal neurons. We investigated here what is the functional effect of selective-cholinergic and non-selective septal stimulation on septo-hippocampal system. We show for the first time selective activation of cholinergic cells and their differential network effect in medial septum of freely-behaving transgenic rats. Our data show that depolarization of cholinergic septal neurons evokes frequency-dependent response from the non-cholinergic septal neurons and hippocampal interneurons. Our findings provide vital evidence that cholinergic effect on septo-hippocampal axis is behavior-dependent. During the active behavioral state the activation of septal cholinergic projections is insufficient to evoke significant change in the spiking of the hippocampal neurons. The efficiency of septo-hippocampal processing during active exploration relates to the firing patterns of the non-cholinergic theta-bursting cells. Non-selective septal theta-burst stimulation resets the spiking of hippocampal theta cells, increases theta synchronization, entrains the spiking of hippocampal place cells, and tunes the spatial properties in a timing-dependent manner. The spatial properties are augmented only when the stimulation is applied in the periphery of the place field or 400–650 ms before the animals approached the center of the field. In summary, our data show that selective cholinergic activation triggers a robust network effect in the septo-hippocampal system during inactive behavioral state, whereas the non-cholinergic septal activation regulates hippocampal functional properties during explorative behavior. Together, our findings uncover fast septal modulation on hippocampal network and reveal how septal inputs up-regulate and down-regulate the encoding of spatial representation. PMID:26175674

  14. Medial septum regulates the hippocampal spatial representation.

    PubMed

    Mamad, Omar; McNamara, Harold M; Reilly, Richard B; Tsanov, Marian

    2015-01-01

    The hippocampal circuitry undergoes attentional modulation by the cholinergic medial septum. However, it is unclear how septal activation regulates the spatial properties of hippocampal neurons. We investigated here what is the functional effect of selective-cholinergic and non-selective septal stimulation on septo-hippocampal system. We show for the first time selective activation of cholinergic cells and their differential network effect in medial septum of freely-behaving transgenic rats. Our data show that depolarization of cholinergic septal neurons evokes frequency-dependent response from the non-cholinergic septal neurons and hippocampal interneurons. Our findings provide vital evidence that cholinergic effect on septo-hippocampal axis is behavior-dependent. During the active behavioral state the activation of septal cholinergic projections is insufficient to evoke significant change in the spiking of the hippocampal neurons. The efficiency of septo-hippocampal processing during active exploration relates to the firing patterns of the non-cholinergic theta-bursting cells. Non-selective septal theta-burst stimulation resets the spiking of hippocampal theta cells, increases theta synchronization, entrains the spiking of hippocampal place cells, and tunes the spatial properties in a timing-dependent manner. The spatial properties are augmented only when the stimulation is applied in the periphery of the place field or 400-650 ms before the animals approached the center of the field. In summary, our data show that selective cholinergic activation triggers a robust network effect in the septo-hippocampal system during inactive behavioral state, whereas the non-cholinergic septal activation regulates hippocampal functional properties during explorative behavior. Together, our findings uncover fast septal modulation on hippocampal network and reveal how septal inputs up-regulate and down-regulate the encoding of spatial representation.

  15. Force depression decays during shortening in the medial gastrocnemius of the rat.

    PubMed

    Till, Olaf; Siebert, Tobias; Blickhan, Reinhard

    2014-03-21

    Force depression due to shortening of activated skeletal muscles has previously been described to be long lasting during isometric contractions following the shortening. In the present study, using the medial gastrocnemius of the rat, effects of force depression have been made apparent during shortening by computationally partially compensating for the direct effect of shortening velocity due to the tension-velocity relation. Evidence was found for the decay and complete disappearance of force depression already during continuation of the shortening contraction to short muscle lengths.

  16. Medial pivot knee in primary total knee arthroplasty.

    PubMed

    Atzori, Francesco; Salama, Wael; Sabatini, Luigi; Mousa, Shazly; Khalefa, Abdelrahman

    2016-01-01

    Total knee arthroplasty (TKA) with a medial pivot design was developed in order to mimic normal knee kinematics; the highly congruent medial compartment implant should improve clinical results and decrease contact stresses. Clinical and radiographic mid-term outcomes are satisfactory, but we need other studies to evaluate long-term results and indications for unusual cases.

  17. Angiotensin II Induces Region-Specific Medial Disruption during Evolution of Ascending Aortic Aneurysms

    PubMed Central

    Rateri, Debra L.; Davis, Frank M.; Balakrishnan, Anju; Howatt, Deborah A.; Moorleghen, Jessica J.; O’Connor, William N.; Charnigo, Richard; Cassis, Lisa A.; Daugherty, Alan

    2015-01-01

    Angiotensin II (Ang II) promotes development of ascending aortic aneurysms (AAs), but progression of this pathology is undefined. We evaluated factors potentially involved in progression, and determined the temporal sequence of tissue changes during development of Ang II–induced ascending AAs. Ang II infusion into C57BL/6J mice promoted rapid expansion of the ascending aorta, with significant increases within 5 days, as determined by both in vivo ultrasonography and ex vivo sequential acquisition of tissues. Rates of expansion were not significantly different in LDL receptor–null mice fed a saturated fat-enriched diet, demonstrating a lack of effect of hypercholesterolemia. Augmenting systolic blood pressure with norepinephrine infusion had no significant effect on ascending aortic expansion. Pathological changes observed within 5 days of Ang II infusion included increased medial thickness and intramural hemorrhage characterized by erythrocyte extravasation in outer lamellar layers of the media. Intramedial hemorrhage was not observed after prolonged Ang II infusion, although partial medial disruption was present. Elastin fragmentation and transmural medial breaks of the ascending aorta were observed with continued Ang II infusion, which were restricted to anterior aspects. CD45+ cells accumulated in adventitia but were minimal in media. Similar pathology was observed in tissues obtained from patients with ascending AAs. In conclusion, Ang II promotes ascending AAs through region-specific changes that are independent of hypercholesterolemia or systolic blood pressure. PMID:25038458

  18. The medial scaffold of 3D unorganized point clouds.

    PubMed

    Leymarie, Frederic F; Kimia, Benjamin B

    2007-02-01

    We introduce the notion of the medial scaffold, a hierarchical organization of the medial axis of a 3D shape in the form of a graph constructed from special medial curves connecting special medial points. A key advantage of the scaffold is that it captures the qualitative aspects of shape in a hierarchical and tightly condensed representation. We propose an efficient and exact method for computing the medial scaffold based on a notion of propagation along the scaffold itself, starting from initial sources of the flow and constructing the scaffold during the propagation. We examine this method specifically in the context of an unorganized cloud of points in 3D, e.g., as obtained from laser range finders, which typically involve hundreds of thousands of points, but the ideas are generalizable to data arising from geometrically described surface patches. The computational bottleneck in the propagation-based scheme is in finding the initial sources of the flow. We thus present several ideas to avoid the unnecessary consideration of pairs of points which cannot possibly form a medial point source, such as the "visibility" of a point from another given a third point and the interaction of clusters of points. An application of using the medial scaffold for the representation of point samplings of real-life objects is also illustrated.

  19. Optogenetic dissection of medial prefrontal cortex circuitry

    PubMed Central

    Riga, Danai; Matos, Mariana R.; Glas, Annet; Smit, August B.; Spijker, Sabine; Van den Oever, Michel C.

    2014-01-01

    The medial prefrontal cortex (mPFC) is critically involved in numerous cognitive functions, including attention, inhibitory control, habit formation, working memory and long-term memory. Moreover, through its dense interconnectivity with subcortical regions (e.g., thalamus, striatum, amygdala and hippocampus), the mPFC is thought to exert top-down executive control over the processing of aversive and appetitive stimuli. Because the mPFC has been implicated in the processing of a wide range of cognitive and emotional stimuli, it is thought to function as a central hub in the brain circuitry mediating symptoms of psychiatric disorders. New optogenetics technology enables anatomical and functional dissection of mPFC circuitry with unprecedented spatial and temporal resolution. This provides important novel insights in the contribution of specific neuronal subpopulations and their connectivity to mPFC function in health and disease states. In this review, we present the current knowledge obtained with optogenetic methods concerning mPFC function and dysfunction and integrate this with findings from traditional intervention approaches used to investigate the mPFC circuitry in animal models of cognitive processing and psychiatric disorders. PMID:25538574

  20. Subspecialization in the human posterior medial cortex

    PubMed Central

    Bzdok, Danilo; Heeger, Adrian; Langner, Robert; Laird, Angela R.; Fox, Peter T.; Palomero-Gallagher, Nicola; Vogt, Brent A.; Zilles, Karl; Eickhoff, Simon B.

    2014-01-01

    The posterior medial cortex (PMC) is particularly poorly understood. Its neural activity changes have been related to highly disparate mental processes. We therefore investigated PMC properties with a data-driven exploratory approach. First, we subdivided the PMC by whole-brain coactivation profiles. Second, functional connectivity of the ensuing PMC regions was compared by task-constrained meta-analytic coactivation mapping (MACM) and task-unconstrained resting-state correlations (RSFC). Third, PMC regions were functionally described by forward/reverse functional inference. A precuneal cluster was mostly connected to the intraparietal sulcus, frontal eye fields, and right temporo-parietal junction; associated with attention and motor tasks. A ventral posterior cingulate cortex (PCC) cluster was mostly connected to the ventromedial prefrontal cortex and middle left inferior parietal cortex (IPC); associated with facial appraisal and language tasks. A dorsal PCC cluster was mostly connected to the dorsomedial prefrontal cortex, anterior/posterior IPC, posterior midcingulate cortex, and left dorsolateral prefrontal cortex; associated with delay discounting. A cluster in the retrosplenial cortex was mostly connected to the anterior thalamus and hippocampus. Furthermore, all PMC clusters were congruently coupled with the default mode network according to task-constrained but not task-unconstrained connectivity. We thus identified distinct regions in the PMC and characterized their neural networks and functional implications. PMID:25462801

  1. A dysexecutive syndrome of the medial thalamus.

    PubMed

    Liebermann, Daniela; Ploner, Christoph J; Kraft, Antje; Kopp, Ute A; Ostendorf, Florian

    2013-01-01

    Thalamic stroke is associated with neurological and cognitive sequelae. Resulting neuropsychological deficits vary with the vascular territory involved. Whereas sensory, motor and memory deficits following thalamic stroke are comparatively well characterized, the exact relationship between executive dysfunction and thalamic damage remains more ambiguous. To assess the pattern of executive-cognitive deficits following thalamic stroke and its possible association with distinct thalamic nuclei, 19 patients with focal thalamic lesions were examined with high-resolution structural imaging and neuropsychological testing. Twenty healthy individuals served as controls. Patient MRIs were co-registered to an atlas of the human thalamus. Lesion overlap and subtraction analyses were used for lesion-to-symptom mapping. In eight patients (42.1%), neuropsychological assessment demonstrated a disproportionate deficit in the Wisconsin Card Sorting Test (WCST), while other executive and memory functions were much less affected. Subtraction analysis revealed an area in the left medial thalamus, mainly consisting of the centromedian and parafascicular nuclei (CM-Pf complex) that was damaged in these patients and spared in patients with normal WCST performance. Thus, damage to the CM-Pf complex may yield a distinct dysexecutive syndrome in which deficient maintenance and shifting between cognitive sets predominates. We hypothesize that the CM-Pf complex may contribute to maintenance and shifting of cognitive sets by virtue of its dense connections with the striatum. The pattern of executive dysfunction following thalamic stroke may vary considerably with lesion location.

  2. Treatment algorithms in refractory partial epilepsy.

    PubMed

    Jobst, Barbara C

    2009-09-01

    An algorithm is a "step-by-step procedure for solving a problem or accomplishing some end....in a finite number of steps." (Merriam-Webster, 2009). Medical algorithms are decision trees to help with diagnostic and therapeutic decisions. For the treatment of epilepsy there is no generally accepted treatment algorithm, as individual epilepsy centers follow different diagnostic and therapeutic guidelines. This article presents two algorithms to guide decisions in the treatment of refractory partial epilepsy. The treatment algorithm describes a stepwise diagnostic and therapeutic approach to intractable medial temporal and neocortical epilepsy. The surgical algorithm guides decisions in the surgical treatment of neocortical epilepsy.

  3. A Distributed Neural Network Model for the Distinct Roles of Medial and Lateral HVC in Zebra Finch Song Production.

    PubMed

    Galvis, Daniel; Wu, Wei; Hyson, Richard L; Johnson, Frank; Bertram, Richard

    2017-04-05

    Male zebra finches produce a song consisting of a canonical sequence of syllables, learned from a tutor and repeated throughout its adult life. Much of the neural circuitry responsible for this behavior is located in the cortical premotor region HVC (acronym is name). In a recent study from our lab, we found that partial bilateral ablation of the medial portion of HVC has effects on the song that are qualitatively different from those of bilateral ablation of the lateral portion. In this report we describe a neural network organization that can explain these data, and in so doing suggests key roles for other brain nuclei in the production of song. We also suggest that syllables and the gaps between them are each coded separately by neural chains within HVC, and that the timing mechanisms for syllables and gaps are distinct. The design principles underlying this model assign distinct roles for medial and lateral HVC circuitry that explain the data on medial and lateral ablations. In addition, despite the fact that the neural coding of song sequence is distributed among several brain nuclei in our model, it accounts for data showing that cooling of HVC stretches syllables uniformly and to a greater extent than gaps. Finally, the model made unanticipated predictions about details of the effects of medial and lateral HVC ablations that were then confirmed by reanalysis of these previously acquired behavioral data.

  4. CT evaluation of medial clavicular epiphysis as a method of bone age determination in adolescents and young adults

    PubMed Central

    Ufuk, Furkan; Agladioglu, Kadir; Karabulut, Nevzat

    2016-01-01

    PURPOSE We aimed to investigate the use of computed tomography (CT) staging of the medial clavicular epiphysis ossification in forensic bone age determination, and find a CT criterion to determine whether an individual is adult or not. METHODS Chest CT and pulmonary CT angiography exams of 354 patients between 10 and 30 years of age (mean, 21.4 years) were retrospectively evaluated for epiphyseal ossification phase of the bilateral medial clavicles (708 clavicles) and compared with the sex and chronologic age of the individuals. The ossification phase of the medial clavicular epiphyses was classified from stage I to stage V using a modified staging system. RESULTS Epiphyseal ossification center appeared from 11 to 21 years of age. Partial fusion occurred between 16 and 23 years of age. Complete fusion was first achieved at the ages of 18 and 19 years for male and female individuals, respectively. The probability of an individual being ≥18 years old was 70.8% in stage III A and 100% in stages III B, IV, and V in females and males. CONCLUSION CT evaluation of the medial clavicular epiphysis is helpful in forensic age determination and stage III B can be used as a criterion to make the prediction that an individual is older than 18 years. PMID:27015321

  5. Photocopy of photograph in Fitzsimons Army Medial Center Real Property ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in Fitzsimons Army Medial Center Real Property Book (green cloth cover), south and west sides. - Fitzsimons General Hospital, Officers Quarters, Northeast Corner of West Harlow Avenue & North Seventh Street, Aurora, Adams County, CO

  6. Medial tibial stress syndrome: a critical review.

    PubMed

    Moen, Maarten H; Tol, Johannes L; Weir, Adam; Steunebrink, Miriam; De Winter, Theodorus C

    2009-01-01

    Medial tibial stress syndrome (MTSS) is one of the most common leg injuries in athletes and soldiers. The incidence of MTSS is reported as being between 4% and 35% in military personnel and athletes. The name given to this condition refers to pain on the posteromedial tibial border during exercise, with pain on palpation of the tibia over a length of at least 5 cm. Histological studies fail to provide evidence that MTSS is caused by periostitis as a result of traction. It is caused by bony resorption that outpaces bone formation of the tibial cortex. Evidence for this overloaded adaptation of the cortex is found in several studies describing MTSS findings on bone scan, magnetic resonance imaging (MRI), high-resolution computed tomography (CT) scan and dual energy x-ray absorptiometry. The diagnosis is made based on physical examination, although only one study has been conducted on this subject. Additional imaging such as bone, CT and MRI scans has been well studied but is of limited value. The prevalence of abnormal findings in asymptomatic subjects means that results should be interpreted with caution. Excessive pronation of the foot while standing and female sex were found to be intrinsic risk factors in multiple prospective studies. Other intrinsic risk factors found in single prospective studies are higher body mass index, greater internal and external ranges of hip motion, and calf girth. Previous history of MTSS was shown to be an extrinsic risk factor. The treatment of MTSS has been examined in three randomized controlled studies. In these studies rest is equal to any intervention. The use of neoprene or semi-rigid orthotics may help prevent MTSS, as evidenced by two large prospective studies.

  7. GABAergic Projections from the Medial Septum Selectively Inhibit Interneurons in the Medial Entorhinal Cortex

    PubMed Central

    Gonzalez-Sulser, Alfredo; Parthier, Daniel; Candela, Antonio; McClure, Christina; Pastoll, Hugh; Garden, Derek; Sürmeli, Gülşen

    2014-01-01

    The medial septum (MS) is required for theta rhythmic oscillations and grid cell firing in the medial entorhinal cortex (MEC). While GABAergic, glutamatergic, and cholinergic neurons project from the MS to the MEC, their synaptic targets are unknown. To investigate whether MS neurons innervate specific layers and cell types in the MEC, we expressed channelrhodopsin-2 in mouse MS neurons and used patch-clamp recording in brain slices to determine the response to light activation of identified cells in the MEC. Following activation of MS axons, we observed fast monosynaptic GABAergic IPSPs in the majority (>60%) of fast-spiking (FS) and low-threshold-spiking (LTS) interneurons in all layers of the MEC, but in only 1.5% of nonstellate principal cells (NSPCs) and in no stellate cells. We also observed fast glutamatergic responses to MS activation in a minority (<5%) of NSPCs, FS, and LTS interneurons. During stimulation of MS inputs at theta frequency (10 Hz), the amplitude of GABAergic IPSPs was maintained, and spike output from LTS and FS interneurons was entrained at low (25–60 Hz) and high (60–180 Hz) gamma frequencies, respectively. By demonstrating cell type-specific targeting of the GABAergic projection from the MS to the MEC, our results support the idea that the MS controls theta frequency activity in the MEC through coordination of inhibitory circuits. PMID:25505326

  8. GABAergic projections from the medial septum selectively inhibit interneurons in the medial entorhinal cortex.

    PubMed

    Gonzalez-Sulser, Alfredo; Parthier, Daniel; Candela, Antonio; McClure, Christina; Pastoll, Hugh; Garden, Derek; Sürmeli, Gülşen; Nolan, Matthew F

    2014-12-10

    The medial septum (MS) is required for theta rhythmic oscillations and grid cell firing in the medial entorhinal cortex (MEC). While GABAergic, glutamatergic, and cholinergic neurons project from the MS to the MEC, their synaptic targets are unknown. To investigate whether MS neurons innervate specific layers and cell types in the MEC, we expressed channelrhodopsin-2 in mouse MS neurons and used patch-clamp recording in brain slices to determine the response to light activation of identified cells in the MEC. Following activation of MS axons, we observed fast monosynaptic GABAergic IPSPs in the majority (>60%) of fast-spiking (FS) and low-threshold-spiking (LTS) interneurons in all layers of the MEC, but in only 1.5% of nonstellate principal cells (NSPCs) and in no stellate cells. We also observed fast glutamatergic responses to MS activation in a minority (<5%) of NSPCs, FS, and LTS interneurons. During stimulation of MS inputs at theta frequency (10 Hz), the amplitude of GABAergic IPSPs was maintained, and spike output from LTS and FS interneurons was entrained at low (25-60 Hz) and high (60-180 Hz) gamma frequencies, respectively. By demonstrating cell type-specific targeting of the GABAergic projection from the MS to the MEC, our results support the idea that the MS controls theta frequency activity in the MEC through coordination of inhibitory circuits.

  9. Medial entorhinal cortex and medial septum contribute to self-motion-based linear distance estimation.

    PubMed

    Jacob, Pierre-Yves; Gordillo-Salas, Marta; Facchini, Justine; Poucet, Bruno; Save, Etienne; Sargolini, Francesca

    2017-02-04

    Path integration is a navigation strategy that requires animals to integrate self-movements during exploration to determine their position in space. The medial entorhinal cortex (MEC) has been suggested to play a pivotal role in this process. Grid cells, head-direction cells, border cells as well as speed cells within the MEC collectively provide a dynamic representation of the animal position in space based on the integration of self-movements. All these cells are strongly modulated by theta oscillations, thus suggesting that theta rhythmicity in the MEC may be essential for integrating and coordinating self-movement information during navigation. In this study, we first show that excitotoxic MEC lesions, but not dorsal hippocampal lesions, impair the ability of rats to estimate linear distances based on self-movement information. Next, we report similar deficits following medial septum inactivation, which strongly impairs theta oscillations in the entorhinal-hippocampal circuits. Taken together, these findings demonstrate a major role of the MEC and MS in estimating distances to be traveled, and point to theta oscillations within the MEC as a neural mechanism responsible for the integration of information generated by linear self-displacements.

  10. The perforator-based conjoint (chimeric) medial Sural(MEDIAL GASTROCNEMIUS) free flap.

    PubMed

    Sano, Kazufumi; Hallock, Geoffrey G; Hamazaki, Masahiro; Daicyo, Yoshihiro

    2004-12-01

    The prototypical conjoint or so-called "chimeric" free flap heretofore has been composed of several large independent flaps, each supplied by a separate major branch, that ultimately arise from a common source vessel. The perforator-based type of chimeric flap is a relatively new concept, usually involving multiple muscle perforator flaps each based on a solitary musculocutaneous perforator, but still arising from the same "mother" vessel. This principle of split cutaneous perforator flaps has been now successfully adapted to the medial suralMEDIAL GASTROCNEMIUS perforator free flap on 2 separate occasions. As a chimeric flap, there was greater flexibility in insetting, and overall flap width may be larger but still narrow enough to allow primary donor site closure; and yet, by definition, only a single recipient site was needed for any microanastomoses. This is further proof that the perforator-based chimeric free flap may be an option for any muscle perforator flap donor site, so that potential donor territories for conjoint flaps have become virtually unlimited.

  11. Medial rectus muscle anchoring in complete oculomotor nerve palsy.

    PubMed

    Lee, Si Hyung; Chang, Jee Ho

    2015-10-01

    The management of exotropia resulting from complete oculomotor nerve palsy is challenging. Conventional therapeutic interventions, including supramaximal resection and recession, superior oblique tendon resection and transposition, and several ocular anchoring procedures have yielded less-than-adequate results. Here we describe a novel surgical technique of anchoring the medial rectus muscle to the medial orbital wall in combination with lateral rectus disinsertion and reattachment to the lateral orbital wall.

  12. Medial Patellofemoral Ligament Reconstruction Femoral Tunnel Accuracy

    PubMed Central

    Hiemstra, Laurie A.; Kerslake, Sarah; Lafave, Mark

    2017-01-01

    Background: Medial patellofemoral ligament (MPFL) reconstruction is a procedure aimed to reestablish the checkrein to lateral patellar translation in patients with symptomatic patellofemoral instability. Correct femoral tunnel position is thought to be crucial to successful MPFL reconstruction, but the accuracy of this statement in terms of patient outcomes has not been tested. Purpose: To assess the accuracy of femoral tunnel placement in an MPFL reconstruction cohort and to determine the correlation between tunnel accuracy and a validated disease-specific, patient-reported quality-of-life outcome measure. Study Design: Case series; Level of evidence, 4. Methods: Between June 2008 and February 2014, a total of 206 subjects underwent an MPFL reconstruction. Lateral radiographs were measured to determine the accuracy of the femoral tunnel by measuring the distance from the center of the femoral tunnel to the Schöttle point. Banff Patella Instability Instrument (BPII) scores were collected a mean 24 months postoperatively. Results: A total of 155 (79.5%) subjects had adequate postoperative lateral radiographs and complete BPII scores. The mean duration of follow-up (±SD) was 24.4 ± 8.2 months (range, 12-74 months). Measurement from the center of the femoral tunnel to the Schöttle point resulted in 143 (92.3%) tunnels being categorized as “good” or “ideal.” There were 8 failures in the cohort, none of which occurred in malpositioned tunnels. The mean distance from the center of the MPFL tunnel to the center of the Schöttle point was 5.9 ± 4.2 mm (range, 0.5-25.9 mm). The mean postoperative BPII score was 65.2 ± 22.5 (range, 9.2-100). Pearson r correlation demonstrated no statistically significant relationship between accuracy of femoral tunnel position and BPII score (r = –0.08; 95% CI, –0.24 to 0.08). Conclusion: There was no evidence of a correlation between the accuracy of MPFL reconstruction femoral tunnel in relation to the Schöttle point and

  13. Knee stabilization in patients with medial compartment knee osteoarthritis

    PubMed Central

    Lewek, Michael D.; Ramsey, Dan K.; Snyder-Mackler, Lynn; Rudolph, Katherine S.

    2005-01-01

    OBJECTIVE Individuals with medial knee osteoarthritis (MKOA) experience knee laxity and instability. Muscle stabilization strategies may influence the long term integrity of the joint. In this study we determined how individuals with medial knee OA respond to a rapid valgus knee movement to investigate the relationship between muscle stabilization strategies and knee instability. METHODS Twenty one subjects with MKOA and genu varum, and 19 control subjects were tested. Subjects stood with the test limb on a moveable platform that translated laterally to rapidly stress the knee’s medial periarticular structures and create a potentially destabilizing feeling at the knee joint. Knee motion and muscle responses were recorded. Subjects rated their knee instability with a self-report questionnaire about knee instability during daily activities. RESULTS Prior to plate movement the OA subjects demonstrated more medial muscle co-contraction (p=0.014). Following plate movement the OA subjects shifted less weight off the test limb (p = 0.013) and had more medial co-contraction (p=0.037). Those without instability had higher VMMH co-contraction than those who reported more instability (p=0.038). Knee stability correlated positively with VMMH co-contraction prior to plate movement (r = 0.459; p = 0.042). CONCLUSION This study demonstrates that individuals with MKOA attempt to stabilize the knee with greater medial muscle co-contraction in response to laxity that appears on only the medial side of the joint. This strategy presumably contributes to higher joint compression and could exacerbate joint destruction and needs to be altered to slow or stop the progression of the OA disease process. PMID:16142714

  14. Relationship between foot function and medial knee joint loading in people with medial compartment knee osteoarthritis

    PubMed Central

    2013-01-01

    Background Dynamic joint loading, particularly the external knee adduction moment (KAM), is an important surrogate measure for the medio-lateral distribution of force across the knee joint in people with knee osteoarthritis (OA). Foot motion may alter the load on the medial tibiofemoral joint and hence affect the KAM. Therefore, this study aimed to investigate the relationship between tibia, rearfoot and forefoot motion in the frontal and transverse planes and the KAM in people with medial compartment knee OA. Method Motion of the knee, tibia, rearfoot and forefoot and knee moments were evaluated in 32 patients with clinically and radiographically-confirmed OA, predominantly in the medial compartment. Pearson’s correlation coefficient was used to investigate the association between peak values of tibia, rearfoot and forefoot motion in the frontal and transverse planes and 1st peak KAM, 2nd peak KAM, and the knee adduction angular impulse (KAAI). Results Lateral tilt of the tibia was significantly associated with increased 1st peak KAM (r = 0.60, p < 0.001), 2nd peak KAM (r = 0.67, p = 0.001) and KAAI (r = 0.82, p = 0.001). Increased peak rearfoot eversion was significantly correlated with decreased 2nd peak KAM (r = 0.59, p < 0.001) and KAAI (r = 0.50, p = 0.004). Decreased rearfoot internal rotation was significantly associated with increased 2nd peak KAM (r = −0.44, p = 0.01) and KAAI (r = −0.38, p = 0.02), while decreased rearfoot internal rotation relative to the tibia was significantly associated with increased 2nd peak KAM (r = 0.43, p = 0.01). Significant negative correlations were found between peak forefoot eversion relative to the rearfoot and 2nd peak KAM (r = −0.53, p = 0.002) and KAAI (r = −0.51, p = 0.003) and between peak forefoot inversion and 2nd peak KAM (r = −0.54, p = 0.001) and KAAI (r = −0.48, p = 0.005). Conclusion Increased rearfoot

  15. Ultrastructure of medial rectus muscles in patients with intermittent exotropia

    PubMed Central

    Yao, J; Wang, X; Ren, H; Liu, G; Lu, P

    2016-01-01

    Purpose To study the ultrastructure of the medial rectus in patients with intermittent exotropia at different ages. Patients and methods The medial recti were harvested surgically from 20 patients with intermittent exotropia. Patients were divided into adolescent (age<18 years, n=10) and adult groups (age >18 years, n=10). The normal control group included five patients without strabismus and undergoing eye enucleation. Hematoxylin and eosin staining and transmission electron microscopy were used to visualize the medial recti. Western blot was used to determine the levels of myosin and actin. Results Varying fiber thickness, atrophy, and misalignment of the medial recti were visualized under optical microscope in patients with exotropia. Electron microscopy revealed sarcomere destruction, myofilament disintegration, unclear dark and light bands, collagen proliferation, and fibrosis. The adolescent group manifested significantly higher levels of myosin and actin than the adult group (P<0.05). Conclusion Younger patients with intermittent exotropia show stronger contraction of the medial recti compared with older patients. Our findings suggest that childhood was the appropriate time for surgery as the benefit of the intervention was better than in adulthood. PMID:26514242

  16. "The Superficial Quad Technique" for Medial Patellofemoral Ligament Reconstruction: The Surgical Video Technique.

    PubMed

    Goyal, Deepak

    2015-10-01

    With the introduction of the superficial quad technique, there has been a recent revival of interest in the quadriceps tendon as a graft choice for medial patellofemoral ligament (MPFL) reconstruction. The superficial quad technique has many anatomic advantages because the length, breadth, and thickness of the graft are similar to those of the native MPFL; moreover, the graft provides a continuous patellar attachment at the superior half of the medial border of the patella. The technique requires neither a patellar bony procedure nor patellar hardware. Biomechanically, the mean strength and stiffness of the graft are very similar to those of the native MPFL. The anatomic and biomechanical advantages depend on correct identification of the anatomic superficial lamina of the quadriceps tendon; hence the correct harvesting technique for the superficial lamina is crucial. Various sub-techniques for harvesting the quadriceps graft have emerged recently, such as superficial strip, pedicled, or partial graft harvesting; these can create confusion for surgeons. Additional confusion related to the preparation and fixation of the graft should also be addressed to avoid any potential complications. A step-by-step video of the superficial quad technique is presented, covering the exact dissection of the graft material and its preparation, delivery, and fixation.

  17. Medial temporal lobe contributions to cued retrieval of items and contexts.

    PubMed

    Hannula, Deborah E; Libby, Laura A; Yonelinas, Andrew P; Ranganath, Charan

    2013-10-01

    Several models have proposed that different regions of the medial temporal lobes contribute to different aspects of episodic memory. For instance, according to one view, the perirhinal cortex represents specific items, parahippocampal cortex represents information regarding the context in which these items were encountered, and the hippocampus represents item-context bindings. Here, we used event-related functional magnetic resonance imaging (fMRI) to test a specific prediction of this model-namely, that successful retrieval of items from context cues will elicit perirhinal recruitment and that successful retrieval of contexts from item cues will elicit parahippocampal cortex recruitment. Retrieval of the bound representation in either case was expected to elicit hippocampal engagement. To test these predictions, we had participants study several item-context pairs (i.e., pictures of objects and scenes, respectively), and then had them attempt to recall items from associated context cues and contexts from associated item cues during a scanned retrieval session. Results based on both univariate and multivariate analyses confirmed a role for hippocampus in content-general relational memory retrieval, and a role for parahippocampal cortex in successful retrieval of contexts from item cues. However, we also found that activity differences in perirhinal cortex were correlated with successful cued recall for both items and contexts. These findings provide partial support for the above predictions and are discussed with respect to several models of medial temporal lobe function.

  18. Medial Temporal Lobe Contributions to Cued Retrieval of Items and Contexts

    PubMed Central

    Hannula, Deborah E.; Libby, Laura A.; Yonelinas, Andrew P.; Ranganath, Charan

    2013-01-01

    Several models have proposed that different regions of the medial temporal lobes contribute to different aspects of episodic memory. For instance, according to one view, the perirhinal cortex represents specific items, parahippocampal cortex represents information regarding the context in which these items were encountered, and the hippocampus represents item-context bindings. Here, we used event-related functional magnetic resonance imaging (fMRI) to test a specific prediction of this model – namely, that successful retrieval of items from context cues will elicit perirhinal recruitment and that successful retrieval of contexts from item cues will elicit parahippocampal cortex recruitment. Retrieval of the bound representation in either case was expected to elicit hippocampal engagement. To test these predictions, we had participants study several item-context pairs (i.e., pictures of objects and scenes, respectively), and then had them attempt to recall items from associated context cues and contexts from associated item cues during a scanned retrieval session. Results based on both univariate and multivariate analyses confirmed a role for hippocampus in content-general relational memory retrieval, and a role for parahippocampal cortex in successful retrieval of contexts from item cues. However, we also found that activity differences in perirhinal cortex were correlated with successful cued recall for both items and contexts. These findings provide partial support for the above predictions and are discussed with respect to several models of medial temporal lobe function. PMID:23466350

  19. Tendinopathies Around the Elbow Part 2: Medial Elbow, Distal Biceps and Triceps Tendinopathies.

    PubMed

    Donaldson, Oliver; Vannet, Nicola; Gosens, Taco; Kulkarni, Rohit

    2014-01-01

    In the second part of this review article the management of medial elbow tendinopathy, distal biceps and distal triceps tendinopathy will be discussed. There is a scarcity of publications concerning any of these tendinopathies. This review will summarise the current best available evidence in their management. Medial elbow tendinopathy, also known as Golfer's elbow, is up to 6 times less common than lateral elbow tendinopathy. The tendinopathy occurs in the insertion of pronator teres and flexor carpi radialis. Diagnosis is usually apparent through a detailed history and examination but care must be made to exclude other conditions affecting the ulnar nerve or less commonly the ulnar collateral ligament complex. If doubt exists then MRI/US and electrophysiology can be used. Treatment follows a similar pattern to that of lateral elbow tendinopathy. Acute management is with activity modification and topical NSAIDs. Injection therapy and surgical excision are utilised for recalcitrant cases. Distal biceps and triceps tendinopathies are very rare and there is limited evidence published. Sequelae of tendinopathy include tendon rupture and so it is vital to manage these tendinopathies appropriately in order to minimise this significant complication. Their management and that of partial tears will be considered.

  20. A pseudo-iatrogenic case of medial clavicular fracture

    PubMed Central

    Staal, Heleen Muriel; Willems, Willem Jacob

    2008-01-01

    Medial fractures are the least common type of clavicular fracture (2–10%). The patient is a 29-year-old gynaecology resident with hyper-laxity and sternoclavicular instability. The latter had been surgically stabilized with Dacron® tape, which eroded the bone causing an usura. Acute right shoulder pain occurred 10 years later. CT revealed medial clavicular stress fracture. After 4 weeks of conservative management, internal fixation followed. Five months postoperatively the patient performed all activities without pain. In this patient the weakened medial clavicle due to usura clearly played a role in both the site and nature of the fracture. Furthermore, CT is essential in arriving at the correct diagnosis. PMID:18427920

  1. A pseudo-iatrogenic case of medial clavicular fracture.

    PubMed

    Poelmann, Tibor Antonius Johannes; Staal, Heleen Muriel; Willems, Willem Jacob

    2008-04-01

    Medial fractures are the least common type of clavicular fracture (2-10%). The patient is a 29-year-old gynaecology resident with hyper-laxity and sternoclavicular instability. The latter had been surgically stabilized with Dacron((R)) tape, which eroded the bone causing an usura. Acute right shoulder pain occurred 10 years later. CT revealed medial clavicular stress fracture. After 4 weeks of conservative management, internal fixation followed. Five months postoperatively the patient performed all activities without pain. In this patient the weakened medial clavicle due to usura clearly played a role in both the site and nature of the fracture. Furthermore, CT is essential in arriving at the correct diagnosis.

  2. Traumatic fragmented medial coronoid process in a Chihuahua.

    PubMed

    Hadley, H S; Wheeler, J L; Manley, P A

    2009-01-01

    Fragmented medial coronoid process (FMCP) is a disease process that has not previously been reported in toy-breed dogs. This report describes a presumptive case of FMCP in a 14-month-old Chihuahua that was presented for evaluation approximately four weeks following acute onset of moderate lameness in the left forelimb. Definitive diagnosis of a fragmented medial coronoid process was based upon computed tomography (CT) scan. A CT scan also demonstrated moderate joint incongruity in the affected elbow. Surgical removal of the fragment and subtotal coronoidectomy were performed via a medial arthrotomy. An ulnar ostectomy was also performed to address joint incongruity. Histology of specimens removed at surgery did not demonstrate evidence of microdamage as characteristic of FMCP in large breed dogs, and instead, suggested that the fracture was acute and traumatic in nature. Rapid return to function was observed following surgery.

  3. Medial collateral ligament reconstruction in the baseball Pitcher's elbow.

    PubMed

    Erne, Holger C; Zouzias, Ioannis C; Rosenwasser, Melvin P

    2009-08-01

    Pitchers are prone to elbow injuries because of high and repetitive valgus stresses on the elbow. The anterior bundle of the medial ulnar collateral ligament (MCL) of the elbow is the primary restraint and is often attenuated with time, leading to functional incompetence and ultimate failure. Pitchers with a history of medial elbow pain, reduced velocity, and loss of command may have an MCL injury in evolution. Physical examination and imaging can confirm the diagnosis. Treatment begins with rest and activity modification. All medial elbow pain is not MCL injury. Surgery is considered only for talented athletes who wish to return to competitive play and may include elite scholastic and other collegiates and professionals. The technique for MCL reconstruction was first described in 1986. Many variations have been offered since then, which can result in predictable outcomes, allowing many to return to the same level of competitive play.

  4. Medial Meniscal Extrusion Relates to Cartilage Loss in Specific Femorotibial Subregions- Data from the Osteoarthritis Initiative

    PubMed Central

    Bloecker, K.; Wirth, W.; Guermazi, A.; Hunter, DJ; Resch, H.; Hochreiter, J.; Eckstein, F.

    2015-01-01

    Objective Medial meniscal extrusion is known to be related to structural progression of knee OA. However, it is unclear whether medial meniscal extrusion is more strongly associated with cartilage loss in certain medial femorotibial subregions than to others. Methods Segmentation of the medial tibial and femoral cartilage (baseline; 1-year follow-up) and the medial meniscus (baseline) was performed in 60 participants with frequent knee pain (age 61.3±9.2y, BMI 31.3±3.9 kg/m2) and with unilateral medial radiographic joint space narrowing (JSN) grade 1–3, using double echo steady state MR-images. Medial meniscal extrusion distance and extrusion area (%) between the external meniscal and tibial margin at baseline, and longitudinal medial cartilage loss in eight anatomical subregions were determined. Results A significant association (Pearson correlation coefficient) was seen between medial meniscus extrusion area in JSN knees and cartilage loss over one year throughout the entire medial femorotibial compartment. The strongest correlation was with cartilage loss in the external medial tibia (r=−0.34 [p<0.01] in JSN, and r=−0.30 [p=0.02] in noJSN knees). Conclusion Medial meniscus extrusion was associated with subsequent medial cartilage loss. The external medial tibial cartilage may be particularly vulnerable to thinning once the meniscus extrudes and its surface is “exposed” to direct, non-physiological, cartilage-cartilage contact. PMID:25988986

  5. Pituitary adenoma with seizures: PET demonstration of reduced glucose utilization in the medial temporal lobe

    SciTech Connect

    Bairamian, D.; Di Chiro, G.; Blume, H.; Ehrenberg, B.

    1986-05-01

    A patient with a benign chromophobe adenoma, who had incomplete surgical removal followed by radiotherapy, continued to have epileptic seizures up to two or three times a day. She was studied with positron emission tomography using /sup 18/F-2-deoxyglucose (FDG). This technique showed a high level of glucose utilization in the area of the operated tumor but also clear reduction of glucose utilization in the left medial temporal region adjacent to the sella and the scar tissue from the neoplasm. This area of reduced glucose utilization corresponded well to the same finding observed in other patients with complex partial epilepsy. A left temporal anterior lobectomy was carried out followed by improved control of the epilepsy. Positron emission tomography using FDG, together with electrophysiological examinations, may assist in the management of epilepsy related to pituitary tumors.

  6. Foot polydactyly and bipartite medial cuneiform: A case of co-occurrence in a Celtic skeleton from Verona (Italy).

    PubMed

    Laffranchi, Z; Martín Flórez, J S; Jiménez Brobeil, S A; Castellani, V

    2015-06-01

    We report a case of bilateral foot polydactyly and bipartite medial cuneiform in a male individual buried in a Celtic/Roman necropolis (3rd to 1st century BCE) in the city of Verona (Italy). During the construction of an underground garage in the main courtyard of the Bishop's Seminary at Verona between 2005 and 2010, archaeologists uncovered the remains of 174 individuals (108 non-adults and 66 adults). It is thought that these graves could belong to some of the first inhabitants of the urban area of Verona. The individual presented here (US 2807) is a middle-aged male (40-50 years) in a good state of preservation. His estimated stature is 1756 mm (± 32.1 mm). This male presents congenital anomalies in the feet and dental agenesis. We believe this to be the only known archaeological case of bilateral postaxial polydactyly with forked (Y) shape, in which both fifth metatarsals are associated with complete bipartition of the left medial cuneiform and partial bipartition of the right one. Polydactyly is fairly common in modern clinical cases but bipartite medial cuneiform is relatively rare; neither of these congenital conditions is well documented archaeologically.

  7. Arthroscopic Treatment of Medial Femoral Condylar Coronal Fractures and Nonunions

    PubMed Central

    Ercin, Ersin; Bilgili, M. Gokhan; Basaran, S. Hakan; Baca, Emre; Kural, Cemal; Avkan, M. Cevdet

    2013-01-01

    Nonunion of medial femoral condylar coronal fractures are uncommon. In neglected Hoffa fractures despite nonunion, there is a risk of missing accompanying ligamentous and intra-articular injuries. Neither preoperative clinical examination nor magnetic resonance imaging showed these injuries before arthroscopy. Arthroscopy before internal fixation gives additional information and changes the surgical protocol for these fractures and nonunions. PMID:24400191

  8. Medial Patellofemoral Ligament Reconstruction in a Below-Knee Amputee.

    PubMed

    El-Tawil, Sherif; Elfons Tawafig, Marian; Miles, Jonathan

    2015-01-01

    Patellar instability is a common finding in patients with below-knee amputation and yet management options are not commonly described in the literature. We describe the first reported case of a medial patellofemoral ligament reconstruction using allograft in a patient with a below-knee amputation. Clinical outcome at two-year follow-up remains very good.

  9. Medial Patellofemoral Ligament Reconstruction in a Below-Knee Amputee

    PubMed Central

    El-Tawil, Sherif; Elfons Tawafig, Marian; Miles, Jonathan

    2015-01-01

    Patellar instability is a common finding in patients with below-knee amputation and yet management options are not commonly described in the literature. We describe the first reported case of a medial patellofemoral ligament reconstruction using allograft in a patient with a below-knee amputation. Clinical outcome at two-year follow-up remains very good. PMID:26579321

  10. Medial Temporal Lobe Memory in Childhood: Developmental Transitions

    ERIC Educational Resources Information Center

    Townsend, Elise L.; Richmond, Jenny L.; Vogel-Farley, Vanessa K.; Thomas, Kathleen

    2010-01-01

    The medial temporal lobes (MTL) support declarative memory and mature structurally and functionally during the postnatal years in humans. Although recent work has addressed the development of declarative memory in early childhood, less is known about continued development beyond this period of time. The purpose of this investigation was to explore…

  11. Medial Temporal Lobe Structures Contribute to On-Line Processing

    ERIC Educational Resources Information Center

    Warren, David

    2009-01-01

    For the last five decades, the medial temporal lobes have been generally understood to facilitate enduring representation of certain kinds of information. In particular, knowledge about the relations among items and concepts appears to rely on that region of the brain. Recent results suggest that those same structures also play a subtle role in…

  12. Theta Synchronizes the Activity of Medial Prefrontal Neurons during Learning

    ERIC Educational Resources Information Center

    Paz, Rony; Bauer, Elizabeth P.; Pare, Denis

    2008-01-01

    Memory consolidation is thought to involve the gradual transfer of transient hippocampal-dependent traces to distributed neocortical sites via the rhinal cortices. Recently, medial prefrontal (mPFC) neurons were shown to facilitate this process when their activity becomes synchronized. However, the mechanisms underlying this enhanced synchrony…

  13. Medial Prefrontal Cortex Lesions Abolish Contextual Control of Competing Responses

    ERIC Educational Resources Information Center

    Haddon, J. E.; Killcross, A. S.

    2005-01-01

    There is much debate as to the extent and nature of functional specialization within the different subregions of the prefrontal cortex. The current study was undertaken to investigate the effect of damage to medial prefrontal cortex subregions in the rat. Rats were trained on two biconditional discrimination tasks, one auditory and one visual, in…

  14. Scene-Selectivity and Retinotopy in Medial Parietal Cortex

    PubMed Central

    Silson, Edward H.; Steel, Adam D.; Baker, Chris I.

    2016-01-01

    Functional imaging studies in human reliably identify a trio of scene-selective regions, one on each of the lateral [occipital place area (OPA)], ventral [parahippocampal place area (PPA)], and medial [retrosplenial complex (RSC)] cortical surfaces. Recently, we demonstrated differential retinotopic biases for the contralateral lower and upper visual fields within OPA and PPA, respectively. Here, using functional magnetic resonance imaging, we combine detailed mapping of both population receptive fields (pRF) and category-selectivity, with independently acquired resting-state functional connectivity analyses, to examine scene and retinotopic processing within medial parietal cortex. We identified a medial scene-selective region, which was contained largely within the posterior and ventral bank of the parieto-occipital sulcus (POS). While this region is typically referred to as RSC, the spatial extent of our scene-selective region typically did not extend into retrosplenial cortex, and thus we adopt the term medial place area (MPA) to refer to this visually defined scene-selective region. Intriguingly MPA co-localized with a region identified solely on the basis of retinotopic sensitivity using pRF analyses. We found that MPA demonstrates a significant contralateral visual field bias, coupled with large pRF sizes. Unlike OPA and PPA, MPA did not show a consistent bias to a single visual quadrant. MPA also co-localized with a region identified by strong differential functional connectivity with PPA and the human face-selective fusiform face area (FFA), commensurate with its functional selectivity. Functional connectivity with OPA was much weaker than with PPA, and similar to that with face-selective occipital face area (OFA), suggesting a closer link with ventral than lateral cortex. Consistent with prior research, we also observed differential functional connectivity in medial parietal cortex for anterior over posterior PPA, as well as a region on the lateral

  15. A Finite Element Analysis of Medial Patellofemoral Ligament Reconstruction

    PubMed Central

    DeVries Watson, Nicole A.; Duchman, Kyle R.; Bollier, Matthew J.; Grosland, Nicole M.

    2015-01-01

    Background The medial patellofemoral ligament is the primary soft-tissue restraint to lateral patella translation. Medial patellofemoral ligament reconstruction has become a viable surgical option to provide patellar stability in patients with recurrent instability. The primary goal of this study was to determine the effect of medial patellofemoral ligament reconstruction on the lateral force-displacement behavior of the patella using finite element analyses. Methods A finite element model of the knee was created using cadaveric image data. Experimental testing was performed to validate the computational model. After validation, the model was modified to study the effect of various medial patellofemoral ligament reconstruction insertion sites, allowing comparison of patellofemoral contact force and pressure. Results For the intact anatomic model, the lateral restraining force was 80.0 N with a corresponding patellar contact area of 54.97 mm2. For the anatomic reconstructed medial patellofemoral ligament model, the lateral restraining force increased to 148.9 N with a contact area of 71.78 mm2. This compared favorably to the corresponding experimental study. The force required to laterally displace the patella increased when the femoral insertion site was moved anteriorly or distally. The lateral restraining force decreased when the femoral insertion site moved proximally and the patellar insertion site moved either proximal or distal by 5 mm. Conclusion The line of action was altered with insertion site position, which in turn changed the amount of force it took to displace the patella laterally. Considering the model constraints, an anterior femoral attachment may over constrain the patella and increase cartilage wear due to increase contact area and restraining force. Clinical Relevance A malpositioned femoral tunnel in MPFL reconstruction could increase restraining forces and PF contact pressure, thus it is suggested to use intra-operative fluoroscopy to confirm

  16. Partial (focal) seizure

    MedlinePlus

    ... Jacksonian seizure; Seizure - partial (focal); Temporal lobe seizure; Epilepsy - partial seizures ... Abou-Khalil BW, Gallagher MJ, Macdonald RL. Epilepsies. In: Daroff ... Practice . 7th ed. Philadelphia, PA: Elsevier; 2016:chap 101. ...

  17. Partial tooth gear bearings

    NASA Technical Reports Server (NTRS)

    Vranish, John M. (Inventor)

    2010-01-01

    A partial gear bearing including an upper half, comprising peak partial teeth, and a lower, or bottom, half, comprising valley partial teeth. The upper half also has an integrated roller section between each of the peak partial teeth with a radius equal to the gear pitch radius of the radially outwardly extending peak partial teeth. Conversely, the lower half has an integrated roller section between each of the valley half teeth with a radius also equal to the gear pitch radius of the peak partial teeth. The valley partial teeth extend radially inwardly from its roller section. The peak and valley partial teeth are exactly out of phase with each other, as are the roller sections of the upper and lower halves. Essentially, the end roller bearing of the typical gear bearing has been integrated into the normal gear tooth pattern.

  18. Medial Auditory Thalamus Inactivation Prevents Acquisition and Retention of Eyeblink Conditioning

    ERIC Educational Resources Information Center

    Halverson, Hunter E.; Poremba, Amy; Freeman, John H.

    2008-01-01

    The auditory conditioned stimulus (CS) pathway that is necessary for delay eyeblink conditioning was investigated using reversible inactivation of the medial auditory thalamic nuclei (MATN) consisting of the medial division of the medial geniculate (MGm), suprageniculate (SG), and posterior intralaminar nucleus (PIN). Rats were given saline or…

  19. Dynamic Changes in Acetylcholine Output in the Medial Striatum during Place Reversal Learning

    ERIC Educational Resources Information Center

    Ragozzino, Michael E.; Choi, Daniel

    2004-01-01

    The present studies explored the role of the medial striatum in learning when task contingencies change. Experiment 1 examined whether the medial striatum is involved in place reversal learning. Testing occurred in a modified cross-maze across two consecutive sessions. Injections of the local anesthetic, bupivacaine, into the medial striatum, did…

  20. Medial prefrontal D1 dopamine neurons control food intake

    PubMed Central

    Land, Benjamin B; Narayanan, Nandakumar S; Liu, Rong-Jian; Gianessi, Carol A; Brayton, Catherine E; Grimaldi, David; Sarhan, Maysa; Guarnieri, Douglas J; Deisseroth, Karl; Aghajanian, George K; Dileone, Ralph J

    2014-01-01

    Although the prefrontal cortex influences motivated behavior, its role in food intake remains unclear. Here, we demonstrate a role for D1-type dopamine receptor-expressing neurons in the medial prefrontal cortex (mPFC) in the regulation of feeding. Food intake increases activity in D1 neurons of the mPFC in mice, and optogenetic photostimulation of D1 neurons increases feeding. Conversely, inhibition of D1 neurons decreases intake. Stimulation-based mapping of prefrontal D1 neuron projections implicates the medial basolateral amygdala (mBLA) as a downstream target of these afferents. mBLA neurons activated by prefrontal D1 stimulation are CaMKII positive and closely juxtaposed to prefrontal D1 axon terminals. Finally, photostimulating these axons in the mBLA is sufficient to increase feeding, recapitulating the effects of mPFC D1 stimulation. These data describe a new circuit for top-down control of food intake. PMID:24441680

  1. Downregulation of the posterior medial frontal cortex prevents social conformity.

    PubMed

    Klucharev, Vasily; Munneke, Moniek A M; Smidts, Ale; Fernández, Guillén

    2011-08-17

    We often change our behavior to conform to real or imagined group pressure. Social influence on our behavior has been extensively studied in social psychology, but its neural mechanisms have remained largely unknown. Here we demonstrate that the transient downregulation of the posterior medial frontal cortex by theta-burst transcranial magnetic stimulation reduces conformity, as indicated by reduced conformal adjustments in line with group opinion. Both the extent and probability of conformal behavioral adjustments decreased significantly relative to a sham and a control stimulation over another brain area. The posterior part of the medial frontal cortex has previously been implicated in behavioral and attitudinal adjustments. Here, we provide the first interventional evidence of its critical role in social influence on human behavior.

  2. Cochlear shape description and analyzing via medial models

    NASA Astrophysics Data System (ADS)

    Gaa, Johannes; Kahrs, Lüder A.; Müller, Samuel; Majdani, Omid; Ortmaier, Tobias

    2015-03-01

    Planning and analyzing of surgical interventions are often based on computer models derived from computed tomography images of the patient. In the field of cochlear implant insertion the modeling of several structures of the inner ear is needed. One structure is the overall helical shape of the cochlea itself. In this paper we analyze the cochlea by applying statistical shape models with medial representation. The cochlea is considered as tubular structure. A model representing the skeleton of training data and an atomic composition of the structure is built. We reduce the representation to a linear chain of atoms. As result a compact discrete model is possible. It is demonstrated how to place the atoms and build up their correspondence through a population of training data. The outcome of the applied representation is discussed in terms of impact on automated segmentation algorithms and known advantages of medial models are revisited.

  3. Taiwanese life scientists less "medialized" than their Western colleagues.

    PubMed

    Lo, Yin-Yueh; Peters, Hans Peter

    2015-01-01

    The article presents results from surveys of life scientists in Taiwan (n=270) and in Germany (n=326). Fewer Taiwanese than German researchers have frequent contact with the media and they rate their experiences with journalists less positively. Furthermore, they are less prepared to adapt to journalistic expectations and to a greater extent than German researchers they expect journalists to consider scientific criteria in their reporting. These findings are interpreted in Weingart's "medialization of science" framework as indicators of lower medialization of science in Taiwan than in Germany. However, Taiwanese scientists are more willing than German scientists to accept journalistic simplification at the expense of accuracy. This is explained as an adaptation to the media system and to the perceived scientific literacy of the media audience. We hypothesize that cultural differences regarding the relative priority of relational vs. rational communication goals may also contribute to more tolerance of journalistic simplification in Taiwan.

  4. Large heel soft tissue defects managed successfully with reverse medial crural fasciocutaneous flap: a 7-year single-center experience with 21 consecutive cases.

    PubMed

    Jing-Chun, Zhao; Kai, Shi; Jia-Ao, Yu; Chun-Jing, Xian; Lai-Jin, Lu; Chun-Hui, Xie

    2015-01-01

    The medial crural fasciocutaneous flap is a reliable cutaneous flap that can be used for soft tissue reconstruction in the extremities. The purpose of this article is to evaluate the application and clinical significance of this surgical technique in the reconstruction of heel soft tissue defects. Twenty-one cases of heel soft tissue defect between March 2005 and March 2012 were included in this study. Wound sizes varied from 5.0 × 5.5 to 7.5 × 10.0 cm. All cases were managed with a reverse medial crural fasciocutaneous flap. Patient demographics and case information were analyzed and are reported. The sizes of the reverse medial crural fasciocutaneous flap varied from 6.5 × 10.0 to 9.0 × 15.0 cm; the average size was 7.7 × 13.8 cm. Out of the 21 consecutive cases, 20 flaps survived intact and one flap underwent partial necrosis. Follow-up observations were conducted for 6-36 months. The cosmetic results were satisfactory, without apparent bulkiness; the weight-bearing outcomes were satisfactory. The donor site can be closed primarily or by skin graft. Reverse medial crural fasciocutaneous flap transfer is appropriate for the reconstruction of heel soft tissue defects. The method is safe and can cover large heel defects.

  5. Medial vestibular connections with the hypocretin (orexin) system

    NASA Technical Reports Server (NTRS)

    Horowitz, Seth S.; Blanchard, Jane; Morin, Lawrence P.

    2005-01-01

    The mammalian medial vestibular nucleus (MVe) receives input from all vestibular endorgans and provides extensive projections to the central nervous system. Recent studies have demonstrated projections from the MVe to the circadian rhythm system. In addition, there are known projections from the MVe to regions considered to be involved in sleep and arousal. In this study, afferent and efferent subcortical connectivity of the medial vestibular nucleus of the golden hamster (Mesocricetus auratus) was evaluated using cholera toxin subunit-B (retrograde), Phaseolus vulgaris leucoagglutinin (anterograde), and pseudorabies virus (transneuronal retrograde) tract-tracing techniques. The results demonstrate MVe connections with regions mediating visuomotor and postural control, as previously observed in other mammals. The data also identify extensive projections from the MVe to regions mediating arousal and sleep-related functions, most of which receive immunohistochemically identified projections from the lateral hypothalamic hypocretin (orexin) neurons. These include the locus coeruleus, dorsal and pedunculopontine tegmental nuclei, dorsal raphe, and lateral preoptic area. The MVe itself receives a projection from hypocretin cells. CTB tracing demonstrated reciprocal connections between the MVe and most brain areas receiving MVe efferents. Virus tracing confirmed and extended the MVe afferent connections identified with CTB and additionally demonstrated transneuronal connectivity with the suprachiasmatic nucleus and the medial habenular nucleus. These anatomical data indicate that the vestibular system has access to a broad array of neural functions not typically associated with visuomotor, balance, or equilibrium, and that the MVe is likely to receive information from many of the same regions to which it projects.

  6. Dopamine in the medial amygdala network mediates human bonding

    PubMed Central

    Touroutoglou, Alexandra; Rudy, Tali; Salcedo, Stephanie; Feldman, Ruth; Hooker, Jacob M.; Dickerson, Bradford C.; Catana, Ciprian; Barrett, Lisa Feldman

    2017-01-01

    Research in humans and nonhuman animals indicates that social affiliation, and particularly maternal bonding, depends on reward circuitry. Although numerous mechanistic studies in rodents demonstrated that maternal bonding depends on striatal dopamine transmission, the neurochemistry supporting maternal behavior in humans has not been described so far. In this study, we tested the role of central dopamine in human bonding. We applied a combined functional MRI-PET scanner to simultaneously probe mothers’ dopamine responses to their infants and the connectivity between the nucleus accumbens (NAcc), the amygdala, and the medial prefrontal cortex (mPFC), which form an intrinsic network (referred to as the “medial amygdala network”) that supports social functioning. We also measured the mothers’ behavioral synchrony with their infants and plasma oxytocin. The results of this study suggest that synchronous maternal behavior is associated with increased dopamine responses to the mother’s infant and stronger intrinsic connectivity within the medial amygdala network. Moreover, stronger network connectivity is associated with increased dopamine responses within the network and decreased plasma oxytocin. Together, these data indicate that dopamine is involved in human bonding. Compared with other mammals, humans have an unusually complex social life. The complexity of human bonding cannot be fully captured in nonhuman animal models, particularly in pathological bonding, such as that in autistic spectrum disorder or postpartum depression. Thus, investigations of the neurochemistry of social bonding in humans, for which this study provides initial evidence, are warranted. PMID:28193868

  7. A combinatorial optogenetic approach to medial habenula function

    NASA Astrophysics Data System (ADS)

    Turner, Eric E.; Hsu, Yun-Wei; Wang, Si; Morton, Glenn; Zeng, Hongkui

    2013-03-01

    The habenula is a brain region found in all vertebrate species. It consists of medial and lateral subnuclei which make complex descending connections to the brainstem. Although the medial habenula (MHb) and its projection, the fasciculus retroflexus (FR), have been recognized for decades, their function remains obscure. The small size of the MHb in rodents, and the cellular and molecular complexity of this region, have made it difficult to study the function of this region with high specificity. Here we describe a Cre-mediated genetic system for expressing the microbial opsin channelrhodopsin (ChR2) specifically in the dorsal (dMHb) and ventral (vMHb) medial habenula. Genetically targeted expression of ChR2 allows MHb neurons to be selectively activated with light in acute brain slices with electrophysiological readouts, and in vivo by means of custom-built fiber optic cannulas. These tools will allow highly specific studies of MHb circuitry and the role of the MHb in behaviors related to addiction and mood regulation.

  8. Medial Gastrocnemius Myoelectric Control of a Robotic Ankle Exoskeleton

    PubMed Central

    Kinnaird, Catherine R.; Ferris, Daniel P.

    2010-01-01

    A previous study from our laboratory showed that when soleus electromyography was used to control the amount of plantar flexion assistance from a robotic ankle exoskeleton, subjects significantly reduced their soleus activity to quickly return to normal gait kinematics. We speculated that subjects were primarily responding to the local mechanical assistance of the exoskeleton rather than directly attempting to reduce exoskeleton mechanical power via decreases in soleus activity. To test this observation we studied ten healthy subjects walking on a treadmill at 1.25 m/s while wearing a robotic exoskeleton proportionally controlled by medial gastrocnemius activation. We hypothesized that subjects would primarily decrease soleus activity due to its synergistic mechanics with the exoskeleton. Subjects decreased medial gastrocnemius recruitment by 12% (p<0.05) but decreased soleus recruitment by 27% (p<0.05). In agreement with our hypothesis, the primary reduction in muscle activity was not for the control muscle (medial gastrocnemius) but for the anatomical synergist to the exoskeleton (soleus). These findings indicate that anatomical morphology needs to be considered carefully when designing software and hardware for robotic exoskeletons. PMID:19211321

  9. Radiofrequency Neurotomy of Cervical Medial Branches for Chronic Cervicobrachialgia

    PubMed Central

    Shin, Woo-Ram; Shin, Dong-Gyu; Shin, Dong-Ah

    2006-01-01

    Chronic neck and arm pain or cervicobrachialgia commonly occurs with the degeneration of cervical spine. Authors investigated the usefulness of radiofrequency (RF) neurotomies of cervical medial branches in patients with cervicobrachialgia and analyzed the factors which can influence the treatment outcome. Demographic data, types of pain distribution, responses of double controlled blocks, electrical stimulation parameters, numbers and levels of neurotomies, and surgical outcomes were evaluated after mean follow-up of 12 months. Pain distribution pattern was not significantly correlated with the results of diagnostic blocks. Average stimulation intensity was 0.45 V, ranging from 0.3 to 0.69, to elicit pain response in cervical medial branches. The most common involvement of nerve branches was C4 (89%), followed by C5 (82%), C6 (75%), and C7 (43%). Among total of 28 patients, nineteen (68%) reported successful outcome according to outcome criteria after 6 months of follow-up (p=0.001), and eight (42%) of 19 patients reported complete relief (100%) of pain. Four patients showed recurrence of pain between 6 and 12 months. It was therefore concluded that cervical medial branch neurotomy is considered useful therapeutic modality for the management of cervicobrachialgia in selected patients, particularly in degenerative zygapophyseal disorders. PMID:16479077

  10. Radiofrequency neurotomy of cervical medial branches for chronic cervicobrachialgia.

    PubMed

    Shin, Woo-Ram; Kim, Hyoung-Ihl; Shin, Dong-Gyu; Shin, Dong-Ah

    2006-02-01

    Chronic neck and arm pain or cervicobrachialgia commonly occurs with the degeneration of cervical spine. Authors investigated the usefulness of radiofrequency (RF) neurotomies of cervical medial branches in patients with cervicobrachialgia and analyzed the factors which can influence the treatment outcome. Demographic data, types of pain distribution, responses of double controlled blocks, electrical stimulation parameters, numbers and levels of neurotomies, and surgical outcomes were evaluated after mean follow-up of 12 months. Pain distribution pattern was not significantly correlated with the results of diagnostic blocks. Average stimulation intensity was 0.45 V, ranging from 0.3 to 0.69, to elicit pain response in cervical medial branches. The most common involvement of nerve branches was C4 (89%), followed by C5 (82%), C6 (75%), and C7 (43%). Among total of 28 patients, nineteen (68%) reported successful outcome according to outcome criteria after 6 months of followup (p=0.001), and eight (42%) of 19 patients reported complete relief (100%) of pain. Four patients showed recurrence of pain between 6 and 12 months. It was therefore concluded that cervical medial branch neurotomy is considered useful therapeutic modality for the management of cervicobrachialgia in selected patients, particularly in degenerative zygapophyseal disorders.

  11. Arthroscopic Removal of Shotgun Pellet From Within the Medial Meniscus

    PubMed Central

    Lacy, Kyle; Cooke, Chris; Cooke, Pat; Tonnos, Frederick

    2016-01-01

    Arthroscopic techniques are effective for the removal of intra-articular bullet and metal fragments after gunshot wounds to the shoulder, hip, knee, and sacroiliac joints. Surgical removal of bullets retained within the synovial joints is indicated; lead is dissolved by synovial fluid over time, leading to proliferative synovitis, lead arthropathy, elevated serum lead levels, and lead toxicity. We present an arthroscopic technique for removal of a shotgun pellet retained within the medial meniscus. In this technique, diagnostic knee arthroscopy is initially performed, which allows for localization of the pellet within the medial meniscus. An up-biter is used to resect the inner rim of meniscus surrounding the pellet, and the pellet is removed with a grasper. This arthroscopic approach is advantageous because it allows for efficient visualization of the pellet within the meniscus, thorough visualization of all compartments of the knee, a reduction in blood loss, and a decrease in surgical morbidity to the surrounding cartilaginous, neurovascular, and soft-tissue structures. This technique may therefore be one option to address bullet fragments or shotgun pellets that are retained within the medial meniscus. PMID:27073774

  12. Arthroscopic trans-portal deep medial collateral ligament pie-crusting release.

    PubMed

    Atoun, Ehud; Debbi, Ronen; Lubovsky, Omri; Weiler, Andreas; Debbi, Eytan; Rath, Ehud

    2013-02-01

    Arthroscopic treatments of meniscal injuries of the knee are among the most common orthopaedic procedures performed. Adequate visualization of the posterior horn of the medial meniscus might be challenging, especially in patients with tight medial compartments. In these cases instrument manipulation in an attempt to reach the posterior horn of the meniscus can cause an iatrogenic chondral injury because of the narrow medial joint space. A transcutaneous medial collateral ligament (MCL) pie-crusting release facilitates expansion of the medial joint space in a case of a tight medial compartment. Nevertheless, it might cause injury to the superficial MCL, infection, and pain and injury to the saphenous nerve because of multiple needle punctures of the skin. We describe an inside-out, arthroscopic deep MCL pie-crusting release, which allows access to the medial meniscus through the anterior approach to provide good visualization of the footprint and sufficient working space.

  13. The effect of different depths of medial heel skive on plantar pressures

    PubMed Central

    2012-01-01

    Background Foot orthoses are often used to treat lower limb injuries associated with excessive pronation. There are many orthotic modifications available for this purpose, with one being the medial heel skive. However, empirical evidence for the mechanical effects of the medial heel skive modification is limited. This study aimed to evaluate the effect that different depths of medial heel skive have on plantar pressures. Methods Thirty healthy adults (mean age 24 years, range 18–46) with a flat-arched or pronated foot posture and no current foot pain or deformity participated in this study. Using the in-shoe pedar-X® system, plantar pressure data were collected for the rearfoot, midfoot and forefoot while participants walked along an 8 metre walkway wearing a standardised shoe. Experimental conditions included a customised foot orthosis with the following 4 orthotic modifications: (i) no medial heel skive, (ii) a 2 mm medial heel skive, (iii) a 4 mm medial heel skive and (iv) a 6 mm medial heel skive. Results Compared to the foot orthosis with no medial heel skive, statistically significant increases in peak pressure were observed at the medial rearfoot – there was a 15% increase (p = 0.001) with the 4 mm skive and a 29% increase (p < 0.001) with the 6 mm skive. No significant change was observed with the 2 mm medial heel skive. With respect to the midfoot and forefoot, there were no significant differences between the orthoses. Conclusions This study found that a medial heel skive of 4 mm or 6 mm increases peak pressure under the medial rearfoot in asymptomatic adults with a flat-arched or pronated foot posture. Plantar pressures at the midfoot and forefoot were not altered by a medial heel skive of 2, 4 or 6 mm. These findings provide some evidence for the effects of the medial heel skive orthotic modification. PMID:22889267

  14. Multimodal intervention in older adults improves resting-state functional connectivity between the medial prefrontal cortex and medial temporal lobe.

    PubMed

    Li, Rui; Zhu, Xinyi; Yin, Shufei; Niu, Yanan; Zheng, Zhiwei; Huang, Xin; Wang, Baoxi; Li, Juan

    2014-01-01

    The prefrontal cortex and medial temporal lobe are particularly vulnerable to the effects of aging. The disconnection between them is suggested to be an important cause of cognitive decline in normal aging. Here, using multimodal intervention training, we investigated the functional plasticity in resting-state connectivity of these two regions in older adults. The multimodal intervention, comprised of cognitive training, Tai Chi exercise, and group counseling, was conducted to explore the regional connectivity changes in the default-mode network, as well as changes in prefrontal-based voxel-wise connectivity in the whole brain. Results showed that the intervention selectively affected resting-state functional connectivity between the medial prefrontal cortex and medial temporal lobe. Moreover, the strength of resting-state functional connectivity between these regions correlated with individual cognitive performance. Our results suggest that multimodal intervention could postpone the effects of aging and improve the function of the regions that are most heavily influenced by aging, as well as play an important role in preserving the brain and cognition during old age.

  15. A Novel Medial Soft Tissue Release Method for Varus Deformity during Total Knee Arthroplasty: Femoral Origin Release of the Medial Collateral Ligament

    PubMed Central

    Lee, Seung-Yup; Yang, Jae-Hyuk; Lee, Yong-In

    2016-01-01

    Introduction Numerous methods of medial soft tissue release for severe varus deformity during total knee arthroplasty (TKA) have been reported. These include tibial stripping of the superficial medial collateral ligament (MCL), pie-crusting technique, and medial epicondylar osteotomy. However, there are inherent disadvantages in these techniques. Authors hereby present a novel quantitative method: femoral origin release of the medial collateral ligament (FORM). Surgical Technique For medial tightness remaining even after the release of the deep MCL and semimembranosus, the FORM is initiated with identification of the femoral insertion area of the MCL with the knee in flexion. Starting from the most posterior part of the femoral insertion, one third of the MCL femoral insertion is released from its attachment. If necessary, further sequential medial release is performed. Materials and Methods Seventeen knees that underwent the FORM were evaluated for radiological and clinical outcomes. Results Regardless of the extent of the FORM, no knees showed residual valgus instability at 24 weeks after surgery. Conclusions As the FORM is performed in a stepwise manner, fine adjustment during medial release might be beneficial to prevent inadvertent over-release of the medial structures of the knee. PMID:27274473

  16. Arthroscopic decompressive medial release of the varus arthritic knee: Expanding the functional envelope.

    PubMed

    Leon, H O; Blanco, C E; Guthrie, T B

    2001-05-01

    We present the rationale and technique for treating medial knee osteoarthritis by dynamically unloading the medial compartment of the knee. Recent advances in kinematic studies indicate a dynamic linkage between differing degrees of freedom in the knee joint. Both the adduction moment and the foot progression angle are important determinants of medial compartment loading. The medially osteoarthritic knee has progressive compromise of free motion in more than 1 plane. Arthroscopic decompressive medial release unloads the medial compartment by release of the medial capsule and medial collateral ligament in the presence of intact cruciate ligaments, which may allow a decreased adduction moment and decrease of the external rotation restraint in extension found in more severely osteoarthritic knees. A case series of 38 patients with medial gonarthrosis was treated by this technique at the Hermanos Ameijeiras Hospital in Havana, Cuba. All patients had good results without postoperative valgus instability or significant complications. We feel that this technique warrants further clinical and biomechanical study for its use in isolation or in combination with high tibial osteotomy or minimally invasive selective osteotomy for the treatment of medial gonarthrosis of the knee. A minimally invasive, selective approach to biomechanical factors in osteoarthritis may be combined with other modulating techniques in efforts to forestall or prevent the need for total joint replacement.

  17. Medial tibial pain: a dynamic contrast-enhanced MRI study.

    PubMed

    Mattila, K T; Komu, M E; Dahlström, S; Koskinen, S K; Heikkilä, J

    1999-09-01

    The purpose of this study was to compare the sensitivity of different magnetic resonance imaging (MRI) sequences to depict periosteal edema in patients with medial tibial pain. Additionally, we evaluated the ability of dynamic contrast-enhanced imaging (DCES) to depict possible temporal alterations in muscular perfusion within compartments of the leg. Fifteen patients with medial tibial pain were examined with MRI. T1-, T2-weighted, proton density axial images and dynamic and static phase post-contrast images were compared in ability to depict periosteal edema. STIR was used in seven cases to depict bone marrow edema. Images were analyzed to detect signs of compartment edema. Region-of-interest measurements in compartments were performed during DCES and compared with controls. In detecting periosteal edema, post-contrast T1-weighted images were better than spin echo T2-weighted and proton density images or STIR images, but STIR depicted the bone marrow edema best. DCES best demonstrated the gradually enhancing periostitis. Four subjects with severe periosteal edema had visually detectable pathologic enhancement during DCES in the deep posterior compartment of the leg. Percentage enhancement in the deep posterior compartment of the leg was greater in patients than in controls. The fast enhancement phase in the deep posterior compartment began slightly slower in patients than in controls, but it continued longer. We believe that periosteal edema in bone stress reaction can cause impairment of venous flow in the deep posterior compartment. MRI can depict both these conditions. In patients with medial tibial pain, MR imaging protocol should include axial STIR images (to depict bone pathology) with T1-weighted axial pre and post-contrast images, and dynamic contrast enhanced imaging to show periosteal edema and abnormal contrast enhancement within a compartment.

  18. Modulating Phonation Through Alteration of Vocal Fold Medial Surface Contour

    PubMed Central

    Mau, Ted; Muhlestein, Joseph; Callahan, Sean; Chan, Roger W.

    2012-01-01

    Objectives 1. To test whether alteration of the vocal fold medial surface contour can improve phonation. 2. To demonstrate that implant material properties affect vibration even when implant is deep to the vocal fold lamina propria. Study Design Induced phonation of excised human larynges. Methods Thirteen larynges were harvested within 24 hours post-mortem. Phonation threshold pressure (PTP) and flow (PTF) were measured before and after vocal fold injections using either calcium hydroxylapatite (CaHA) or hyaluronic acid (HA). Small-volume injections (median 0.0625 mL) were targeted to the infero-medial aspect of the thyroarytenoid (TA) muscle. Implant locations were assessed histologically. Results The effect of implantation on PTP was material-dependent. CaHA tended to increase PTP, whereas HA tended to decrease PTP (Wilcoxon test P = 0.00013 for onset). In contrast, the effect of implantation on PTF was similar, with both materials tending to decrease PTF (P = 0.16 for onset). Histology confirmed implant presence in the inferior half of the vocal fold vertical thickness. Conclusions Taken together, these data suggested the implants may have altered the vocal fold medial surface contour, potentially resulting in a less convergent or more rectangular glottal geometry as a means to improve phonation. An implant with a closer viscoelastic match to vocal fold cover is desirable for this purpose, as material properties can affect vibration even when the implant is not placed within the lamina propria. This result is consistent with theoretical predictions and implies greater need for surgical precision in implant placement and care in material selection. PMID:22865592

  19. Medial prefrontal cortical integration of psychological stress in rats.

    PubMed

    McDougall, S J; Widdop, Robert E; Lawrence, Andrew J

    2004-11-01

    The present study aimed to determine whether the medial prefrontal cortex (mPFC) (prelimbic and infralimbic regions) is implicated in the integration of a stress response. Sprague-Dawely rats were implanted with telemetry probes and guide cannulae so that either muscimol or vehicle could be administered locally within the mPFC or dorsomedial hypothalamus (DMH). The heart rate and blood pressure of rats was continuously recorded as either muscimol or vehicle was administered centrally and rats were either exposed to restraint stress or left alone in their home cages. After the stress challenge, or equivalent period, rats that had received intra-mPFC injections were processed for immunohistochemical detection of Fos throughout the neuraxis. Bilateral microinjection of muscimol into the mPFC had no effect upon either baseline cardiovascular parameters or restraint stress-induced tachycardia or pressor responses whereas, in the DMH, pretreatment with muscimol attenuated the cardiovascular stress response. Analysis of Fos expression throughout the CNS of nonstressed rats showed no effect of muscimol injections into the mPFC on baseline expression in the nuclei examined. In contrast, rats that had received muscimol injections into their mPFC and were subsequently restrained exhibited an increase in the number of Fos-positive cells in the DMH, medial amygdala, and medial nucleus tractus solitarius as compared to vehicle-injected rats that experienced restraint stress. These results indicate that, during acute psychological stress, the mPFC does not modulate the cardiovascular system in rats but does inhibit specific subcortical nuclei to exert control over aspects of an integrated response to a stressor.

  20. Partial triceps disruption: a case report.

    PubMed

    Foulk, David M; Galloway, Marc T

    2011-03-01

    Partial triceps tendon disruptions are a rare injury that can lead to debilitating outcomes if misdiagnosed or managed inappropriately. The clinician should have a high index of suspicion when the mechanism involves a fall onto an outstretched arm and there is resultant elbow extension weakness along with pain and swelling. The most common location of rupture is at the tendon-osseous junction. This case report illustrates a partial triceps tendon disruption with involvement of, primarily, the medial head and the superficial expansion. Physical examination displayed weakness with resisted elbow extension in a flexed position over 90°. Radiographs revealed a tiny fleck of bone proximal to the olecranon, but this drastically underestimated the extent of injury upon surgical exploration. Magnetic resonance imaging is essential to ascertain the percentage involvement of the tendon; it can be used for patient education and subsequently to determine treatment recommendations. Although excellent at finding associated pathology, it may misjudge the size of the tear. As such, physicians must consider associated comorbidities and patient characteristics when formulating treatment plans.

  1. Partial Torus Instability

    NASA Astrophysics Data System (ADS)

    Olmedo, Oscar; Zhang, J.

    2010-05-01

    Flux ropes are now generally accepted to be the magnetic configuration of Coronal Mass Ejections (CMEs), which may be formed prior or during solar eruptions. In this study, we model the flux rope as a current-carrying partial torus loop with its two footpoints anchored in the photosphere, and investigate its instability in the context of the torus instability (TI). Previous studies on TI have focused on the configuration of a circular torus and revealed the existence of a critical decay index. Our study reveals that the critical index is a function of the fractional number of the partial torus, defined by the ratio between the arc length of the partial torus above the photosphere and the circumference of a circular torus of equal radius. We refer to this finding the partial torus instability (PTI). It is found that a partial torus with a smaller fractional number has a smaller critical index, thus requiring a more gradually decreasing magnetic field to stabilize the flux rope. On the other hand, the partial torus with a larger fractional number has a larger critical index. In the limit of a circular torus when the fractional number approaches one, the critical index goes to a maximum value that depends on the distribution of the external magnetic field. We demonstrate that the partial torus instability helps us to understand the confinement, growth, and eventual eruption of a flux rope CME.

  2. The Efferent Medial Olivocochlear-Hair Cell Synapse

    PubMed Central

    Elgoyhen, Ana Belén; Katz, Eleonora

    2011-01-01

    Amplification of incoming sounds in the inner ear is modulated by an efferent pathway which travels back from the brain all the way to the cochlea. The medial olivocochlear system makes synaptic contacts with hair cells, where the neurotransmitter acetylcholine is released. Synaptic transmission is mediated by a unique nicotinic cholinergic receptor composed of α9 and α10 subunits, which is highly Ca2+ permeable and is coupled to a Ca2+-activated SK potassium channel. Thus, hyperpolarization of hair cells follows efferent fiber activation. In this work we review the literature that has enlightened our knowledge concerning the intimacies of this synapse. PMID:21762779

  3. Considerations for the Management of Medial Orbital Wall Blowout Fracture

    PubMed Central

    Park, Youngsoo; Chung, Kyu Jin

    2016-01-01

    Recently, diagnoses of and operations for medial orbital blowout fracture have increased because of the development of imaging technology. In this article, the authors review the literature, and overview the accumulated knowledge about the orbital anatomy, fracture mechanisms, surgical approaches, reconstruction materials, and surgical methods. In terms of surgical approaches, transcaruncular, transcutaneous, and transnasal endoscopic approaches are discussed. Reconstruction methods including onlay covering, inlay implantation, and repositioning methods are also discussed. Consideration and understanding of these should lead to more optimal outcomes. PMID:27218019

  4. Snapping knee caused by the thickening of the medial hamstrings.

    PubMed

    de la Hera Cremades, B; Escribano Rueda, L; Lara Rubio, A

    2016-11-17

    We report a case of symptomatic subluxation of the semitendinosus and gracilis over the medial condyle of the tibia caused by the thickening of its tendons. Snapping was reproduced on active extension. Clinical examination and, above all, dynamic ultrasound were the key for the diagnosis because other imaging tests were normal. Due to failure of conservative treatment with physiotherapy and infiltrations, surgery was undertaken, involving desinsertion and excision of distal 8cm segment of the semitendinosus and gracilis tendons. At the present time (6 months postoperatively), the patient is symptom-free and has returned to the previous normal life activities.

  5. The medial antebrachial cutaneous nerve: antidromic and orthodromic conduction studies.

    PubMed

    Seror, Paul

    2002-09-01

    Medial antebrachial cutaneous nerve (MABCN) conduction studies were performed antidromically and orthodromically in 70 control subjects to determine normal values and define the lower limits of normality. The mean sensory action potential (SAP) amplitudes were 17.7 and 17.5 microV and the sensory conduction velocities were 60 and 61 m/s, respectively, with the antidromic and orthodromic techniques. With both techniques, no SAP amplitude was lower than 6 microV. The lower limits of normal of the interside amplitude ratio were 1.66 when both techniques were used and 2.0 when only one was used.

  6. Medial ectropion repair of lower eyelids with a cicatricial component.

    PubMed

    Hesse, Richard J

    2011-01-01

    A new technique for the management of medial ectropion with a mild to moderate cicatricial component is presented that avoids the necessity for skin grafting. A subciliary incision is made inferior to the punctum and extending laterally, followed by preseptal dissection to the orbital rim. A base-up triangle of the posterior lamella is then excised lateral to the punctum. This is closed with a marginal mattress suture. Tightening of the posterior lamella in this fashion produces laxity in the anterior lamella, which can then be closed without tension, eliminating the need for skin grafting.

  7. A geometric morphometric analysis of the medial tibial condyle of African hominids.

    PubMed

    Sylvester, Adam D

    2013-10-01

    Although the hominid knee has been heavily scrutinized, shape variation of the medial tibial condyle has yet to be described. Humans, chimpanzees, and gorillas differ in the shape of their medial femoral condyles and in their capacity for external and internal rotation of the tibia relative to the femur. I hypothesize that these differences should be reflected in the shape of the medial tibial condyle of these hominids. Here I use geometric morphometric techniques to uncover shape differences between the medial tibial condyles of humans, chimpanzees, and gorillas. Humans are distinguished from the other two species by having a much more oval-shaped medial tibial condyle, while those of chimpanzees and gorillas are more triangular in outline. Gorillas (especially males) are distinguished by having more concavely-curved condyles (mediolateral direction), which is interpreted as an effect of heavy loading through the medial compartment of the knee in conjunction with differences in the degree of arboreality.

  8. Parametric study of orthopedic insole of valgus foot on partial foot amputation.

    PubMed

    Guo, Jun-Chao; Wang, Li-Zhen; Chen, Wei; Du, Cheng-Fei; Mo, Zhong-Jun; Fan, Yu-Bo

    2016-01-01

    Orthopedic insole was important for partial foot amputation (PFA) to achieve foot balance and avoid foot deformity. The inapposite insole orthosis was thought to be one of the risk factors of reamputation for foot valgus patient, but biomechanical effects of internal tissues on valgus foot had not been clearly addressed. In this study, plantar pressure on heel and metatarsal regions of PFA was measured using F-Scan. The three-dimensional finite element (FE) model of partial foot evaluated different medial wedge angles (MWAs) (0.0°-10.0°) of orthopedic insole on valgus foot. The effect of orthopedic insole on the internal bone stress, the medial ligament tension of ankle, plantar fascia tension, and plantar pressure was investigated. Plantar pressure on medial heel region was about 2.5 times higher than that of lateral region based on the F-Scan measurements. FE-predicted results showed that the tension of medial ankle ligaments was the lowest, and the plantar pressure was redistributed around the heel, the first metatarsal, and the lateral longitudinal arch regions when MWA of orthopedic insole ranged from 7.5° to 8.0°. The plantar fascias maintained about 3.5% of the total load bearing on foot. However, the internal stresses from foot bones increased. The simulation in this study would provide the suggestion of guiding optimal design of orthopedic insole and therapeutic planning to pedorthist.

  9. Partial knee replacement - slideshow

    MedlinePlus

    ... page: //medlineplus.gov/ency/presentations/100225.htm Partial knee replacement - series—Normal anatomy To use the sharing ... A.M. Editorial team. Related MedlinePlus Health Topics Knee Replacement A.D.A.M., Inc. is accredited ...

  10. Twisted partially pure spinors

    NASA Astrophysics Data System (ADS)

    Herrera, Rafael; Tellez, Ivan

    2016-08-01

    Motivated by the relationship between orthogonal complex structures and pure spinors, we define twisted partially pure spinors in order to characterize spinorially subspaces of Euclidean space endowed with a complex structure.

  11. Reconstruction of medial patellofemoral ligament using quadriceps tendon combined with reconstruction of medial patellotibial ligament using patellar tendon: initial experience☆

    PubMed Central

    Hinckel, Betina Bremer; Gobbi, Riccardo Gomes; Bonadio, Marcelo Batista; Demange, Marco Kawamura; Pécora, José Ricardo; Camanho, Gilberto Luis

    2016-01-01

    Objective To describe a surgical technique for anatomical reconstruction of the medial patellofemoral ligament using the quadriceps tendon, combined with reconstruction of the medial patellotibial ligament using the patellar tendon; and to present the initial results from a case series. Method The proposed technique was used on a series of cases of patients with diagnoses of patellofemoral instability and indications for surgical treatment, who were attended by the Knee Group of HC-IOT, University of São Paulo. The following were evaluated before and after the operation: range of motion (ROM), apprehension test, lateral translation test, patellar inclination test, inverted J sign, subluxation upon extension, pain from compression of the patella and pain from contraction of the quadriceps. After the operation, the patients were asked whether any new episode of dislocation had occurred, what their degree of satisfaction with the surgery was (on a scale from 0 to 10) and whether they would be prepared to go through this operation again. Results Seven knees were operated, in seven patients, with a mean follow-up of 5.46 months (±2.07). Four patients who presented apprehension before the operation did not show this after the operation. The lateral translation test became normal for all the patients, while the patellar inclination test remained positive for two patients. The patients with an inverted J sign continued to be positive for this sign. Five patients were positive for subluxation upon extension before the operation, but all patients were negative for this after the operation. None of the patients presented any new episode of dislocation of the patella. All of them stated that they were satisfied: five gave a satisfaction score of 9 and two, a score of 10. All of them said that they would undergo the operation again. Only one patient presented a postoperative complication: dehiscence of the wound. Conclusion Reconstruction of the medial patellofemoral ligament

  12. Partially coherent nonparaxial beams.

    PubMed

    Duan, Kailiang; Lü, Baida

    2004-04-15

    The concept of a partially coherent nonparaxial beam is proposed. A closed-form expression for the propagation of nonparaxial Gaussian Schell model (GSM) beams in free space is derived and applied to study the propagation properties of nonparaxial GSM beams. It is shown that for partially coherent nonparaxial beams a new parameter f(sigma) has to be introduced, which together with the parameter f, determines the beam nonparaxiality.

  13. Medial cortex strain distribution during noncemented total hip arthroplasty.

    PubMed

    Elias, J J; Nagao, M; Chu, Y H; Carbone, J J; Lennox, D W; Chao, E Y

    2000-01-01

    Intraoperative proximal femur fractures are a significant concern during noncemented total hip arthroplasty. The current study was performed to investigate the hypothesis that broaching the femur and inserting the stem without using mallet applied impact loads will reduce the risk of intraoperative fracture. Rosette strain gauges were applied to the medial and anteromedial cortex of six human anatomic specimen femurs to compare the strain distribution for broaching and stem insertion. Eight additional femurs were used to compare the strain distribution for stem insertion using impact loading and constant rate stem insertion. For the impact loading stem insertions, the soft tissues surrounding the femur were modeled. Constant rate stem insertions were performed using a mechanical testing machine. The largest strains measured at the medial and anteromedial sites primarily were aligned with the femur hoop axis. The largest strain magnitude, orientation, and sign (tensile or compressive) varied widely among femurs. The stem insertion strains were significantly larger than the broaching strains (two-way analysis of variance with replication). The impact stem insertion strains were not significantly different from the constant rate stem insertion strains. The results indicate that the femur geometry and material properties have a greater influence on the strain distribution than does the implantation technique.

  14. Perineoscrotal reconstruction using a medial circumflex femoral artery perforator flap.

    PubMed

    Karsidag, Semra; Akcal, Arzu; Sirvan, Selami Serhat; Guney, Soner; Ugurlu, Kemal

    2011-02-01

    Major scrotal defects may result from infection due to Fournier's gangrene, excision of scrotal skin diseases, traumatic avulsion of scrotal and penile skin, and genital burns. The wide spectrum of bacterial flora of the perineum, difficulty in providing immobilisation, and obtaining a natural contour of the testes make testicular cover very difficult. Various methods have been reported to cover the penoscrotal area, including skin grafting, transposing them to medial thigh skin, and use of local fasciocutaneous or musculocutaneous flaps. In this report, reconstruction using six local medial circumflex femoral artery perforator (MCFAP) flaps was undertaken in five male patients (mean age, 47 years) with complex penoscrotal or perineal wounds. The cause of the wounds in four patients was Fournier's gangrene, and was a wide papillomateous lesion in the other patient. Flap width was 6-10 cm and flap length was 10-18 cm. The results showed that a MCFAP flap provided the testes with a pliable local flap without being bulky and also protected the testicle without increasing the temperature. The other advantage of the MCFAP flap was that the donor-site scar could be concealed in the gluteal crease. Our results demonstrated that the MCFAP flap is an ideal local flap for covering penoscrotal defects.

  15. Medial prefrontal cortex role in recognition memory in rodents.

    PubMed

    Morici, Juan Facundo; Bekinschtein, Pedro; Weisstaub, Noelia V

    2015-10-01

    The study of the neurobiology of recognition memory, defined by the integration of the different components of experiences that support recollection of past experiences have been a challenge for memory researches for many years. In the last twenty years, with the development of the spontaneous novel object recognition task and all its variants this has started to change. The features of recognition memory include a particular object or person ("what"), the context in which the experience took place, which can be the arena itself or the location within a particular arena ("where") and the particular time at which the event occurred ("when"). This definition instead of the historical anthropocentric one allows the study of this type of episodic memory in animal models. Some forms of recognition memory that require integration of different features recruit the medial prefrontal cortex. Focusing on findings from spontaneous recognition memory tasks performed by rodents, this review concentrates on the description of previous works that have examined the role that the medial prefrontal cortex has on the different steps of recognition memory. We conclude that this structure, independently of the task used, is required at different memory stages when the task cannot be solved by a single item strategy.

  16. Clinical results in reconstruction of medial patellofemoral ligament

    PubMed Central

    Irigoitia, Nicolas Alejandro; Catan, Agustín Felipe; Arroquy, Damián; Guiñazu, Jorge; Vilaseca, Tomas; Nazur, Gabriel; Bisso, Martín Carboni

    2017-01-01

    Background: The reconstruction of the medial patellofemoral ligament (MPFL) is the most suitable treatment for the patellar instability at the present in patients with two or more episodes of dislocation or only one with condral lesion. This is because it is the principal medial stabilizer of the patella. This process could be supplemented with an osseous correction as tibial tuberosity transference. Objectives: assess the clinical results of the reconstruction of the MPLF in patients with patellar instability. Study Design: Case series, level of evidence IV. Methods: We enroll all patients with this procedure between form April 2011 to February 2015, the sample has 27 reconstruction in 25 patients, who has two or more episodes of patellar dislocation. The graft used was gracilis tendon, set with suture anchor, and tibial tuberosity transfer in 9 patients who need an osseous procedure. Results: The average Kujala score was 90,1 points ( 64-100). Was necessary tibial tuberosity transference in one third of se sample. And in those patients there no difference compared with the isolated reconstruction.There was no episode of patellar dislocation or a second surgical time in the sample. Conclusion: The reconstruction of MPLF show excellent clinical outcomes in a short and medium terms , with 0% of dislocation and no second surgical time, in this kind of patients.

  17. The medial gastrocnemius muscle attenuates force fluctuations during plantar flexion.

    PubMed

    Shinohara, Minoru; Yoshitake, Yasuhide; Kouzaki, Motoki; Fukunaga, Tetsuo

    2006-02-01

    Force fluctuations during steady contractions of multiple agonist muscles may be influenced by the relative contribution of force by each muscle. The purpose of the study was to compare force fluctuations during steady contractions performed with the plantar flexor muscles in different knee positions. Nine men (25.8+/-5.1 years) performed steady contractions of the plantar flexor muscles in the knee-flexed and knee-extended (greater involvement of the gastrocnemii muscles) positions. The maximal voluntary contraction (MVC) force was 32% greater in the knee-extended position compared with the knee-flexed position. The target forces were 2.5-10% MVC force in the respective position. The amplitude of electromyogram in the medial gastrocnemius muscle was greater in the knee-extended position (10.50+/-9.80%) compared with the knee-flexed position (1.26+/-1.15%, P<0.01). The amplitude of electromyogram in the soleus muscle was not influenced by the knee position. The amplitude of electromyogram in the lateral gastrocnemius and tibialis anterior muscles was marginal and unaltered with knee position. At the same force (in Newtons), the standard deviation of force was lower in the knee-extended position compared with the knee-flexed position. These results indicate that force fluctuations during plantar flexion are attenuated with greater involvement of the medial gastrocnemius muscle.

  18. Function of the medial meniscus in force transmission and stability.

    PubMed

    Walker, Peter S; Arno, Sally; Bell, Christopher; Salvadore, Gaia; Borukhov, Ilya; Oh, Cheongeun

    2015-06-01

    We studied the combined role of the medial meniscus in distributing load and providing stability. Ten normal knees were loaded in combinations of compressive and shear loading as the knee was flexed over a full range. A digital camera tracked the motion, from which femoral-tibial contacts were determined by computer modelling. Load transmission was determined from the Tekscan for the anterior horn, central body, posterior horn, and the uncovered cartilage in the centre of the meniscus. For the three types of loading; compression only, compression and anterior shear, compression and posterior shear; between 40% and 80% of the total load was transmitted through the meniscus. The overall average was 58%, the remaining 42% being transmitted through the uncovered cartilage. The anterior horn was loaded only up to 30 degrees flexion, but played a role in controlling anterior femoral displacement. The central body was loaded 10-20% which would provide some restraint to medial femoral subluxation. Overall the posterior horn carried the highest percentage of the shear load, especially after 30 degrees flexion when a posterior shear force was applied, where the meniscus was estimated to carry 50% of the shear force. This study added new insights into meniscal function during weight bearing conditions, particularly its role in early flexion, and in transmitting shear forces.

  19. Modified endoscopic medial maxillectomy for zygomatic implant salvage

    PubMed Central

    Tajudeen, Bobby A.; Adappa, Nithin D.; Palmer, James N.

    2016-01-01

    Objectives: Odontogenic chronic rhinosinusitis (CRS) is an epidemiologically important disease process due, in part, to the increasingly commonplace use of dental restorative procedures such as zygomatic implantation. Traditional management of this clinical entity typically entails extraction of the infected hardware via an open or endoscopic approach. We describe a novel management strategy of odontogenic CRS following bilateral zygomatic implantation for oral rehabilitation that we surgically salvaged via a modified endoscopic medial maxillectomy. Methods: We describe the presentation and management of a case of metachronous development of bilateral CRS subsequent to zygomatic implantation. Results: The patient's postoperative course was characterized by marked endoscopic, radiologic, and symptomatic improvement as measured by the 22-item Sino-Nasal Outcome Test. Conclusion: We describe a novel treatment strategy for the management of odontogenic sinusitis resulting from erroneous zygomatic implant placement. Modified endoscopic medial maxillectomy in this clinical context facilitates mucosal normalization of the affected sinus, while permitting preservation of oral function through salvage of the displaced implant. PMID:28107147

  20. Medial Elbow Exposure for Coronoid Fractures: FCU-Split Versus Over-the-Top

    DTIC Science & Technology

    2013-12-01

    margin of the mass anteriorly) was split and the pronator teres was released from the medial epicondyle and reflected off the anterior elbow capsule and...ORIGINAL ARTICLE Medial Elbow Exposure for Coronoid Fractures: FCU-Split Versus Over-the-Top Jeannie Huh, MD,* Chad A. Krueger, MD,* Michael J...fractures is unknown. The purpose of this study was to quantitatively compare the osseous and ligamentous exposure of the medial elbow using the flexor

  1. The Mechanical Benefit of Medial Support Screws in Locking Plating of Proximal Humerus Fractures

    PubMed Central

    Liu, Yanjie; Pan, Yao; Zhang, Wei; Zhang, Changqing; Zeng, Bingfang; Chen, Yunfeng

    2014-01-01

    Background The purpose of this study was to evaluate the biomechanical advantages of medial support screws (MSSs) in the locking proximal humeral plate for treating proximal humerus fractures. Methods Thirty synthetic left humeri were randomly divided into 3 subgroups to establish two-part surgical neck fracture models of proximal humerus. All fractures were fixed with a locking proximal humerus plate. Group A was fixed with medial cortical support and no MSSs; Group B was fixed with 3 MSSs but without medial cortical support; Group C was fixed with neither medial cortical support nor MSSs. Axial compression, torsional stiffness, shear stiffness, and failure tests were performed. Results Constructs with medial support from cortical bone showed statistically higher axial and shear stiffness than other subgroups examined (P<0.0001). When the proximal humerus was not supported by medial cortical bone, locking plating with medial support screws exhibited higher axial and torsional stiffness than locking plating without medial support screws (P≤0.0207). Specimens with medial cortical bone failed primarily by fracture of the humeral shaft or humeral head. Specimens without medial cortical bone support failed primarily by significant plate bending at the fracture site followed by humeral head collapse or humeral head fracture. Conclusions Anatomic reduction with medial cortical support was the stiffest construct after a simulated two-part fracture. Significant biomechanical benefits of MSSs in locking plating of proximal humerus fractures were identified. The reconstruction of the medial column support for proximal humerus fractures helps to enhance mechanical stability of the humeral head and prevent implant failure. PMID:25084520

  2. PARTIAL TORUS INSTABILITY

    SciTech Connect

    Olmedo, Oscar; Zhang Jie

    2010-07-20

    Flux ropes are now generally accepted to be the magnetic configuration of coronal mass ejections (CMEs), which may be formed prior to or during solar eruptions. In this study, we model the flux rope as a current-carrying partial torus loop with its two footpoints anchored in the photosphere, and investigate its stability in the context of the torus instability (TI). Previous studies on TI have focused on the configuration of a circular torus and revealed the existence of a critical decay index of the overlying constraining magnetic field. Our study reveals that the critical index is a function of the fractional number of the partial torus, defined by the ratio between the arc length of the partial torus above the photosphere and the circumference of a circular torus of equal radius. We refer to this finding as the partial torus instability (PTI). It is found that a partial torus with a smaller fractional number has a smaller critical index, thus requiring a more gradually decreasing magnetic field to stabilize the flux rope. On the other hand, a partial torus with a larger fractional number has a larger critical index. In the limit of a circular torus when the fractional number approaches 1, the critical index goes to a maximum value. We demonstrate that the PTI helps us to understand the confinement, growth, and eventual eruption of a flux-rope CME.

  3. Partial Torus Instability

    NASA Astrophysics Data System (ADS)

    Olmedo, Oscar; Zhang, Jie

    2010-07-01

    Flux ropes are now generally accepted to be the magnetic configuration of coronal mass ejections (CMEs), which may be formed prior to or during solar eruptions. In this study, we model the flux rope as a current-carrying partial torus loop with its two footpoints anchored in the photosphere, and investigate its stability in the context of the torus instability (TI). Previous studies on TI have focused on the configuration of a circular torus and revealed the existence of a critical decay index of the overlying constraining magnetic field. Our study reveals that the critical index is a function of the fractional number of the partial torus, defined by the ratio between the arc length of the partial torus above the photosphere and the circumference of a circular torus of equal radius. We refer to this finding as the partial torus instability (PTI). It is found that a partial torus with a smaller fractional number has a smaller critical index, thus requiring a more gradually decreasing magnetic field to stabilize the flux rope. On the other hand, a partial torus with a larger fractional number has a larger critical index. In the limit of a circular torus when the fractional number approaches 1, the critical index goes to a maximum value. We demonstrate that the PTI helps us to understand the confinement, growth, and eventual eruption of a flux-rope CME.

  4. Medial tibial pain. A prospective study of its cause among military recruits.

    PubMed

    Milgrom, C; Giladi, M; Stein, M; Kashtan, H; Margulies, J; Chisin, R; Steinberg, R; Swissa, A; Aharonson, Z

    1986-12-01

    In a prospective study of 295 infantry recruits during 14 weeks of basic training, 41% had medial tibial pain. Routine scintigraphic evaluation in cases of medial tibial bone pain showed that 63% had abnormalities. A stress fracture was found in 46%. Only two patients had periostitis. None had ischemic medial compartment syndrome. Physical examination could not differentiate between cases with medial tibial bone pain secondary to stress fractures and those with scintigraphically normal tibias. When both pain and swelling were localized in the middle one-third of the tibia, the lesion most likely proved to be a stress fracture.

  5. The significance of medial sural artery integrity in popliteal artery trauma: a case report.

    PubMed

    Tzilalis, V D; Georgiadis, G S; Papas, T T; Arvanitis, D P; Lazarides, M K

    2005-12-01

    Two patients with popliteal artery trauma who underwent secondary amputations due to refractory calf sepsis despite a patent arterial repair are presented in this case report. The medial sural artery, the main arterial supply of the medial head of the gastrocnemius, was surgically severed in both patients owing to the use of a continuous medial incision from the supra level to infragenicular level. The compromised arterial supply of the medial head of the gastrocnemius muscle may have contributed to the devitalization of the muscle and the subsequent calf sepsis, and it is speculated that this was related to the unfavorable outcome.

  6. The medial malleolus osteoligamentous complex and its role in ankle fractures.

    PubMed

    Davidovitch, Roy I; Egol, Kenneth A

    2009-01-01

    Ankle stability in ankle fractures is dependent on multiple factors. The medial malleolus and the associated deltoid ligament provide for ankle stability on the medial side. Over the years, the relative importance of this medial malleolar osteoligamentous complex (MMOLC) has been debated. This review will describe the evolution of ankle fracture surgery from the perspective of the contribution of the MMOLC to re-establishing ankle stability. Also discussed are the surgical and nonsurgical treatment options, various presentations of medial sided injuries in ankle fractures, and, finally, current recommendations for fixation.

  7. Pelvic limb alignment in small breed dogs: a comparison between affected and free subjects from medial patellar luxation.

    PubMed

    Olimpo, Matteo; Piras, Lisa Adele; Peirone, Bruno

    2016-01-01

    Small breed dogs are 12 times more likely to develop medial patellar luxation (MPL) than large breed dogs and breed predisposition has been reported. Many surgical techniques are available for correction of patellar luxation in dogs. However, recent studies reported an 8% incidence of reluxation when traditional techniques are used. The relatively high frequency of major complications and patellar reluxation may be partially caused by inadequate appreciation of the underlying skeletal deformity and subsequent incorrect selection and application of traditional techniques. The aims of this study were to report the normal values of the anatomic and mechanical joint angles of the femur and tibia in small breed dogs and to compare these data to a population of small breed dogs affected by different degrees of MPL. Normal values of the anatomic and mechanical angles of the femur are similar to the ones reported in literature in Pomeranian dogs. Normal values of the anatomic and mechanical angles of the tibia have been described for the first time. Significant differences were found between normal population and dogs affected by grade 4 MPL in relation to anatomical Lateral Distal Femoral Angle (aLDFA), mechanical Medial Proximal Tibial Angle (mMPTA), and mechanical Caudal Proximal Tibial Angle (mCaPTA).

  8. A Case of Spontaneous Osteonecrosis of the Knee with Early and Simultaneous Involvement of the Medial Femoral Condyle and Medial Tibial Plateau

    PubMed Central

    Fujita, Shinya; Arai, Yuji; Honjo, Kuniaki; Nakagawa, Shuji; Kubo, Toshikazu

    2016-01-01

    Spontaneous osteonecrosis of the knee (SPONK) usually involves a single condyle, most often the medial femoral condyle (MFC). Involvement of the medial tibial plateau (MTP) is less common, occurring in about 2% of knees with SPONK. Early onset SPONK on the ipsilateral side of the medial compartment is very rare, with, to our knowledge, only four cases reported to date. We describe a very rare case of SPONK with early simultaneous development in the MFC and MTP. Serial plain radiographs and magnetic resonance imaging showed that SPONK in both condyles followed a similar progressive course. The pathological findings in these lesions were similar to those observed in subchondral insufficiency fractures. PMID:27242941

  9. Are Early Results of Robotic Assisted Medial Unicompartmental Knee Arthroplasty Successful?

    PubMed Central

    Haklar, Uğur; Ulusoy, Ertuğrul; Şimşek, Tayfun; Terzi, Nuray

    2014-01-01

    Objectives: Robotic surgery studies have been increasing in literature in the past years due to its operative advantages on reducing error and improving functional success in partial knee arthroplasty. Methods: Data were prospectively collected in 21 patients (31 knees) who underwent MAKOplasty, robotic assisted unicondylar medial knee arthroplasty, between June 2013 – January 2014 in our clinic with an average follow-up time of 5.5 months. Clinical outcomes were evaluated with American Knee Society Scoring System. Additionally, intra-operative digitally planned implant positions on the robot’s software were compared with post-operative radiographic component alignment. In the radiographic evaluation; anatomic axis of the tibia was observed in the coronal plane. Tibial posterior slope and flexion angle of the femoral component were observed in the sagittal plane. Results: Pre-operatively 1 patient was scored fair (60 points) and 20 patients were scored poor (mean, 46.6 points) on American Knee Society Scoring System. Post-operatively all 21 patients had excellent knee scores (mean, 99.67 points). Function-wise 7 patients were scored fair (mean, 60 points) and 14 patients were scored poor (mean, 30.7 points) again on American Knee Society Functional Scoring System. Post-operatively all 21 patients exhibited excellent function scores (mean, 99.04 points). In the radiological evaluation, intra-operative robotic analyses were compared with post-operative radiographic alignment. No significant difference was observed statistically (paired t-test, p < 0.05). This comparison is valuable as Lonner, Hernigou, Collier report that mal-alignment by as little as 2° may predispose to implant failures. Conclusion: Robotic assistance greatly improves clinical and functional outcomes and may help prevent implant failures due to surgical error and mal-alignment in partial knee arthroplasty.

  10. Ultrasound-Assisted Endoscopic Partial Plantar Fascia Release

    PubMed Central

    Ohuchi, Hiroshi; Ichikawa, Ken; Shinga, Kotaro; Hattori, Soichi; Yamada, Shin; Takahashi, Kazuhisa

    2013-01-01

    Various surgical treatment procedures for plantar fasciitis, such as open surgery, percutaneous release, and endoscopic surgery, exist. Skin trouble, nerve disturbance, infection, and persistent pain associated with prolonged recovery time are complications of open surgery. Endoscopic partial plantar fascia release offers the surgeon clear visualization of the anatomy at the surgical site. However, the primary medial portal and portal tract used for this technique have been shown to be in close proximity to the posterior tibial nerves and their branches, and there is always the risk of nerve damage by introducing the endoscope deep to the plantar fascia. By performing endoscopic partial plantar fascia release under ultrasound assistance, we could dynamically visualize the direction of the endoscope and instrument introduction, thus preventing nerve damage from inadvertent insertion deep to the fascia. Full-thickness release of the plantar fascia at the ideal position could also be confirmed under ultrasound imaging. We discuss the technique for this new procedure. PMID:24265989

  11. Comparison of Medial and Lateral Meniscus Root Tears.

    PubMed

    Koo, Ji Hyun; Choi, Sang-Hee; Lee, Seung Ah; Wang, Joon Ho

    2015-01-01

    The meniscus root plays an essential role in maintaining the circumferential hoop tension and preventing meniscal displacement. Studies on meniscus root tears have investigated the relationship of osteoarthritis and an anterior cruciate ligament tear. However, few studies have directly compared the medial and lateral root tears. To assess the prevalence of meniscal extrusion and its relationship with clinical features in medial and lateral meniscus root tears, we performed a retrospective review of the magnetic resonance imaging (MRI) results of 42 knee patients who had meniscus posterior horn root tears and who had undergone arthroscopic operations. The presence of meniscal extrusion was evaluated and the exact extent was measured from the tibial margin. The results were correlated with arthroscopic findings. Clinical features including patients' ages, joint abnormalities, and previous trauma histories were evaluated. Twenty-two patients had medial meniscus root tears (MMRTs) and twenty patients had lateral meniscus root tears (LMRTs). Meniscal extrusion was present in 18 MMRT patients and one LMRT patient. The mean extent of extrusion was 4.2mm (range, 0.6 to 7.8) in the MMRT group and 0.9mm (range, -1.9 to 3.4) in the LMRT group. Five patients with MMRT had a history of trauma, while 19 patients with LMRT had a history of trauma. Three patients with MMRT had anterior cruciate ligament (ACL) tears, while 19 patients with LMRT had ACL tears. The mean age of the patients was 52 years (range: 29-71 years) and 30 years (range: 14-62 years) in the MMRT and LMRT group, respectively. There was a significant correlation between a MMRT and meniscal extrusion (p<0.0001), and between an ACL tear and LMRT (p<0.0001). A history of trauma was significantly common in LMRT (p<0.0001). LMRT patients were significantly younger than MMRT patients (p<0.0001). Kellgren-Lawrence (K-L) grade differed significantly between MMRT and LMRT group (p<0.0001). Meniscal extrusion is common in

  12. Radiological analysis of the medial epicondyle in the adolescent throwing athlete

    PubMed Central

    Ng, Wuey Min; Chan, Chee Ken; Takahashi, Norimasa; Kawai, Nobuaki; Teh, Kok Kheng; Saravana, R; Sugaya, Hiroyuki

    2017-01-01

    INTRODUCTION Injuries to the medial structures of the elbow due to overhead throwing games are well documented. However, variations of medial epicondyles are not well described, especially in athletes with fused medial epicondyles. In this study, we evaluated variations in the medial epicondyle of baseball players who were aged 15–17 years and had fused epicondyles. METHODS In this cross-sectional observational study, 155 skeletally mature baseball players with unilateral medial elbow pain and 310 elbow radiographs were reviewed by two independent reviewers. The medial epicondyles were categorised into three groups: normal, elongated or separated. RESULTS Among the 155 patients, 65 (41.9%) had normal epicondyles, 41 (26.5%) had elongated epicondyles and 49 (31.6%) had separated epicondyles. The medial epicondyle was larger on the dominant arm for 125 (80.6%) patients; the mean surface area on the dominant arm was 222.50 ± 45.77 mm2, while that of the non-dominant arm was 189.14 ± 39.56 mm2 (p < 0.01). Among the three categories of medial epicondyles, separated epicondyles had the largest surface area, followed by elongated and normal epicondyles. CONCLUSION Medial epicondyles in adolescent throwing athletes can be categorised into three different groups according to their shape (normal, elongated and separated). We observed a correlation between the shape and the surface area of the medial epicondyle in adolescent throwing athletes, with separated medial epicondyles having the largest surface area. Further studies and follow-up are needed to determine the prognostic value and clinical significance of these morphological variations. PMID:26976222

  13. Oxygen partial pressure sensor

    DOEpatents

    Dees, D.W.

    1994-09-06

    A method for detecting oxygen partial pressure and an oxygen partial pressure sensor are provided. The method for measuring oxygen partial pressure includes contacting oxygen to a solid oxide electrolyte and measuring the subsequent change in electrical conductivity of the solid oxide electrolyte. A solid oxide electrolyte is utilized that contacts both a porous electrode and a nonporous electrode. The electrical conductivity of the solid oxide electrolyte is affected when oxygen from an exhaust stream permeates through the porous electrode to establish an equilibrium of oxygen anions in the electrolyte, thereby displacing electrons throughout the electrolyte to form an electron gradient. By adapting the two electrodes to sense a voltage potential between them, the change in electrolyte conductivity due to oxygen presence can be measured. 1 fig.

  14. Oxygen partial pressure sensor

    DOEpatents

    Dees, Dennis W.

    1994-01-01

    A method for detecting oxygen partial pressure and an oxygen partial pressure sensor are provided. The method for measuring oxygen partial pressure includes contacting oxygen to a solid oxide electrolyte and measuring the subsequent change in electrical conductivity of the solid oxide electrolyte. A solid oxide electrolyte is utilized that contacts both a porous electrode and a nonporous electrode. The electrical conductivity of the solid oxide electrolyte is affected when oxygen from an exhaust stream permeates through the porous electrode to establish an equilibrium of oxygen anions in the electrolyte, thereby displacing electrons throughout the electrolyte to form an electron gradient. By adapting the two electrodes to sense a voltage potential between them, the change in electrolyte conductivity due to oxygen presence can be measured.

  15. Methanol partial oxidation reformer

    DOEpatents

    Ahmed, Shabbir; Kumar, Romesh; Krumpelt, Michael

    1999-01-01

    A partial oxidation reformer comprising a longitudinally extending chamber having a methanol, water and an air inlet and an outlet. An igniter mechanism is near the inlets for igniting a mixture of methanol and air, while a partial oxidation catalyst in the chamber is spaced from the inlets and converts methanol and oxygen to carbon dioxide and hydrogen. Controlling the oxygen to methanol mole ratio provides continuous slightly exothermic partial oxidation reactions of methanol and air producing hydrogen gas. The liquid is preferably injected in droplets having diameters less than 100 micrometers. The reformer is useful in a propulsion system for a vehicle which supplies a hydrogen-containing gas to the negative electrode of a fuel cell.

  16. Methanol partial oxidation reformer

    DOEpatents

    Ahmed, S.; Kumar, R.; Krumpelt, M.

    1999-08-17

    A partial oxidation reformer is described comprising a longitudinally extending chamber having a methanol, water and an air inlet and an outlet. An igniter mechanism is near the inlets for igniting a mixture of methanol and air, while a partial oxidation catalyst in the chamber is spaced from the inlets and converts methanol and oxygen to carbon dioxide and hydrogen. Controlling the oxygen to methanol mole ratio provides continuous slightly exothermic partial oxidation reactions of methanol and air producing hydrogen gas. The liquid is preferably injected in droplets having diameters less than 100 micrometers. The reformer is useful in a propulsion system for a vehicle which supplies a hydrogen-containing gas to the negative electrode of a fuel cell. 7 figs.

  17. Methanol partial oxidation reformer

    DOEpatents

    Ahmed, S.; Kumar, R.; Krumpelt, M.

    1999-08-24

    A partial oxidation reformer is described comprising a longitudinally extending chamber having a methanol, water and an air inlet and an outlet. An igniter mechanism is near the inlets for igniting a mixture of methanol and air, while a partial oxidation catalyst in the chamber is spaced from the inlets and converts methanol and oxygen to carbon dioxide and hydrogen. Controlling the oxygen to methanol mole ratio provides continuous slightly exothermic partial oxidation reactions of methanol and air producing hydrogen gas. The liquid is preferably injected in droplets having diameters less than 100 micrometers. The reformer is useful in a propulsion system for a vehicle which supplies a hydrogen-containing gas to the negative electrode of a fuel cell. 7 figs.

  18. Methanol partial oxidation reformer

    DOEpatents

    Ahmed, Shabbir; Kumar, Romesh; Krumpelt, Michael

    2001-01-01

    A partial oxidation reformer comprising a longitudinally extending chamber having a methanol, water and an air inlet and an outlet. An igniter mechanism is near the inlets for igniting a mixture of methanol and air, while a partial oxidation catalyst in the chamber is spaced from the inlets and converts methanol and oxygen to carbon dioxide and hydrogen. Controlling the oxygen to methanol mole ratio provides continuous slightly exothermic partial oxidation reactions of methanol and air producing hydrogen gas. The liquid is preferably injected in droplets having diameters less than 100 micrometers. The reformer is useful in a propulsion system for a vehicle which supplies a hydrogen-containing gas to the negative electrode of a fuel cell.

  19. Salter-Harris Type-IV injuries of the distal tibial epiphyseal growth plate, with emphasis on those involving the medial malleolus.

    PubMed

    Cass, J R; Peterson, H A

    1983-10-01

    Salter-Harris Type-IV fractures of the epiphysis extend through the articular cartilage, epiphysis, physis, and metaphysis and have a high rate of complications secondary to premature partial closure of the physis. In this study we attempted to determine which Type-IV fractures of the distal end of the tibia result in premature partial closure, how the various treatment modalities affect the risk of premature physeal closure, and how the complication itself might be best managed. Thirty-two Type-IV fractures of the distal end of the tibia were seen at the Mayo Clinic during a five-year period. Eighteen injuries involved the medial malleolus, thirteen were so-called triplane fractures, and one was a fracture of the lateral part of the plafond. In the eighteen ankles with a fracture that involved the medial malleolus, extension of the fracture into the metaphysis could often be appreciated only on oblique roentgenograms. The patients' ages at the time of fracture ranged from one year and one month to fifteen years and six months old. In nine of the eighteen tibiae with a fracture of the medial malleolus premature partial closure of the distal physis developed, resulting in angular deformity or limb-length discrepancy sufficient to require operative treatment (epiphyseodesis, corrective osteotomy, or excision of a physeal bar). A physeal bar was best detected by tomograms made in two planes and by scanograms. Bar formation may be treated by excision of the bar, arrest of the whole physis, osteotomy, or combinations of these procedures. Of the thirteen patients with a triplane fracture and the one with a Type-IV fracture of the lateral part of the plafond, all fourteen were near maturity at the time of injury, and no growth-arrest problems developed.

  20. Sports injury to a bipartite medial cuneiform in a child.

    PubMed

    Eves, Timothy B; Ahmad, Mudussar A; Oddy, Michael J

    2014-01-01

    We report the case of an 11-year-old boy who had sustained a soccer injury to his mid-foot. Plain radiography did not reveal any fracture to account for the severity of his symptoms or his inability to bear weight. Magnetic resonance imaging was undertaken and demonstrated the medial cuneiform to be a bipartite bone consisting of 2 ossicles connected by a synchondrosis. No acute fracture or diastasis of the bipartite bone was demonstrated; however, significant bone marrow edema was noted, corresponding to the site of the injury and his clinical point bony tenderness. This anatomic variant should be considered as a rare differential diagnosis in the skeletally immature foot. The injury was treated nonoperatively with a non-weightbearing cast and pneumatic walker immobilization, with successful resolution of his symptoms and a return to sports activity by 4 months after injury.

  1. The Vascularized Medial Femoral Corticoperiosteal Flap for Thumb Reconstruction

    PubMed Central

    Amin, Kavit; Darhouse, Nagham; Sivakumar, Bran; Floyd, David

    2015-01-01

    Summary: We present an interesting method of shaping a vascularized medial femoral condyle (MFC) flap into a “neophalanx” for phalangeal reconstruction. Our patient presented with limited strength and function secondary to fracture nonunion of the proximal phalanx of the dominant thumb. Following excision of the pseudarthrosis, an MFC corticoperiosteal flap was harvested, sculpted into a prism shape and inset. The superomedial genicular pedicle was anastomosed to the princeps pollicis artery and a cephalic tributary. On follow-up, new bone growth was seen on radiographs and the patient had substantially improved function, with full metacarpophalangeal extension, a Kapandji score of 9, and a markedly reduced Disabilities of the Arm, Shoulder and Hand score of 2.68. The MFC flap is useful for reconstruction of bony defects, with minimal donor morbidity. This versatile vascularized flap can be crafted to requisite shapes and is useful for small defects in the hand, including phalangeal reconstruction. PMID:26495205

  2. Medial temporal lobe memory in childhood: Developmental transitions

    PubMed Central

    Townsend, Elise L.; Richmond, Jenny L.; Vogel-Farley, Vanessa K.; Thomas, Kathleen

    2009-01-01

    The medial temporal lobes (MTL) support declarative memory and mature structurally and functionally during the postnatal years in humans. Although recent work has addressed the development of declarative memory in early childhood, less is known about continued development beyond this period of time. The purpose of this investigation was to explore MTL-dependent memory across middle childhood. Children (6 – 10 years old) and adults completed two computerized tasks, place learning (PL) and transitive inference (TI), that each examined relational memory, as well as the flexible use of relational learning. Findings suggest that the development of relational memory precedes the development of the ability to use relational knowledge flexibly in novel situations. Implications for the development of underlying brain areas and ideas for future neuroimaging investigations are discussed. PMID:20712740

  3. Failed medial patellofemoral ligament reconstruction: Causes and surgical strategies

    PubMed Central

    Sanchis-Alfonso, Vicente; Montesinos-Berry, Erik; Ramirez-Fuentes, Cristina; Leal-Blanquet, Joan; Gelber, Pablo E; Monllau, Joan Carles

    2017-01-01

    Patellar instability is a common clinical problem encountered by orthopedic surgeons specializing in the knee. For patients with chronic lateral patellar instability, the standard surgical approach is to stabilize the patella through a medial patellofemoral ligament (MPFL) reconstruction. Foreseeably, an increasing number of revision surgeries of the reconstructed MPFL will be seen in upcoming years. In this paper, the causes of failed MPFL reconstruction are analyzed: (1) incorrect surgical indication or inappropriate surgical technique/patient selection; (2) a technical error; and (3) an incorrect assessment of the concomitant risk factors for instability. An understanding of the anatomy and biomechanics of the MPFL and cautiousness with the imaging techniques while favoring clinical over radiological findings and the use of common sense to determine the adequate surgical technique for each particular case, are critical to minimizing MPFL surgery failure. Additionally, our approach to dealing with failure after primary MPFL reconstruction is also presented. PMID:28251062

  4. Medial prefrontal cortex predicts internally driven strategy shifts

    PubMed Central

    Schuck, Nicolas W.; Gaschler, Robert; Wenke, Dorit; Heinzle, Jakob; Frensch, Peter A.; Haynes, John-Dylan; Reverberi, Carlo

    2015-01-01

    Summary Many daily behaviors require us to actively focus on the current task and ignore all other distractions. Yet, ignoring everything else might hinder the ability to discover new ways to achieve the same goal. Here, we studied the neural mechanisms that support the spontaneous change to better strategies while an established strategy is executed. Multivariate neuroimaging analysis showed that before the spontaneous change to an alternative strategy, medial prefrontal cortex (MPFC) encoded information that was irrelevant for the current strategy but necessary for the later strategy. Importantly, this neural effect was related to future behavioral changes: information encoding in MPFC was changed only in participants who eventually switched their strategy and started before the actual strategy change. This allowed us to predict spontaneous strategy shifts ahead of time. These findings suggest that MPFC might internally simulate alternative strategies and sheds new light on the organization of PFC. PMID:25819613

  5. Partially strong WW scattering

    SciTech Connect

    Cheung Kingman; Chiang Chengwei; Yuan Tzuchiang

    2008-09-01

    What if only a light Higgs boson is discovered at the CERN LHC? Conventional wisdom tells us that the scattering of longitudinal weak gauge bosons would not grow strong at high energies. However, this is generally not true. In some composite models or general two-Higgs-doublet models, the presence of a light Higgs boson does not guarantee complete unitarization of the WW scattering. After partial unitarization by the light Higgs boson, the WW scattering becomes strongly interacting until it hits one or more heavier Higgs bosons or other strong dynamics. We analyze how LHC experiments can reveal this interesting possibility of partially strong WW scattering.

  6. The topology of dermatomal projection in the medial lemniscal system

    PubMed Central

    Werner, Gerhard; Whitsel, Barry L.

    1967-01-01

    1. The topographic organization of first order afferent fibres in the lumbar, sacral and coccygeal dorsal roots, and in the fasciculus gracilis was studied in squirrel monkeys. 2. At the entry zone, progressing from caudal to rostral, dorsal root filaments receive fibres from tail and hind-limb receptive fields which serially overlap and describe a spiral-shaped trajectory. The latter starts with tail, progresses post-axially towards the foot, crosses the foot from lateral to medial, and ascends the preaxial leg. 3. In the fasciculus gracilis, this arrangement of fibres at the dorsal root entry zone is preserved in its entirety. It assumes the form of a fibre lamination, with the most caudal dorsal root fibres occupying a dorso-medial location; further rostral dorsal root fibres come to lie more ventrolaterally. 4. Dorsum and sole of foot project in an overlapping and interdigitating manner to the fibre lamina of the 7th lumber dermatome in the fasciculus gracilis. Thereby, dorsum and sole of foot behave in the projection as if they were one and the same surface. 5. The argument is presented that the foot and its projection on to the cross-sectional plane of the dorsal funiculus are topologically equivalent and that the hind-limb as a whole and its projection are not. On the other hand, homotopic mapping of the foot together with the sequential fibre organization in the dorsal funiculus enable many more types of closed curves on the body surface to remain arc-wise connected in the projection than would otherwise be possible. ImagesPlate 1 PMID:4963874

  7. Proximal Scaphoid Arthroplasty Using the Medial Femoral Trochlea Flap

    PubMed Central

    Higgins, James P.; Burger, Heinze K.

    2013-01-01

    Background The medial trochlea of the femur (medial femoral trochlea, MFT) provides a source of convex osteocartilaginous vascularized bone that has been demonstrated to have a similar contour to the proximal scaphoid. This provides a potential solution for difficult recalcitrant proximal pole scaphoid nonunions. Materials and Methods Sixteen consecutive patients who underwent MFT proximal scaphoid arthroplasty were reviewed. Follow-up data were recorded at a minimum of 6 months, with an average of 14 months. The results of this cohort were previously reported in detail but are summarized herein. Description of Technique The ability to reconstruct both bone and cartilage of the nonunion enables the surgeon to resect the nonunited proximal pole to prepare for scaphoid reconstruction. A segment of osteocartilaginous MFT is harvested in dimensions required by the scaphoid defect. The MFT segment is harvested on the transverse branch of the descending geniculate vessels. Fixation may be achieved with ease due to the size of the reconstructed segment. Results Computed tomography imaging demonstrated 15 of 16 reconstructed scaphoids achieving osseous union. Follow-up range of motion (ROM) of the wrist averaged 46.0° extension (range 28-80°) and 43.8° flexion (range 10-80°), which was similar to preoperative (average 45.7° extension and 43.0° flexion). Scapholunate angles remained unaffected (51.6° preoperatively and 48.6° postoperatively), indicating preservation of carpal relationships. Conclusions Vascularized MFT flaps provide a useful tool in the treatment of difficult proximal pole scaphoid nonunions. Early follow-up demonstrates high rate of achieving union with acceptable ROM and good pain relief. PMID:24436821

  8. Medialized Versus Lateralized Center of Rotation in Reverse Shoulder Arthroplasty.

    PubMed

    Streit, Jonathan J; Shishani, Yousef; Gobezie, Reuben

    2015-12-01

    Reverse shoulder arthroplasty may be performed using components that medialize or lateralize the center of rotation. The purpose of this prospective study was to directly compare 2 reverse shoulder arthroplasty designs. Two treatment groups and 1 control group were identified. Group I comprised 9 patients using a medialized Grammont-style (GRM) prosthesis with a neck-shaft angle of 155°. Group II comprised 9 patients using a lateralized (LAT) prosthesis with a neck-shaft angle of 135°. Pre- and postoperative assessment of range of motion, American Shoulder and Elbow Surgeons score, and visual analog scale pain score were performed. Radiographic measurements of lateral humeral offset and acromiohumeral distance were compared. The GRM prosthesis achieved greater forward flexion (143.9° vs 115.6°; P=.05), whereas the LAT achieved greater external rotation (35.0° vs 28.3°; P=.07). The lateral humeral offset was greater for the LAT prosthesis compared with the GRM prosthesis, but this distance was not significantly different from that found in the control group. The acromiohumeral distance was significantly greater in the GRM prosthesis group compared with both the LAT and the control groups. The results of this study confirm that different reverse shoulder arthroplasty designs produce radiographically different anatomy. Whereas the GRM prosthesis significantly alters the anatomy of the shoulder, the LAT design can preserve some anatomic relationships found in the normal shoulder. The clinical outcomes indicate that this may have an effect on range of motion, with traditional designs achieving greater forward flexion and lateralized designs achieving greater external rotation.

  9. Reversed Procrastination by Focal Disruption of Medial Frontal Cortex.

    PubMed

    Jha, Ashwani; Diehl, Beate; Scott, Catherine; McEvoy, Andrew W; Nachev, Parashkev

    2016-11-07

    An enduring puzzle in the neuroscience of voluntary action is the origin of the remarkably wide dispersion of the reaction time distribution, an interval far greater than is explained by synaptic or signal transductive noise [1, 2]. That we are able to change our planned actions-a key criterion of volition [3]-so close to the time of their onset implies decision-making must reach deep into the execution of action itself [4-6]. It has been influentially suggested the reaction time distribution therefore reflects deliberate neural procrastination [7], giving alternative response tendencies sufficient time for fair competition in pursuing a decision threshold that determines which one is behaviorally manifest: a race model, where action selection and execution are closely interrelated [8-11]. Although the medial frontal cortex exhibits a sensitivity to reaction time on functional imaging that is consistent with such a mechanism [12-14], direct evidence from disruptive studies has hitherto been lacking. If movement-generating and movement-delaying neural substrates are closely co-localized here, a large-scale lesion will inevitably mask any acceleration, for the movement itself could be disrupted. Circumventing this problem, here we observed focal intracranial electrical disruption of the medial frontal wall in the context of the pre-surgical evaluation of two patients with epilepsy temporarily reversing such hypothesized procrastination. Effector-specific behavioral acceleration, time-locked to the period of electrical disruption, occurred exclusively at a specific locus at the ventral border of the pre-supplementary motor area. A cardinal prediction of race models of voluntary action is thereby substantiated in the human brain.

  10. Situational Restriction of Elevation in Adduction Relieved by Faden on the Medial Rectus

    PubMed Central

    Muralidhar, R.; Vijayalakshmi, P.; Sujatha, K.; Shetty, Shashikanth; Malay, K.; Rosenberg, Steve

    2016-01-01

    We describe a patient with situational restriction of elevation in adduction in his left eye. Clinical examination pointed to instability of the left medial rectus pulley. This was corrected by Faden on the medial rectus. The importance of this relatively new concept in identifying and treating orbital pulley instability is discussed. PMID:27162460

  11. Left medial orbitofrontal cortex volume correlates with skydive-elicited euphoric experience.

    PubMed

    Carlson, Joshua M; Cha, Jiook; Fekete, Tomer; Greenberg, Tsafrir; Mujica-Parodi, Lilianne R

    2016-11-01

    The medial orbitofrontal cortex has been linked to the experience of positive affect. Greater medial orbitofrontal cortex volume is associated with greater expression of positive affect and reduced medial orbital frontal cortex volume is associated with blunted positive affect. However, little is known about the experience of euphoria, or extreme joy, and how this state may relate to variability in medial orbitofrontal cortex structure. To test the hypothesis that variability in euphoric experience correlates with the volume of the medial orbitofrontal cortex, we measured individuals' (N = 31) level of self-reported euphoria in response to a highly anticipated first time skydive and measured orbitofrontal cortical volumes with structural magnetic resonance imaging. Skydiving elicited a large increase in self-reported euphoria. Participants' euphoric experience was predicted by the volume of their left medial orbitofrontal cortex such that, the greater the volume, the greater the euphoria. Further analyses indicated that the left medial orbitofrontal cortex and amygdalo-hippocampal complex independently explain variability in euphoric experience and that medial orbitofrontal cortex volume, in conjunction with other structures within the mOFC-centered corticolimbic circuit, can be used to predict individuals' euphoric experience.

  12. Anterolateral Versus Medial Plating of Distal Extra-articular Tibia Fractures: A Biomechanical Model.

    PubMed

    Pirolo, Joseph M; Behn, Anthony W; Abrams, Geoffrey D; Bishop, Julius A

    2015-09-01

    Both medial and anterolateral plate applications have been described for the treatment of distal tibia fractures, each with distinct advantages and disadvantages. The objective of this study was to compare the biomechanical properties of medial and anterolateral plating constructs used to stabilize simulated varus and valgus fracture patterns of the distal tibia. In 16 synthetic tibia models, a 45° oblique cut was made to model an Orthopedic Trauma Association type 43-A1.2 distal tibia fracture in either a varus or valgus injury pattern. Each fracture was then reduced and plated with a precontoured medial or anterolateral distal tibia plate. The specimens were biomechanically tested in axial and torsional loading, cyclic axial loading, and load to failure. For the varus fracture pattern, medial plating showed less fracture site displacement and rotation and was stiffer in both axial and torsional loading (P<.05). For the valgus fracture pattern, there was no statistically significant difference between medial and anterolateral plating. There were no significant differences between the 2 constructs for either fracture pattern with respect to ultimate load, displacement, or energy absorption in load to failure testing. When used to stabilize varus fracture patterns, medial plates showed superior biomechanical performance compared with anterolateral plates. In this application, the medial plates functioned in anti-glide mode. For valgus fracture patterns, no biomechanical differences between anterolateral and medial plating were observed. In clinical practice, surgeons should take this biomechanical evidence into account when devising a treatment strategy for fixation of distal tibia fractures.

  13. Partial polarizer filter

    NASA Technical Reports Server (NTRS)

    Title, A. M. (Inventor)

    1978-01-01

    A birefringent filter module comprises, in seriatum. (1) an entrance polarizer, (2) a first birefringent crystal responsive to optical energy exiting the entrance polarizer, (3) a partial polarizer responsive to optical energy exiting the first polarizer, (4) a second birefringent crystal responsive to optical energy exiting the partial polarizer, and (5) an exit polarizer. The first and second birefringent crystals have fast axes disposed + or -45 deg from the high transmitivity direction of the partial polarizer. Preferably, the second crystal has a length 1/2 that of the first crystal and the high transmitivity direction of the partial polarizer is nine times as great as the low transmitivity direction. To provide tuning, the polarizations of the energy entering the first crystal and leaving the second crystal are varied by either rotating the entrance and exit polarizers, or by sandwiching the entrance and exit polarizers between pairs of half wave plates that are rotated relative to the polarizers. A plurality of the filter modules may be cascaded.

  14. Dilemmas of partial cooperation.

    PubMed

    Stark, Hans-Ulrich

    2010-08-01

    Related to the often applied cooperation models of social dilemmas, we deal with scenarios in which defection dominates cooperation, but an intermediate fraction of cooperators, that is, "partial cooperation," would maximize the overall performance of a group of individuals. Of course, such a solution comes at the expense of cooperators that do not profit from the overall maximum. However, because there are mechanisms accounting for mutual benefits after repeated interactions or through evolutionary mechanisms, such situations can constitute "dilemmas" of partial cooperation. Among the 12 ordinally distinct, symmetrical 2 x 2 games, three (barely considered) variants are correspondents of such dilemmas. Whereas some previous studies investigated particular instances of such games, we here provide the unifying framework and concisely relate it to the broad literature on cooperation in social dilemmas. Complementing our argumentation, we study the evolution of partial cooperation by deriving the respective conditions under which coexistence of cooperators and defectors, that is, partial cooperation, can be a stable outcome of evolutionary dynamics in these scenarios. Finally, we discuss the relevance of such models for research on the large biodiversity and variation in cooperative efforts both in biological and social systems.

  15. Reverse Evans peroneus brevis medial ankle stabilization for balancing valgus ankle contracture during total ankle replacement.

    PubMed

    Roukis, Thomas S; Prissel, Mark A

    2014-01-01

    Medial ankle instability secondary to deltoid ligament insufficiency is frequently encountered when performing total ankle replacement and remains a challenge. In the present techniques report, we describe a "reverse" Evans peroneus brevis tendon nonanatomic deltoid ligament reconstruction for medial ankle stabilization harvested through limited incisions using simple topographic anatomic landmarks. The harvested peroneus brevis tendon is brought through a drill hole in the talus from laterally to medially, aiming for the junction of the talar neck and body plantar to the midline. The tendon is the brought superiorly and obliquely to the anterior medial aspect of the distal tibia where it is secured under a plate and screw construct. This modified Evans peroneus brevis tendon nonanatomic deltoid ligament reconstruction is useful in providing medial ankle stability during or after primary and revision total ankle replacement.

  16. The medial septum acts through the medial preoptic area for thermoregulation and works with it for sleep regulation.

    PubMed

    Srividya, Rajagopalan; Mallick, Hruda Nanda; Kumar, Velayudhan Mohan

    2007-01-01

    The chronic changes in sleep-wakefulness (S-W), body temperature (Tb), locomotor activity (LMA) and thermal preference were studied in male Wistar rats after the destruction of neurons in both the medial preoptic area (mPOA) and the medial septum (MS) by intracerebral injection of N-methyl-D-aspartic acid. An increase in the Tb, and a preference for higher ambient temperature (Tamb) of 30 degrees C were observed after the combined lesion of the mPOA and the MS. Similar changes were reported to occur after the lesion that was restricted to the mPOA. But these alterations were in contrast to the decrease in Tb and preference for lower Tamb, observed after the MS lesion. The thermostat of the brain would have been reset at a higher level after the combined lesion, as there was an increase in Tb, along with a preference for a higher Tamb, and an increase in LMA. There was a reduction in the frequency and the duration of the slow wave sleep (SWS) episodes, and a reduction in the frequency of the paradoxical sleep (PS) episodes after the combined lesion. The destruction of the MS neurons was probably responsible for the reduction in the frequency of SWS, whereas the loss of mPOA neurons was responsible for the decrease in the duration of SWS and frequency of PS. It can be suggested that the MS exerts its influence on thermoregulation through the mPOA. However, the MS and the mPOA seem to play independent, but complementary roles in sleep promotion.

  17. Connections of the medial telencephalic wall in the spotted African Lungfish.

    PubMed

    Northcutt, R Glenn; Westhoff, Guido

    2011-01-01

    The extent and boundaries of the roof, or pallium, of the telencephalon in lungfishes have been debated for over 30 years, and two hypotheses exist. Proponents of a restricted pallium claim that the medial border of the pallium occurs in a dorsal position and that the entire medial hemispheric wall is formed by the septal nuclei. Proponents of an extended pallium claim that the medial border of the pallium occurs in a more ventral position and that the medial hemispheric wall is divided into a dorsal medial pallium and ventral septal nuclei, as in amphibians. Immunohistochemical data have generally been interpreted to support the hypothesis of an extended pallium, but disagreement still exists. To clarify the extent of the pallium in lungfishes, the connections of the dorsal and ventral divisions of the medial hemispheric wall in the Spotted African Lungfish were examined using a number of neuronal tracers. In amphibians and other tetrapods, the afferent projections to the medial pallium and the septal nuclei differ extensively, as do the commissural routes taken by decussating interhemispheric connections. Although the descending projections of the medial pallium and septal nuclei are very similar to one another in amphibians and other tetrapods, they do differ in that the septal nuclei and the ventral thalamus are extensively interlinked, whereas the medial pallium lacks such connections. These differences also characterize the connections of the dorsal and ventral divisions of the medial hemispheric wall in the Spotted African Lungfish, which supports the hypothesis of an extended pallium. The telencephalic organization in lungfishes thus appears remarkably similar to that in amphibians and reflects a pattern that almost certainly existed in the last common ancestor of lungfishes and tetrapods.

  18. Transcaruncular Approach for Treatment of Medial Wall and Large Orbital Blowout Fractures

    PubMed Central

    Nguyen, Dennis C.; Shahzad, Farooq; Snyder-Warwick, Alison; Patel, Kamlesh B.; Woo, Albert S.

    2015-01-01

    We evaluate the safety and efficacy of the transcaruncular approach for reconstruction of medial orbital wall fractures and the combined transcaruncular–transconjunctival approach for reconstruction of large orbital defects involving the medial wall and floor. A retrospective review of the clinical and radiographic data of patients who underwent either a transcaruncular or a combined transcaruncular–transconjunctival approach by a single surgeon for orbital fractures between June 2007 and June 2013 was undertaken. Seven patients with isolated medial wall fractures underwent a transcaruncular approach, and nine patients with combined medial wall and floor fractures underwent a transcaruncular–transconjunctival approach with a lateral canthotomy. Reconstruction was performed using a porous polyethylene implant. All patients with isolated medial wall fractures presented with enophthalmos. In the combined medial wall and floor group, five out of eight patients had enophthalmos with two also demonstrating hypoglobus. The size of the medial wall defect on preoperative computed tomography (CT) scan ranged from 2.6 to 4.6 cm2; the defect size of combined medial wall and floor fractures was 4.5 to 12.7 cm2. Of the 11 patients in whom postoperative CT scans were obtained, all were noted to have acceptable placement of the implant. All patients had correction of enophthalmos and hypoglobus. One complication was noted, with a retrobulbar hematoma having developed 2 days postoperatively. The transcaruncular approach is a safe and effective method for reconstruction of medial orbital floor fractures. Even large fractures involving the orbital medial wall and floor can be adequately exposed and reconstructed with a combined transcaruncular–transconjunctival-lateral canthotomy approach. The level of evidence of this study is IV (case series with pre/posttest). PMID:26889348

  19. Partially coherent ultrafast spectrography

    PubMed Central

    Bourassin-Bouchet, C.; Couprie, M.-E.

    2015-01-01

    Modern ultrafast metrology relies on the postulate that the pulse to be measured is fully coherent, that is, that it can be completely described by its spectrum and spectral phase. However, synthesizing fully coherent pulses is not always possible in practice, especially in the domain of emerging ultrashort X-ray sources where temporal metrology is strongly needed. Here we demonstrate how frequency-resolved optical gating (FROG), the first and one of the most widespread techniques for pulse characterization, can be adapted to measure partially coherent pulses even down to the attosecond timescale. No modification of experimental apparatuses is required; only the processing of the measurement changes. To do so, we take our inspiration from other branches of physics where partial coherence is routinely dealt with, such as quantum optics and coherent diffractive imaging. This will have important and immediate applications, such as enabling the measurement of X-ray free-electron laser pulses despite timing jitter. PMID:25744080

  20. Laparoscopic partial splenic resection.

    PubMed

    Uranüs, S; Pfeifer, J; Schauer, C; Kronberger, L; Rabl, H; Ranftl, G; Hauser, H; Bahadori, K

    1995-04-01

    Twenty domestic pigs with an average weight of 30 kg were subjected to laparoscopic partial splenic resection with the aim of determining the feasibility, reliability, and safety of this procedure. Unlike the human spleen, the pig spleen is perpendicular to the body's long axis, and it is long and slender. The parenchyma was severed through the middle third, where the organ is thickest. An 18-mm trocar with a 60-mm Endopath linear cutter was used for the resection. The tissue was removed with a 33-mm trocar. The operation was successfully concluded in all animals. No capsule tears occurred as a result of applying the stapler. Optimal hemostasis was achieved on the resected edges in all animals. Although these findings cannot be extended to human surgery without reservations, we suggest that diagnostic partial resection and minor cyst resections are ideal initial indications for this minimally invasive approach.

  1. Hierarchical partial order ranking.

    PubMed

    Carlsen, Lars

    2008-09-01

    Assessing the potential impact on environmental and human health from the production and use of chemicals or from polluted sites involves a multi-criteria evaluation scheme. A priori several parameters are to address, e.g., production tonnage, specific release scenarios, geographical and site-specific factors in addition to various substance dependent parameters. Further socio-economic factors may be taken into consideration. The number of parameters to be included may well appear to be prohibitive for developing a sensible model. The study introduces hierarchical partial order ranking (HPOR) that remedies this problem. By HPOR the original parameters are initially grouped based on their mutual connection and a set of meta-descriptors is derived representing the ranking corresponding to the single groups of descriptors, respectively. A second partial order ranking is carried out based on the meta-descriptors, the final ranking being disclosed though average ranks. An illustrative example on the prioritization of polluted sites is given.

  2. Partially coherent ultrafast spectrography

    NASA Astrophysics Data System (ADS)

    Bourassin-Bouchet, C.; Couprie, M.-E.

    2015-03-01

    Modern ultrafast metrology relies on the postulate that the pulse to be measured is fully coherent, that is, that it can be completely described by its spectrum and spectral phase. However, synthesizing fully coherent pulses is not always possible in practice, especially in the domain of emerging ultrashort X-ray sources where temporal metrology is strongly needed. Here we demonstrate how frequency-resolved optical gating (FROG), the first and one of the most widespread techniques for pulse characterization, can be adapted to measure partially coherent pulses even down to the attosecond timescale. No modification of experimental apparatuses is required; only the processing of the measurement changes. To do so, we take our inspiration from other branches of physics where partial coherence is routinely dealt with, such as quantum optics and coherent diffractive imaging. This will have important and immediate applications, such as enabling the measurement of X-ray free-electron laser pulses despite timing jitter.

  3. Partially integrated exhaust manifold

    SciTech Connect

    Hayman, Alan W; Baker, Rodney E

    2015-01-20

    A partially integrated manifold assembly is disclosed which improves performance, reduces cost and provides efficient packaging of engine components. The partially integrated manifold assembly includes a first leg extending from a first port and terminating at a mounting flange for an exhaust gas control valve. Multiple additional legs (depending on the total number of cylinders) are integrally formed with the cylinder head assembly and extend from the ports of the associated cylinder and terminate at an exit port flange. These additional legs are longer than the first leg such that the exit port flange is spaced apart from the mounting flange. This configuration provides increased packaging space adjacent the first leg for any valving that may be required to control the direction and destination of exhaust flow in recirculation to an EGR valve or downstream to a catalytic converter.

  4. Activated partial thromboplastin time.

    PubMed

    Ignjatovic, Vera

    2013-01-01

    Activated partial thromboplastin time (APTT) is a commonly used coagulation assay that is easy to perform, is affordable, and is therefore performed in most coagulation laboratories, both clinical and research, worldwide. The APTT is based on the principle that in citrated plasma, the addition of a platelet substitute, factor XII activator, and CaCl2 allows for formation of a stable clot. The time required for the formation of a stable clot is recorded in seconds and represents the actual APTT result.

  5. Effects of different medial arch support heights on rearfoot kinematics

    PubMed Central

    Mayer, Frank; Baur, Heiner

    2017-01-01

    Background Foot orthoses are usually assumed to be effective by optimizing mechanically dynamic rearfoot configuration. However, the effect from a foot orthosis on kinematics that has been demonstrated scientifically has only been marginal. The aim of this study was to examine the effect of different heights in medial arch-supported foot orthoses on rear foot motion during gait. Methods Nineteen asymptomatic runners (36±11years, 180±5cm, 79±10kg; 41±22km/week) participated in the study. Trials were recorded at 3.1 mph (5 km/h) on a treadmill. Athletes walked barefoot and with 4 different not customized medial arch-supported foot orthoses of various arch heights (N:0 mm, M:30 mm, H:35 mm, E:40mm). Six infrared cameras and the `Oxford Foot Model´ were used to capture motion. The average stride in each condition was calculated from 50 gait cycles per condition. Eversion excursion and internal tibia rotation were analyzed. Descriptive statistics included calculating the mean ± SD and 95% CIs. Group differences by condition were analyzed by one factor (foot orthoses) repeated measures ANOVA (α = 0.05). Results Eversion excursion revealed the lowest values for N and highest for H (B:4.6°±2.2°; 95% CI [3.1;6.2]/N:4.0°±1.7°; [2.9;5.2]/M:5.2°±2.6°; [3.6;6.8]/H:6.2°±3.3°; [4.0;8.5]/E:5.1°±3.5°; [2.8;7.5]) (p>0.05). Range of internal tibia rotation was lowest with orthosis H and highest with E (B:13.3°±3.2°; 95% CI [11.0;15.6]/N:14.5°±7.2°; [9.2;19.6]/M:13.8°±5.0°; [10.8;16.8]/H:12.3°±4.3°; [9.0;15.6]/E:14.9°±5.0°; [11.5;18.3]) (p>0.05). Differences between conditions were small and the intrasubject variation high. Conclusion Our results indicate that different arch support heights have no systematic effect on eversion excursion or the range of internal tibia rotation and therefore might not exert a crucial influence on rear foot alignment during gait. PMID:28257426

  6. The Medial Orbitofrontal Cortex Regulates Sensitivity to Outcome Value

    PubMed Central

    Zimmermann, Kelsey S.; Allen, Amanda G.; Taylor, Jane R.

    2016-01-01

    An essential component of goal-directed decision-making is the ability to maintain flexible responding based on the value of a given reward, or “reinforcer.” The medial orbitofrontal cortex (mOFC), a subregion of the ventromedial prefrontal cortex, is uniquely positioned to regulate this process. We trained mice to nose poke for food reinforcers and then stimulated this region using CaMKII-driven Gs-coupled designer receptors exclusively activated by designer drugs (DREADDs). In other mice, we silenced the neuroplasticity-associated neurotrophin brain-derived neurotrophic factor (BDNF). Activation of Gs-DREADDs increased behavioral sensitivity to reinforcer devaluation, whereas Bdnf knockdown blocked sensitivity. These changes were accompanied by modifications in breakpoint ratios in a progressive ratio task, and they were recapitulated in Bdnf+/− mice. Replacement of BDNF selectively in the mOFC in Bdnf+/− mice rescued behavioral deficiencies, as well as phosphorylation of extracellular-signal regulated kinase 1/2 (ERK1/2). Thus, BDNF expression in the mOFC is both necessary and sufficient for the expression of typical effort allocation relative to an anticipated reinforcer. Additional experiments indicated that expression of the immediate-early gene c-fos was aberrantly elevated in the Bdnf+/− dorsal striatum, and BDNF replacement in the mOFC normalized expression. Also, systemic administration of an MAP kinase kinase inhibitor increased breakpoint ratios, whereas the addition of discrete cues bridging the response–outcome contingency rescued breakpoints in Bdnf+/− mice. We argue that BDNF–ERK1/2 in the mOFC is a key regulator of “online” goal-directed action selection. SIGNIFICANCE STATEMENT Goal-directed response selection often involves predicting the consequences of one's actions and the value of potential payoffs. Lesions or chemogenetic inactivation of the medial orbitofrontal cortex (mOFC) in rats induces failures in retrieving outcome

  7. Location and tension of the medial palpebral ligament.

    PubMed

    Hwang, Kun; Huan, Fan; Nam, Yong Seok; Han, Seung Ho; Kim, Dae Joong

    2013-11-01

    The aim of this study was to elucidate the precise anatomic location and tension of the medial palpebral ligament (MPL). Eleven hemifaces of 10 fresh Korean adult cadavers were used in this study. Nine specimens were used for measurement of dissection and tension, and 2 were used for histologic study. Measurements of tensile strength of each part of the MPL and Horner muscle were performed using a force gauge.The MPL consisted of 2 layers in all specimens dissected. The superficial layer of the palpebral ligament (SMPL) was observed from the anterior lacrimal crest to the upper and lower tarsal plates. The deep layer of the palpebral ligament (DMPL) lay from the anterior lacrimal crest to the posterior lacrimal crest, covering the lacrimal sac. The Horner muscle was observed at the posterior lacrimal crest just lateral to the attachment of the DMPL and ran laterally to the tarsal plate deep to the SMPL. The SMPL began at 4.5 ± 2.3 mm lateral to the nasomaxillary suture line to the upper and lower tarsal plates. Its transverse length was 9.6 ± 1.5 mm, and vertical width was 2.4 ± 0.7 mm, and its thickness was 4.5 ± 2.3 mm. The transverse length of the DMPL was 3.7 ± 0.4 mm, and its vertical width was 2.9 ± 1.3 mm, with a thickness of 0.3 ± 0.1 mm. The transverse length of the Horner muscle was 7.6 ± 1.9 mm, and its vertical width was 4.06 ± 1.5 mm, with a thickness of 0.4 ± 0.1 mm. The tensile strength of the SMPL was 13.4 ± 3.2 N, that of the DMPL was 4.1 ± 1.7 N, and that for Horner muscle was 9.0 ± 3.1 N. The tensile strength of the SMPL was significantly higher than that of the DMPL (P = 0.003).We reconfirmed that the MPL consisted of 2 layers: superficial layer and deep layer. Our results might be of use in surgeries of the medial canthi.

  8. Laparoscopic partial adrenalectomy.

    PubMed

    Ikeda, Y; Takami, H; Tajima, G; Sasaki, Y; Takayama, J; Kurihara, H; Niimi, M

    2002-01-01

    Since corticosteroids are indispensable hormones, partial or cortical-sparing adrenalectomies may be adopted for the surgical treatment of adrenal diseases. In this article, we describe the technique and results of these procedures. Laparoscopic partial or cortical-sparing adrenalectomy has been performed in 10 patients. Seven cases had an aldosterone-producing adenoma (APA) and three had a pheochromocytoma. Three cases with an APA and a case with a pheochromocytoma had tumors located far from the adrenal central vein, and the vein could be preserved. Four cases with an APA and two with a pheochromocytoma had tumors located close to the adrenal central vein, and it was necessary to section the central vein to resect them. All endoscopic procedures were performed successfully. There were no postoperative complications. At follow-up, adrenal 131I-adosterol scintigrams showed the preservation of remnant adrenal function in all patients. Laparoscopic partial or cortical-sparing adrenal surgery was safely performed, and adrenal function was preserved irrespective of whether the adrenal central vein could be preserved or not. We consider this to be a useful operative technique for selected cases.

  9. The effects of thermal capsulorrhaphy of medial parapatellar capsule on patellar lateral displacement

    PubMed Central

    Zheng, Naiquan; Davis, Brent R; Andrews, James R

    2008-01-01

    Background The effectiveness of thermal shrinkage on the medial parapatellar capsule for treating recurrent patellar dislocation is controversial. One of reasons why it is still controversial is that the effectiveness is still qualitatively measured. The purpose of this study was to quantitatively determine the immediate effectiveness of the medial parapatellar capsule shrinkage as in clinical setting. Methods Nine cadaveric knees were used to collect lateral displacement data before and after medial shrinkage or open surgery. The force and displacement were recorded while a physician pressed the patella from the medial side to mimic the physical exam used in clinic. Ten healthy subjects were used to test the feasibility of the technique on patients and establish normal range of lateral displacement of the patella under a medial force. The force applied, the resulting displacement and the ratio of force over displacement were compared among four data groups (normal knees, cadaveric knees before medial shrinkage, after shrinkage and after open surgery). Results Displacements of the cadaveric knees both before and after thermal modification were similar to normal subjects, and the applied forces were significantly higher. No significant differences were found between before and after thermal modification groups. After open surgery, displacements were reduced significantly while applied forces were significantly higher. Conclusion No immediate difference was found after thermal shrinkage of the medial parapatellar capsule. Open surgery immediately improved of the lateral stiffness of the knee capsule. PMID:18826583

  10. The effect of different types of insoles or shoe modifications on medial loading of the knee in persons with medial knee osteoarthritis: a randomised trial

    PubMed Central

    Chapman, Graham J.; Parkes, Matthew J.; Forsythe, Laura.; Felson, David T.

    2015-01-01

    ABSTRACT Many conservative treatments exist for medial knee osteoarthritis (OA) which aims to reduce the external knee adduction moment (EKAM). The objective of this study was to determine the difference between different shoes and lateral wedge insoles on EKAM, knee adduction angular impulse (KAAI), external knee flexion moment, pain, and comfort when walking in individuals with medial knee OA. Seventy individuals with medial knee OA underwent three‐dimensional walking gait analysis in five conditions (barefoot, control shoe, typical wedge, supported wedge, and mobility shoe) with pain and comfort recorded concurrently. The change in EKAM, KAAI, external knee flexion moment, pain, and comfort were assessed using multiple linear regressions and pairwise comparisons. Compared with the control shoe, lateral wedge insoles and barefoot walking significantly reduced early stance EKAM and KAAI. The mobility shoe showed no effect. A significant reduction in latter stance EKAM was seen in the lateral wedge insoles compared to the other conditions, with only the barefoot condition reducing the external knee flexion moment. However, the mobility shoe showed significant immediate knee pain reduction and improved comfort scores. Different lateral wedge insoles show comparable reductions in medial knee loading and in our study, the mobility shoe did not affect medial loading. © 2015 The Authors. Journal of Orthopaedic Research Published by Wiley Periodicals, Inc. J Orthop Res 33:1646–1654, 2015. PMID:25991385

  11. The effect of different types of insoles or shoe modifications on medial loading of the knee in persons with medial knee osteoarthritis: a randomised trial.

    PubMed

    Jones, Richard K; Chapman, Graham J; Parkes, Matthew J; Forsythe, Laura; Felson, David T

    2015-11-01

    Many conservative treatments exist for medial knee osteoarthritis (OA) which aims to reduce the external knee adduction moment (EKAM). The objective of this study was to determine the difference between different shoes and lateral wedge insoles on EKAM, knee adduction angular impulse (KAAI), external knee flexion moment, pain, and comfort when walking in individuals with medial knee OA. Seventy individuals with medial knee OA underwent three-dimensional walking gait analysis in five conditions (barefoot, control shoe, typical wedge, supported wedge, and mobility shoe) with pain and comfort recorded concurrently. The change in EKAM, KAAI, external knee flexion moment, pain, and comfort were assessed using multiple linear regressions and pairwise comparisons. Compared with the control shoe, lateral wedge insoles and barefoot walking significantly reduced early stance EKAM and KAAI. The mobility shoe showed no effect. A significant reduction in latter stance EKAM was seen in the lateral wedge insoles compared to the other conditions, with only the barefoot condition reducing the external knee flexion moment. However, the mobility shoe showed significant immediate knee pain reduction and improved comfort scores. Different lateral wedge insoles show comparable reductions in medial knee loading and in our study, the mobility shoe did not affect medial loading.

  12. Correlation between the knee adduction torque and medial contact force for a variety of gait patterns.

    PubMed

    Zhao, Dong; Banks, Scott A; Mitchell, Kim H; D'Lima, Darryl D; Colwell, Clifford W; Fregly, Benjamin J

    2007-06-01

    The external knee adduction torque has been proposed as a surrogate measure for medial compartment load during gait. However, a direct link between these two quantities has not been demonstrated using in vivo measurement of medial compartment load. This study uses in vivo data collected from a single subject with an instrumented knee implant to evaluate this link. The subject performed five different overground gait motions (normal, fast, slow, wide, and toe-out) with simultaneous collection of instrumented implant, video motion, and ground reaction data. For each trial, the knee adduction torque was measured externally while the total axial force applied to the tibial insert was measured internally. Based on data collected from the same subject performing treadmill gait under fluoroscopic motion analysis, a regression equation was developed to calculate medial contact force from the implant load cell measurements. Correlation analyses were performed for the stance phase and entire gait cycle to quantify the relationship between the knee adduction torque and both the medial contact force and the medial to total contact force ratio. When the entire gait cycle was analyzed, R(2) for medial contact force was 0.77 when all gait trials were analyzed together and between 0.69 and 0.93 when each gait trial was analyzed separately (p < 0.001 in all cases). For medial to total force ratio, R(2) was 0.69 for all trials together and between 0.54 and 0.90 for each trial separately (p < 0.001 in all cases). When only the stance phase was analyzed, R(2) values were slightly lower. These results support the hypothesis that the knee adduction torque is highly correlated with medial compartment contact force and medial to total force ratio during gait.

  13. The Role of Medial Frontal Cortex in Action Anticipation in Professional Badminton Players

    PubMed Central

    Xu, Huan; Wang, Pin; Ye, Zhuo’er; Di, Xin; Xu, Guiping; Mo, Lei; Lin, Huiyan; Rao, Hengyi; Jin, Hua

    2016-01-01

    Some studies show that the medial frontal cortex is associated with more skilled action anticipation, while similar findings are not observed in some other studies, possibly due to the stimuli employed and the participants used as the control group. In addition, no studies have investigated whether there is any functional connectivity between the medial frontal cortex and other brain regions in more skilled action anticipation. Therefore, the present study aimed to re-investigate how the medial frontal cortex is involved in more skilled action anticipation by circumventing the limitations of previous research and to investigate that the medial frontal cortex functionally connected with other brain regions involved in action processing in more skilled action anticipation. To this end, professional badminton players and novices were asked to anticipate the landing position of the shuttlecock while watching badminton match videos or to judge the gender of the players in the matches. The video clips ended right at the point that the shuttlecock and the racket came into contact to reduce the effect of information about the trajectory of the shuttlecock. Novices who lacked training and watching experience were recruited for the control group to reduce the effect of sport-related experience on the medial frontal cortex. Blood oxygenation level-dependent activation was assessed by means of functional magnetic resonance imaging. Compared to novices, badminton players exhibited stronger activation in the left medial frontal cortex during action anticipation and greater functional connectivity between left medial frontal cortex and some other brain regions (e.g., right posterior cingulate cortex). Therefore, the present study supports the position that the medial frontal cortex plays a role in more skilled action anticipation and that there is a specific brain network for more skilled action anticipation that involves right posterior cingulate cortex, right fusiform gyrus

  14. The Necessity of the Medial Temporal Lobe for Statistical Learning

    PubMed Central

    Schapiro, Anna C.; Gregory, Emma; Landau, Barbara; McCloskey, Michael; Turk-Browne, Nicholas B.

    2014-01-01

    The sensory input that we experience is highly patterned, and we are experts at detecting these regularities. Although the extraction of such regularities, or statistical learning (SL), is typically viewed as a cortical process, recent studies have implicated the medial temporal lobe (MTL), including the hippocampus. These studies have employed fMRI, leaving open the possibility that the MTL is involved but not necessary for SL. Here, we examined this issue in a case study of LSJ, a patient with complete bilateral hippocampal loss and broader MTL damage. In Experiments 1 and 2, LSJ and matched control participants were passively exposed to a continuous sequence of shapes, syllables, scenes, or tones containing temporal regularities in the co-occurrence of items. In a subsequent test phase, the control groups exhibited reliable SL in all conditions, successfully discriminating regularities from recombinations of the same items into novel foil sequences. LSJ, however, exhibited no SL, failing to discriminate regularities from foils. Experiment 3 ruled out more general explanations for this failure, such as inattention during exposure or difficulty following test instructions, by showing that LSJ could discriminate which individual items had been exposed. These findings provide converging support for the importance of the MTL in extracting temporal regularities. PMID:24456393

  15. Medial temporal lobe roles in human path integration.

    PubMed

    Yamamoto, Naohide; Philbeck, John W; Woods, Adam J; Gajewski, Daniel A; Arthur, Joeanna C; Potolicchio, Samuel J; Levy, Lucien; Caputy, Anthony J

    2014-01-01

    Path integration is a process in which observers derive their location by integrating self-motion signals along their locomotion trajectory. Although the medial temporal lobe (MTL) is thought to take part in path integration, the scope of its role for path integration remains unclear. To address this issue, we administered a variety of tasks involving path integration and other related processes to a group of neurosurgical patients whose MTL was unilaterally resected as therapy for epilepsy. These patients were unimpaired relative to neurologically intact controls in many tasks that required integration of various kinds of sensory self-motion information. However, the same patients (especially those who had lesions in the right hemisphere) walked farther than the controls when attempting to walk without vision to a previewed target. Importantly, this task was unique in our test battery in that it allowed participants to form a mental representation of the target location and anticipate their upcoming walking trajectory before they began moving. Thus, these results put forth a new idea that the role of MTL structures for human path integration may stem from their participation in predicting the consequences of one's locomotor actions. The strengths of this new theoretical viewpoint are discussed.

  16. Medial efferent mechanisms in children with auditory processing disorders.

    PubMed

    Mishra, Srikanta K

    2014-01-01

    Auditory processing disorder (APD) affects about 2-5% of children. However, the nature of this disorder is poorly understood. Children with APD typically have difficulties in complex listening situations. One mechanism thought to aid in listening-in-noise is the medial olivocochlear (MOC) inhibition. The purpose of this review was to critically analyze the published data on MOC inhibition in children with APD to determine whether the MOC efferents are involved in these individuals. The otoacoustic emission (OAE) methods used to assay MOC reflex were examined in the context of the current understanding of OAE generation mechanisms. Relevant literature suggests critical differences in the study population and OAE methods. Variables currently known to influence MOC reflex measurements, for example, middle-ear muscle reflexes or OAE signal-to-noise ratio, were not controlled in most studies. The use of potentially weaker OAE methods and the remarkable heterogeneity across studies does not allow for a definite conclusion whether or not the MOC reflex is altered in children with APD. Further carefully designed studies are needed to confirm the involvement of MOC efferents in APD. Knowledge of efferent functioning in children with APD would be mechanistically and clinically beneficial.

  17. The role of the medial prefrontal cortex in social categorization.

    PubMed

    Molenberghs, Pascal; Morrison, Samantha

    2014-03-01

    Group membership is an important aspect of our everyday behavior. Recently, we showed that existing relevant in-group labels increased activation in the medial prefrontal cortex (MPFC) compared with out-group labels, suggesting a role of the MPFC in social categorization. However, the question still remains whether this increase in MPFC activation for in-group representation is solely related with previous experience with the in-group. To test this, we randomly assigned participants to a red or blue team and in a subsequent functional magnetic resonance imaging experiment they categorized red and blue team words as belonging to either the in-group or the out-group. Results showed that even under these minimal conditions increased activation was found in the MPFC when participants indicated that they belonged to a group, as compared with when they did not. This effect was found to be associated with the level of group identification. These results confirm the role of MPFC in social categorization.

  18. Decoding Representations of Scenes in the Medial Temporal Lobes

    PubMed Central

    Bonnici, Heidi M; Kumaran, Dharshan; Chadwick, Martin J; Weiskopf, Nikolaus; Hassabis, Demis; Maguire, Eleanor A

    2012-01-01

    Recent theoretical perspectives have suggested that the function of the human hippocampus, like its rodent counterpart, may be best characterized in terms of its information processing capacities. In this study, we use a combination of high-resolution functional magnetic resonance imaging, multivariate pattern analysis, and a simple decision making task, to test specific hypotheses concerning the role of the medial temporal lobe (MTL) in scene processing. We observed that while information that enabled two highly similar scenes to be distinguished was widely distributed throughout the MTL, more distinct scene representations were present in the hippocampus, consistent with its role in performing pattern separation. As well as viewing the two similar scenes, during scanning participants also viewed morphed scenes that spanned a continuum between the original two scenes. We found that patterns of hippocampal activity during morph trials, even when perceptual inputs were held entirely constant (i.e., in 50% morph trials), showed a robust relationship with participants' choices in the decision task. Our findings provide evidence for a specific computational role for the hippocampus in sustaining detailed representations of complex scenes, and shed new light on how the information processing capacities of the hippocampus may influence the decision making process. © 2011 Wiley Periodicals, Inc. PMID:21656874

  19. Medial temporal lobe damage impairs representation of simple stimuli.

    PubMed

    Warren, David E; Duff, Melissa C; Tranel, Daniel; Cohen, Neal J

    2010-01-01

    Medial temporal lobe (MTL) damage in humans is typically thought to produce a circumscribed impairment in the acquisition of new enduring memories, but recent reports have documented deficits even in short-term maintenance. We examined possible maintenance deficits in a population of MTL amnesics, with the goal of characterizing their impairments as either representational drift or outright loss of representation over time. Patients and healthy comparisons performed a visual search task in which the similarity of various lures to a target was varied parametrically. Stimuli were simple shapes varying along one of several visual dimensions. The task was performed in two conditions, one presenting a sample target simultaneously with the search array and the other imposing a delay between sample and array. Eye-movement data collected during search revealed that the duration of fixations to items varied with lure-target similarity for all participants, i.e., fixations were longer for items more similar to the target. In the simultaneous condition, patients and comparisons exhibited an equivalent effect of similarity on fixation durations. However, imposing a delay modulated the effect differently for the two groups: in comparisons, fixation duration to similar items was exaggerated; in patients, the original effect was diminished. These findings indicate that MTL lesions subtly impair short-term maintenance of even simple stimuli, with performance reflecting not the complete loss of the maintained representation but rather a degradation or progressive drift of the representation over time.

  20. Structural development and dorsoventral maturation of the medial entorhinal cortex.

    PubMed

    Ray, Saikat; Brecht, Michael

    2016-04-02

    We investigated the structural development of superficial-layers of medial entorhinal cortex and parasubiculum in rats. The grid-layout and cholinergic-innervation of calbindin-positive pyramidal-cells in layer-2 emerged around birth while reelin-positive stellate-cells were scattered throughout development. Layer-3 and parasubiculum neurons had a transient calbindin-expression, which declined with age. Early postnatally, layer-2 pyramidal but not stellate-cells co-localized with doublecortin - a marker of immature neurons - suggesting delayed functional-maturation of pyramidal-cells. Three observations indicated a dorsal-to-ventral maturation of entorhinal cortex and parasubiculum: (i) calbindin-expression in layer-3 neurons decreased progressively from dorsal-to-ventral, (ii) doublecortin in layer-2 calbindin-positive-patches disappeared dorsally before ventrally, and (iii) wolframin-expression emerged earlier in dorsal than ventral parasubiculum. The early appearance of calbindin-pyramidal-grid-organization in layer-2 suggests that this pattern is instructed by genetic information rather than experience. Superficial-layer-microcircuits mature earlier in dorsal entorhinal cortex, where small spatial-scales are represented. Maturation of ventral-entorhinal-microcircuits - representing larger spatial-scales - follows later around the onset of exploratory behavior.

  1. Anterior medial prefrontal cortex implements social priming of mimicry.

    PubMed

    Wang, Yin; Hamilton, Antonia F de C

    2015-04-01

    The neural and cognitive mechanisms by which primed constructs can impact on social behavior are poorly understood. In the present study, we used functional magnetic resonance imaging (fMRI) to explore how scrambled sentence priming can impact on mimicry behavior. Sentences involving pro/antisocial events from a first/third-person point of view were presented in short blocks, followed by a reaction-time assessment of mimicry. Behavioral results showed that both prosociality and viewpoint impact on mimicry, and fMRI analysis showed this effect is implemented by anterior medial prefrontal cortex (amPFC). We suggest that social primes may subtly modulate processing in amPFC in a manner linked to the later behavior, and that this same region also implements the top-down control of mimicry responses. This priming may be linked to processing of self-schemas in amPFC. Our findings demonstrate how social priming can be studied with fMRI, and have important implications for our understanding of the underlying mechanisms of prime-to-behavior effects as well as for current theories in social psychology.

  2. Single-cell recordings in the human medial temporal lobe

    PubMed Central

    Rey, Hernan G; Ison, Matias J; Pedreira, Carlos; Valentin, Antonio; Alarcon, Gonzalo; Selway, Richard; Richardson, Mark P; Quian Quiroga, Rodrigo

    2015-01-01

    Recordings from individual neurons in patients who are implanted with depth electrodes for clinical reasons have opened the possibility to narrow down the gap between neurophysiological studies in animals and non-invasive (e.g. functional magnetic resonance imaging, electroencephalogram, magnetoencephalography) investigations in humans. Here we provide a description of the main procedures for electrode implantation and recordings, the experimental paradigms used and the main steps for processing the data. We also present key characteristics of the so-called ‘concept cells’, neurons in the human medial temporal lobe with selective and invariant responses that represent the meaning of the stimulus, and discuss their proposed role in declarative memory. Finally, we present novel results dealing with the stability of the representation given by these neurons, by studying the effect of stimulus repetition in the strength of the responses. In particular, we show that, after an initial decay, the response strength reaches an asymptotic value after approximately 15 presentations that remains above baseline for the whole duration of the experiment. PMID:25163775

  3. Basket-Weave Technique for Medial Patellofemoral Ligament Reconstruction

    PubMed Central

    Kodkani, Pranjal S.

    2015-01-01

    The anatomy of the medial patellofemoral ligament (MPFL) has been well defined, with parts of its uppermost fibers having a soft-tissue insertion onto the vastus intermedius. Bone tunnels and implants on the patellar side therefore cannot replicate this anatomic construct precisely. Because of implants and tunnels, complications have been reported with bone tunnel fracture. Similarly, on the femoral side, rigid fixation with implants can result in over-constraint with compromised results. Moreover, bone tunnels cannot be used in skeletally immature cases. To overcome issues related to bone tunneling and implants, as well as to reconstruct the MPFL in a precise anatomic manner, an all–soft-tissue fixation technique was devised. Bony landmarks were used as reference points instead of radiologic markers to achieve a more precise construct and to eliminate intraoperative radiography. Hamstring graft was used to reconstruct the MPFL. Special suturing techniques were used to achieve optimal graft fixation with minimal suture knots. A special tissue elevator–suture passer device was designed to facilitate graft passage and ease in performing the procedure. This technique permits differential tensioning, and therefore one achieves stability throughout the range of motion. PMID:26258044

  4. Behavioral control, the medial prefrontal cortex, and resilience

    PubMed Central

    Maier, Steven F.; Amat, Jose; Baratta, Michael V.; Paul, Evan; Watkins, Linda R.

    2006-01-01

    The degree of control that an organism has over a stressor potently modulates the impact of the stressor, with uncontrollable stressors producing a constellation of outcomes that do not occur if the stressor is behaviorally controllable. It has generally been assumed that this occurs because uncontrollability actively potentiates the effects of stressors. Here it will be suggested that in addition, or instead, the presence of control actively inhibits the impact of stressors. At least in part this occurs because (i) the presence of control is detected by regions of the ventral medial prefrontal cortex (mPFCv); and (ii) detection of control activates mPFCv output to stress-responsive brain stem and limbic structures that actively inhibit stress-induced activation of these structures, Furthermore, an initial experience with control over stress alters the mPFCv response to subsequent stressors so that mPFCv output is activated even if the subsequent stressor is uncontrollable, thereby making the organism resilient. The general implications of these results for understanding resilience in the face of adversity are discussed. PMID:17290798

  5. Correlating Function and Imaging Measures of the Medial Longitudinal Fasciculus

    PubMed Central

    Sakaie, Ken; Takahashi, Masaya; Remington, Gina; Wang, Xiaofeng; Conger, Amy; Conger, Darrel; Dimitrov, Ivan; Jones, Stephen; Frohman, Ashley; Frohman, Teresa; Sagiyama, Koji; Togao, Osamu

    2016-01-01

    Objective To test the validity of diffusion tensor imaging (DTI) measures of tissue injury by examining such measures in a white matter structure with well-defined function, the medial longitudinal fasciculus (MLF). Injury to the MLF underlies internuclear ophthalmoparesis (INO). Methods 40 MS patients with chronic INO and 15 healthy controls were examined under an IRB-approved protocol. Tissue integrity of the MLF was characterized by DTI parameters: longitudinal diffusivity (LD), transverse diffusivity (TD), mean diffusivity (MD) and fractional anisotropy (FA). Severity of INO was quantified by infrared oculography to measure versional disconjugacy index (VDI). Results LD was significantly lower in patients than in controls in the medulla-pons region of the MLF (p < 0.03). FA was also lower in patients in the same region (p < 0.0004). LD of the medulla-pons region correlated with VDI (R = -0.28, p < 0.05) as did FA in the midbrain section (R = 0.31, p < 0.02). Conclusions This study demonstrates that DTI measures of brain tissue injury can detect injury to a functionally relevant white matter pathway, and that such measures correlate with clinically accepted evaluation indices for INO. The results validate DTI as a useful imaging measure of tissue integrity. PMID:26800522

  6. A general role for medial prefrontal cortex in event prediction

    PubMed Central

    Alexander, William H.; Brown, Joshua W.

    2014-01-01

    A recent computational neural model of medial prefrontal cortex (mPFC), namely the predicted response-outcome (PRO) model (Alexander and Brown, 2011), suggests that mPFC learns to predict the outcomes of actions. The model accounted for a wide range of data on the mPFC. Nevertheless, numerous recent findings suggest that mPFC may signal predictions and prediction errors even when the predicted outcomes are not contingent on prior actions. Here we show that the existing PRO model can learn to predict outcomes in a general sense, and not only when the outcomes are contingent on actions. A series of simulations show how this generalized PRO model can account for an even broader range of findings in the mPFC, including human ERP, fMRI, and macaque single-unit data. The results suggest that the mPFC learns to predict salient events in general and provides a theoretical framework that links mPFC function to model-based reinforcement learning, Bayesian learning, and theories of cognitive control. PMID:25071539

  7. Role of the medial prefrontal cortex in coping and resilience *

    PubMed Central

    Maier, Steven F.; Watkins, Linda R.

    2010-01-01

    The degree of behavioral control that an organism has over an aversive event is well known to modulate the behavioral and neurochemical consequences of exposure to the event. Here we review recent research that suggests that the experience of control over a potent stressor alters how the organism responds to future aversive events as well as to the stressor being controlled. More specifically, subjects that have experienced control show blunted behavioral and neurochemical responses to subsequent stressors occurring days to months later. Indeed, these subjects respond as if a later uncontrollable stressor is actually controllable. Further, we review research indicating that the stress-resistance induced by control depends on control-induced activation of ventral medial prefrontal cortical (vmPFC) inhibitory control over brainstem and limbic structures. Furthermore, there appears to be plasticity in these circuits such that the experience of control alters the vmPFC in such a way that later uncontrollable stressors now activate the vmPFC circuitry, leading to inhibition of stress-responsive limbic and brainstem structures, i.e., stressor resistance. This controllability-induced proactive stressor resistance generalizes across very different stressors and may be involved in determining individual difference in reactions to traumatic events. PMID:20727864

  8. Structural development and dorsoventral maturation of the medial entorhinal cortex

    PubMed Central

    Ray, Saikat; Brecht, Michael

    2016-01-01

    We investigated the structural development of superficial-layers of medial entorhinal cortex and parasubiculum in rats. The grid-layout and cholinergic-innervation of calbindin-positive pyramidal-cells in layer-2 emerged around birth while reelin-positive stellate-cells were scattered throughout development. Layer-3 and parasubiculum neurons had a transient calbindin-expression, which declined with age. Early postnatally, layer-2 pyramidal but not stellate-cells co-localized with doublecortin – a marker of immature neurons – suggesting delayed functional-maturation of pyramidal-cells. Three observations indicated a dorsal-to-ventral maturation of entorhinal cortex and parasubiculum: (i) calbindin-expression in layer-3 neurons decreased progressively from dorsal-to-ventral, (ii) doublecortin in layer-2 calbindin-positive-patches disappeared dorsally before ventrally, and (iii) wolframin-expression emerged earlier in dorsal than ventral parasubiculum. The early appearance of calbindin-pyramidal-grid-organization in layer-2 suggests that this pattern is instructed by genetic information rather than experience. Superficial-layer-microcircuits mature earlier in dorsal entorhinal cortex, where small spatial-scales are represented. Maturation of ventral-entorhinal-microcircuits – representing larger spatial-scales – follows later around the onset of exploratory behavior. DOI: http://dx.doi.org/10.7554/eLife.13343.001 PMID:27036175

  9. Medial Prefrontal Cortex Reduces Memory Interference by Modifying Hippocampal Encoding.

    PubMed

    Guise, Kevin G; Shapiro, Matthew L

    2017-04-05

    The prefrontal cortex (PFC) is crucial for accurate memory performance when prior knowledge interferes with new learning, but the mechanisms that minimize proactive interference are unknown. To investigate these, we assessed the influence of medial PFC (mPFC) activity on spatial learning and hippocampal coding in a plus maze task that requires both structures. mPFC inactivation did not impair spatial learning or retrieval per se, but impaired the ability to follow changing spatial rules. mPFC and CA1 ensembles recorded simultaneously predicted goal choices and tracked changing rules; inactivating mPFC attenuated CA1 prospective coding. mPFC activity modified CA1 codes during learning, which in turn predicted how quickly rats adapted to subsequent rule changes. The results suggest that task rules signaled by the mPFC become incorporated into hippocampal representations and support prospective coding. By this mechanism, mPFC activity prevents interference by "teaching" the hippocampus to retrieve distinct representations of similar circumstances.

  10. Assessing cognitive function following medial prefrontal stroke in the rat.

    PubMed

    Livingston-Thomas, Jessica M; Jeffers, Matthew S; Nguemeni, Carine; Shoichet, Molly S; Morshead, Cindi M; Corbett, Dale

    2015-11-01

    Cognitive impairments are prevalent following clinical stroke; however, preclinical research has focused almost exclusively on motor deficits. In order to conduct systematic evaluations into the nature of post-stroke cognitive dysfunction and recovery, it is crucial to develop focal stroke models that predominantly affect cognition while leaving motor function intact. Herein, we evaluated a range of cognitive functions 1-4 months following focal medial prefrontal cortex (mPFC) stroke using a battery of tests. Male Sprague-Dawley rats underwent focal ischemia induced in the mPFC using bilateral intracerebral injections of endothelin-1, or sham surgery. Cognitive function was assessed using an open field, several object recognition tests, attentional set-shifting, light-dark box, spontaneous alternation, Barnes maze, and win-shift/win-stay tests. Prefrontal cortex damage resulted in significant changes in object recognition function, behavioural flexibility, and anxiety-like behaviour, while spontaneous alternation and locomotor function remained intact. These deficits are similar to the cognitive deficits following stroke in humans. Our results suggest that this model may be useful for identifying and developing potential therapies for improving post-stroke cognitive dysfunction.

  11. Capsaicin augments synaptic transmission in the rat medial preoptic nucleus.

    PubMed

    Karlsson, Urban; Sundgren-Andersson, Anna K; Johansson, Staffan; Krupp, Johannes J

    2005-05-10

    The medial preoptic nucleus (MPN) is the major nucleus of the preoptic area (POA), a hypothalamic area involved in the regulation of body-temperature. Injection of capsaicin into this area causes hypothermia in vivo. Capsaicin also causes glutamate release from hypothalamic slices. However, no data are available on the effect of capsaicin on synaptic transmission within the MPN. Here, we have studied the effect of exogenously applied capsaicin on spontaneous synaptic activity in hypothalamic slices of the rat. Whole-cell patch-clamp recordings were made from visually identified neurons located in the MPN. In a subset of the studied neurons, capsaicin enhanced the frequency of spontaneous glutamatergic EPSCs. Remarkably, capsaicin also increased the frequency of GABAergic IPSCs, an effect that was sensitive to removal of extracellular calcium, but insensitive to tetrodotoxin. This suggests an action of capsaicin at presynaptic GABAergic terminals. In contrast to capsaicin, the TRPV4 agonist 4alpha-PDD did not affect GABAergic IPSCs. Our results show that capsaicin directly affects synaptic transmission in the MPN, likely through actions at presynaptic terminals as well as on projecting neurons. Our data add to the growing evidence that capsaicin receptors are not only expressed in primary afferent neurons, but also contribute to synaptic processing in some CNS regions.

  12. Transient medial prefrontal perturbation reduces false memory formation.

    PubMed

    Berkers, Ruud M W J; van der Linden, Marieke; de Almeida, Rafael F; Müller, Nils C J; Bovy, Leonore; Dresler, Martin; Morris, Richard G M; Fernández, Guillén

    2017-03-01

    Knowledge extracted across previous experiences, or schemas, benefit encoding and retention of congruent information. However, they can also reduce specificity and augment memory for semantically related, but false information. A demonstration of the latter is given by the Deese-Roediger-McDermott (DRM) paradigm, where the studying of words that fit a common semantic schema are found to induce false memories for words that are congruent with the given schema, but were not studied. The medial prefrontal cortex (mPFC) has been ascribed the function of leveraging prior knowledge to influence encoding and retrieval, based on imaging and patient studies. Here, we used transcranial magnetic stimulation (TMS) to transiently perturb ongoing mPFC processing immediately before participants performed the DRM-task. We observed the predicted reduction in false recall of critical lures after mPFC perturbation, compared to two control groups, whereas veridical recall and recognition memory performance remained similar across groups. These data provide initial causal evidence for a role of the mPFC in biasing the assimilation of new memories and their consolidation as a function of prior knowledge.

  13. Medial PFC Damage Abolishes the Self-reference Effect

    PubMed Central

    Philippi, Carissa L.; Duff, Melissa C.; Denburg, Natalie L.; Tranel, Daniel; Rudrauf, David

    2012-01-01

    Functional neuroimaging studies suggest that the medial PFC (mPFC) is a key component of a large-scale neural system supporting a variety of self-related processes. However, it remains unknown whether the mPFC is critical for such processes. In this study, we used a human lesion approach to examine this question. We administered a standard trait judgment paradigm [Kelley, W. M., Macrae, C. N., Wyland, C. L., Caglar, S., Inati, S., & Heatherton, T. F. Finding the self? An event-related fMRI study. Journal of Cognitive Neuroscience, 14, 785–794, 2002] to patients with focal brain damage to the mPFC. The self-reference effect (SRE), a memory advantage conferred by self-related processing, served as a measure of intact self-processing ability. We found that damage to the mPFC abolished the SRE. The results demonstrate that the mPFC is necessary for the SRE and suggest that this structure is important for self-referential processing and the neural representation of self. PMID:21942762

  14. Gene expression profiling of the dorsolateral and medial orbitofrontal cortex in schizophrenia

    PubMed Central

    Mladinov, Mihovil; Sedmak, Goran; Fuller, Heidi R.; Babić Leko, Mirjana; Mayer, Davor; Kirincich, Jason; Štajduhar, Andrija; Borovečki, Fran; Hof, Patrick R.

    2016-01-01

    Abstract Schizophrenia is a complex polygenic disorder of unknown etiology. Over 3,000 candidate genes associated with schizophrenia have been reported, most of which being mentioned only once. Alterations in cognitive processing - working memory, metacognition and mentalization - represent a core feature of schizophrenia, which indicates the involvement of the prefrontal cortex in the pathophysiology of this disorder. Hence we compared the gene expression in postmortem tissue from the left and right dorsolateral prefrontal cortex (DLPFC, Brodmann's area 46), and the medial part of the orbitofrontal cortex (MOFC, Brodmann's area 11/12), in six patients with schizophrenia and six control brains. Although in the past decade several studies performed transcriptome profiling in schizophrenia, this is the first study to investigate both hemispheres, providing new knowledge about possible brain asymmetry at the level of gene expression and its relation to schizophrenia. We found that in the left hemisphere, twelve genes from the DLPFC and eight genes from the MOFC were differentially expressed in patients with schizophrenia compared to controls. In the right hemisphere there was only one gene differentially expressed in the MOFC. We reproduce the involvement of previously reported genes TARDBP and HNRNPC in the pathogenesis of schizophrenia, and report seven novel genes: SART1, KAT7, C1D, NPM1, EVI2A, XGY2, and TTTY15. As the differentially expressed genes only partially overlap with previous studies that analyzed other brain regions, our findings indicate the importance of considering prefrontal cortical regions, especially those in the left hemisphere, for obtaining disease-relevant insights. PMID:28123834

  15. Chronic Ritalin Administration during Adulthood Increases Serotonin Pool in Rat Medial Frontal Cortex

    PubMed Central

    Daniali, Samira; Nahavandi, Arezo; Madjd, Zahra; Shahbazi, Ali; Niknazar, Somayeh; Shahbazzadeh, Delavar

    2013-01-01

    Background: Ritalin has high tendency to be abused. It has been the main indication to control attention deficit hyperactivity disorder. The college students may seek for it to improve their memory, decrease the need for sleep (especially during exams), which at least partially, can be related to serotonergic system. Therefore, it seems worthy to evaluate the effect of Ritalin intake on mature brain. There are many studies on Ritalin effect on developing brain, but only few studies on adults are available. This study was undertaken to find Ritalin effect on serotonin transporter (SERT) density in medial frontal cortex (MFC) of mature rat. Methods: Thirty male Wistar rats were used in the study. Rats were assigned into five groups (n = 6 per group): one control, two Ritalin and two vehicle groups. Twelve rats received Ritalin (20 mg/kg/twice a day) orally for eleven continuous days. After one week of withdrawal and another two weeks of rest, in order to evaluate short-term effects of Ritalin, six rats were sacrificed. Another six rats were studied to detect the long-term effects of Ritalin; therefore, they were sacrificed 12 weeks after the previous group. The immunohistochemistry was performed to evaluate the results. Results: Immunohistochemistry studies showed a higher density of SERT in both 2 and 12 weeks after withdrawal from Ritalin intake in MFC of rat and there was no significant difference between these two groups. Conclusions: Our findings demonstrated both short- and long-term effects of Ritalin on frontal serotonergic system after withdrawal period. PMID:23748891

  16. Glutamate co-transmission from developing medial nucleus of the trapezoid body--lateral superior olive synapses is cochlear dependent in kanamycin-treated rats.

    PubMed

    Lee, Jae Ho; Pradhan, Jonu; Maskey, Dhiraj; Park, Ki Sup; Hong, Sung Hwa; Suh, Myung-Whan; Kim, Myeung Ju; Ahn, Seung Cheol

    2011-02-11

    Cochlear dependency of glutamate co-transmission at the medial nucleus of the trapezoid body (MNTB)--the lateral superior olive (LSO) synapses was investigated using developing rats treated with high dose kanamycin. Rats were treated with kanamycin from postnatal day (P) 3 to P8. A scanning electron microscopic study on P9 demonstrated partial cochlear hair cell damage. A whole cell voltage clamp experiment demonstrated the increased glutamatergic portion of postsynaptic currents (PSCs) elicited by MNTB stimulation in P9-P11 kanamycin-treated rats. The enhanced VGLUT3 immunoreactivities (IRs) in kanamycin-treated rats and asymmetric VGLUT3 IRs in the LSO of unilaterally cochlear ablated rats supported the electrophysiologic data. Taken together, it is concluded that glutamate co-transmission is cochlear-dependent and enhanced glutamate co-transmission in kanamycin-treated rats is induced by partial cochlear damage.

  17. Miniarthrotomy assisted percutaneous screw fixation for displaced medial malleolus fractures – A novel technique

    PubMed Central

    Saini, Pramod; Aggrawal, Abhinav; Meena, Sanjay; Trikha, Vivek; Mittal, Samarth

    2014-01-01

    Aim To describe here a technique of miniarthrotomy assisted percutaneous screw insertion for displaced Herscovici type B and C medial malleolar fractures. Method Incision was made centred over the superomedial angle of the ankle mortise, about half a cm medial to tibialis anterior. Arthrotomy was done and reduction obtained. Percuntaneously, two 4 mm cancellous cannulated screws were inserted through medial malleolus. Results and conclusion This approach allows direct visualization of reduction, removal of entrapped soft tissue and preservation of saphenous vein and nerve. PMID:25983507

  18. Treatment of medial and posteromedial knee instability: indications, techniques, and review of the results.

    PubMed

    Bonasia, D E; Bruzzone, M; Dettoni, F; Marmotti, A; Blonna, D; Castoldi, F; Gasparetto, F; D'Elicio, D; Collo, G; Rossi, R

    2012-01-01

    Injuries of the posteromedial corner of the knee are relatively common. These can be isolated or combined with other ligament lesions. In some cases the treatment of postero-medial corner injuries is controversial. After a brief description of the anatomy and biomechanics of the medial side of the knee, this paper reviews the indications for isolated and multiligamentous medial/posteromedial corner injuries both in the acute and in the chronic setting. In addition, the most common surgical techniques for repair and reconstruction are described in addition to outcomes based upon a review of the literature.

  19. Ulnar entrapment neuropathy along the medial intermuscular septum in the midarm.

    PubMed

    Nakajima, Masashi; Ono, Nobuko; Kojima, Tomoko; Kusunose, Koichi

    2009-05-01

    We report a patient with primary ulnar entrapment neuropathy in the midarm. Stimulation of multiple sites along the ulnar nerve showed a motor conduction block at a distance of 7.5-10 cm proximal to the medial epicondyle, where the nerve was compressed by the medial intermuscular septum. Anatomically, the possibility of ulnar nerve entrapment in this segment has long been suggested, and stimulation at least 10 cm above the medial epicondyle may reveal the entrapment. Muscle Nerve 39: 707-710, 2009.

  20. Medial pterygoid trismus (myospasm) following inferior alveolar nerve block: case report and literature review.

    PubMed

    Wright, Edward F

    2011-01-01

    A patient developed a medial pterygoid trismus (myospasm) the day after receiving three inferior alveolar nerve blocks and a routine restoration. She had a significantly restricted mouth opening and significant medial pterygoid muscle pain when she opened beyond the restriction; however, she had no swelling, lymphadenopathy, or fever. A medial pterygoid myospasm can occur secondary to an inferior alveolar nerve block. This disorder generally is treated by the application of heat, muscle stretches, analgesic and/or muscle relaxant ingestion, and a physical therapy referral. The severity of the disorder typically dictates the extent of therapy that is needed.

  1. Partial Southwest Elevation Mill #5 West (Part 3), Partial ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Partial Southwest Elevation - Mill #5 West (Part 3), Partial Southwest Elevation - Mill #5 West (with Section of Courtyard) (Parts 1 & 2) - Boott Cotton Mills, John Street at Merrimack River, Lowell, Middlesex County, MA

  2. Effects of aripiprazole and terguride on dopamine synthesis in the dorsal striatum and medial prefrontal cortex of preweanling rats.

    PubMed

    Iñiguez, S D; Cortez, A M; Crawford, C A; McDougall, S A

    2008-01-01

    The purpose of this study was to determine whether aripiprazole, a D2-like partial agonist increasingly prescribed to children, alters DA synthesis via actions at autoreceptors in the dorsal striatum and medial prefrontal cortex (mPFC) of preweanling rats. The ability of dopaminergic agents to alter DOPA accumulation in the striatum and mPFC was measured after NSD-1015 on postnatal day (PD) 20. Dopaminergic tone was manipulated by administering reserpine, gamma-butyrolactone (GBL), or through amphetamine withdrawal. Results showed that the partial agonists aripiprazole and terguride increased striatal DOPA accumulation under normosensitive conditions, but decreased DOPA accumulation in states of low dopaminergic tone. A different pattern of results was observed in the mPFC, because terguride and haloperidol, but not aripiprazole, increased DOPA accumulation under normosensitive conditions. In conclusion, the present data show that aripiprazole affects striatal synthesis modulating autoreceptors in an adult-typical manner during the late preweanling period. Unlike in adult rats, however, the mPFC of preweanling rats appears to contain transitory synthesis modulating autoreceptors that are sensitive to drug manipulation.

  3. Paternalism and partial autonomy.

    PubMed Central

    O'Neill, O

    1984-01-01

    A contrast is often drawn between standard adult capacities for autonomy, which allow informed consent to be given or withheld, and patients' reduced capacities, which demand paternalistic treatment. But patients may not be radically different from the rest of us, in that all human capacities for autonomous action are limited. An adequate account of paternalism and the role that consent and respect for persons can play in medical and other practice has to be developed within an ethical theory that does not impose an idealised picture of unlimited autonomy but allows for the variable and partial character of actual human autonomy. PMID:6520849

  4. Experts' Understanding of Partial Derivatives Using the Partial Derivative Machine

    ERIC Educational Resources Information Center

    Roundy, David; Weber, Eric; Dray, Tevian; Bajracharya, Rabindra R.; Dorko, Allison; Smith, Emily M.; Manogue, Corinne A.

    2015-01-01

    Partial derivatives are used in a variety of different ways within physics. Thermodynamics, in particular, uses partial derivatives in ways that students often find especially confusing. We are at the beginning of a study of the teaching of partial derivatives, with a goal of better aligning the teaching of multivariable calculus with the needs of…

  5. Is Titan Partially Differentiated?

    NASA Astrophysics Data System (ADS)

    Mitri, G.; Pappalardo, R. T.; Stevenson, D. J.

    2009-12-01

    The recent measurement of the gravity coefficients from the Radio Doppler data of the Cassini spacecraft has improved our knowledge of the interior structure of Titan (Rappaport et al. 2008 AGU, P21A-1343). The measured gravity field of Titan is dominated by near hydrostatic quadrupole components. We have used the measured gravitational coefficients, thermal models and the hydrostatic equilibrium theory to derive Titan's interior structure. The axial moment of inertia gives us an indication of the degree of the interior differentiation. The inferred axial moment of inertia, calculated using the quadrupole gravitational coefficients and the Radau-Darwin approximation, indicates that Titan is partially differentiated. If Titan is partially differentiated then the interior must avoid melting of the ice during its evolution. This suggests a relatively late formation of Titan to avoid the presence of short-lived radioisotopes (Al-26). This also suggests the onset of convection after accretion to efficiently remove the heat from the interior. The outer layer is likely composed mainly of water in solid phase. Thermal modeling indicates that water could be present also in liquid phase forming a subsurface ocean between an outer ice I shell and a high pressure ice layer. Acknowledgments: This work was conducted at the Jet Propulsion Laboratory, California Institute of Technology, under contract with the National Aeronautics and Space Administration.

  6. Furnace brazing under partial vacuum

    NASA Technical Reports Server (NTRS)

    Mckown, R. D.

    1979-01-01

    Brazing furnace utilizing partial-vacuum technique reduces tooling requirements and produces better bond. Benefit in that partial vacuum helps to dissociate metal oxides that inhibit metal flow and eliminates heavy tooling required to hold parts together during brazing.

  7. Assessment of medial and lateral neurovascular structures after percutaneous posterior calcaneal displacement osteotomy: a cadaver study.

    PubMed

    Didomenico, Lawrence A; Anain, Joseph; Wargo-Dorsey, Mari

    2011-01-01

    A prospective investigation of the effects on the medial and lateral neurovascular structures of the rearfoot after percutaneous posterior calcaneal displacement osteotomy was performed using 20 below the knee fresh frozen cadaver specimens. This anatomic study aimed to examine the medial and lateral neurovascular structures to determine whether they were jeopardized during execution of the osteotomy. After completion of the osteotomy, the medial plantar, lateral plantar, medial calcaneal, sural, and posterior tibial neurovascular structures, along with their respective branches, were inspected for iatrogenic injury. Our findings demonstrated that the percutaneous, subperiosteal osteotomy minimized trauma to the local soft tissue envelope and protected the adjacent neurovascular structures. Because no iatrogenic injury was observed in the cadaveric specimens, we postulated that percutaneous calcaneal displacement osteotomy is a safe, predictable, and advantageous alternative compared with open techniques for osteotomy and could result in reduced postoperative complications. The results of this investigation remain to be confirmed in the clinical setting.

  8. Biomechanical validation of medial pie-crusting for soft-tissue balancing in knee arthroplasty.

    PubMed

    Mihalko, William M; Woodard, Erik L; Hebert, Casey T; Crockarell, John R; Williams, John L

    2015-02-01

    Balancing a varus knee is traditionally accomplished by releasing the medial soft-tissue sleeve off the tibia. Recently, "pie-crusting" (PC) medial structures has been described. In a biomechanical cadaver study we compared PC to traditional release (TR) to determine their effects on flexion and extension gaps. PC was done in five specimens along the anterior half of the medial soft-tissue sleeve and five along the posterior half, followed by a traditional release. In 90° flexion, valgus laxity after TR was significantly greater than after PC alone. PC of the anterior or posterior aspect of the medial soft-tissue sleeve can effect changes more in flexion than in extension, respectively. Complete TR did not provide more gap opening than PC in extension, but produced more effect in flexion.

  9. Recruitment of the Rhesus soleus and medial gastrocnemius before, during and after spaceflight

    NASA Technical Reports Server (NTRS)

    Roy, R. R.; Hodgson, J. A.; Aragon, J.; Day, M. K.; Kozlovskaya, I.; Edgerton, V. R.

    1996-01-01

    Electromyograms were recorded from the soleus and medial gastrocnemius muscles and tendon force from the medial gastrocnemius muscle of 2 juvenile Rhesus monkeys before, during and after Cosmos flight 2229 and of ground control animals. Recording sessions were made while the Rhesus were performing a foot pedal motor task. Preflight testing indicated normal patterns of recruitment between the soleus and medial gastrocnemius, i.e. a higher level of recruitment of the soleus compared to the medial gastrocnemius during the task. Recording began two days into the spaceflight and showed that the media gastrocnemius was recruited preferentially over the soleus. This observation persisted throughout the flight and for the 2 week period of postflight testing. These data indicate a significant change in the relative recruitment of slow and fast extensor muscles under microgravity conditions. The appearance of clonic-like activity in one muscle of each Rhesus during flight further suggests a reorganization in the neuromotor system in a microgravity environment.

  10. Avulsion of the anterior medial meniscus root: case report and surgical technique.

    PubMed

    Feucht, Matthias J; Minzlaff, Philipp; Saier, Tim; Lenich, Andreas; Imhoff, Andreas B; Hinterwimmer, Stefan

    2015-01-01

    Injuries of the meniscus roots have become increasingly recognised as a serious pathology of the knee joint. However, the current available literature focuses primarily on posterior meniscus root tears. In this article, a case with an isolated avulsion of the anterior medial meniscus root is presented, and a new arthroscopic technique to treat this type of injury is described. The anterior horn of the medial meniscus was sutured with a double-looped nonabsorbable suture and reattached to the tibial plateau using a knotless suture anchor. This technique may also be useful to treat avulsion injuries of the anterolateral or posteromedial meniscus root, and symptomatic subluxation of the medial meniscus in case of a variant insertion anatomy with an absent attachment of the anterior horn of the medial meniscus to the tibial plateau. Level of evidence V.

  11. Cellular components of the human medial amygdaloid nucleus.

    PubMed

    Dall'Oglio, Aline; Xavier, Léder L; Hilbig, Arlete; Ferme, Denise; Moreira, Jorge E; Achaval, Matilde; Rasia-Filho, Alberto A

    2013-02-15

    The medial nucleus (Me) is a superficial component of the amygdaloid complex. Here we assessed the density and morphology of the neurons and glial cells, the glial fibrillary acidic protein (GFAP) immunoreactivity, and the ultrastructure of the synaptic sites in the human Me. The optical fractionator method was applied. The Me presented an estimated mean neuronal density of 1.53 × 10⁵ neurons/mm³ (greater in the left hemisphere), more glia (72% of all cells) than neurons, and a nonneuronal:neuronal ratio of 2.7. Golgi-impregnated neurons had round or ovoid, fusiform, angular, and polygonal cell bodies (10-30 μm in diameter). The length of the dendrites varied, and pleomorphic spines were found in sparsely spiny or densely spiny cells (1.5-5.2 spines/dendritic μm). The axons in the Me neuropil were fine or coarsely beaded, and fibers showed simple or notably complex collateral terminations. The protoplasmic astrocytes were either isolated or formed small clusters and showed GFAP-immunoreactive cell bodies and multiple branches. Furthermore, we identified both asymmetrical (with various small, clear, round, electron-lucent vesicles and, occasionally, large, dense-core vesicles) and symmetrical (with small, flattened vesicles) axodendritic contacts, also including multisynaptic spines. The astrocytes surround and may compose tripartite or tetrapartite synapses, the latter including the extracellular matrix between the pre- and the postsynaptic elements. Interestingly, the terminal axons exhibited a glomerular-like structure with various asymmetrical contacts. These new morphological data on the cellular population and synaptic complexity of the human Me can contribute to our knowledge of its role in health and pathological conditions.

  12. High-Frequency Resonance in the Gerbil Medial Superior Olive

    PubMed Central

    Mikiel-Hunter, Jason; Kotak, Vibhakar; Rinzel, John

    2016-01-01

    A high-frequency, subthreshold resonance in the guinea pig medial superior olive (MSO) was recently linked to the efficient extraction of spatial cues from the fine structure of acoustic stimuli. We report here that MSO neurons in gerbil also have resonant properties and, based on our whole-cell recordings and computational modeling, that a low-voltage-gated potassium current, IKLT, underlies the resonance. We show that resonance was lost following dynamic clamp replacement of IKLT with a leak conductance and in the model when voltage-gating of IKLT was suppressed. Resonance was characterized using small amplitude sinusoidal stimuli to generate impedance curves as typically done for linear systems analysis. Extending our study into the nonlinear, voltage-dependent regime, we increased stimulus amplitude and found, experimentally and in simulations, that the subthreshold resonant frequency (242Hz for weak stimuli) increased continuously to the resonant frequency for spiking (285Hz). The spike resonance of these phasic-firing (type III excitable) MSO neurons and of the model is of particular interest also because previous studies of resonance typically involved neurons/models (type II excitable, such as the standard Hodgkin-Huxley model) that can fire tonically for steady inputs. To probe more directly how these resonances relate to MSO neurons as slope-detectors, we presented periodic trains of brief, fast-rising excitatory post-synaptic potentials (EPSCs) to the model. While weak subthreshold EPSC trains were essentially low-pass filtered, resonance emerged as EPSC amplitude increased. Interestingly, for spike-evoking EPSC trains, the threshold amplitude at spike resonant frequency (317Hz) was lower than the single ESPC threshold. Our finding of a frequency-dependent threshold for repetitive brief EPSC stimuli and preferred frequency for spiking calls for further consideration of both subthreshold and suprathreshold resonance to fast and precise temporal processing

  13. Fear Expression Suppresses Medial Prefrontal Cortical Firing in Rats

    PubMed Central

    Giustino, Thomas F.; Fitzgerald, Paul J.; Maren, Stephen

    2016-01-01

    The medial prefrontal cortex (mPFC) plays a crucial role in emotional learning and memory in rodents and humans. While many studies suggest a differential role for the prelimbic (PL) and infralimbic (IL) subdivisions of mPFC, few have considered the relationship between neural activity in these two brain regions recorded simultaneously in behaving animals. Importantly, how concurrent PL and IL activity relate to conditioned freezing behavior is largely unknown. Here we used single-unit recordings targeting PL and IL in awake, behaving rats during the acquisition and expression of conditioned fear. On Day 1, rats received either signaled or unsignaled footshocks in the recording chamber; an auditory conditioned stimulus (CS) preceded signaled footshocks. Twenty-four hours later, animals were returned to the recording chamber (modified to create a novel context) where they received 5 CS-alone trials. After fear conditioning, both signaled and unsignaled rats exhibited high levels of post-shock freezing that was associated with an enduring suppression of mPFC spontaneous firing, particularly in the IL of signaled rats. Twenty-four hours later, CS presentation produced differential conditioned freezing in signaled and unsignaled rats: freezing increased in rats that had received signaled shocks, but decreased in animals in the unsignaled condition (i.e., external inhibition). This group difference in CS-evoked freezing was mirrored in the spontaneous firing rate of neurons in both PL and IL. Interestingly, differences in PL and IL firing rate highly correlated with freezing levels. In other words, in the signaled group IL spontaneous rates were suppressed relative to PL, perhaps limiting IL-mediated suppression of fear and allowing PL activity to dominate performance, resulting in high levels of freezing. This was not observed in the unsignaled group, which exhibited low freezing. These data reveal that the activity of mPFC neurons is modulated by both associative and

  14. Visualization of the medial forebrain bundle using diffusion tensor imaging.

    PubMed

    Hana, Ardian; Hana, Anisa; Dooms, Georges; Boecher-Schwarz, Hans; Hertel, Frank

    2015-01-01

    Diffusion tensor imaging is a technique that enables physicians the portrayal of white matter tracts in vivo. We used this technique in order to depict the medial forebrain bundle (MFB) in 15 consecutive patients between 2012 and 2015. Men and women of all ages were included. There were six women and nine men. The mean age was 58.6 years (39-77). Nine patients were candidates for an eventual deep brain stimulation. Eight of them suffered from Parkinson's disease and one had multiple sclerosis. The remaining six patients suffered from different lesions which were situated in the frontal lobe. These were 2 metastasis, 2 meningiomas, 1 cerebral bleeding, and 1 glioblastoma. We used a 3DT1-sequence for the navigation. Furthermore T2- and DTI- sequences were performed. The FOV was 200 × 200 mm(2), slice thickness 2 mm, and an acquisition matrix of 96 × 96 yielding nearly isotropic voxels of 2 × 2 × 2 mm. 3-Tesla-MRI was carried out strictly axial using 32 gradient directions and one b0-image. We used Echo-Planar-Imaging (EPI) and ASSET parallel imaging with an acceleration factor of 2. b-value was 800 s/mm(2). The maximal angle was 50°. Additional scanning time was < 9 min. We were able to visualize the MFB in 12 of our patients bilaterally and in the remaining three patients we depicted the MFB on one side. It was the contralateral side of the lesion. These were 2 meningiomas and one metastasis. Portrayal of the MFB is possible for everyday routine for neurosurgical interventions. As part of the reward circuitry it might be of substantial importance for neurosurgeons during deep brain stimulation in patients with psychiatric disorders. Surgery in this part of the brain should always take the preservation of this white matter tract into account.

  15. Anatomical segmentation of the human medial prefrontal cortex.

    PubMed

    Córcoles-Parada, M; Müller, Ncj; Ubero, M; Serrano-Del-Pueblo, V M; Mansilla, F; Marcos-Rabal, P; Artacho-Pérula, E; Dresler, M; Insausti, R; Fernández, G; Muñoz-López, M

    2017-03-20

    The medial prefrontal areas 32, 24, 14, and 25 (mPFC) form part of the limbic memory system, but little is known about their functional specialization in humans. To add anatomical precision to structural and functional MRI data, we aimed to identify these mPFC subareas in histological preparations of human brain tissue, determine sulci most consistently related with mPFC areal boundaries, and use these sulci to delineate mPFC areas in MRIs. To achieve this, we obtained 3D MRI data from 11 ex vivo hemispheres and processed them for cyto- and myelo-architectonic analysis. The architectonic boundaries of mPFC areas were identified in histology and cortical surface length and volumes were measured. Unfolded maps of histologically determined boundaries were generated to identify the association of mPFC areal boundaries with sulci across cases. This analysis showed that cingulate and superior rostral were the sulci most consistently related to mPFC areal boundaries. Based on presence/absence and anastomosis between such sulci, 6 sulci patterns in the 11 hemispheres were found. A further analysis of 102 hemispheres of in vivo MRI scans (N=51 males, mean±sd 24.1±3.1 years of age) showed similar sulci patterns, which allowed us to delineate the mFPC areas in them. The volumes of mPFC areas across histological, ex vivo and in vivo MRI delineations were comparable and probabilistic maps generated from the MRIs of the102 hemispheres. Probabilistic maps of mPFC areas were registered to MNI space and are available for regional analysis of fMRI data. This article is protected by copyright. All rights reserved.

  16. Medial olivocochlear efferent reflex inhibition of human cochlear nerve responses.

    PubMed

    Lichtenhan, J T; Wilson, U S; Hancock, K E; Guinan, J J

    2016-03-01

    Inhibition of cochlear amplifier gain by the medial olivocochlear (MOC) efferent system has several putative roles: aiding listening in noise, protection against damage from acoustic overexposure, and slowing age-induced hearing loss. The human MOC reflex has been studied almost exclusively by measuring changes in otoacoustic emissions. However, to help understand how the MOC system influences what we hear, it is important to have measurements of the MOC effect on the total output of the organ of Corti, i.e., on cochlear nerve responses that couple sounds to the brain. In this work we measured the inhibition produced by the MOC reflex on the amplitude of cochlear nerve compound action potentials (CAPs) in response to moderate level (52-60 dB peSPL) clicks from five, young, normal hearing, awake, alert, human adults. MOC activity was elicited by 65 dB SPL, contralateral broadband noise (CAS). Using tympanic membrane electrodes, approximately 10 h of data collection were needed from each subject to yield reliable measurements of the MOC reflex inhibition on CAP amplitudes from one click level. The CAS produced a 16% reduction of CAP amplitude, equivalent to a 1.98 dB effective attenuation (averaged over five subjects). Based on previous reports of efferent effects as functions of level and frequency, it is possible that much larger effective attenuations would be observed at lower sound levels or with clicks of higher frequency content. For a preliminary comparison, we also measured MOC reflex inhibition of DPOAEs evoked from the same ears with f2's near 4 kHz. The resulting effective attenuations on DPOAEs were, on average, less than half the effective attenuations on CAPs.

  17. Visualization of the medial forebrain bundle using diffusion tensor imaging

    PubMed Central

    Hana, Ardian; Hana, Anisa; Dooms, Georges; Boecher-Schwarz, Hans; Hertel, Frank

    2015-01-01

    Diffusion tensor imaging is a technique that enables physicians the portrayal of white matter tracts in vivo. We used this technique in order to depict the medial forebrain bundle (MFB) in 15 consecutive patients between 2012 and 2015. Men and women of all ages were included. There were six women and nine men. The mean age was 58.6 years (39–77). Nine patients were candidates for an eventual deep brain stimulation. Eight of them suffered from Parkinson‘s disease and one had multiple sclerosis. The remaining six patients suffered from different lesions which were situated in the frontal lobe. These were 2 metastasis, 2 meningiomas, 1 cerebral bleeding, and 1 glioblastoma. We used a 3DT1-sequence for the navigation. Furthermore T2- and DTI- sequences were performed. The FOV was 200 × 200 mm2, slice thickness 2 mm, and an acquisition matrix of 96 × 96 yielding nearly isotropic voxels of 2 × 2 × 2 mm. 3-Tesla-MRI was carried out strictly axial using 32 gradient directions and one b0-image. We used Echo-Planar-Imaging (EPI) and ASSET parallel imaging with an acceleration factor of 2. b-value was 800 s/mm2. The maximal angle was 50°. Additional scanning time was < 9 min. We were able to visualize the MFB in 12 of our patients bilaterally and in the remaining three patients we depicted the MFB on one side. It was the contralateral side of the lesion. These were 2 meningiomas and one metastasis. Portrayal of the MFB is possible for everyday routine for neurosurgical interventions. As part of the reward circuitry it might be of substantial importance for neurosurgeons during deep brain stimulation in patients with psychiatric disorders. Surgery in this part of the brain should always take the preservation of this white matter tract into account. PMID:26581828

  18. Medial Temporal Lobe Activity Predicts Successful Relational Memory Binding

    PubMed Central

    Hannula, Deborah E.; Ranganath, Charan

    2009-01-01

    Previous neuropsychological findings have implicated medial temporal lobe (MTL) structures in retaining object-location relations over the course of short delays, but MTL effects have not always been reported in neuroimaging investigations with similar short-term memory requirements. Here, we used event-related functional magnetic resonance imaging to test the hypothesis that the hippocampus and related MTL structures support accurate retention of relational memory representations, even across short delays. On every trial, four objects were presented, each in one of nine possible locations of a three-dimensional grid. Participants were to mentally rotate the grid and then maintain the rotated representation in anticipation of a test stimulus: a rendering of the grid, rotated 90° from the original viewpoint. The test stimulus was either a “match” display, in which object-location relations were intact, or a “mismatch” display, in which one object occupied a new, previously unfilled location (mismatch position), or two objects had swapped locations (mismatch swap). Encoding phase activation in anterior and posterior regions of the left hippocampus, and in bilateral perirhinal cortex, predicted subsequent accuracy on the short-term memory decision, as did bilateral posterior hippocampal activity after the test stimulus. Notably, activation in these posterior hippocampal regions was also sensitive to the degree to which object-location bindings were preserved in the test stimulus; activation was greatest for match displays, followed by mismatch-position displays, and finally mismatch-swap displays. These results indicate that the hippocampus and related MTL structures contribute to successful encoding and retrieval of relational information in visual short-term memory. PMID:18171929

  19. MEG identifies dorsal medial brain activations during sleep.

    PubMed

    Ioannides, Andreas A; Kostopoulos, George K; Liu, Lichan; Fenwick, Peter B C

    2009-01-15

    All sleep stages contain epochs with high-amplitude electrophysiological phasic events, alternating with quieter "core periods." High-amplitude and core state properties cannot be disentangled with PET and fMRI. Here from high temporal resolution magnetoencephalography data, regional changes in neuronal activity were extracted during core periods in different frequency bands for each sleep stage and waking. We found that gamma-band activity increases in precuneus during light sleep (stages 1/2) and in the left dorso-medial prefrontal cortex (L-DMPFC) during deep sleep (stages 3/4). The L-DMPFC activated area expands laterally during rapid eye movement (REM) sleep, into a volume of about 5 cm(3) bounded by regions attributed to Theory of Mind (ToM) and default systems, both involved in introspection. Gamma band activity in this area was higher during REM sleep than other sleep stages and active wakefulness. There is a tantalizing correspondence between increased wide-band activity (dominated by low frequencies) in early non-REM (NREM) sleep stages and increases in gamma-band activity in late NREM and REM periods that we attribute to a lateral disinhibition mechanism. The results provide a description of regional electrophysiological changes in awake state, light and deep sleep, and REM sleep. These changes are most pronounced in the L-DMPFC and the other areas around the dorsal midline that are close to, but do not overlap with areas of the default and ToM systems, suggesting that the DMPFC, particularly in the left hemisphere, plays an important role in late NREM stages, in REM and possibly in dreaming.

  20. ANTIDEPRESSANT EFFECT OF OPTOGENETIC STIMULATION OF THE MEDIAL PREFRONTAL CORTEX

    PubMed Central

    Covington, Herbert E.; Lobo, Mary Kay; Maze, Ian; Vialou, Vincent; Hyman, James M; Zaman, Samir; LaPlant, Quincey; Mouzon, Ezekiel; Ghose, Subroto; Tamminga, Carol A.; Neve, Rachael L.; Deisseroth, Karl; Nestler, Eric J.

    2010-01-01

    Brain stimulation and imaging studies in humans have highlighted a key role for the prefrontal cortex in clinical depression, however, it remains unknown whether excitation or inhibition of prefrontal cortical neuronal activity is associated with antidepressant responses. Here, we examined cellular indicators of functional activity, including the immediate early genes (IEG), zif268 (egr1), c-fos and arc, in the prefrontal cortex of clinically depressed humans obtained postmortem. We also examined these genes in the ventral portion of the medial prefrontal cortex (mPFC) of mice after chronic social defeat stress, a mouse model of depression. In addition, we used viral vectors to overexpress channel rhodopsin 2 (a light-activated cation channel) in mouse mPFC in order to optogenetically drive “burst” patterns of cortical firing in-vivo and examine the behavioral consequences. Prefrontal cortical tissue derived from clinically depressed humans displayed significant reductions in IEG expression, consistent with a deficit in neuronal activity within this brain region. Mice subjected to chronic social defeat stress exhibited similar reductions in levels of IEG expression in mPFC. Interestingly, some of these changes were not observed in defeated mice that escape the deleterious consequences of the stress, i.e., resilient animals. In those mice that expressed a strong depressive-like phenotype, i.e., susceptible animals, optogenetic stimulation of mPFC exerted potent antidepressant-like effects, without affecting general locomotor activity, anxiety-like behaviors, or social memory. These results indicate that the activity of the mPFC is a key determinant of depression-like behavior, as well as antidepressant responses. PMID:21123555

  1. Passive limitation of adduction after Cüppers's 'Fadenoperation' on medial recti.

    PubMed Central

    Paliaga, G P; Braga, M

    1989-01-01

    In 40 eyes of 20 esotropic subjects in which a 'Fadenoperation' was performed on the medial recti we measured the resistance to ocular rotation in adduction before and after the operation. The difference between the two sets of force measurements demonstrates that the Fadenoperation on medial recti produces a mechanical restriction to adduction which can explain the effect of the surgical procedure on the strabismic deviation. PMID:2765442

  2. Post traumatic osteoma of tibial insertion of medial collateral ligament of knee joint.

    PubMed

    Shanker, V S; Gadikoppula, S; Loeffler, M D

    1998-03-01

    Two cases are presented of post traumatic para-articular osteoma developing at the site of tibial attachment of the medial collateral ligament of knee joint. These occurred after injuries sustained while playing football and in one case the ossified mass was treated with surgical excision for unresolved symptoms after conservative measures. A comparison is made with Pellegrini Stieda disease, which is a similar affection of the femoral insertion of the medial ligament of the knee joint.

  3. In vivo medial and lateral tibial loads during dynamic and high flexion activities.

    PubMed

    Zhao, Dong; Banks, Scott A; D'Lima, Darryl D; Colwell, Clifford W; Fregly, Benjamin J

    2007-05-01

    Though asymmetric loading between the medial and lateral compartments of total knee replacements may contribute to implant loosening and failure, the in vivo contact force distribution during dynamic daily activities remains unknown. This study reports in vivo medial and lateral contact forces experienced by a well-aligned knee implant for a variety of activities. In vivo implant motion and total axial load data were collected from a single knee replacement patient performing treadmill gait (hands resting on handlebars), step up/down, lunge, and kneel activities. In vivo motion was measured using video fluoroscopy, while in vivo axial loads were collected simultaneously using an instrumented tibial component. An elastic foundation contact model employing linear and nonlinear polyethylene material properties was constructed to calculate medial and lateral contact forces based on the measured kinematics, total axial loads, and centers of pressure. For all activities, the predicted medial and lateral contact forces were insensitive to the selected material model. The percentage of medial to total contact force ranged from 18 to 60 for gait, 47 to 65 for step up/down, and 55 to 60 for kneel and lunge. At maximum load during the motion cycle, medial force was 1.2 BW for gait and 2.0 BW for step up/down, while the corresponding lateral forces were 1.0 and 1.5 BW, respectively. At mean load in the final static pose, medial force was 0.2 BW for kneel and 0.9 BW for lunge, with corresponding lateral forces of 0.1 and 0.7 BW, respectively. For this patient, a constant load split of 55% medial-45% lateral during loaded activity would be a reasonable approximation for these test conditions.

  4. Computed Tomographic Distinction of Intimal and Medial Calcification in the Intracranial Internal Carotid Artery

    PubMed Central

    Vos, Annelotte; Van Hecke, Wim; Vink, Aryan; Bleys, Ronald L. A. W.; Verdoorn, Daphne; Mali, Willem P. Th. M.; Hendrikse, Jeroen; Koek, Huiberdina L.; de Jong, Pim A.; De Vis, Jill B.

    2017-01-01

    Background Intracranial internal carotid artery (iICA) calcification is associated with stroke and is often seen as a proxy of atherosclerosis of the intima. However, it was recently shown that these calcifications are predominantly located in the tunica media and internal elastic lamina (medial calcification). Intimal and medial calcifications are thought to have a different pathogenesis and clinical consequences and can only be distinguished through ex vivo histological analysis. Therefore, our aim was to develop CT scoring method to distinguish intimal and medial iICA calcification in vivo. Methods First, in both iICAs of 16 cerebral autopsy patients the intimal and/or medial calcification area was histologically assessed (142 slides). Brain CT images of these patients were matched to the corresponding histological slides to develop a CT score that determines intimal or medial calcification dominance. Second, performance of the CT score was assessed in these 16 patients. Third, reproducibility was tested in a separate cohort. Results First, CT features of the score were circularity (absent, dot(s), <90°, 90–270° or 270–360°), thickness (absent, ≥1.5mm, or <1.5mm), and morphology (indistinguishable, irregular/patchy or continuous). A high sum of features represented medial and a lower sum intimal calcifications. Second, in the 16 patients the concordance between the CT score and the dominant calcification type was reasonable. Third, the score showed good reproducibility (kappa: 0.72 proportion of agreement: 0.82) between the categories intimal, medial or absent/indistinguishable. Conclusions The developed CT score shows good reproducibility and can differentiate reasonably well between intimal and medial calcification dominance in the iICA, allowing for further (epidemiological) studies on iICA calcification. PMID:28060941

  5. Knee adduction moment and medial contact force--facts about their correlation during gait.

    PubMed

    Kutzner, Ines; Trepczynski, Adam; Heller, Markus O; Bergmann, Georg

    2013-01-01

    The external knee adduction moment is considered a surrogate measure for the medial tibiofemoral contact force and is commonly used to quantify the load reducing effect of orthopedic interventions. However, only limited and controversial data exist about the correlation between adduction moment and medial force. The objective of this study was to examine whether the adduction moment is indeed a strong predictor for the medial force by determining their correlation during gait. Instrumented knee implants with telemetric data transmission were used to measure tibiofemoral contact forces in nine subjects. Gait analyses were performed simultaneously to the joint load measurements. Skeletal kinematics, as well as the ground reaction forces and inertial parameters, were used as inputs in an inverse dynamics approach to calculate the external knee adduction moment. Linear regression analysis was used to analyze the correlation between adduction moment and medial force for the whole stance phase and separately for the early and late stance phase. Whereas only moderate correlations between adduction moment and medial force were observed throughout the whole stance phase (R(2) = 0.56) and during the late stance phase (R(2) = 0.51), a high correlation was observed at the early stance phase (R(2) = 0.76). Furthermore, the adduction moment was highly correlated to the medial force ratio throughout the whole stance phase (R(2) = 0.75). These results suggest that the adduction moment is a surrogate measure, well-suited to predicting the medial force ratio throughout the whole stance phase or medial force during the early stance phase. However, particularly during the late stance phase, moderate correlations and high inter-individual variations revealed that the predictive value of the adduction moment is limited. Further analyses are necessary to examine whether a combination of other kinematic, kinetic or neuromuscular factors may lead to a more reliable

  6. Knee Adduction Moment and Medial Contact Force – Facts about Their Correlation during Gait

    PubMed Central

    Kutzner, Ines; Trepczynski, Adam; Heller, Markus O.; Bergmann, Georg

    2013-01-01

    The external knee adduction moment is considered a surrogate measure for the medial tibiofemoral contact force and is commonly used to quantify the load reducing effect of orthopedic interventions. However, only limited and controversial data exist about the correlation between adduction moment and medial force. The objective of this study was to examine whether the adduction moment is indeed a strong predictor for the medial force by determining their correlation during gait. Instrumented knee implants with telemetric data transmission were used to measure tibiofemoral contact forces in nine subjects. Gait analyses were performed simultaneously to the joint load measurements. Skeletal kinematics, as well as the ground reaction forces and inertial parameters, were used as inputs in an inverse dynamics approach to calculate the external knee adduction moment. Linear regression analysis was used to analyze the correlation between adduction moment and medial force for the whole stance phase and separately for the early and late stance phase. Whereas only moderate correlations between adduction moment and medial force were observed throughout the whole stance phase (R2 = 0.56) and during the late stance phase (R2 = 0.51), a high correlation was observed at the early stance phase (R2 = 0.76). Furthermore, the adduction moment was highly correlated to the medial force ratio throughout the whole stance phase (R2 = 0.75). These results suggest that the adduction moment is a surrogate measure, well-suited to predicting the medial force ratio throughout the whole stance phase or medial force during the early stance phase. However, particularly during the late stance phase, moderate correlations and high inter-individual variations revealed that the predictive value of the adduction moment is limited. Further analyses are necessary to examine whether a combination of other kinematic, kinetic or neuromuscular factors may lead to a more reliable prediction of

  7. Intralaminar and medial thalamic influence on cortical synchrony, information transmission and cognition

    PubMed Central

    Saalmann, Yuri B.

    2014-01-01

    The intralaminar and medial thalamic nuclei are part of the higher-order thalamus, which receives little sensory input, and instead forms extensive cortico-thalamo-cortical pathways. The large mediodorsal thalamic nucleus predominantly connects with the prefrontal cortex, the adjacent intralaminar nuclei connect with fronto-parietal cortex, and the midline thalamic nuclei connect with medial prefrontal cortex and medial temporal lobe. Taking into account this connectivity pattern, it is not surprising that the intralaminar and medial thalamus has been implicated in a variety of cognitive functions, including memory processing, attention and orienting, as well as reward-based behavior. This review addresses how the intralaminar and medial thalamus may regulate information transmission in cortical circuits. A key neural mechanism may involve intralaminar and medial thalamic neurons modulating the degree of synchrony between different groups of cortical neurons according to behavioral demands. Such a thalamic-mediated synchronization mechanism may give rise to large-scale integration of information across multiple cortical circuits, consequently influencing the level of arousal and consciousness. Overall, the growing evidence supports a general role for the higher-order thalamus in the control of cortical information transmission and cognitive processing. PMID:24847225

  8. Differential effects of unilateral lesions in the medial amygdala on spontaneous and induced ovulation.

    PubMed

    Sanchez, M A; Dominguez, R

    1995-01-01

    The possible existence of asymmetry in the control of ovulation by the medial amygdala was explored. Unilateral lesions of the medial amygdala were performed on each day of the estrous cycle. The estral index diminished in almost all animals with a lesion in the right side of medial amygdala. Lesions of the right medial amygdala, when performed on diestrus-1, resulted in a significant decrease in the number of rats ovulating compared to controls (4/8 vs. 8/8, p < 0.05). In ovulating animals a significant reduction in the number of ova shed by the left ovary was found (2.2 +/- 0.8 vs. 6.3 +/- 0.8, p < 0.05). Lesions of the stria terminalis performed on diestrus-1 did not affect ovulation. In a second experiment, administration of GnRH did not restore ovulation in rats with lesions of the right medial amygdala. However, sequential injections of PMSG-hCG did result in ovulation by all members of a group of lesioned animals. In this last condition a significant decrease in the number of ova shed by the right ovary was found compared to animals in the lesion-only condition (1.5 +/- 0.5 vs. 6.0 +/- 1.5, p < 0.05). These data suggest that control of ovulation by the medial amygdala is asymmetric and varies during the estrous cycle.

  9. [Anatomical variants of the medial calcaneal nerve and the Baxter nerve in the tarsal tunnel].

    PubMed

    Martín-Oliva, X; Elgueta-Grillo, J; Veliz-Ayta, P; Orosco-Villaseñor, S; Elgueta-Grillo, M; Viladot-Perice, R

    2013-01-01

    The tarsal tunnel is composed of the posterior border of the medial malleoulus, the posterior aspect of the talus and the medial aspect of the calcaneus. The medial calcaneal nerve emerges from the posterior aspect of the posterior tibial nerve in 75% of cases and from the lateral plantar nerve in the remaining 25%. Finally, the medial calcaneal nerve ends as a single terminal branch in 79% of cases and in numerous terminal branches in the remaining 21%. To describe the anatomical variants of the posterior tibial nerve and its terminal branches. To describe the steps for tarsal tunnel release. To describe Baxter nerve release. The anatomical variants of the posterior tibial nerve and its terminal branches within the tarsal tunnel were studied. Then the Lam technique was performed; it consists of: 1) opening of the laciniate ligament, 2) opening of the fascia over the abductor hallucis muscle, 3) exoneurolysis of the posterior tibial nerve and its terminal branches, identifying the emergence and pathway of the medial calcaneal branch, the lateral plantar nerve and its Baxter nerve branch and the medial plantar nerve. Baxter nerve was found in 100% of cases. In 100% of cases in our series the nerve going to the abductor digiti minimi muscle of the foot was found; 87.5% of cases had two terminal branches. The dissections proved that a crucial step was the release of the distal tarsal tunnel.

  10. Dual role of medial A10 dopamine neurons in affective encoding.

    PubMed

    Liu, Zhong-Hua; Shin, Rick; Ikemoto, Satoshi

    2008-11-01

    Increasing evidence suggests that the activation of medial A10 neurons mediates positive affective encoding. However, little is known about the functions of the inhibition of midbrain dopamine neurons. Here we show evidence suggesting that the inhibition of medial A10 neurons mediates a negative affective state, leading to negative affective encoding, whereas blunting the activation of medial A10 neurons disrupts positive affective encoding involving food reward. We used a microinjection procedure, in which the D(2) dopamine receptor agonist quinpirole was administered into the cell body region of the dopamine neurons, a procedure that reduces dopamine cell firing. Microinjections of quinpirole into the posteromedial ventral tegmental area, but not its more lateral counterparts, led to conditioned place aversion. Quinpirole administration to this site also decreased food intake and basal dopamine concentration in the ventromedial striatum, a major projection area of medial A10 neurons. In addition, moderate quinpirole doses that did not lead to conditioned place aversion or disrupt food intake abolished food-conditioned place preference, suggesting that blunting dopamine impulse activity in response to food reward disrupts positive affective encoding in associated external stimuli. Our data support the hypothesis that activation of medial A10 dopamine neurons mediates a positive affective state, leading to positive affective encoding, while their inhibition mediates a negative affective state, leading to negative affective encoding. Together with previous findings, we propose that medial A10 neurons are an important component of the mechanism via which animals learn to avoid negative incentive stimuli.

  11. Medial epicondylitis in occupational settings: prevalence, incidence and associated risk factors

    PubMed Central

    Descatha, Alexis; Leclerc, Annette; Chastang, Jean-François; Roquelaure, Yves

    2003-01-01

    As medial epicondylitis has not been studied alone, we investigated its links between personal and occupational factors in repetitive work, and its course. 1757 workers were examined by an occupational health physician in 1993–94. 598 of them were re-examined three years later. Prevalence was between 4 and 5%, with annual incidence estimated at 1.5%. Forceful work was a risk factor for medial epicondylitis (OR 1.95 CI [1.15–3.32]), but not exposure to repetitive work (OR 1.11, CI [0.59–2.10]). Workers with medial epicondylitis had a significantly higher prevalence of other work-related upper-limb musculoskeletal disorders (WRMD). Risk factors differed for medial and lateral epicondylitis. The prognosis for medial epicondylitis in this population was good with a three-year recovery rate at 81%. Medial epicondylitis was clearly associated with forceful work and other upper-limb WRMD, and its prognosis was good. PMID:14506342

  12. The JCR:LA-cp rat: a novel rodent model of cystic medial necrosis.

    PubMed

    Pung, Yuh Fen; Chilian, William M; Bennett, Martin R; Figg, Nichola; Kamarulzaman, Mohd Hamzah

    2017-03-01

    Although there are multiple rodent models of the metabolic syndrome, very few develop vascular complications. In contrast, the JCR:LA-cp rat develops both metabolic syndrome and early atherosclerosis in predisposed areas. However, the pathology of the normal vessel wall has not been described. We examined JCR:LA control (+/+) or cp/cp rats fed normal chow diet for 6 or 18 mo. JCR:LA-cp rats developed multiple features of advanced cystic medial necrosis including "cysts," increased collagen formation and proteoglycan deposition around cysts, apoptosis of vascular smooth muscle cells, and spotty medial calcification. These appearances began within 6 mo and were extensive by 18 mo. JCR:LA-cp rats had reduced medial cellularity, increased medial thickness, and vessel hypoxia that was most marked in the adventitia. In conclusion, the normal chow-fed JCR:LA-cp rat represents a novel rodent model of cystic medial necrosis, associated with multiple metabolic abnormalities, vascular smooth muscle cell apoptosis, and vessel hypoxia.NEW & NOTEWORTHY Triggers for cystic medial necrosis (CMN) have been difficult to study due to lack of animal models to recapitulate the pathologies seen in humans. Our study is the first description of CMN in the rat. Thus the JCR:LA-cp rat represents a useful model to investigate the underlying molecular changes leading to the development of CMN.

  13. Anconeus epitrochlearis as a source of medial elbow pain in baseball pitchers.

    PubMed

    Li, Xinning; Dines, Joshua S; Gorman, Matthew; Limpisvasti, Orr; Gambardella, Ralph; Yocum, Lou

    2012-07-01

    Medial elbow pain is reported in 18% to 69% of baseball players aged of 9 and 19 years. This is due to the large valgus stresses focused on the medial side of the elbow during overhead activities. In overhead throwers and pitchers, pain can be attributed to valgus extension overload with resultant posteromedial impingement, overuse of the flexor-pronator musculature resulting in medial epicondylitis, or occasional muscle tears or ruptures. The anconeus epitrochlearis is a known cause of cubital tunnel syndrome and has been postulated as a source of medial elbow pain in overhead athletes. This article describes the cases of 3 right-handed baseball pitchers with persistent right-sided medial elbow pain during throwing despite a prolonged period of rest, physical therapy, and nonsteroidal anti-inflammatory drugs. Two patients had symptoms of cubital tunnel syndrome as diagnosed by electromyogram and nerve conduction studies and the presence of the anconeus epitrochlearis muscle per magnetic resonance imaging. All patients underwent isolated release of the anconeus muscle without ulnar nerve transposition and returned to their previous levels of activity. The diagnosis and treatment of pitchers who present with medial-sided elbow pain can be complex. The differential should include an enlarged or inflamed anconeus epitrochlearis muscle as a possible cause. Conservative management should be the first modality. However, surgical excision with isolated release of the muscle can be successful in returning patients with persistent pain despite a trial of conservative management to their previous levels of function.

  14. Predictors of Visual Outcome Following Surgical Resection of Medial Sphenoid Wing Meningiomas

    PubMed Central

    Chaichana, Kaisorn L.; Jackson, Christopher; Patel, Amar; Miller, Neil R.; Subramanian, Prem; Lim, Michael; Gallia, Gary; Olivi, Alessandro; Weingart, Jon; Brem, Henry; Quiñones-Hinojosa, Alfredo

    2012-01-01

    Objective Medial sphenoid wing meningiomas (SWMs) are relatively common tumors that are associated with significant morbidity and mortality, primarily from their anatomic proximity to many critical neurological and vascular structures. A major complication is visual deterioration. This study aimed to identify predictors of visual outcome following medial SWM resection. Design Retrospective, stepwise multivariate proportional hazards regression analysis. Setting Johns Hopkins Hospital. Participants All patients who underwent medial SWM resection from 1998 to 2009. Main Outcome Measures Visual function. Results Sixty-five medial SWM resections were performed. After multivariate proportional hazards regression analysis, preoperative visual decline (relative risk [RR] 95% confidence interval [CI]; 13.431 [2.601 to 46.077], p = 0.006), subtotal resection (RR [95% CI]; 3.717 [1.204 to 13.889], p = 0.02), and repeat surgery (RR [95% CI]; 5.681 [1.278 to 19.802], p = 0.03) were found to be independent predictors of visual decline at last follow-up. Tumor recurrence and postoperative radiation therapy trended toward, but did not reach statistical significance. Conclusion These findings advocate for early and aggressive surgical intervention for patients with medial SWMs to maximize the likelihood of subsequent visual preservation. This may provide patients and physicians with prognostic information that may guide medical and surgical therapy for patients with medial SWMs. PMID:24083123

  15. Regional divergence of palate medial edge epithelium along the anterior to posterior axis.

    PubMed

    Jin, Jiu-Zhen; Warner, Dennis R; Ding, Jixiang

    2014-01-01

    Recent studies have shown that mouse palatal mesenchymal cells undergo regional specification along the anterior-posterior (A-P) axis defined by anterior Shox2 and Msx1 expression and posterior Meox2 expression. A-P regional specification of the medial edge epithelium, which is directly responsible for palate fusion, has long been proposed, but it has not yet been demonstrated due to the lack of regional specific markers. In this study, we have demonstrated that the palate medial edge epithelium is regionalized along the A-P axis, similar to that for the underlying mesenchyme. Mmp13, a medial edge epithelium specific marker, was uniformly expressed from anterior to posterior in wild-type mouse palatal shelves. Previous studies demonstrated that medial edge epithelium expression of Mmp13 was regulated by TGF-beta3. We have found that the changes in Mmp13 expression in TGF-beta3 knockouts varied along the A-P axis, and can be broken down into three distinct regions. These regions correlated with regional specification of the underlying medial edge mesenchymal cells and timing of palate fusion. Mouse palate medial edge epithelium along the A-P axis can be divided into different regions according to the differential response to the loss of TGF-beta3.

  16. Medial septum lesions disrupt exploratory trip organization: evidence for septohippocampal involvement in dead reckoning.

    PubMed

    Martin, Megan M; Horn, Katharine L; Kusman, Kelly J; Wallace, Douglas G

    2007-02-28

    Rats organize their open field behavior into a series of exploratory trips focused around a central location or home base. In addition, differences in movement kinematics have been used to fractionate the exploratory trip into tour (i.e., sequences of linear movement or progressions punctuated by stops) and homeward (i.e., single progression direct to the home base) segments. The observation of these characteristics independent of environmental familiarity and visual cue availability has suggested a role for self-movement information or dead reckoning in organizing exploratory behavior. Although previous work has implicated a role for the septohippocampal system in dead reckoning based navigation, as of yet, no studies have investigated the contribution of the medial septum to dead reckoning. First, the present study examined the organization of exploratory behavior under dark and light conditions in control rats and rats receiving either electrolytic or sham medial septum lesions. Medial septum lesions produced a significant increase in homeward segment path circuity and variability of temporal pacing of linear speeds. Second, as an independent assessment of the effectiveness of the medial septum lesions, rats were trained to locate a hidden platform in the standard water maze procedure. Consistent with previous research, medial septum lesions attenuated learning the location of the hidden platform. These results demonstrate a role for the medial septum in organizing exploratory behavior and provide further support for the role of the septohippocampal system in dead reckoning based navigation.

  17. Dual Role of Medial A10 Dopamine Neurons in Affective Encoding

    PubMed Central

    Liu, Zhong-Hua; Shin, Rick; Ikemoto, Satoshi

    2008-01-01

    Increasing evidence suggests that the activation of medial A10 neurons mediates positive affective encoding. However, little is known about the functions of the inhibition of midbrain dopamine neurons. Here we show evidence suggesting that the inhibition of medial A10 neurons mediates a negative affective state, leading to negative affective encoding, whereas blunting the activation of medial A10 neurons disrupts positive affective encoding involving food reward. We used a microinjection procedure, in which the D2 dopamine receptor agonist quinpirole was administered into the cell body region of the dopamine neurons, a procedure that reduces dopamine cell firing. Microinjections of quinpirole into the posteromedial ventral tegmental area, but not its more lateral counterparts, led to conditioned place aversion. Quinpirole administration to this site also decreased food intake and basal dopamine concentration in the ventromedial striatum, a major projection area of medial A10 neurons. In addition, moderate quinpirole doses that did not lead to conditioned place aversion or disrupt food intake abolished food-conditioned place preference, suggesting that blunting dopamine impulse activity in response to food reward disrupts positive affective encoding in associated external stimuli. Our data support the hypothesis that activation of medial A10 dopamine neurons mediates a positive affective state, leading to positive affective encoding, while their inhibition mediates a negative affective state, leading to negative affective encoding. Together with previous findings, we propose that medial A10 neurons are an important component of the mechanism via which animals learn to avoid negative incentive stimuli. PMID:18256592

  18. Sensitivity of medial and lateral knee contact force predictions to frontal plane alignment and contact locations.

    PubMed

    Saliba, Christopher M; Brandon, Scott C E; Deluzio, Kevin J

    2017-03-12

    Musculoskeletal models are increasingly used to estimate medial and lateral knee contact forces, which are difficult to measure in vivo. The sensitivity of contact force predictions to modeling parameters is important to the interpretation and implication of results generated by the model. The purpose of this study was to quantify the sensitivity of knee contact force predictions to simultaneous errors in frontal plane knee alignment and contact locations under different dynamic conditions. We scaled a generic musculoskeletal model for N=23 subjects' stature and radiographic knee alignment, then perturbed frontal plane alignment and mediolateral contact locations within experimentally-possible ranges of 10° to -10° and 10 to -10mm, respectively. The sensitivity of first peak, second peak, and mean medial and lateral knee contact forces to knee adduction angle and contact locations was modeled using linear regression. Medial loads increased, and lateral loads decreased, by between 3% and 6% bodyweight for each degree of varus perturbation. Shifting the medial contact point medially increased medial loads and decreased lateral loads by between 1% and 4% bodyweight per millimeter. This study demonstrates that realistic measurement errors of 5mm (contact distance) or 5° (frontal plane alignment) could result in a combined 50% BW error in subject specific contact force estimates. We also show that model sensitivity varies between subjects as a result of differences in gait dynamics. These results demonstrate that predicted knee joint contact forces should be considered as a range of possible values determined by model uncertainty.

  19. Partially segmented deformable mirror

    DOEpatents

    Bliss, Erlan S.; Smith, James R.; Salmon, J. Thaddeus; Monjes, Julio A.

    1991-01-01

    A partially segmented deformable mirror is formed with a mirror plate having a smooth and continuous front surface and a plurality of actuators to its back surface. The back surface is divided into triangular areas which are mutually separated by grooves. The grooves are deep enough to make the plate deformable and the actuators for displacing the mirror plate in the direction normal to its surface are inserted in the grooves at the vertices of the triangular areas. Each actuator includes a transducer supported by a receptacle with outer shells having outer surfaces. The vertices have inner walls which are approximately perpendicular to the mirror surface and make planar contacts with the outer surfaces of the outer shells. The adhesive which is used on these contact surfaces tends to contract when it dries but the outer shells can bend and serve to minimize the tendency of the mirror to warp.

  20. Partially segmented deformable mirror

    DOEpatents

    Bliss, E.S.; Smith, J.R.; Salmon, J.T.; Monjes, J.A.

    1991-05-21

    A partially segmented deformable mirror is formed with a mirror plate having a smooth and continuous front surface and a plurality of actuators to its back surface. The back surface is divided into triangular areas which are mutually separated by grooves. The grooves are deep enough to make the plate deformable and the actuators for displacing the mirror plate in the direction normal to its surface are inserted in the grooves at the vertices of the triangular areas. Each actuator includes a transducer supported by a receptacle with outer shells having outer surfaces. The vertices have inner walls which are approximately perpendicular to the mirror surface and make planar contacts with the outer surfaces of the outer shells. The adhesive which is used on these contact surfaces tends to contract when it dries but the outer shells can bend and serve to minimize the tendency of the mirror to warp. 5 figures.

  1. Partial oxidation catalyst

    DOEpatents

    Krumpelt, Michael; Ahmed, Shabbir; Kumar, Romesh; Doshi, Rajiv

    2000-01-01

    A two-part catalyst comprising a dehydrogenation portion and an oxide-ion conducting portion. The dehydrogenation portion is a group VIII metal and the oxide-ion conducting portion is selected from a ceramic oxide crystallizing in the fluorite or perovskite structure. There is also disclosed a method of forming a hydrogen rich gas from a source of hydrocarbon fuel in which the hydrocarbon fuel contacts a two-part catalyst comprising a dehydrogenation portion and an oxide-ion conducting portion at a temperature not less than about 400.degree. C. for a time sufficient to generate the hydrogen rich gas while maintaining CO content less than about 5 volume percent. There is also disclosed a method of forming partially oxidized hydrocarbons from ethanes in which ethane gas contacts a two-part catalyst comprising a dehydrogenation portion and an oxide-ion conducting portion for a time and at a temperature sufficient to form an oxide.

  2. Robot-assisted partial nephrectomy: Superiority over laparoscopic partial nephrectomy.

    PubMed

    Shiroki, Ryoichi; Fukami, Naohiko; Fukaya, Kosuke; Kusaka, Mamoru; Natsume, Takahiro; Ichihara, Takashi; Toyama, Hiroshi

    2016-02-01

    Nephron-sparing surgery has been proven to positively impact the postoperative quality of life for the treatment of small renal tumors, possibly leading to functional improvements. Laparoscopic partial nephrectomy is still one of the most demanding procedures in urological surgery. Laparoscopic partial nephrectomy sometimes results in extended warm ischemic time and severe complications, such as open conversion, postoperative hemorrhage and urine leakage. Robot-assisted partial nephrectomy exploits the advantages offered by the da Vinci Surgical System to laparoscopic partial nephrectomy, equipped with 3-D vision and a better degree in the freedom of surgical instruments. The introduction of the da Vinci Surgical System made nephron-sparing surgery, specifically robot-assisted partial nephrectomy, safe with promising results, leading to the shortening of warm ischemic time and a reduction in perioperative complications. Even for complex and challenging tumors, robotic assistance is expected to provide the benefit of minimally-invasive surgery with safe and satisfactory renal function. Warm ischemic time is the modifiable factor during robot-assisted partial nephrectomy to affect postoperative kidney function. We analyzed the predictive factors for extended warm ischemic time from our robot-assisted partial nephrectomy series. The surface area of the tumor attached to the kidney parenchyma was shown to significantly affect the extended warm ischemic time during robot-assisted partial nephrectomy. In cases with tumor-attached surface area more than 15 cm(2) , we should consider switching robot-assisted partial nephrectomy to open partial nephrectomy under cold ischemia if it is imperative. In Japan, a nationwide prospective study has been carried out to show the superiority of robot-assisted partial nephrectomy to laparoscopic partial nephrectomy in improving warm ischemic time and complications. By facilitating robotic technology, robot-assisted partial nephrectomy

  3. Partially supervised speaker clustering.

    PubMed

    Tang, Hao; Chu, Stephen Mingyu; Hasegawa-Johnson, Mark; Huang, Thomas S

    2012-05-01

    Content-based multimedia indexing, retrieval, and processing as well as multimedia databases demand the structuring of the media content (image, audio, video, text, etc.), one significant goal being to associate the identity of the content to the individual segments of the signals. In this paper, we specifically address the problem of speaker clustering, the task of assigning every speech utterance in an audio stream to its speaker. We offer a complete treatment to the idea of partially supervised speaker clustering, which refers to the use of our prior knowledge of speakers in general to assist the unsupervised speaker clustering process. By means of an independent training data set, we encode the prior knowledge at the various stages of the speaker clustering pipeline via 1) learning a speaker-discriminative acoustic feature transformation, 2) learning a universal speaker prior model, and 3) learning a discriminative speaker subspace, or equivalently, a speaker-discriminative distance metric. We study the directional scattering property of the Gaussian mixture model (GMM) mean supervector representation of utterances in the high-dimensional space, and advocate exploiting this property by using the cosine distance metric instead of the euclidean distance metric for speaker clustering in the GMM mean supervector space. We propose to perform discriminant analysis based on the cosine distance metric, which leads to a novel distance metric learning algorithm—linear spherical discriminant analysis (LSDA). We show that the proposed LSDA formulation can be systematically solved within the elegant graph embedding general dimensionality reduction framework. Our speaker clustering experiments on the GALE database clearly indicate that 1) our speaker clustering methods based on the GMM mean supervector representation and vector-based distance metrics outperform traditional speaker clustering methods based on the “bag of acoustic features” representation and statistical

  4. Actinomyces meyeri Popliteal Cyst Infection and Review of the Literature

    PubMed Central

    Palraj, Bharath Raj

    2017-01-01

    A 66-year-old, Caucasian male presented with pain and swelling involving the left knee of one-week duration. Arthrocentesis was negative for evidence of septic arthritis. Magnetic resonance imaging (MRI) study of the left knee showed degenerative arthritis, partial tear of medial meniscus, and a complex fluid collection along the posteromedial aspect of the left knee suggestive of popliteal cyst. He underwent arthroscopy with partial medial meniscectomy. Intraoperative joint fluid was noted to be cloudy but cultures were negative. Arthroscopic procedure provided him with temporary relief but the pain and swelling in the posterior aspect of the left knee recurred in 6 weeks. Repeat MRI showed complex fluid collection in the posterolateral aspect of left knee. Ultrasound guided aspiration of the fluid collection revealed purulent material and cultures grew Actinomyces meyeri. He was treated with 6 weeks of intravenous penicillin regimen followed by 18 months of oral penicillin. PMID:28255479

  5. Removable partial denture occlusion.

    PubMed

    Ivanhoe, John R; Plummer, Kevin D

    2004-07-01

    No single occlusal morphology, scheme, or material will successfully treat all patients. Many patients have been treated, both successfully and unsuccessfully, using widely varying theories of occlusion, choices of posterior tooth form, and restorative materials. Therefore, experience has demonstrated that there is no one righ r way to restore the occlusion of all patients. Partially edentulous patients have many and varied needs. Clinicians must understand the healthy physiologic gnathostomatic system and properly diagnose what is or may become pathologic. Henderson [3] stated that the occlusion of the successfully treated patient allows the masticating mechanism to carry out its physiologic functions while the temporomandibular joints, the neuromuscular mechanism, the teeth and their supporting structures remain in a good state of health. Skills in diagnosis and treatment planning are of utmost importance in treating these patients, for whom the clinician's goals are not only an esthetic and functional restoration but also a lasting harmonious state. Perhaps this was best state by DeVan [55] more than 60 years ago in his often-quoted objective. "The patient's fundamental need is the continued meticulous restoration of what is missing, since what is lost is in a sense irretrievably lost." Because it is clear that there is no one method, no one occlusal scheme, or one material that guarantees success for all patients, recommendations for consideration when establishing or reestablishing occlusal schemes have been presented. These recommendations must be used in conjunction with other diagnostic and technical skills.

  6. Partially solidified systems

    NASA Astrophysics Data System (ADS)

    The evolution of magmas is a topic of considerable importance in geology and geophysics because it affects volcanology, igneous petrology, geothermal energy sources, mantle convection, and the thermaland chemical evolution of the earth. The dynamics and evolution of magmas are strongly affected by the presence of solid crystals that occur either in suspension in liquid or as a rigid porous matrix through which liquid magma can percolate. Such systems are physically complex and difficult to model mathematically. Similar physical situations are encountered by metallurgists who study the solidification of molten alloys, and applied mathematicians have long been interested in such moving boundary problems. Clearly, it would be of mutual benefit to bring together scientists, engineers, and mathematicians with a common interest in such systems. Such a meeting is being organized as a North Atlantic Treaty Organization (NATO) Advanced Research Workshop on the Structure and Dynamics of Partially Solidified Systems, to be held at Stanford University's Fallen Leaf Lodge at Tahoe, Calif., May 12-16, 1986 The invited speakers and their topics are

  7. Partial disassembly of peroxisomes

    PubMed Central

    1985-01-01

    Rat liver peroxisomes were subjected to a variety of procedures intended to partially disassemble or damage them; the effects were analyzed by recentrifugation into sucrose gradients, enzyme analyses, electron microscopy, and SDS PAGE. Freezing and thawing or mild sonication released some matrix proteins and produced apparently intact peroxisomal "ghosts" with crystalloid cores and some fuzzy fibrillar content. Vigorous sonication broke open the peroxisomes but the membranes remained associated with cores and fibrillar and amorphous matrix material. The density of both ghosts and more severely damaged peroxisomes was approximately 1.23. Pyrophosphate (pH 9) treatment solubilized the fibrillar content, yielding ghosts that were empty except for cores. Some matrix proteins such as catalase and thiolase readily leak from peroxisomes. Other proteins were identified that remain in mechanically damaged peroxisomes but are neither core nor membrane proteins because they can be released by pyrophosphate treatment. These constitute a class of poorly soluble matrix proteins that appear to correspond to the fibrillar material observed morphologically. All of the peroxisomal beta-oxidation enzymes are located in the matrix, but they vary greatly in how easily they leak out. Palmitoyl coenzyme A synthetase is in the membrane, based on its co-distribution with the 22-kilodalton integral membrane polypeptide. PMID:2989301

  8. Knee adduction moment relates to medial femoral and tibial cartilage morphology in clinical knee osteoarthritis.

    PubMed

    Maly, Monica R; Acker, Stacey M; Totterman, Saara; Tamez-Peña, José; Stratford, Paul W; Callaghan, Jack P; Adachi, Jonathan D; Beattie, Karen A

    2015-09-18

    The objective was to determine the extent to which the external peak knee adduction moment (KAM) and cumulative knee adductor load explained variation in medial cartilage morphology of the tibia and femur in knee osteoarthritis (OA). Sixty-two adults with clinical knee OA participated (61.5 ± 6.2 years). To determine KAM, inverse dynamics was applied to motion and force data of walking. Cumulative knee adductor load reflected KAM impulse and loading frequency. Loading frequency was captured from an accelerometer. Magnetic resonance imaging scans were acquired with a coronal fat-saturated sequence using a 1.0 T peripheral scanner. Scans were segmented for medial cartilage volume, surface area of the bone-cartilage interface, and thickness. Forward linear regressions assessed the relationship of loading variables with cartilage morphology unadjusted, then adjusted for covariates. In the medial tibia, age and peak KAM explained 20.5% of variance in mean cartilage thickness (p<0.001). Peak KAM alone explained 12.3% of the 5th percentile of medial tibial cartilage thickness (i.e., thinnest cartilage region) (p=0.003). In the medial femur, sex, BMI, age, and peak KAM explained 44% of variance in mean cartilage thickness, with peak KAM contributing 7.9% (p<0.001). 20.7% of variance in the 5th percentile of medial femoral cartilage thickness was explained by BMI and peak KAM (p=0.001). In these models, older age, female sex, greater BMI, and greater peak KAM related with thinner cartilage. Models of KAM impulse produced similar results. In knee OA, KAM peak and impulse, but not loading frequency, were associated with cartilage thickness of the medial tibia and femur.

  9. How Tibiofemoral Alignment and Contact Locations Affect Predictions of Medial and Lateral Tibiofemoral Contact Forces

    PubMed Central

    Lerner, Zachary F.; DeMers, Matthew S.; Delp, Scott L.; Browning, Raymond C.

    2015-01-01

    Understanding degeneration of biological and prosthetic knee joints requires knowledge of the in-vivo loading environment during activities of daily living. Musculoskeletal models can estimate medial/lateral tibiofemoral compartment contact forces, yet anthropometric differences between individuals make accurate predictions challenging. We developed a full-body OpenSim musculoskeletal model with a knee joint that incorporates subject-specific tibiofemoral alignment (i.e. knee varus-valgus) and geometry (i.e. contact locations). We tested the accuracy of our model and determined the importance of these subject-specific parameters by comparing estimated to measured medial and lateral contact forces during walking in an individual with an instrumented knee replacement and post-operative genu valgum (6°). The errors in the predictions of the first peak medial and lateral contact force were 12.4% and 11.9%, respectively, for a model with subject-specific tibiofemoral alignment and contact locations determined via radiographic analysis, vs. 63.1% and 42.0%, respectively, for a model with generic parameters. We found that each degree of tibiofemoral alignment deviation altered the first peak medial compartment contact force by 51N (r2=0.99), while each millimeter of medial-lateral translation of the compartment contact point locations altered the first peak medial compartment contact force by 41N (r2=0.99). The model, available at www.simtk.org/home/med-lat-knee/, enables the specification of subject-specific joint alignment and compartment contact locations to more accurately estimate medial and lateral tibiofemoral contact forces in individuals with non-neutral alignment. PMID:25595425

  10. Forebrain medial septum region facilitates nociception in a rat formalin model of inflammatory pain.

    PubMed

    Lee, Andy Thiam-Huat; Ariffin, Mohammed Zacky; Zhou, Mingyi; Ye, Jenn Zhou; Moochhala, Shabbir M; Khanna, Sanjay

    2011-11-01

    The medial septum is anatomically and functionally linked to the hippocampus, a region implicated in nociception. However, the role of medial septum in nociception remains unclear. To investigate the role of the region in nociception in rats, muscimol, a GABA agonist, or zolpidem, a positive allosteric modulator of GABA(A) receptors, was microinjected into medial septum to attenuate the activity of neurons in the region. Electrophysiological studies in anesthetized rats indicated that muscimol evoked a stronger and longer-lasting suppression of medial septal-mediated activation of hippocampal theta field activity than zolpidem. Similarly, microinjection of muscimol (1 or 2 μg/0.5 μl) into the medial septum of awake rats suppressed both licking and flinching behaviors in the formalin test of inflammatory pain, whereas only the latter behavior was affected by zolpidem (8 or 12 μg/0.5 μl) administered into the medial septum. Interestingly, both drugs selectively attenuated nociceptive behaviors in the second phase of the formalin test that are partly driven by central plasticity. Indeed, muscimol reduced the second phase behaviors by 30% to 60%, which was comparable to the reduction seen with systemic administration of a moderate dose of the analgesic morphine. The reduction was accompanied by a decrease in formalin-induced expression of spinal c-Fos protein that serves as an index of spinal nociceptive processing. The drug effects on nociceptive behaviors were without overt sedation and were distinct from the effects observed after septal lateral microinjections. Taken together, these findings suggest that the activation of medial septum is pro-nociceptive and facilitates aspects of central neural processing underlying nociception.

  11. Functional specialization of medial auditory belt cortex in the alert rhesus monkey.

    PubMed

    Kusmierek, Pawel; Rauschecker, Josef P

    2009-09-01

    Responses of neural units in two areas of the medial auditory belt (middle medial area [MM] and rostral medial area [RM]) were tested with tones, noise bursts, monkey calls (MC), and environmental sounds (ES) in microelectrode recordings from two alert rhesus monkeys. For comparison, recordings were also performed from two core areas (primary auditory area [A1] and rostral area [R]) of the auditory cortex. All four fields showed cochleotopic organization, with best (center) frequency [BF(c)] gradients running in opposite directions in A1 and MM than in R and RM. The medial belt was characterized by a stronger preference for band-pass noise than for pure tones found medially to the core areas. Response latencies were shorter for the two more posterior (middle) areas MM and A1 than for the two rostral areas R and RM, reaching values as low as 6 ms for high BF(c) in MM and A1, and strongly depended on BF(c). The medial belt areas exhibited a higher selectivity to all stimuli, in particular to noise bursts, than the core areas. An increased selectivity to tones and noise bursts was also found in the anterior fields; the opposite was true for highly temporally modulated ES. Analysis of the structure of neural responses revealed that neurons were driven by low-level acoustic features in all fields. Thus medial belt areas RM and MM have to be considered early stages of auditory cortical processing. The anteroposterior difference in temporal processing indices suggests that R and RM may belong to a different hierarchical level or a different computational network than A1 and MM.

  12. Trigonometric Integrals via Partial Fractions

    ERIC Educational Resources Information Center

    Chen, H.; Fulford, M.

    2005-01-01

    Parametric differentiation is used to derive the partial fractions decompositions of certain rational functions. Those decompositions enable us to integrate some new combinations of trigonometric functions.

  13. Intraoperative medial pivot affects deep knee flexion angle and patient-reported outcomes after total knee arthroplasty.

    PubMed

    Nishio, Yusuke; Onodera, Tomohiro; Kasahara, Yasuhiko; Takahashi, Daisuke; Iwasaki, Norimasa; Majima, Tokifumi

    2014-04-01

    The aim of this study was to evaluate the relationship between clinical results including patient-reported outcomes and intraoperative knee kinematic patterns after total knee arthroplasty (TKA). A cross-sectional survey of forty consecutive medial osteoarthritis patients who had a primary TKA using a CT-based navigation system was conducted. Subjects were divided into two groups based on intraoperative kinematic patterns: a medial pivot group (n = 20) and a non-medial pivot group (n = 20). Subjective outcomes with the new Knee Society Score and clinical outcomes were evaluated. The functional activities, patient satisfaction and the knee flexion angle of the medial pivot group were significantly better than those of the non-medial pivot group. An intraoperative medial pivot pattern positively influences deep knee flexion and patient-reported outcomes.

  14. Abnormal isokinetic time-to-peak torque of the medial rotators of the shoulder in subjects with impingement syndrome.

    PubMed

    Mattiello-Rosa, Stela M; Camargo, Paula R; Santos, Alexandre A S; Pádua, Michelle; Reiff, Rodrigo B M; Salvini, Tania F

    2008-01-01

    The time-to-peak torque (TPT) and the peak torque ratio of the lateral to medial rotators (LR/MR) during isokinetic lateral and medial rotation of the shoulder were evaluated in patients with shoulder impingement and in healthy subjects. Fifteen patients with shoulder impingement on the dominant side and 9 healthy subjects were evaluated. TPT and LR/MR were measured bilaterally during isokinetic concentric lateral and medial rotation at 60 degrees/s and 180 degrees/s. The impingement group showed a bilateral decrease in the TPT during medial rotation for both 60 degrees/s and 180 degrees/s. No differences were found in the LR/MR between the groups. It is proposed that decreased (TPT) of the medial rotators can be used as a tool for early detection of shoulder impingement. Notably, the decreased time-to-peak torque of the medial rotators may occur before the alteration in the peak torque ratio.

  15. Experts' understanding of partial derivatives using the partial derivative machine

    NASA Astrophysics Data System (ADS)

    Roundy, David; Weber, Eric; Dray, Tevian; Bajracharya, Rabindra R.; Dorko, Allison; Smith, Emily M.; Manogue, Corinne A.

    2015-12-01

    [This paper is part of the Focused Collection on Upper Division Physics Courses.] Partial derivatives are used in a variety of different ways within physics. Thermodynamics, in particular, uses partial derivatives in ways that students often find especially confusing. We are at the beginning of a study of the teaching of partial derivatives, with a goal of better aligning the teaching of multivariable calculus with the needs of students in STEM disciplines. In this paper, we report on an initial study of expert understanding of partial derivatives across three disciplines: physics, engineering, and mathematics. We report on the central research question of how disciplinary experts understand partial derivatives, and how their concept images of partial derivatives differ, with a focus on experimentally measured quantities. Using the partial derivative machine (PDM), we probed expert understanding of partial derivatives in an experimental context without a known functional form. In particular, we investigated which representations were cued by the experts' interactions with the PDM. Whereas the physicists and engineers were quick to use measurements to find a numeric approximation for a derivative, the mathematicians repeatedly returned to speculation as to the functional form; although they were comfortable drawing qualitative conclusions about the system from measurements, they were reluctant to approximate the derivative through measurement. On a theoretical front, we found ways in which existing frameworks for the concept of derivative could be expanded to include numerical approximation.

  16. TopMaker: Technique Developed for Automatic Multiblock Topology Generation Using the Medial Axis

    NASA Technical Reports Server (NTRS)

    Rigby, David L.

    2004-01-01

    The TopMaker technique was developed in an effort to reduce the time required for grid generation in complex numerical studies. Topology generation accounts for much of the man-hours required for structured multiblock grids. With regard to structured multiblock grids, topology refers to how the blocks are arranged and connected. A two-dimensional multiblock topology generation technique has been developed at the NASA Glenn Research Center. Very general configurations can be addressed by the technique. A configuration is defined by a collection of non-intersecting closed curves, which will be referred to as loops. More than a single loop implies that holes exist in the domain, which poses no problem. This technique requires only the medial vertices and the touch points that define each vertex. From the information about the medial vertices, the connectivity between medial vertices is generated. The physical shape of the medial edge is not required. By applying a few simple rules to each medial edge, a multiblock topology can be generated without user intervention. The resulting topologies contain only the level of complexity dictated by the configurations. Grid lines remain attached to the boundary except at sharp concave turns, where a change in index family is introduced as would be desired. Keeping grid lines attached to the boundary is especially important in computational fluid dynamics, where highly clustered grids are used near no-slip boundaries. This technique is simple and robust and can easily be incorporated into the overall grid-generation process.

  17. TopMaker: A Technique for Automatic Multi-Block Topology Generation Using the Medial Axis

    NASA Technical Reports Server (NTRS)

    Heidmann, James D. (Technical Monitor); Rigby, David L.

    2004-01-01

    A two-dimensional multi-block topology generation technique has been developed. Very general configurations are addressable by the technique. A configuration is defined by a collection of non-intersecting closed curves, which will be referred to as loops. More than a single loop implies that holes exist in the domain, which poses no problem. This technique requires only the medial vertices and the touch points that define each vertex. From the information about the medial vertices, the connectivity between medial vertices is generated. The physical shape of the medial edge is not required. By applying a few simple rules to each medial edge, the multiblock topology is generated with no user intervention required. The resulting topologies contain only the level of complexity dictated by the configurations. Grid lines remain attached to the boundary except at sharp concave turns where a change in index family is introduced as would be desired. Keeping grid lines attached to the boundary is especially important in the area of computational fluid dynamics where highly clustered grids are used near no-slip boundaries. This technique is simple and robust and can easily be incorporated into the overall grid generation process.

  18. Voltage dependence of subthreshold resonance frequency in layer II of medial entorhinal cortex.

    PubMed

    Shay, Christopher F; Boardman, Ian S; James, Nicholas M; Hasselmo, Michael E

    2012-08-01

    The resonance properties of individual neurons in entorhinal cortex (EC) may contribute to their functional properties in awake, behaving rats. Models propose that entorhinal grid cells could arise from shifts in the intrinsic frequency of neurons caused by changes in membrane potential owing to depolarizing input from neurons coding velocity. To test for potential changes in intrinsic frequency, we measured the resonance properties of neurons at different membrane potentials in neurons in medial and lateral EC. In medial entorhinal neurons, the resonant frequency of individual neurons decreased in a linear manner as the membrane potential was depolarized between -70 and -55 mV. At more hyperpolarized membrane potentials, cells asymptotically approached a maximum resonance frequency. Consistent with the previous studies, near resting potential, the cells of the medial EC possessed a decreasing gradient of resonance frequency along the dorsal to ventral axis, and cells of the lateral EC lacked resonant properties, regardless of membrane potential or position along the medial to lateral axis within lateral EC. Application of 10 μM ZD7288, the H-channel blocker, abolished all resonant properties in MEC cells, and resulted in physiological properties very similar to lateral EC cells. These results on resonant properties show a clear change in frequency response with depolarization that could contribute to the generation of grid cell firing properties in the medial EC.

  19. Effect of center of pressure modulation on knee adduction moment in medial compartment knee osteoarthritis.

    PubMed

    Haim, Amir; Wolf, Alon; Rubin, Guy; Genis, Yulya; Khoury, Mona; Rozen, Nimrod

    2011-11-01

    The knee adduction moment (KAM) provides a major contribution to the elevated load in the medial compartment of the knee. An abnormally high KAM has been linked with the progression of knee osteoarthritis (OA). Footwear-generated biomechanical manipulations reduce the magnitude of this moment by conveying a more laterally shifted trajectory of the foot's center of pressure (COP), reducing the distance between the ground reaction force and the center of the knee joint, thus lowering the magnitude of the torque. We sought to examine the outcome of a COP shift in a cohort of female patients suffering from medial knee OA. Twenty-two female patients suffering from medial compartment knee OA underwent successive gait analysis testing and direct pedobarographic examination of the COP trajectory with a foot-worn biomechanical device allowing controlled manipulation of the COP. Modulation of the COP coronal trajectory from medial to lateral offset resulted in a significant reduction of the KAM. This trend was demonstrated in subjects with mild-to-moderate OA and in patients suffering from severe stages of the disease. Our results indicate that controlled manipulation of knee coronal kinetics in individuals suffering from medial knee OA can be facilitated by customized COP modification.

  20. Maturation and maintenance of cholinergic medial septum neurons require glucocorticoid receptor signaling.

    PubMed

    Guijarro, Christian; Rutz, Susanne; Rothmaier, Katharina; Turiault, Marc; Zhi, Qixia; Naumann, Thomas; Frotscher, Michael; Tronche, Francois; Jackisch, Rolf; Kretz, Oliver

    2006-05-01

    Glucocorticoids have been shown to influence trophic processes in the nervous system. In particular, they seem to be important for the development of cholinergic neurons in various brain regions. Here, we applied a genetic approach to investigate the role of the glucocorticoid receptor (GR) on the maturation and maintenance of cholinergic medial septal neurons between P15 and one year of age by using a mouse model carrying a CNS-specific conditional inactivation of the GR gene (GRNesCre). The number of choline acetyltransferase and p75NTR immuno-positive neurons in the medial septum (MS) was analyzed by stereology in controls versus mutants. In addition, cholinergic fiber density, acetylcholine release and cholinergic key enzyme activity of these neurons were determined in the hippocampus. We found that in GRNesCre animals the number of medial septal cholinergic neurons was significantly reduced during development. In addition, cholinergic cell number further decreased with aging in these mutants. The functional GR gene is therefore required for the proper maturation and maintenance of medial septal cholinergic neurons. However, the loss of cholinergic neurons in the medial septum is not accompanied by a loss of functional cholinergic parameters of these neurons in their target region, the hippocampus. This pinpoints to plasticity of the septo-hippocampal system, that seems to compensate for the septal cell loss by sprouting of the remaining neurons.

  1. Metric Measurements and Attachment Levels of the Medial Patellofemoral Ligament: An Anatomical Study in Cadavers

    PubMed Central

    Aragão, José Aderval; Reis, Francisco Prado; de Vasconcelos, Diego Protásio; Feitosa, Vera Lúcia Corrêa; Nunes, Marco Antonio Prado

    2008-01-01

    OBJECTIVE To determine the metric measurements and to verify the attachment levels of the medial patellofemoral ligament in human cadavers. METHODS Seventeen knees (eight right and nine left knees) from 10 cadavers (nine male and one female) were dissected and stored in a 10% formaldehyde solution. All of the knees were whole and did not show any macroscopic signs of injuries. RESULTS The medial patellofemoral ligament was present in 88% of the knees studied, localized transversally between the medial femoral epicondyle and the medial margin of the patella. Its dimensions were quite variable, even between the knees of the same individual. The width of the patellar insertion ranged from 16 to 38.8 mm, with a mean of 27.90 mm, and its mean length was 55.67 mm. The margins of the ligament were concave or rectilinear. At the upper margin, the concave form predominated and was better characterized, while at the lower margin, the rectilinear form predominated. CONCLUSIONS The medial patellofemoral ligament is a very distinct structure with variable anatomical aspects and is always located in a plane inferior to the vastus medialis obliquus muscle. PMID:18719768

  2. Physical examination and imaging of medial collateral ligament and posteromedial corner of the knee.

    PubMed

    Craft, Jason A; Kurzweil, Peter R

    2015-06-01

    The medial collateral ligament (MCL) is the most commonly injured knee ligament. Most will heal well with nonoperative treatment. However, not all medial knee injuries are the same. A detailed physical examination can help determine the severity of the medial-sided injury. When combined with advanced imaging, the examination will delineate damage to associated medial knee structures, including the location of MCL damage, posteromedial capsule injuries, and combined cruciate injuries. Failure to recognize MCL injuries that may be prone to chronic laxity can lead to significant disability, joint damage, and failure of concomitant cruciate ligament reconstructions. Magnetic resonance imaging is the mainstay of diagnostic imaging, with coronal sequences allowing full assessment of the MCL complex. Tangential views aid in the diagnosis of concomitant injuries. Stress radiography can play a role in evaluating MCL healing and subtle chronic laxity. Ultrasonography is also gaining acceptance as a means to assess MCL injuries. Use of a detailed examination and advanced imaging will allow optimal treatment of medial knee injuries and improve clinical outcomes.

  3. Structural and functional alterations to rat medial prefrontal cortex following chronic restraint stress and recovery

    PubMed Central

    Goldwater, Deena S.; Pavlides, Constantine; Hunter, Richard G.; Bloss, Erik B.; Hof, Patrick R.; McEwen, Bruce S.; Morrison, John H.

    2009-01-01

    Chronic stress has been shown in animal models to result in altered dendritic morphology of pyramidal neurons of the medial prefrontal cortex (mPFC). It has been hypothesized that the stress-induced dendritic retractions and spine loss lead to disrupted connectivity that results in stress-induced functional impairment of mPFC. While these alterations were initially viewed as a neurodegenerative event, it has recently been established that stress induced dendritic alterations are reversible if animals are given time to recover from chronic stress. However, whether spine growth accompanies dendritic extension remains to be demonstrated. It is also not known if recovery-phase dendritic extension allows for re-establishment of functional capacity. The goal of this study, therefore, was to characterize the structural and functional effects of chronic stress and recovery on the infralimbic (IL) region of the rat mPFC. We compared neuronal morphology of layer V IL pyramidal neurons from animals subjected to 21 days of chronic restraint stress (CRS) to those that experienced CRS followed by a 21 day recovery period. Layer V pyramidal cell functional capacity was assessed by intra-IL long-term potentiation (LTP) both in the absence and presence of SKF38393, a dopamine receptor partial agonist and a known PFC LTP modulator. We found that stress-induced IL apical dendritic retraction and spine loss co-occur with receptor-mediated impairments to catecholaminergic facilitation of synaptic plasticity. We also found that while post-stress recovery did not reverse distal dendritic retraction, it did result in over-extension of proximal dendritic neuroarchitecture and spine growth as well as a full reversal of CRS-induced impairments to catecholaminergic-mediated synaptic plasticity. Our results support the hypothesis that disease-related PFC dysfunction is a consequence of network disruption secondary to altered structural and functional plasticity and that circuitry

  4. A Novel Implant System for Unloading the Medial Compartment of the Knee by Lateral Displacement of the Iliotibial Band

    PubMed Central

    Shenoy, Vivek N.; Gifford, Hanson S.; Kao, John T.

    2017-01-01

    Background: Medial knee osteoarthritis (OA) typically occurs with excessive mechanical load within the medial compartment, resulting in degeneration of the articular cartilage. Purpose: A novel extracapsular implant (Latella Knee Implant) has been developed to unload the medial compartment of the knee. The implant displaces the iliotibial band (ITB) over the lateral femoral condyle, thereby increasing its effective moment arm, resulting in a transfer of load from the medial compartment to the lateral compartment of the knee. A cadaveric study was performed to evaluate the effect of altering the moment arm of the ITB on knee biomechanics. Study Design: Controlled laboratory study. Methods: A 6-degrees-of-freedom robotic testing system was utilized to measure medial and lateral compartment loads in 8 fresh-frozen cadaveric knees at various ITB loads and knee flexion angles. Measurements were made with and without the implant in place. The system measured the compartment forces at flexion angles between 0° and 30° under 3 simulated loading conditions (300 N quadriceps, 100 N hamstrings, and [1] 0 N ITB, [2] 50 N ITB, [3] 100 N ITB). Results: Lateral displacement of the ITB between 15 and 20 mm resulted in medial compartment unloading between 34% and 65%. Conclusion: Unloading the medial compartment with this novel implant has the potential to address the treatment gap for patients with medial knee OA. Clinical Relevance: Currently, there exists a treatment gap for patients with medial compartment OA who have exhausted conservative management but whose disease and symptoms do not warrant more invasive surgical procedures. An extracapsular implant to unload the medial compartment could fill this treatment gap by providing patients and surgeons with a less invasive option for early to mid-stage OA. Unloading the medial compartment may alleviate pain and improve function, allowing patients with early-stage medial OA to remain active longer prior to considering more

  5. The expression of plasticity-related genes in an acute model of stress is modulated by chronic desipramine in a time-dependent manner within medial prefrontal cortex.

    PubMed

    Nava, Nicoletta; Treccani, Giulia; Müller, Heidi Kaastrup; Popoli, Maurizio; Wegener, Gregers; Elfving, Betina

    2017-01-01

    It is well established that stress plays a major role in the pathogenesis of neuropsychiatric diseases. Stress-induced alteration of synaptic plasticity has been hypothesized to underlie the morphological changes observed by neuroimaging in psychiatric patients in key regions such as hippocampus and prefrontal cortex (PFC). We have recently shown that a single acute stress exposure produces significant short-term alterations of structural plasticity within medial PFC. These alterations were partially prevented by previous treatment with chronic desipramine (DMI). In the present study we evaluated the effects of acute Foot-shock (FS)-stress and pre-treatment with the traditional antidepressant DMI on the gene expression of key regulators of synaptic plasticity and structure. Expression of Homer, Shank, Spinophilin, Densin-180, and the small RhoGTPase related gene Rac1 and downstream target genes, Limk1, Cofilin1 and Rock1 were investigated 1 day (1d), 7 d and 14d after FS-stress exposure. We found that DMI specifically increases the short-term expression of Spinophilin, as well as Homer and Shank family genes, and that both acute stress and DMI exert significant long-term effects on mRNA levels of genes involved in spine plasticity. These findings support the knowledge that acute FS stress and antidepressant treatment induce both rapid and sustained time-dependent alterations in structural components of synaptic plasticity in rodent medial PFC.

  6. Ankle inversion taping using kinesiology tape for treating medial ankle sprain in an amateur soccer player

    PubMed Central

    Lee, Sun-Min; Lee, Jung-Hoon

    2015-01-01

    [Purpose] The purpose of this study was to report the effects of ankle inversion taping using kinesiology tape in a patient with a medial ankle sprain. [Subject] A 28-year-old amateur soccer player suffered a Grade 2 medial ankle sprain during a match. [Methods] Ankle inversion taping was applied to the sprained ankle every day for 2 months. [Results] His symptoms were reduced after ankle inversion taping application for 2 months. The self-reported function score, the reach distances in the Star Excursion Balance Test, and the weight-bearing ankle dorsiflexion were increased. [Conclusion] This study showed that ankle inversion taping using kinesiology tape may be an effective therapy for a patient with a medial ankle sprain. PMID:26311991

  7. Management of acute isolated medial and posteromedial instability of the knee.

    PubMed

    Roth, Jonathan; Taylor, Dean C

    2015-06-01

    Medial-sided knee injuries are very common, the medial collateral ligament being the most commonly injured ligament of the knee. Injuries to the medial side of the knee can occur in isolation or concomitant with other knee ligament injuries. Isolated grade I and II injuries have been typically treated nonoperatively with excellent results. Isolated grade III injuries, however, are less common and more controversial. Although some recent literature has shown acceptable results with nonoperative treatment of isolated grade III injuries, most authors recommend surgical treatment. A variety of operative techniques have been described, including repair, augmentation, and reconstruction, all with favorable outcomes. Choice of treatment method should be based on injury pattern with the goal of regaining valgus and anteromedial rotatory stability of the knee.

  8. [SOUND SIGNALS OF DANGER ACTIVATE THE NITRERGIC SYSTEM OF THE MEDIAL PREFRONTAL CORTEX].

    PubMed

    Sudorgina, P V; Saulskaya, N B

    2015-07-01

    In Sprague-Dawley rats by means of in vivo microdialysis, we have shown that presentation to rats-during conditioned fear expression of a sound conditioned stimulus previously paired with footshock (CS+) produces an increase in extracellular levels of citrulline (an NO co-product) in the medial prefrontal cortex. Presentation to the same rats of a different sound stimulus (not associated with footshock) (CS-) causes a very small increase in extracellular citrulline level. CS+ induced citrulline increase is prevented by infusions into the medial prefrontal cortex of Nomega-propyl-L-arginine (1 mM), a neuronal NO synthase inhibitor and it is not observed in control rats (same procedure, no footshock). These data indicate for the first time that sound signals of danger, but not safety signals activate nitrergic system of the medial prefrontal cortex.

  9. Extracellular norepinephrine in the medial hypothalamus increases during feeding in chicks: a microdialysis study.

    PubMed

    Tachibana, T; Utimura, D; Kato, H; Kubo, T; Sugahara, K

    2000-11-01

    Norepinephrinergic function in the medial hypothalamus is important for the regulation of feeding behavior in chicks as well as in rats. This study was conducted to clarify the variation of extracellular norepinephrine (NE) in the medial hypothalamus, including the paraventricular nucleus (PVN) and the ventromedial hypothalamic nucleus (VMN), during feeding behavior of layer-type chicks. To measure extracellular NE and 4-hydroxy-3-methoxyphenylglycol (MHPG), a major metabolite of NE, we used microdialysis and high-pressure liquid chromatography (HPLC) with electrochemical detection. After the collection of baseline samples, food-deprived animals were allowed access to the food for 3 h. Extracellular NE significantly increased during the first hour of access to food, and then returned to baseline levels. MHPG also increased during the feeding, but its increase continued throughout the remainder of the experiment. This study suggests that the variation of NE in the medial hypothalamus may be involved in the control of feeding in layer-type chicks.

  10. Intact Visual Perception in Memory-Impaired Patients with Medial Temporal Lobe Lesions

    PubMed Central

    Shrager, Yael; Gold, Jeffrey J.; Hopkins, Ramona O.; Squire, Larry R.

    2006-01-01

    A recent proposal that structures of the medial temporal lobe support visual perception in addition to memory challenges the long-standing idea that the ability to acquire new memories is separable from other cognitive and perceptual functions. In four experiments, we have put this proposal to a rigorous test. Six memory-impaired patients with well characterized lesions of either the hippocampal region or the hippocampal region plus additional medial temporal lobe structures were assessed on difficult tests of visual perceptual discrimination. Across all four experiments, the patients performed as well as controls. The results show that visual perception is intact in memory-impaired patients with damage to the medial temporal lobe even when perception is assessed with challenging tasks. Furthermore, the results support the principle that the ability to acquire new memories is a distinct cerebral function, dissociable from other perceptual and cognitive functions. PMID:16495450

  11. Grossly apparent cartilage erosion of the patellar articular surface in dogs with congenital medial patellar luxation.

    PubMed

    Daems, R; Janssens, L A; Béosier, Y M

    2009-01-01

    One hundred and forty-five stifles of client-owned dogs that underwent corrective surgery for congenital medial patellar luxation were inspected for cartilage erosion on the articular surface of the patella. The lesions were mapped in surface percentage ranges of 20% and by location. Two-thirds of the patellae had cartilage erosion. Cartilage erosion varied between 0 and 100% of the total patellar articular surface and was localised mainly on the medial and distal side of the patella. Dogs with Grade IV patellar luxations and heavier dogs were more affected. The majority of dogs in our study with congenital medial patellar luxation had grossly apparent cartilage erosion on the articular surface of the patella, which may help to explain why certain patients do not function well clinically after technically successful corrective surgery.

  12. A new surgical technique for medial collateral ligament balancing: multiple needle puncturing.

    PubMed

    Bellemans, Johan; Vandenneucker, Hilde; Van Lauwe, Johan; Victor, Jan

    2010-10-01

    In this article, we present our experience with a new technique for medial soft tissue balancing, where we make multiple punctures in the medial collateral ligament (MCL) using a 19-gauge needle, to progressively stretch the MCL until a correct ligament balance is achieved. Ligament status was evaluated both before and after the procedure using computer navigation and mediolateral stress testing. The procedure was considered successful when 2 to 4-mm mediolateral joint line opening was obtained in extension and 2 to 6 mm in flexion. In 34 of 35 cases, a progressive correction of medial tightness was achieved according to the above described criteria. One case was considered overreleased in extension. Needle puncturing is a new, effective, and safe technique for progressive correction of MCL tightness in the varus knee.

  13. Vocal fold medialization with tragal cartilage and perichondrium in high vagal paralysis.

    PubMed

    Chirilă, Magdalena; Mureşan, Rodica

    2013-05-01

    The goal of this pilot study was to test vocal fold medialization using autologous tragal cartilage and perichondrium by direct approach for treating high vagal paralysis. Five patients with the skull base tumors with involvement of the vagus nerve underwent concurrent vocal fold medialization with surgical excision. The patients were evaluated preoperatively, and at 14, 60 days, and 6 months later. Complete medialization with horizontal and vertical realignment was achieved. Improvement of voice and breathiness was correlated with the increase of closed quotient; the contact area of the vocal fold mucosa has increased. This advancement reduces breathiness and induced an improvement in subglottic pressure with aerodynamic parameters improvement, which led to stabilization of the vocal fold oscillation and a better voice quality recovery. This method can be considered a safe, quick, and efficient phonosurgical procedure combined with a skull-base surgical procedure.

  14. Panmedullary edema with inferior olivary hypertrophy in bilateral medial medullary infarction.

    PubMed

    Inoue, Yasuteru; Miyashita, Fumio; Koga, Masatoshi; Yamada, Naoaki; Toyoda, Kazunori; Minematsu, Kazuo

    2014-03-01

    Bilateral medial medullary infarction (MMI) is a rare type of stroke with poor outcomes. Inferior olivary nucleus hypertrophy results from a pathologic lesion in the Guillain-Mollaret triangle. The relationship between inferior olivary nucleus hypertrophy and the medullary lesion is obscure. To the best of our knowledge, only 1 autopsy case with unilateral medial medullary infarction that was associated with ipsilateral inferior olivary nucleus hypertrophy has been reported. We describe a rare case with acute infarction in the bilateral medial medulla oblongata accompanied by subacute bilateral inferior olivary nucleus hypertrophy and panmedullary edema. The hypertrophy appeared to have been caused by local ischemic damage to the termination of the central tegmental tract at the bilateral inferior olivary nucleus.

  15. Glutamate microinjection in the medial septum of rats decreases paradoxical sleep and increases slow wave sleep.

    PubMed

    Mukherjee, Didhiti; Kaushik, Mahesh K; Jaryal, Ashok Kumar; Kumar, Velayudhan Mohan; Mallick, Hruda Nanda

    2012-05-09

    The role of the medial septum in suppressing paradoxical sleep and promoting slow wave sleep was suggested on the basis of neurotoxic lesion studies. However, these conclusions need to be substantiated with further experiments, including chemical stimulation studies. In this report, the medial septum was stimulated in adult male rats by microinjection of L-glutamate. Sleep-wakefulness was electrophysiologically recorded, through chronically implanted electrodes, for 2 h before the injection and 4 h after the injection. There was a decrease in paradoxical sleep during the first hour and an increase in slow wave sleep during the second hour after the injection. The present findings not only supported the lesion studies but also showed that the major role of the medial septum is to suppress paradoxical sleep.

  16. Reconstruction of lateral forefoot using reversed medial plantar flap with free anterolateral thigh flap.

    PubMed

    Fujioka, Masaki; Hayashida, Kenji; Senju, Chikako

    2014-01-01

    Skin defects of the heel have frequently been reconstructed using the medial plantar flap; however, forefoot coverage has remained a challenge, because the alternatives for flap coverage have been very limited. We describe a case of malignant melanoma on the lateral forefoot that was radically removed and reconstructed successfully with a distally based medial plantar flap, together with a free anterolateral thigh flap. The advantages of this flap include that it does not reduce the vascular supply to the foot owing to reconstruction of the medial plantar vascular systems, reduces the risk of flap congestion, minimizes donor site morbidity, and enables the transport of structurally similar tissues to the plantar forefoot. We believe this technique is a reasonable reconstructive option for large lateral plantar forefoot defects.

  17. Transient medial patellar dislocation: injury patterns at US and MR imaging.

    PubMed

    Le Corroller, Thomas; Dediu, Melania; Champsaur, Pierre

    2009-05-01

    Medial dislocation of the patella is an unusual entity. It is usually an iatrogenic complication of surgical lateral retinacular release. We describe the clinical, ultrasound (US), and magnetic resonance (MR) imaging features of a transient medial patellar dislocation in a 19-year-old patient with trochlear groove dysplasia presenting no surgical history. US showed acute injury to the lateral patellar retinaculum with complete avulsion at its patellar insertion. MR imaging confirmed the complete tear of the lateral patellar retinaculum and disclosed contusion of the anteromedial portion of the medial femoral condyle and lateral patella. This case is noteworthy because the injury patterns of patellar soft tissue restraints differ markedly from the classical features of lateral patellar dislocation.

  18. Improvements in memory after medial septum stimulation are associated with changes in hippocampal cholinergic activity and neurogenesis.

    PubMed

    Jeong, Da Un; Lee, Ji Eun; Lee, Sung Eun; Chang, Won Seok; Kim, Sung June; Chang, Jin Woo

    2014-01-01

    Deep brain stimulation (DBS) has been found to have therapeutic effects in patients with dementia, but DBS mechanisms remain elusive. To provide evidence for the effectiveness of DBS as a treatment for dementia, we performed DBS in a rat model of dementia with intracerebroventricular administration of 192 IgG-saporins. We utilized four groups of rats, group 1, unlesioned control; group 2, cholinergic lesion; group 3, cholinergic lesion plus medial septum (MS) electrode implantation (sham stimulation); group 4, cholinergic lesions plus MS electrode implantation and stimulation. During the probe test in the water maze, performance of the lesion group decreased for measures of time spent and the number of swim crossings over the previous platform location. Interestingly, the stimulation group showed an equivalent performance to the normal group on all measures. And these are partially reversed by the electrode implantation. Acetylcholinesterase activity in the hippocampus was decreased in lesion and implantation groups, whereas activity in the stimulation group was not different from the normal group. Hippocampal neurogenesis was increased in the stimulation group. Our results revealed that DBS of MS restores spatial memory after damage to cholinergic neurons. This effect is associated with an increase in hippocampal cholinergic activity and neurogenesis.

  19. Ostectomy and Medial Plantar Artery Flap Reconstruction for Charcot Foot Ulceration Involving the Midfoot.

    PubMed

    Sato, Tomoya; Ichioka, Shigeru

    2016-01-01

    Charcot foot is a serious complication of diabetes, characterized by deformity and overlying ulceration. The condition most commonly affects the midfoot. However, little information is available on the use of a medial plantar artery flap to treat diabetic midfoot ulceration. The purpose of the present study was to evaluate the versatility of ostectomy and medial plantar flap reconstruction for midfoot plantar ulceration associated with rocker-bottom deformity secondary to Charcot foot. Four patients underwent ostectomy and medial plantar flap reconstruction. Before flap reconstruction, the devitalized soft tissues and bone were radically resected. After the infection had been controlled, the ulcerated portion was minimally excised, and the bony prominence underlying the ulcer was removed. A medial plantar artery flap was applied to the ulcer. The donor site was covered with a split-thickness skin graft or artificial dermis. In all patients, the ulcers healed and independent ambulation was achieved. However, 1 patient experienced ulcer recurrence, and subsequent infection necessitated a major amputation. Limb salvage is challenging in the setting of deformity and intractable plantar ulceration. The advantages of medial plantar artery flap reconstruction are that tissues with a rich blood supply are used to cover the exposed bone, and the flap can withstand the pressure and shear stress of the patient's body weight. However, a dominant artery in the foot is sacrificed. Therefore, the patency of the dorsalis pedis artery must be confirmed in every patient. The results of the present study have demonstrated that a medial plantar artery can be an effective alternative for diabetic patients with a plantar ulcer secondary to Charcot foot.

  20. Medial Orbitofrontal Neurons Preferentially Signal Cues Predicting Changes in Reward during Unblocking

    PubMed Central

    Lopatina, Nina; McDannald, Michael A.; Styer, Clay V.; Peterson, Jacob F.; Sadacca, Brian F.; Cheer, Joseph F.

    2016-01-01

    The orbitofrontal cortex (OFC) has been broadly implicated in the ability to use the current value of expected outcomes to guide behavior. Although value correlates have been prominently reported in lateral OFC, they are more often associated with more medial areas. Further, recent studies in primates have suggested a dissociation in which the lateral OFC is involved in credit assignment and representation of reward identity and more medial areas are critical to representing value. Previously, we used unblocking to test more specifically what information about outcomes is represented by OFC neurons in rats; consistent with the proposed dichotomy between the lateral and medial OFC, we found relatively little linear value coding in the lateral OFC (Lopatina et al., 2015). Here we have repeated this experiment, recording in the medial OFC, to test whether such value signals might be found there. Neurons were recorded in an unblocking task as rats learned about cues that signaled either more, less, or the same amount of reward. We found that medial OFC neurons acquired responses to these cues; however, these responses did not signal different reward values across cues. Surprisingly, we found that cells developed responses to cues predicting a change, particularly a decrease, in reward value. This is consistent with a special role for medial OFC in representing current value to support devaluation/revaluation sensitive changes in behavior. SIGNIFICANCE STATEMENT This study uniquely examines encoding in rodent mOFC at the single-unit level in response to cues that predict more, less, or no change in reward in rats during training in a Pavlovian unblocking task, finding more cells responding to change-predictive cues and stronger activity in response to cues predictive of less reward. PMID:27511013

  1. Medial Tibiofemoral-Joint Stiffness in Males and Females Across the Lifespan.

    PubMed

    Aronson, Patricia; Rijke, Arie; Hertel, Jay; Ingersoll, Christopher D

    2014-02-12

    Context : Analyzing ligament stiffness between males and females at 3 maturational stages across the lifespan may provide insight into whether changes in ligament behavior with aging may contribute to joint laxity. Objective : To compare the stiffness of the medial structures of the tibiofemoral joint and the medial collateral ligament to determine if there are differences at 3 distinct ages and between the sexes. Design : Cross-sectional study. Setting : Laboratory. Patients or Other Participants : A total of 108 healthy and physically active volunteers with no previous knee surgery, no knee injury, and no use of exogenous hormones in the past 6 months participated. They were divided into 6 groups based on sex and age (8-10, 18-40, 50-75 years). Main Outcome Measure(s) : Ligament stiffness of the tibiofemoral joint was measured with an arthrometer in 0° and 20° of tibiofemoral-joint flexion. The slope values of the force-strain line that represents stiffness of the medial tibiofemoral joint at 0° and the medial collateral ligament at 20° of flexion were obtained. Results : When height and mass were controlled, we found a main effect (P < .001) for age group: the 8- to 10-year olds were less stiff than both the 18- to 40- and the 50- to 75-year-old groups. No effects of sex or tibiofemoral-joint position on stiffness measures were noted when height and mass were included as covariates. Conclusions : Prepubescent medial tibiofemoral-joint stiffness was less than postpubescent knee stiffness. Medial tibiofemoral-joint stiffness was related to height and mass after puberty in men and women.

  2. Multiple telencephalic and extratelencephalic embryonic domains contribute neurons to the medial extended amygdala.

    PubMed

    Bupesh, Munisamy; Legaz, Isabel; Abellán, Antonio; Medina, Loreta

    2011-06-01

    Dysfunctions in emotional control and social behavior are behind human neuropsychiatric disorders, some of which are associated with an alteration of amygdalar development. The medial extended amygdala is a key telencephalic center for control of social behavior, but very little is known about its development. We used in vitro migration assays for analyzing the origin of the neurons of the medial extended amygdala in mouse embryos (E13.5-E16.5). We compared the migration assays with immunofluorescence/immunohistochemistry for calbindin and radial glial fibers and with mRNA expression of several genetic markers of distinct forebrain subdivisions. We provide experimental evidence for multiple embryonic origins of the principal neurons of the medial extended amygdala. In particular, we provide novel evidence indicating that a major part of the neurons derives from a caudoventral pallidal subdivision (previously called or included as part of the anterior peduncular area), forming a cell corridor with similar molecular features (expression of Lhx6 and calbindin), connectivity, and function, which relates to reproductive behavior. We also provide novel experimental evidence indicating that the ventral pallium produces some neurons for the medial amygdala, which correlates with data from Lhx9 expression. Our results also confirm that some neurons of the medial extended amygdala originate in the preoptic area (our results indicate that these cells specifically originate in its commissural subdivision) and the supraoptoparaventricular domain of the hypothalamus. Our study helps to set up the foundations for a better understanding of medial amygdalar control of behavior in normal and abnormal conditions.

  3. Oxford unicompartmental knee arthroplasty: medial pain and functional outcome in the medium term

    PubMed Central

    2011-01-01

    Background In our experience results of the Oxford unicompartmental knee replacement have not been as good as had been expected. A common post operative complaint is of persistent medial knee discomfort, it is not clear why this phenomenon occurs and we have attempted to address this in our study. Methods 48 patients were retrospectively identified at a mean of 4.5 years (range = 3 to 6 years) following consecutive Oxford medial Unicompartmental Knee arthroplasties for varus anteromedial osteoarthritis. The mean age at implantation was 67 years (range 57-86). Of these 48 patients, 4 had died, 4 had undergone revision of their unicompartmental knee replacements and 2 had been lost to follow up leaving 38 patients with 40 replaced knees available for analysis using the 'new Oxford Knee Score' questionnaire. During assessment patients were asked specifically whether or not they still experienced medial knee discomfort or pain. Results The mean 'Oxford score' was only 32.7 (range = 16 to 48) and 22 of the 40 knees were uncomfortable or painful medially. The accuracy of component positioning was recorded, using standard post operative xrays, by summing the angulation or displacement of each component in two planes from the ideal position (according to the 'Oxford knee system radiographic criteria'). No correlation was demonstrated between the radiographic scores and the 'Oxford scores', or with the presence or absence of medial knee discomfort or pain. Conclusion In our hands the functional outcome following Oxford Unicompartmental knee replacement was variable, with a high incidence of medial knee discomfort which did not correlate with the postoperative radiographic scores, pre-op arthritis and positioning of the prosthesis. PMID:21981987

  4. Medial Tibiofemoral-Joint Stiffness in Males and Females Across the Lifespan

    PubMed Central

    Aronson, Patricia; Rijke, Arie; Hertel, Jay; Ingersoll, Christopher D.

    2014-01-01

    Context: Analyzing ligament stiffness between males and females at 3 maturational stages across the lifespan may provide insight into whether changes in ligament behavior with aging may contribute to joint laxity. Objective: To compare the stiffness of the medial structures of the tibiofemoral joint and the medial collateral ligament to determine if there are differences at 3 distinct ages and between the sexes. Design: Cross-sectional study. Setting: Laboratory. Patients or Other Participants: A total of 108 healthy and physically active volunteers with no previous knee surgery, no acute knee injury, and no use of exogenous hormones in the past 6 months participated. They were divided into 6 groups based on sex and age (8–10, 18–40, 50–75 years). Main Outcome Measure(s): Ligament stiffness of the tibiofemoral joint was measured with an arthrometer in 0° and 20° of tibiofemoral-joint flexion. The slope values of the force-strain line that represents stiffness of the medial tibiofemoral joint at 0° and the medial collateral ligament at 20° of flexion were obtained. Results: When height and mass were controlled, we found a main effect (P < .001) for age group: the 8- to 10-year olds were less stiff than both the 18- to 40- and the 50- to 75-year-old groups. No effects of sex or tibiofemoral-joint position on stiffness measures were noted when height and mass were included as covariates. Conclusions: Prepubescent medial tibiofemoral-joint stiffness was less than postpubescent knee stiffness. Medial tibiofemoral-joint stiffness was related to height and mass after puberty in men and women. PMID:24955624

  5. The correlation between medial plica and trochlear dysplasis: An MRI study

    PubMed Central

    Ekin, Elif E; Yildiz, Hülya K; Mutlu, Harun; Çetinkaya, Engin

    2016-01-01

    Background: Trochlear dysplasia is the most commonly encountered congenital etiologic factor of anterior knee pain. Aims: The purpose of this study was to evaluate the relationship between trochlear dysplasia with medial patellar plica as well as to investigate the distribution of plica types according to types of dysplasia. Settings and Design: This is a retrospective case-control study. Materials and Methods: This study was conducted among 138 knee magnetic resonance imaging (MRI) scans. The presence of medial plica and its types were compared among 69 patients in whom trochlear dysplasia had been detected and 69 individuals with normal trochlear who were of the same age and gender as the patient group. Statistical Analysis: Trochlear dysplasia and medial plica was compared by Chi-square with Yates correction and Fisher's exact probability tests (P < 0.001). The data were presented as mean, standard deviation, minimum–maximum, frequency, and percentage. Results: Of all the patients (n = 138), the number of patients in whom plica was observed was n = 104 (75.3%), and the distribution of plica type was as follows: n = 70 (67.3%) Type 1, n = 25 (24%) Type 2, and n = 9 (8.6%) Type 3. Medial plica was more frequently observed in patients with trochlear dysplasia (P < 0.001). Type 2 and Type 3 medial plica were more frequently encountered in trochlear dysplasia (P < 0.001). Type 3 plica was not seen in patients with normal trochlea. Conclusion: Medial patellar plica is more frequently seen in trochlear dysplasia. As the type of trochlear dysplasia progresses, the prevalence of thicker and shelf-shaped plica increases. PMID:28104937

  6. The effects of kinematically aligned total knee arthroplasty on stress at the medial tibia

    PubMed Central

    Tian, Y.; Tanaka, Y.; Kuriyama, S.; Ito, H.; Furu, M.; Matsuda, S.

    2017-01-01

    Objectives Little biomechanical information is available about kinematically aligned (KA) total knee arthroplasty (TKA). The purpose of this study was to simulate the kinematics and kinetics after KA TKA and mechanically aligned (MA) TKA with four different limb alignments. Materials and Methods Bone models were constructed from one volunteer (normal) and three patients with three different knee deformities (slight, moderate and severe varus). A dynamic musculoskeletal modelling system was used to analyse the kinematics and the tibiofemoral contact force. The contact stress on the tibial insert, and the stress to the resection surface and medial tibial cortex were examined by using finite element analysis. Results In all bone models, posterior translation on the lateral side and external rotation in the KA TKA models were greater than in the MA TKA models. The tibiofemoral force at the medial side was increased in the moderate and severe varus models with KA TKA. In the severe varus model with KA TKA, the contact stress on the tibial insert and the stress to the resection surface and to the medial tibial cortex were increased by 41.5%, 32.2% and 53.7%, respectively, compared with MA TKA, and the bone strain at the medial side was highest among all models. Conclusion Near normal kinematics was observed in KA TKA. However, KA TKA increased the contact force, stress and bone strain at the medial side for moderate and severe varus knee models. The application of KA TKA for severe varus knees may be inadequate. Cite this article: S. Nakamura, Y. Tian, Y. Tanaka, S. Kuriyama, H. Ito, M. Furu, S. Matsuda. The effects of kinematically aligned total knee arthroplasty on stress at the medial tibia: A case study for varus knee. Bone Joint Res 2017;6:43–51. DOI: 10.1302/2046-3758.61.BJR-2016-0090.R1. PMID:28077396

  7. Role of the medial septum cholinoceptors in anxiogenic-like effects of nicotine.

    PubMed

    Zarrindast, Mohammad-Reza; Tajik, Rohjan; Ebrahimi-Ghiri, Mohaddeseh; Nasehi, Mohammad; Rezayof, Ameneh

    2013-07-02

    The medial septum which is extensively connected to the hippocampus is involved in cholinergic theta oscillation control as well as the anxiety related disorders. In the present study, we aimed to investigate the possible involvement of the medial septum cholinoceptors in the nicotine-induced anxiogenic-like behaviors in rats, using the elevated plus-maze (EPM) test. Intraperitoneal administration of nicotine at 0.6 and 0.8 mg/kg, decreased the open-arms time percentage (%OAT) and open-arms entries percentage (%OAE); indicating an anxiogenic-like response. Intra-medial septum microinjection of mecamylamine, a nicotinic acetylcholine receptor (nAChR) antagonist at the doses of 1-4 μg/rat, increased %OAT (4 μg/rat), suggesting an anxiolytic-like effect. This however, did not alter the anxiogenic-like response induced by the effective dose of nicotine (0.6 mg/kg). Moreover, co-administration of the subthreshold dose of mecamylamine (2 μg/rat) plus nicotine at the dose of 0.5 or 0.6 mg/kg, increased or decreased the anxiolytic-like behaviors, respectively. On the other hand, sole intra-medial septum infusion of atropine, a muscarinic acetylcholine receptor (mAChR) antagonist, induced an anxiolytic (0.05 μg/rat) and anxiogenic (0.25 μg/rat)-like effects, respectively. The dose of 0.05 μg/rat however, blocked the nicotine response. Furthermore, intra-medial septum microinjection of the highest dose of mecamylamine (4 μg/rat) plus nicotine (0.6 mg/kg) decreased the locomotor activity, while other treatments had no effect on this parameter. Our results suggested that, nicotine-induced anxiogenic-like behaviors may be mediated via the activation of cholinoceptors and possibly other receptor mechanism(s) in the medial septum.

  8. Histaminergic receptors of medial septum and conditioned place preference: D1 dopamine receptor mechanism.

    PubMed

    Zarrindast, Mohammad-Reza; Moghimi, Maryam; Rostami, Parvin; Rezayof, Ameneh

    2006-09-13

    In the present study, the effects of intra-medial septum injections of histamine and/or the histamine H1 or H2 receptor antagonists on the acquisition of conditioned place preference (CPP) in male Wistar rats have been investigated. Our data showed that the conditioning treatments with intra-medial septum injection of different doses of histamine (0.5-15 microg/rat) induced a significant CPP for the drug-associated place. Using a 3-day schedule of conditioning, it was found that the histamine H1 receptor antagonist, pyrilamine (10 and 15 microg/rat, intra-medial septum) also induced a significant place preference. In addition, pyrilamine inhibited the histamine (7.5 microg/rat)-induced place preference. Intra-medial septum administration of the histamine H2 receptor antagonist, ranitidine (5-15 microg/rat) alone or in combination with histamine did not produce a significant place preference or place aversion. On the other hand, intra-medial septum administration of the dopamine D1 receptor antagonist, SCH 233390 (0.5, 0.75 and 1 microg/rat) inhibited the histamine (7.5 microg/rat) or pyrilamine (15 microg/rat)-induced place preference in a dose-dependent manner, but no effect was observed for the dopamine D2 receptor antagonist, sulpiride on the histamine or pyrilamine response. The administration of histamine (2.5-15 microg/rat) or pyrilamine (10 and 15 microg/rat) during acquisition increased locomotor activity of the animals on the testing days. The results suggest that histaminergic receptors of the medial septum may be involved in CPP and thus it is postulated that dopamine D1 receptors may play an important role in this effect.

  9. Effect of Posterior Horn Medial Meniscus Root Tear on In Vivo Knee Kinematics

    PubMed Central

    Marsh, Chelsea A.; Martin, Daniel E.; Harner, Christopher D.; Tashman, Scott

    2014-01-01

    Background: Medial meniscus root tear (MMRT) is a recently recognized yet frequently missed meniscal tear pattern that biomechanically creates an environment approaching meniscal deficiency. Hypothesis/Purpose: The purpose of this study was to assess the effect of MMRT on tibiofemoral kinematics and arthrokinematics during daily activities by comparing the injured knees of subjects with isolated MMRT to their uninjured contralateral knees. The hypothesis was that the injured knee will demonstrate significantly more lateral tibial translation and adduction than the uninjured knee, and that the medial compartment will exhibit significantly different arthrokinematics than the lateral compartment in the affected limb. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Seven subjects with isolated MMRT were recruited and volumetric, density-based 3-dimensional models of their distal femurs and proximal tibia were created from computed tomography scans. High-speed, biplane radiographs were obtained of both their affected and unaffected knees. Moving 3-dimensional models of tibiofemoral kinematics were calculated using model-based tracking to assess overall kinematic variables and specific measures of tibiofemoral joint contact. The affected knees of the subjects were then compared to their unaffected contralateral knees. Results: Affected knees demonstrated significantly more lateral tibial translation than the uninjured contralateral limb in all dynamic activities. Additionally, the medial compartment displayed greater amounts of mobility than the lateral compartment in the injured limbs. Conclusion: This study suggests that MMRT causes significant changes in in vivo knee kinematics and arthrokinematics and that the magnitude of these changes is influenced by dynamic task difficulty. Clinical Relevance: Medial meniscus root tears lead to significant changes in joint arthrokinematics, with increased lateral tibial translation and greater medial

  10. Forelimb movements in cats with complete or partial bulbar pyramid lesions.

    PubMed

    Dalmeida, R E; Yu, J

    1981-01-01

    Adult cats were trained to use a forelimb to open a hinged door against resistance for a food reward. Normal cats performed the task with only toe or wrist motions. Cats with unilateral complete bulbar pyramid section showed persistent deficits in distal limb movements with toe fanning, wrist stiffness and pulling from elbow and shoulder. Partial medial or lateral pyramid lesions produced similar but less severe effects. These results suggest a significant role of the corticospinal system in distal limb movements and a lack of topographical localization of pyramid fibers related to these movements in cats.

  11. Spontaneous correction of partial physeal arrest: report of a case and review of the literature.

    PubMed

    Gkiokas, Andreas; Brilakis, Emmanuel

    2012-07-01

    This study describes the rare phenomenon of partial physeal arrest spontaneous correction. It concerns a case of a 3.5-year-old girl who suffered from a Salter-Harris IV fracture of the distal tibial epiphysis, which was managed conservatively. After fracture healing an osseous bridge was formed at the medial part of the physis, leading to a varus deformity. The parents refused the operation, but 6 years later, both the ankle's deformity and the shortening of the extremity had been spontaneously corrected. It seems that the growth potential of the physis healthy portion is able to break the already transformed osseous bridge.

  12. Selective disappearance of medial back muscles in a case of myotonic dystrophy type 1.

    PubMed

    Morihara, Ryuta; Hishikawa, Nozomi; Yamashita, Toru; Deguchi, Kentaro; Kurata, Tomoko; Abe, Koji

    2015-01-01

    Here, we report a unique case of late-onset myotonic dystrophy type 1 in a 64-year-old woman, with selective disappearance of the medial lower back muscles. We compared the clinical features of this patient with those of a cohort of 29 patients with myotonic dystrophy type 1 to clarify the correlation between clinical features and lower back muscle atrophy. After classification into three subgroups according to muscle atrophy pattern, medial muscle atrophy was present in 17.2% of the patients. Affected patients were older at onset than non-affected patients, and limb muscle power and respiratory function decreased with atrophy progression.

  13. Medial malleolus fracture of the ankle combined with rupture of the Achilles tendon

    PubMed Central

    Lu, Jike; Maruo Holledge, Masumi

    2016-01-01

    A 59-year-old man fell off a 60-cm-high step, with his ankle in a twisted position, and sustained a closed fracture of the medial malleolus, with an ipsilateral complete Achilles tendon (TA) rupture. The TA rupture was initially missed but diagnosed by ultrasound examination, 2 weeks post-operatively. The ankle fracture was diagnosed from routine radiographs. Such a combination of injuries has been reported infrequently in the literature, but significant similarities have been described in the mechanism of injury and fracture patterns. Nevertheless, three of five reported cases with combined medial malleolus fractures were initially misdiagnosed. PMID:27141047

  14. Post traumatic osteoma of tibial insertion of medial collateral ligament of knee joint

    PubMed Central

    Shanker, V. S.; Gadikoppula, S.; Loeffler, M. D.

    1998-01-01

    Two cases are presented of post traumatic para-articular osteoma developing at the site of tibial attachment of the medial collateral ligament of knee joint. These occurred after injuries sustained while playing football and in one case the ossified mass was treated with surgical excision for unresolved symptoms after conservative measures. A comparison is made with Pellegrini Stieda disease, which is a similar affection of the femoral insertion of the medial ligament of the knee joint. 




 PMID:9562171

  15. Perforator arteries of the medial upper arm: anatomical basis of a new flap donor site.

    PubMed

    Perignon, D; Havet, E; Sinna, R

    2013-01-01

    The development of perforator flaps' concept based on knowledge on vascular anatomy of the skin represents a major improvement in reconstructive surgery. Succeeding description about vascular territories and anatomical basics of the main donor sites, the study of hidden donor sites, such as medial upper arm, constitutes a new step and an additional refinement. 20 upper limbs of 10 fresh adult cadavers were studied with colored latex injections. The origin and distribution of the perforator arteries of the superior ulnar collateral artery and the brachial artery were investigated. We have noted constant perforator arteries and described the limits of vascular territories of the medial upper arm.

  16. Editorial Commentary: Is Medial-Side Repair Indicated in the Treatment of Multiligament Knee Injuries?

    PubMed

    Marx, Robert G

    2016-09-01

    Multiligament knee injuries are heterogenous and demand individualized treatment. In addition to the complexity of the injury, factors such as the timing and type of surgery are also crucial to patient outcomes. In a case series, patients who underwent medial-side repair had inferior patient-reported outcomes compared with those who had medial reconstruction or lateral surgery. Interestingly, patients with common peroneal nerve injury did not have inferior outcomes, probably because of the lack of sensitivity of rating scales to measure nerve-related disability. In view of the complexity and heterogeneity of these injuries, the above-mentioned findings may not be generalizable to all patients.

  17. Treatment of the lacrimal excretory system after resection of medial canthal and eyelid tumors.

    PubMed

    Older, J J

    1979-06-01

    A simplified method of lacrimal excretory system repair is presented. If part of a canaliculus is resected during removal of an eyelid tumor, the remaining section of the canaliculus can be exteriorized to the lacrimal lake. A silicone tube is threaded into the canaliculus and allowed to remain in place for one to two weeks. If both canaliculi and the common canaliculus are removed during resection for a medial canthal tumor, a silicone tube can be threaded into the nasolacrimal duct and brought out the area of the medial canthal angle. Conjunctiva which is wrapped around the tube can then form a new drainage canal into the remainder of the lacrimal excretory system.

  18. Mechanism of the Rapid Effect of 17β -Estradiol on Medial Amygdala Neurons

    NASA Astrophysics Data System (ADS)

    Nabekura, Junichi; Oomura, Yutaka; Minami, Taketsugu; Mizuno, Yuji; Fukuda, Atsuo

    1986-07-01

    The mechanism by which sex steroids rapidly modulate the excitability of neurons was investigated by intracellular recording of neurons in rat medial amygdala brain slices. Brief hyperpolarization and increased potassium conductance were produced by 17β - estradiol. This effect persisted after elimination of synaptic input and after suppression of protein synthesis. Thus, 17β -estradiol directly changes the ionic conductance of the postsynaptic membrane of medial amygdala neurons. In addition, a greater proportion of the neurons from females than from males responded to 17β -estradiol.

  19. Indications for the microvascular medial femoral condylar flap in craniomaxillofacial surgery.

    PubMed

    Thiele, Oliver Christian; Kremer, Thomas; Kneser, Ulrich; Mischkowski, Robert Andreas

    2014-07-01

    The medial femoral condylar flap makes it possible to reconstruct bone, cartilage, and skin, but elongation of the pedicle is usually required to bridge the distances to the vascular connections in the neck. The indications in the maxillofacial area include reconstruction of the temporomandibular joint (TMJ), pseudarthrosis of the jaws, osteonecrosis of the jaws and skull, and augmentation of bone in irradiated or otherwise compromised tissue. If small bony defects require safe and reliable osseous, osteochondral, or osteocutaneous reconstruction, the medial femoral condylar flap can be used to fill the gap between small avascular, and larger microvascular, bone transplants.

  20. Experimental generating the partially coherent and partially polarized electromagnetic source.

    PubMed

    Ostrovsky, Andrey S; Rodríguez-Zurita, Gustavo; Meneses-Fabián, Cruz; Olvera-Santamaría, Miguel A; Rickenstorff-Parrao, Carolina

    2010-06-07

    The technique for generating the partially coherent and partially polarized source starting from the completely coherent and completely polarized laser source is proposed and analyzed. This technique differs from the known ones by the simplicity of its physical realization. The efficiency of the proposed technique is illustrated with the results of physical experiment in which an original technique for characterizing the coherence and polarization properties of the generated source is employed.

  1. Local Control of Extracellular Dopamine Levels in the Medial Nucleus Accumbens by a Glutamatergic Projection from the Infralimbic Cortex.

    PubMed

    Quiroz, César; Orrú, Marco; Rea, William; Ciudad-Roberts, Andrés; Yepes, Gabriel; Britt, Jonathan P; Ferré, Sergi

    2016-01-20

    It is generally assumed that infralimbic cortex (ILC) and prelimbic cortex, two adjacent areas of the medial prefrontal cortex (mPFC) in rodents, provide selective excitatory glutamatergic inputs to the nucleus accumbens (NAc) shell and core, respectively. It is also generally believed that mPFC influences the extracellular levels of dopamine in the NAc primarily by an excitatory collateral to the ventral tegmental area (VTA). In the present study, we first established the existence of a selective functional connection between ILC and the posteromedial portions of the VTA (pmVTA) and the mNAc shell (pmNAc shell), by measuring striatal neuronal activation (immunohistochemical analysis of ERK1/2 phosphorylation) and glutamate release (in vivo microdialysis) upon ILC electrical stimulation. A novel optogenetic-microdialysis approach allowed the measurement of extracellular concentrations of glutamate and dopamine in the pmNAc shell upon local light-induced stimulation of glutamatergic terminals from ILC. Cortical electrical and local optogenetic stimulation produced significant increases in the extracellular concentrations of glutamate and dopamine in the pmNAc shell. Local blockade of glutamate release by perfusion of an adenosine A2A receptor antagonist in the pmNAc shell blocked the dopamine release induced by local optogenetic stimulation but only partially antagonized dopamine release induced by cortical electrical stimulation. The results demonstrate that ILC excitatory afferents directly modulate the extracellular concentration of dopamine in the pmNAc shell, but also support the involvement of an indirect mechanism of dopamine control, through a concomitant ILC-mediated activation of the pmVTA. Significance statement: We established the existence of a functional connection between the infralimbic cortex (ILC) and the posteromedial portions of the ventral tegmental area (pmVTA) and the medial nucleus acumbens shell (pmNAc shell). A novel optogenetic

  2. Local Control of Extracellular Dopamine Levels in the Medial Nucleus Accumbens by a Glutamatergic Projection from the Infralimbic Cortex

    PubMed Central

    Quiroz, César; Orrú, Marco; Rea, William; Ciudad-Roberts, Andrés; Yepes, Gabriel; Britt, Jonathan P.

    2016-01-01

    It is generally assumed that infralimbic cortex (ILC) and prelimbic cortex, two adjacent areas of the medial prefrontal cortex (mPFC) in rodents, provide selective excitatory glutamatergic inputs to the nucleus accumbens (NAc) shell and core, respectively. It is also generally believed that mPFC influences the extracellular levels of dopamine in the NAc primarily by an excitatory collateral to the ventral tegmental area (VTA). In the present study, we first established the existence of a selective functional connection between ILC and the posteromedial portions of the VTA (pmVTA) and the mNAc shell (pmNAc shell), by measuring striatal neuronal activation (immunohistochemical analysis of ERK1/2 phosphorylation) and glutamate release (in vivo microdialysis) upon ILC electrical stimulation. A novel optogenetic-microdialysis approach allowed the measurement of extracellular concentrations of glutamate and dopamine in the pmNAc shell upon local light-induced stimulation of glutamatergic terminals from ILC. Cortical electrical and local optogenetic stimulation produced significant increases in the extracellular concentrations of glutamate and dopamine in the pmNAc shell. Local blockade of glutamate release by perfusion of an adenosine A2A receptor antagonist in the pmNAc shell blocked the dopamine release induced by local optogenetic stimulation but only partially antagonized dopamine release induced by cortical electrical stimulation. The results demonstrate that ILC excitatory afferents directly modulate the extracellular concentration of dopamine in the pmNAc shell, but also support the involvement of an indirect mechanism of dopamine control, through a concomitant ILC-mediated activation of the pmVTA. SIGNIFICANCE STATEMENT We established the existence of a functional connection between the infralimbic cortex (ILC) and the posteromedial portions of the ventral tegmental area (pmVTA) and the medial nucleus acumbens shell (pmNAc shell). A novel optogenetic

  3. [Primary recurrent medial subdislocation of both patellae. Long-term review of an exceptional case of miserably malalignment syndrome].

    PubMed

    García-Mata, S; Hidalgo-Ovejero, A

    2007-01-01

    We present a long-term review of a girl aged 11 years and 4 months with medial primary recurrent subluxation of both patellae of several months evolution associated with miserably malalignment syndrome. Not one case of medial recurrent dislocation of the patellae has been described previously. Three years previously following a jump she had suffered a right patellar luxation - self-reduced and not immobilised - followed by 10 subsequent episodes of subluxation and three more medial luxations. She could hardly walk autonomously due to persistent or habitual subluxation and patellofemoral pain, mainly in the right knee. Physical examination revealed habitual medial subluxation of both patellae, with clear medial patellar displacement, quadriceps amyotrophy and medial instability. The medial subluxation suppression test was positive. She showed excessive femoral anteversion of the hips (IR: 90 degrees, ER: 30 degrees), genu varum, neutral tibial torsion, patella alta, dysplastic trochlear grooves with medial condyle hipoplasia and both patellae were dysplastic (Wiberg type III). We performed a derotation subtrochanteric femoral osteotomy and bilateral proximal patellar realignment. Following surgery, bilateral stability of both sides permitted normal walking and running, as well as apprehension and the Smillie test (-), with a hip mobility of 65 degrees ER and 50 degrees IR. Fifteen years after the surgery the patient complains of antero-external knee pain in the right knee during prolonged walking, in getting up and down stairs and when in a prolonged sitting position, diagnosed as excessive lateral pressure syndrome.

  4. Clinical and surgical implications regarding morphometric variations of the medial wall of the orbit in relation to age and gender.

    PubMed

    Morales-Avalos, Rodolfo; Santos-Martínez, Arlette Gabriela; Ávalos-Fernández, Cesia Gisela; Mohamed-Noriega, Karim; Sánchez-Mejorada, Gabriela; Montemayor-Alatorre, Adolfo; Martínez-Fernández, David A; Espinosa-Uribe, Abraham G; Mohamed-Noriega, Jibran; Cuervo-Lozano, Edgar E; Mohamed-Hamsho, Jesús; Quiroga-García, Oscar; Lugo-Guillen, Roberto A; Guzmán-López, Santos; Elizondo-Omaña, Rodrigo E

    2016-09-01

    The ethmoidal foramens are located on the medial wall of the orbit and are key reference points for intraoperative orientation. Detailed knowledge of the anatomy, bony landmarks and morphometric characteristics of the medial wall of the orbit is essential for various surgical procedures. The aim of this study was to determine the morphometric variations in the medial wall of the orbit and establish significant variations regarding age and gender. A total of 110 orbits were analyzed and subdivided by age (over or under 40 years) and gender. The distances of the medial wall of the orbit between the anterior lacrimal crest, the ethmoidal foramen, the optic canal and the interforamina were determined. Safe surgical areas were sought. Statistical tests were used to determine the differences between groups. In men, there is a safe surgical area proximal to the anterior and posterior ethmoidal foramen. In women, this area is in the posterior third of the medial wall of the orbit between the posterior ethmoidal foramen and the optic canal. Regarding variation according to age, the results of this study suggested that the anteroposterior diameter of the medial wall increases with age. This study showed that the anteroposterior total length of the medial orbit wall is similar between genders of similar age, increases with age, and has significant variations in the distances between the various structures that make up the medial orbit wall with regard to gender and age.

  5. Open Wedge High Tibial Osteotomy and Combined Arthroscopic Surgery in Severe Medial Osteoarthritis and Varus Malalignment: Minimum 5-Year Results

    PubMed Central

    Yoo, Moon-Jib; Shin, Yong-Eun

    2016-01-01

    Purpose To evaluate the radiologic and functional outcomes of medial open wedge high tibial osteotomy (HTO) combined with arthroscopic procedure in patients with medial osteoarthritis. Materials and Methods From June 1996 to March 2010, 26 patients (32 knees) who underwent medial open wedge osteotomy and arthroscopic operation for medial osteoarthritis were retrospectively reviewed. Measurements included hip-knee-ankle (HKA) angle, femorotibial angle, medial proximal tibial angle, posterior tibial slope angle, and Kellgren-Lawrence grade. Clinical evaluation was performed using Lysholm knee scoring scale and knee and function score of the American Knee Society. Results Differences between the mean preoperative and postoperative measurements were significant in all angles including the HKA angle (−5.7° and +5.5°), femorotibial angle (−1.9° and +9.8°), and medial proximal tibial angle (82.9° and 90.5°) (p<0.05). Mean Lysholm knee scoring scale was 63.6 preoperatively and 88.7 at the last follow-up, mean Knee Society knee score was 61.2 and 86.6, and mean function score was 59.3 and 87.2, respectively. All differences were significant (p<0.05). Conclusions Medial open wedge HTO in combination with arthroscopic procedure is an effective treatment method for medial osteoarthritis to treat varus deformity and an intra-articular lesion. PMID:27894173

  6. Partial-Payload Support Structure

    NASA Technical Reports Server (NTRS)

    Mitchell, R.; Freeman, M.

    1984-01-01

    Partial-payload support structure (PPSS) is modular, bridge like structure supporting experiments weighing up to 2 tons. PPSS handles such experiments more economically than standard Spacelab pallet system.

  7. Lipids in biocalcification: contrasts and similarities between intimal and medial vascular calcification and bone by NMR.

    PubMed

    Reid, David G; Shanahan, Catherine M; Duer, Melinda J; Arroyo, Luis G; Schoppet, Michael; Brooks, Roger A; Murray, Rachel C

    2012-08-01

    Pathomechanisms underlying vascular calcification biogenesis are still incompletely understood. Biomineral from human atherosclerotic intimal plaques; human, equine, and bovine medial vascular calcifications; and human and equine bone was released from collagenous organic matrix by sodium hydroxide/sodium hypochlorite digestion. Solid-state (13)C NMR of intimal plaque mineral shows signals from cholesterol/cholesteryl esters and fatty acids. In contrast, in mineral from pure medial calcifications and bone mineral, fatty acid signals predominate. Refluxing (chloroform/methanol) intimal plaque calcifications removes the cholesterylic but not the fatty acyl signals. The lipid composition of this refluxed mineral now closely resembles that of the medial and bone mineral, which is unchanged by reflux. Thus, intimal and medial vascular calcifications and bone mineral have in common a pool of occluded mineral-entrained fatty acyl-rich lipids. This population of fatty acid may contain methyl-branched fatty acids, possibly representing lipoprotein particle remnants. Cell signaling and mechanistic parallels between physiological (orthotopic) and pathological (ectopic) calcification are also reflected thus in the NMR spectroscopic fingerprints of mineral-associated and mineral-entrained lipids. Additionally the atherosclerotic plaque mineral alone shows a significant independent pool of cholesterylic lipids. Colocalization of mineral and lipid may be coincidental, but it could also reflect an essential mechanistic component of biomineralization.

  8. Associative Plasticity in the Medial Auditory Thalamus and Cerebellar Interpositus Nucleus During Eyeblink Conditioning

    PubMed Central

    Halverson, Hunter E.; Lee, Inah; Freeman, John H.

    2010-01-01

    Eyeblink conditioning, a type of associative motor learning, requires the cerebellum. The medial auditory thalamus is a necessary source of stimulus input to the cerebellum during auditory eyeblink conditioning. Nothing is currently known about interactions between the thalamus and cerebellum during associative learning. In the current study, neuronal activity was recorded in the cerebellar interpositus nucleus and medial auditory thalamus simultaneously from multiple tetrodes during auditory eyeblink conditioning to examine the relative timing of learning-related plasticity within these interconnected areas. Learning-related changes in neuronal activity correlated with the eyeblink conditioned response were evident in the cerebellum before the medial auditory thalamus over the course of training and within conditioning trials, suggesting that thalamic plasticity may be driven by cerebellar feedback. Short-latency plasticity developed in the thalamus during the first conditioning session and may reflect attention to the conditioned stimulus. Extinction training resulted in a decrease in learning-related activity in both structures and an increase in inhibition within the cerebellum. A feedback projection from the cerebellar nuclei to the medial auditory thalamus was identified, which may play a role in learning by facilitating stimulus input to the cerebellum via the thalamo-pontine projection. PMID:20592200

  9. Interactions between hippocampus and medial septum during sharp waves and theta oscillation in the behaving rat.

    PubMed

    Dragoi, G; Carpi, D; Recce, M; Csicsvari, J; Buzsáki, G

    1999-07-15

    The medial septal region and the hippocampus are connected reciprocally via GABAergic neurons, but the physiological role of this loop is still not well understood. In an attempt to reveal the physiological effects of the hippocamposeptal GABAergic projection, we cross-correlated hippocampal sharp wave (SPW) ripples or theta activity and extracellular units recorded in the medial septum and diagonal band of Broca (MSDB) in freely moving rats. The majority of single MSDB cells (60%) were significantly suppressed during SPWs. Most cells inhibited during SPW (80%) fired rhythmically and phase-locked to the negative peak of the CA1 pyramidal layer theta waves. Because both SPW and the negative peak of local theta waves correspond to the maximum discharge probability of CA1 pyramidal cells and interneuron classes, the findings indicate that the activity of medial septal neurons can be negatively (during SPW) or positively (during theta waves) correlated with the activity of hippocampal interneurons. We hypothesize that the functional coupling between medial septal neurons and hippocampal interneurons varies in a state-dependent manner.

  10. Estrogen receptor-a in medial amygdala neurons regulates body weight

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Estrogen receptor–a (ERa) activity in the brain prevents obesity in both males and females. However, the ERa-expressing neural populations that regulate body weight remain to be fully elucidated. Here we showed that single-minded–1 (SIM1) neurons in the medial amygdala (MeA) express abundant levels ...

  11. "TuNa-saving" endoscopic medial maxillectomy: a surgical technique for maxillary inverted papilloma.

    PubMed

    Pagella, Fabio; Pusateri, Alessandro; Matti, Elina; Avato, Irene; Zaccari, Dario; Emanuelli, Enzo; Volo, Tiziana; Cazzador, Diego; Citraro, Leonardo; Ricci, Giampiero; Tomacelli, Giovanni Leo

    2017-04-03

    The maxillary sinus is the most common site of sinonasal inverted papilloma. Endoscopic sinus surgery, in particular endoscopic medial maxillectomy, is currently the gold standard for treatment of maxillary sinus papilloma. Although a common technique, complications such as stenosis of the lacrimal pathway and consequent development of epiphora are still possible. To avoid these problems, we propose a modification of this surgical technique that preserves the head of the inferior turbinate and the nasolacrimal duct. A retrospective analysis was performed on patients treated for maxillary inverted papilloma in three tertiary medical centres between 2006 and 2014. Pedicle-oriented endoscopic surgery principles were applied and, in select cases where the tumour pedicle was located on the anterior wall, a modified endoscopic medial maxillectomy was carried out as described in this paper. From 2006 to 2014 a total of 84 patients were treated. A standard endoscopic medial maxillectomy was performed in 55 patients (65.4%), while the remaining 29 (34.6%) had a modified technique performed. Three recurrences (3/84; 3.6%) were observed after a minimum follow-up of 24 months. A new surgical approach for select cases of maxillary sinus inverted papilloma is proposed in this paper. In this technique, the endoscopic medial maxillectomy was performed while preserving the head of the inferior turbinate and the nasolacrimal duct ("TuNa-saving"). This technique allowed for good visualization of the maxillary sinus, good oncological control and a reduction in the rate of complications.

  12. Attention, Emotion, and Deactivation of Default Activity in Inferior Medial Prefrontal Cortex

    ERIC Educational Resources Information Center

    Geday, Jacob; Gjedde, Albert

    2009-01-01

    Attention deactivates the inferior medial prefrontal cortex (IMPC), but it is uncertain if emotions can attenuate this deactivation. To test the extent to which common emotions interfere with attention, we measured changes of a blood flow index of brain activity in key areas of the IMPC with positron emission tomography (PET) of labeled water…

  13. Working Memory, Long-Term Memory, and Medial Temporal Lobe Function

    ERIC Educational Resources Information Center

    Jeneson, Annette; Squire, Larry R.

    2012-01-01

    Early studies of memory-impaired patients with medial temporal lobe (MTL) damage led to the view that the hippocampus and related MTL structures are involved in the formation of long-term memory and that immediate memory and working memory are independent of these structures. This traditional idea has recently been revisited. Impaired performance…

  14. Medial parabrachial nucleus neurons modulate d-fenfluramine-induced anorexia through 5HT2C receptors.

    PubMed

    Trifunovic, Radmila; Reilly, Steve

    2006-01-05

    We previously reported that lesions of the medial parabrachial nucleus (PBN) enhanced d-fenfluramine (DFEN)-induced anorexia; a finding that suggests these lesions may potentiate the release of serotonin (5HT) or increase the postsynaptic action of 5HT. In the present study, we used SB 206553 (a 5HT2B/2C receptor antagonist) or m-CPP (a 5HT2C/1B receptor agonist) in a standard behavioral procedure (deprivation-induced feeding) to further explore the role of the medial PBN in drug-induced anorexia. In Experiment 1, DFEN (0 or 1.0 mg/kg) was given alone or in combination with SB 206553 (2.0 or 5.0 mg/kg). In Experiment 2, we investigated the food-suppressive effects of m-CPP (0.5, 1.0 or 2.0 mg/kg). The results of Experiment 1 show that SB 206553, while having no influence on the performance of control subjects, attenuated (2.0 mg/kg) or abolished (5 mg/kg) the potentiating effect of the lesions on DFEN-induced anorexia. In Experiment 2, m-CPP induced a suppression of food intake in nonlesioned animals that was significantly potentiated in rats with medial PBN lesions. These results are consistent with the hypothesis that medial PBN neurons mediate anorexia through 5HT2C receptors.

  15. Dissociated Roles for the Lateral and Medial Septum in Elemental and Contextual Fear Conditioning

    ERIC Educational Resources Information Center

    Calandreau, Ludovic; Jaffard, Robert; Desmedt, Aline

    2007-01-01

    Extensive evidence indicates that the septum plays a predominant role in fear learning, yet the direction of this control is still a matter of debate. Increasing data suggest that the medial (MS) and lateral septum (LS) would be differentially required in fear conditioning depending on whether a discrete conditional stimulus (CS) predicts, or not,…

  16. Distinct Roles for Medial Temporal Lobe Structures in Memory for Objects and Their Locations

    ERIC Educational Resources Information Center

    Buffalo, Elizabeth A.; Bellgowan, Patrick S. F.; Martin, Alex

    2006-01-01

    The ability to learn and retain novel information depends on a system of structures in the medial temporal lobe (MTL) including the hippocampus and the surrounding entorhinal, perirhinal, and parahippocampal cortices. Damage to these structures produces profound memory deficits; however, the unique contribution to memory of each of these…

  17. Network Alterations Supporting Word Retrieval in Patients with Medial Temporal Lobe Epilepsy

    ERIC Educational Resources Information Center

    Protzner, Andrea B.; McAndrews, Mary Pat

    2011-01-01

    Although the hippocampus is not considered a key structure in semantic memory, patients with medial-temporal lobe epilepsy (mTLE) have deficits in semantic access on some word retrieval tasks. We hypothesized that these deficits reflect the negative impact of focal epilepsy on remote cerebral structures. Thus, we expected that the networks that…

  18. Lateral and Medial Ventral Occipitotemporal Regions Interact During the Recognition of Images Revealed from Noise

    PubMed Central

    Nordhjem, Barbara; Ćurčić-Blake, Branislava; Meppelink, Anne Marthe; Renken, Remco J.; de Jong, Bauke M.; Leenders, Klaus L.; van Laar, Teus; Cornelissen, Frans W.

    2016-01-01

    Several studies suggest different functional roles for the medial and the lateral sections of the ventral visual cortex in object recognition. Texture and surface information is processed in medial sections, while shape information is processed in lateral sections. This begs the question whether and how these functionally specialized sections interact with each other and with early visual cortex to facilitate object recognition. In the current research, we set out to answer this question. In an fMRI study, 13 subjects viewed and recognized images of objects and animals that were gradually revealed from noise while their brains were being scanned. We applied dynamic causal modeling (DCM)—a method to characterize network interactions—to determine the modulatory effect of object recognition on a network comprising the primary visual cortex (V1), the lingual gyrus (LG) in medial ventral cortex and the lateral occipital cortex (LO). We found that object recognition modulated the bilateral connectivity between LG and LO. Moreover, the feed-forward connectivity from V1 to LG and LO was modulated, while there was no evidence for feedback from these regions to V1 during object recognition. In particular, the interaction between medial and lateral areas supports a framework in which visual recognition of objects is achieved by networked regions that integrate information on image statistics, scene content and shape—rather than by a single categorically specialized region—within the ventral visual cortex. PMID:26778997

  19. Disruption of the Perineuronal Net in the Hippocampus or Medial Prefrontal Cortex Impairs Fear Conditioning

    ERIC Educational Resources Information Center

    Hylin, Michael J.; Orsi, Sara A.; Moore, Anthony N.; Dash, Pramod K.

    2013-01-01

    The perineuronal net (PNN) surrounds neurons in the central nervous system and is thought to regulate developmental plasticity. A few studies have shown an involvement of the PNN in hippocampal plasticity and memory storage in adult animals. In addition to the hippocampus, plasticity in the medial prefrontal cortex (mPFC) has been demonstrated to…

  20. Hippocampus and Medial Prefrontal Cortex Contributions to Trace and Contextual Fear Memory Expression over Time

    ERIC Educational Resources Information Center

    Beeman, Christopher L.; Bauer, Philip S.; Pierson, Jamie L.; Quinn, Jennifer J.

    2013-01-01

    Previous work has shown that damage to the dorsal hippocampus (DH) occurring at recent, but not remote, timepoints following acquisition produces a deficit in trace conditioned fear memory expression. The opposite pattern has been observed with lesions to the medial prefrontal cortex (mPFC). The present studies address: (1) whether these lesion…

  1. Contributions of the Medial Temporal Lobe to Declarative Memory Retrieval: Manipulating the Amount of Contextual Retrieval

    ERIC Educational Resources Information Center

    Tendolkar, Indira; Arnold, Jennifer; Petersson, Karl Magnus; Weis, Susanne; Brockhaus-Dumke, Anke; van Eijndhoven, Philip; Buitelaar, Jan; Fernandez, Guillen

    2008-01-01

    We investigated how the hippocampus and its adjacent mediotemporal structures contribute to contextual and noncontextual declarative memory retrieval by manipulating the amount of contextual information across two levels of the same contextual dimension in a source memory task. A first analysis identified medial temporal lobe (MTL) substructures…

  2. The Human Medial Temporal Lobe Processes Online Representations of Complex Objects

    ERIC Educational Resources Information Center

    Barense, Morgan D.; Gaffan, David; Graham, Kim S.

    2007-01-01

    There has been considerable debate as to whether structures in the medial temporal lobe (MTL) support both memory and perception, in particular whether the perirhinal cortex may be involved in the perceptual discrimination of complex objects with a large number of overlapping features. Similar experiments testing the discrimination of blended…

  3. Sex determination using discriminant analysis of the medial and lateral condyles of the femur in Koreans.

    PubMed

    Kim, Deog-Im; Kwak, Dai-Soon; Han, Seung-Ho

    2013-12-10

    The proximal and distal parts of the femur show the differences between the sexes. Head diameter and the breadth of the epicondyle of the femur are known to distinguish males from females. The proximal end of the femur is studied to determine sex using discriminant analysis but; its distal end is not done. This study aims to develop an equation specific to Koreans by using the medial and lateral condyles of the femur, and to demonstrate the usefulness of equations for specific population groups. We used three-dimensional images from 202 Korean femurs. Twelve variables were measured with a computer program after the femurs were in alignment. Eleven variables showed a statistically significant difference between the sexes (P<0.01). The most accurate equation used width of the medial and lateral condyles (WDC), with of the medial condyle (WMC), depth of the lateral condyle (DLC), and depth of the intercondylar notch (DIN) (94.1%), and is as follows: D = 0.336 × WDC + (-0.097) × WMC + (-0.153) × DLC + 0.372 × DIN - 20.912. The second highest accuracy was 90.1% for the width dimensional group and WDC. This study shows that the medial and lateral condyles of the femur should be helpful for sex determination in situations where the skull and pelvis are missing and part of the femur is available. The study also demonstrates the need for different equations for different population groups.

  4. Distinct medial temporal networks encode surprise during motivation by reward versus punishment.

    PubMed

    Murty, Vishnu P; LaBar, Kevin S; Adcock, R Alison

    2016-10-01

    Adaptive motivated behavior requires predictive internal representations of the environment, and surprising events are indications for encoding new representations of the environment. The medial temporal lobe memory system, including the hippocampus and surrounding cortex, encodes surprising events and is influenced by motivational state. Because behavior reflects the goals of an individual, we investigated whether motivational valence (i.e., pursuing rewards versus avoiding punishments) also impacts neural and mnemonic encoding of surprising events. During functional magnetic resonance imaging (fMRI), participants encountered perceptually unexpected events either during the pursuit of rewards or avoidance of punishments. Despite similar levels of motivation across groups, reward and punishment facilitated the processing of surprising events in different medial temporal lobe regions. Whereas during reward motivation, perceptual surprises enhanced activation in the hippocampus, during punishment motivation surprises instead enhanced activation in parahippocampal cortex. Further, we found that reward motivation facilitated hippocampal coupling with ventromedial PFC, whereas punishment motivation facilitated parahippocampal cortical coupling with orbitofrontal cortex. Behaviorally, post-scan testing revealed that reward, but not punishment, motivation resulted in greater memory selectivity for surprising events encountered during goal pursuit. Together these findings demonstrate that neuromodulatory systems engaged by anticipation of reward and punishment target separate components of the medial temporal lobe, modulating medial temporal lobe sensitivity and connectivity. Thus, reward and punishment motivation yield distinct neural contexts for learning, with distinct consequences for how surprises are incorporated into predictive mnemonic models of the environment.

  5. Clinical results of single-session bilateral medial patellar luxation repair in 26 small breed dogs.

    PubMed

    Balogh, Daniel G; Kramek, Betty

    2016-04-01

    Medical records of 26 small breed dogs treated with single-session bilateral medial patellar luxation repair were reviewed. Excluding dogs with complications associated with cranial cruciate ligament disease, 20/21 dogs with long-term follow-up achieved a complete or acceptable clinical recovery. The complication rate was not increased compared to that previously reported for unilateral patellar luxation repair.

  6. Adaptation to Cognitive Context and Item Information in the Medial Temporal Lobes

    ERIC Educational Resources Information Center

    Diana, Rachel A.; Yonelinas, Andrew P.; Ranganath, Charan

    2012-01-01

    The medial temporal lobes (MTL) play an essential role in episodic memory, and accumulating evidence indicates that two MTL subregions--the perirhinal (PRc) and parahippocampal (PHc) cortices--might have different functions. According to the binding of item and context theory ( [16] and [21]), PRc is involved in processing item information, the…

  7. Medial Temporal Lobe Activity during Source Retrieval Reflects Information Type, Not Memory Strength

    ERIC Educational Resources Information Center

    Diana, Rachel A.; Yonelinas, Andrew P.; Ranganath, Charan

    2010-01-01

    The medial temporal lobes (MTLs) are critical for episodic memory but the functions of MTL subregions are controversial. According to memory strength theory, MTL subregions collectively support declarative memory in a graded manner. In contrast, other theories assert that MTL subregions support functionally distinct processes. For instance, one…

  8. Stability of the Medial Olivocochlear Reflex as Measured by Distortion Product Otoacoustic Emissions

    ERIC Educational Resources Information Center

    Mishra, Srikanta K.; Abdala, Carolina

    2015-01-01

    Purpose: The purpose of this study was to assess the repeatability of a fine-resolution, distortion product otoacoustic emission (DPOAE)-based assay of the medial olivocochlear (MOC) reflex in normal-hearing adults. Method: Data were collected during 36 test sessions from 4 normal-hearing adults to assess short-term stability and 5 normal-hearing…

  9. Medial Prefrontal Cortex Is Selectively Involved in Response Selection Using Visual Context in the Background

    ERIC Educational Resources Information Center

    Lee, Inah; Shin, Ji Yun

    2012-01-01

    The exact roles of the medial prefrontal cortex (mPFC) in conditional choice behavior are unknown and a visual contextual response selection task was used for examining the issue. Inactivation of the mPFC severely disrupted performance in the task. mPFC inactivations, however, did not disrupt the capability of perceptual discrimination for visual…

  10. Role of Medial Prefrontal Cortex Narp in the Extinction of Morphine Conditioned Place Preference

    ERIC Educational Resources Information Center

    Blouin, Ashley M.; Han, Sungho; Pearce, Anne M.; Cheng, KaiLun; Lee, JongAh J.; Johnson, Alexander W.; Wang, Chuansong; During, Matthew J.; Holland, Peter C.; Shaham, Yavin; Baraban, Jay M.; Reti, Irving M.

    2013-01-01

    Narp knockout (KO) mice demonstrate an impaired extinction of morphine conditioned place preference (CPP). Because the medial prefrontal cortex (mPFC) has been implicated in extinction learning, we tested whether Narp cells in this region play a role in the extinction of morphine CPP. We found that intracranial injections of adenoassociated virus…

  11. Reduced dopamine function within the medial shell of the nucleus accumbens enhances latent inhibition.

    PubMed

    Nelson, A J D; Thur, K E; Horsley, R R; Spicer, C; Marsden, C A; Cassaday, H J

    2011-03-01

    Latent inhibition (LI) manifests as poorer conditioning to a CS that has previously been presented without consequence. There is some evidence that LI can be potentiated by reduced mesoaccumbal dopamine (DA) function but the locus within the nucleus accumbens of this effect is as yet not firmly established. Experiment 1 tested whether 6-hydroxydopamine (6-OHDA)-induced lesions of DA terminals within the core and medial shell subregions of the nucleus accumbens (NAc) would enhance LI under conditions that normally disrupt LI in controls (weak pre-exposure). LI was measured in a thirst motivated conditioned emotional response procedure with 10 pre-exposures (to a noise CS) and 2 conditioning trials. The vehicle-injected and core-lesioned animals did not show LI and conditioned to the pre-exposed CS at comparable levels to the non-pre-exposed controls. 6-OHDA lesions to the medial shell, however, produced potentiation of LI, demonstrated across two extinction tests. In a subsequent experiment, haloperidol microinjected into the medial shell prior to conditioning similarly enhanced LI. These results underscore the dissociable roles of core and shell subregions of the NAc in mediating the expression of LI and indicate that reduced DA function within the medial shell leads to enhanced LI.

  12. LOCAL ORTHOGONAL CUTTING METHOD FOR COMPUTING MEDIAL CURVES AND ITS BIOMEDICAL APPLICATIONS

    PubMed Central

    Einstein, Daniel R.; Dyedov, Vladimir

    2010-01-01

    Medial curves have a wide range of applications in geometric modeling and analysis (such as shape matching) and biomedical engineering (such as morphometry and computer assisted surgery). The computation of medial curves poses significant challenges, both in terms of theoretical analysis and practical efficiency and reliability. In this paper, we propose a definition and analysis of medial curves and also describe an efficient and robust method called local orthogonal cutting (LOC) for computing medial curves. Our approach is based on three key concepts: a local orthogonal decomposition of objects into substructures, a differential geometry concept called the interior center of curvature (ICC), and integrated stability and consistency tests. These concepts lend themselves to robust numerical techniques and result in an algorithm that is efficient and noise resistant. We illustrate the effectiveness and robustness of our approach with some highly complex, large-scale, noisy biomedical geometries derived from medical images, including lung airways and blood vessels. We also present comparisons of our method with some existing methods. PMID:20628546

  13. Dissociable Contributions within the Medial Temporal Lobe to Encoding of Object-Location Associations

    ERIC Educational Resources Information Center

    Sommer, Tobias; Rose, Michael; Glascher, Jan; Wolbers, Thomas; Buchel, Christian

    2005-01-01

    The crucial role of the medial temporal lobe (MTL) in episodic memory is well established. Although there is little doubt that its anatomical subregions--the hippocampus, peri-, entorhinal and parahippocampal cortex (PHC)--contribute differentially to mnemonic processes, their specific functions in episodic memory are under debate. Data from…

  14. Cognitive Functioning after Medial Frontal Lobe Damage Including the Anterior Cingulate Cortex: A Preliminary Investigation

    ERIC Educational Resources Information Center

    Baird, Amee; Dewar, Bonnie-Kate; Critchley, Hugo; Gilbert, Sam J.; Dolan, Raymond J.; Cipolotti, Lisa

    2006-01-01

    Two patients with medial frontal lobe damage involving the anterior cingulate cortex (ACC) performed a range of cognitive tasks, including tests of executive function and anterior attention. Both patients lesions extended beyond the ACC, therefore caution needs to be exerted in ascribing observed deficits to the ACC alone. Patient performance was…

  15. Knee kinematics in medial osteoarthritis during in vivo weight-bearing activities.

    PubMed

    Hamai, Satoshi; Moro-oka, Taka-Aki; Miura, Hiromasa; Shimoto, Takeshi; Higaki, Hidehiko; Fregly, Benjamin J; Iwamoto, Yukihide; Banks, Scott A

    2009-12-01

    Dynamic knee kinematics were analyzed for medial osteoarthritic (OA) knees in three activities, including two types of maximum knee flexion. Continuous x-ray images of kneeling, squatting, and stair climbing motions were taken using a large flat panel detector. CT-derived bone models were used for the model registration-based 3D kinematic measurements. Three-dimensional joint kinematics and contact locations were determined using two methods: bone-fixed coordinate systems and by interrogation of CT-based bone model surfaces. The femur exhibited gradual external rotation with knee flexion for kneeling and squatting activities, and gradual internal rotation with knee extension for stair climbing. From 100 degrees to 120 degrees flexion, contact locations showed a medial pivot pattern similar to normal knees. However, knees with medial OA displayed a femoral internal rotation bias and less posterior translation when compared with normal knees. A classic screw-home movement was not observed in OA knees near extension. Decreased variability with both activities and methods of calculation were demonstrated for all three activities. In conclusion, the weight-bearing kinematics of patients with medial OA differs from normal knees. Pathological changes of the articulating surfaces and the ligaments correspond to observed abnormalities in knee kinematics.

  16. The medial frontal cortex contributes to but does not organize rat exploratory behavior.

    PubMed

    Blankenship, Philip A; Stuebing, Sarah L; Winter, Shawn S; Cheatwood, Joseph L; Benson, James D; Whishaw, Ian Q; Wallace, Douglas G

    2016-11-12

    Animals use multiple strategies to maintain spatial orientation. Dead reckoning is a form of spatial navigation that depends on self-movement cue processing. During dead reckoning, the generation of self-movement cues from a starting position to an animal's current position allow for the estimation of direction and distance to the position movement originated. A network of brain structures has been implicated in dead reckoning. Recent work has provided evidence that the medial frontal cortex may contribute to dead reckoning in this network of brain structures. The current study investigated the organization of rat exploratory behavior subsequent to medial frontal cortex aspiration lesions under light and dark conditions. Disruptions in exploratory behavior associated with medial frontal lesions were consistent with impaired motor coordination, response inhibition, or egocentric reference frame. These processes are necessary for spatial orientation; however, they are not sufficient for self-movement cue processing. Therefore it is possible that the medial frontal cortex provides processing resources that support dead reckoning in other brain structures but does not of itself compute the kinematic details of dead reckoning.

  17. SF-1 in the ventral medial hypothalamic nucleus: A key regulator of homeostasis

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The ventral medial hypothalamic nucleus (VMH) regulates food intake and body weight homeostasis. The nuclear receptor NR5A1 (steroidogenic factor 1; SF-1) is a transcription factor whose expression is highly restricted in the VMH and is required for the development of the nucleus. Neurons expressing...

  18. Diagnosis of hyperostosis of the medial calcaneal tubercle similar to a heel spur.

    PubMed

    Altan, Egemen; Senaran, Hakan; Can, Nuray; Aydin, Bahattin Kerem; Erkocak, Omer Faruk

    2013-01-01

    Calcaneal osteochondromas are rare conditions. To our knowledge, we present the first report of a calcaneal osteochondroma in an adolescent patient that was surprisingly similar to a heel spur, and, in addition, symptoms due to compression of the medial plantar nerve were present.

  19. Material-Specific Lateralization of Working Memory in the Medial Temporal Lobe

    ERIC Educational Resources Information Center

    Wagner, Dylan D.; Sziklas, Viviane; Garver, Krista E.; Jones-Gotman, Marilyn

    2009-01-01

    Mnemonic deficits in patients with medial temporal lobe (MTL) damage arising from temporal lobe epilepsy (TLE) are traditionally constrained to long-term episodic memory, sparing short-term and working memory (WM). This view of WM as being independent of MTL structures has recently been challenged by a small number of patient and neuroimaging…

  20. Partial arthrodeses of the wrist.

    PubMed

    Marcuzzi, A; Cristiani, G; Castagnini, L; Castagnetti, C; Caroli, A

    1995-01-01

    The authors report 16 cases of partial arthrodeses of the wrist for the treatment of Kienboeck's disease, pseudarthrosis of the scaphoid, rotatory subluxation of the scaphoid, rheumatoid arthritis, etc. Based on the good results obtained (76.6%) the authors believe that partial arthrodeses constitute the type of treatment indicated for the treatment of pathologies that involve only some of the carpal bones, and they also emphasize that this type of surgery represents a valid alternative to total arthrodesis of the wrist.

  1. Efficacy and Safety of a Novel Three-Step Medial Release Technique in Varus Total Knee Arthroplasty.

    PubMed

    Kim, Min Woo; Koh, In Jun; Kim, Ju Hwan; Jung, Jae Jong; In, Yong

    2015-09-01

    We investigated the efficacy and safety of our novel three-step medial release technique in varus total knee arthroplasty (TKA) over time. Two hundred sixty seven consecutive varus TKAs were performed by applying the algorithmic release technique which consisted of sequential release of the deep medial collateral ligament (step 1), the semimembranosus (step 2), and multiple needle puncturing of the superficial medial collateral ligament (step 3). One hundred seventeen, 114, and 36 knees were balanced after step 1, 2, and 3 releases, respectively. There were no significant differences in changes of medial and lateral laxities between groups in over a year. Our novel stepwise medial release technique was efficacious and safe in balancing varus knees during TKA.

  2. Large-Scale Meta-Analysis of Human Medial Frontal Cortex Reveals Tripartite Functional Organization

    PubMed Central

    Chang, Luke J.; Banich, Marie T.; Wager, Tor D.; Yarkoni, Tal

    2016-01-01

    The functional organization of human medial frontal cortex (MFC) is a subject of intense study. Using fMRI, the MFC has been associated with diverse psychological processes, including motor function, cognitive control, affect, and social cognition. However, there have been few large-scale efforts to comprehensively map specific psychological functions to subregions of medial frontal anatomy. Here we applied a meta-analytic data-driven approach to nearly 10,000 fMRI studies to identify putatively separable regions of MFC and determine which psychological states preferentially recruit their activation. We identified regions at several spatial scales on the basis of meta-analytic coactivation, revealing three broad functional zones along a rostrocaudal axis composed of 2–4 smaller subregions each. Multivariate classification analyses aimed at identifying the psychological functions most strongly predictive of activity in each region revealed a tripartite division within MFC, with each zone displaying a relatively distinct functional signature. The posterior zone was associated preferentially with motor function, the middle zone with cognitive control, pain, and affect, and the anterior with reward, social processing, and episodic memory. Within each zone, the more fine-grained subregions showed distinct, but subtler, variations in psychological function. These results provide hypotheses about the functional organization of medial prefrontal cortex that can be tested explicitly in future studies. SIGNIFICANCE STATEMENT Activation of medial frontal cortex in fMRI studies is associated with a wide range of psychological states ranging from cognitive control to pain. However, this high rate of activation makes it challenging to determine how these various processes are topologically organized across medial frontal anatomy. We conducted a meta-analysis across nearly 10,000 studies to comprehensively map psychological states to discrete subregions in medial frontal cortex

  3. Transient Superficial Peroneal Nerve Palsy After Anterior Cruciate Ligament Reconstruction

    PubMed Central

    2016-01-01

    A 19-year-old male subject was diagnosed with medial meniscal, lateral meniscal and anterior cruciate ligament (ACL) tear. The symptoms did not subside after 4 months of physical therapy, and he underwent arthroscopic partial medial and lateral meniscectomy and ACL reconstruction. Immediately after the patient woke up from general anesthesia, he started experience loss of sensation in the area of superficial peroneal nerve with inverted dorsiflexion of foot and ankle. Instantly, the bandage and knee brace was removed and a diagnosis of compartment syndrome was ruled out. After eight hours, post-operatively, the patient started receiving physiotherapy. He complained of numbness and tingling in the same area. After 24 h, post-operatively, the patient started to regain dorsiflexion and eversion gradually. Two days after the surgery, the patient exhibited complete recovery of neurological status. PMID:27478579

  4. External Knee Adduction and Flexion Moments during Gait and Medial Tibiofemoral Disease Progression in Knee Osteoarthritis

    PubMed Central

    Chang, Alison H.; Moisio, Kirsten C.; Chmiel, Joan S.; Eckstein, Felix; Guermazi, Ali; Prasad, Pottumarthi V.; Zhang, Yunhui; Almagor, Orit; Belisle, Laura; Hayes, Karen; Sharma, Leena

    2015-01-01

    Objective Test the hypothesis that greater baseline peak external knee adduction moment (KAM), KAM impulse, and peak external knee flexion moment (KFM) during the stance phase of gait are associated with baseline-to-2-year medial tibiofemoral cartilage damage and bone marrow lesion progression, and cartilage thickness loss. Methods Participants all had knee OA in at least one knee. Baseline peak KAM, KAM impulse, and peak KFM (normalized to body weight and height) were captured and computed using a motion analysis system and 6 force plates. Participants underwent MRI of both knees at baseline and two years later. To assess the association between baseline moments and baseline-to-2-year semiquantitative cartilage damage and bone marrow lesion progression and quantitative cartilage thickness loss, we used logistic regression with generalized estimating equations (GEE), adjusting for gait speed, age, gender, disease severity, knee pain severity, and medication use. Results The sample consisted of 391 knees (204 persons): mean age 64.2 years (SD 10.0); BMI 28.4 kg/m2 (5.7); 156 (76.5%) women. Greater baseline peak KAM and KAM impulse were each associated with worsening of medial bone marrow lesions, but not cartilage damage. Higher baseline KAM impulse was associated with 2-year medial cartilage thickness loss assessed both as % loss and as a threshold of loss, whereas peak KAM was related only to % loss. There was no relationship between baseline peak KFM and any medial disease progression outcome measures. Conclusion Findings support targeting KAM parameters in an effort to delay medial OA disease progression. PMID:25677110

  5. Brain Rewarding Stimulation Reduces Extracellular Glutamate Through Glial Modulation in Medial Prefrontal Cortex of Rats.

    PubMed

    Murakami, Gen; Nakamura, Masato; Takita, Masatoshi; Ishida, Yasushi; Ueki, Takatoshi; Nakahara, Daiichiro

    2015-11-01

    Growing evidence implicates a critical involvement of prefrontal glial modulation of extracellular glutamate (GLU) in aversive behaviors. However, nothing is known about whether prefrontal glial cells modulate GLU levels in rewarding behaviors. To address this question, we measured GLU efflux in the medial prefrontal cortex (PFC) of rats associated with rewarding behaviors. We used intracranial self-stimulation (ICSS) of the medial forebrain bundle (MFB) as the rewarding behavior. GLU was indirectly measured using microdialysis combined with on-line fluorometric detection of NADH resulting from the reaction of GLU and NAD(+) catalyzed by GLU dehydrogenase with a time resolution of 1 min. ICSS caused a minute-by-minute change of extracellular GLU in the medial PFC, with a slight decrease during the stimulation, followed by an increase afterward. This bidirectional change was tetrodotoxin insensitive and abolished by the gliotoxin fluorocitrate. To confirm and extend the previous studies of aversion-induced increase of extracellular GLU in the medial PFC, we also measured prefrontal GLU efflux associated with an aversive stimulation, immobilization stress. The temporal change in extracellular GLU caused by this stress was markedly different from that observed during ICSS. A rapid increase in GLU was detected during the aversive stimulation, followed by a large increase afterward. This bimodal change was tetrodotoxin insensitive, similar to that detected for ICSS. These findings indicate a bidirectional regulation of extracellular GLU by prefrontal glial cells associated with rat ICSS behavior, and reveal that glial modulation of GLU neurochemistry in the medial PFC contributes to rewarding as well as aversive behaviors in rats.

  6. Donor-site Morbidity of Medial and Lateral Thigh-based Flaps: A Comparative Study

    PubMed Central

    Purnell, Chad A.; Lewis, Kevin C.; Mioton, Lauren M.; Hanwright, Philip J.; Galiano, Robert D.; Dumanian, Gregory A.; Alghoul, Mohammed S.

    2016-01-01

    Background: Free and pedicled medial and lateral thigh-based flaps are common reconstructive procedures. However, there have been no comparative studies of morbidity between medial and lateral donor sites. Methods: We conducted an Enterprise Data Warehouse-based review of all the senior authors’ (R.D.G., G.A.D., and M.S.A.) thigh-based free and pedicled flaps. Patient demographic data, donor-site complications, drain duration, and number of postoperative visits were collected and compared. Complications were also compared between fasciocutaneous flaps and muscle or myocutaneous flaps, and skin grafted donor sites. Results: We analyzed 352 flap donor sites, with 155 medial and 197 lateral. Two hundred seventeen (217) flaps were pedicled. Flap types included 127 gracilis, 27 rectus femoris, 134 anterolateral thigh, and 36 vastus lateralis-only flaps. There were no significant differences in complications between medial (17.4%) and lateral thigh (21.3%) donor sites, although lateral thigh flaps had a mean of 1 additional postoperative visit. Rates of wound dehiscence/healing issues were significantly higher in both gracilis myocutaneous flaps (25.9%) and flaps requiring a skin grafted donor site (31.2%). Postoperative therapeutic anticoagulation was the only significant risk factor for a donor-site complication. Flap complications resulted in increased drain duration and postoperative office visits. Conclusions: Donor-site morbidity is similar in both lateral and medial thigh-based flaps. The inclusion of muscle in the flap from either donor site does not seem to increase complications, but the inclusion of a skin paddle with gracilis muscle, or a skin grafted lateral thigh donor site, results in increased wound healing complications. PMID:27975004

  7. Consciousness and epilepsy: why are complex-partial seizures complex?

    PubMed Central

    Englot, Dario J.; Blumenfeld, Hal

    2010-01-01

    Why do complex-partial seizures in temporal lobe epilepsy (TLE) cause a loss of consciousness? Abnormal function of the medial temporal lobe is expected to cause memory loss, but it is unclear why profoundly impaired consciousness is so common in temporal lobe seizures. Recent exciting advances in behavioral, electrophysiological, and neuroimaging techniques spanning both human patients and animal models may allow new insights into this old question. While behavioral automatisms are often associated with diminished consciousness during temporal lobe seizures, impaired consciousness without ictal motor activity has also been described. Some have argued that electrographic lateralization of seizure activity to the left temporal lobe is most likely to cause impaired consciousness, but the evidence remains equivocal. Other data correlates ictal consciousness in TLE with bilateral temporal lobe involvement of seizure spiking. Nevertheless, it remains unclear why bilateral temporal seizures should impair responsiveness. Recent evidence has shown that impaired consciousness during temporal lobe seizures is correlated with large-amplitude slow EEG activity and neuroimaging signal decreases in the frontal and parietal association cortices. This abnormal decreased function in the neocortex contrasts with fast polyspike activity and elevated cerebral blood flow in limbic and other subcortical structures ictally. Our laboratory has thus proposed the “network inhibition hypothesis,” in which seizure activity propagates to subcortical regions necessary for cortical activation, allowing the cortex to descend into an inhibited state of unconsciousness during complex-partial temporal lobe seizures. Supporting this hypothesis, recent rat studies during partial limbic seizures have shown that behavioral arrest is associated with frontal cortical slow waves, decreased neuronal firing, and hypometabolism. Animal studies further demonstrate that cortical deactivation and behavioral

  8. Partial anxiolytic action of morphine sulphate following microinjection into the central nucleus of the amygdala in rats.

    PubMed

    File, S E; Rodgers, R J

    1979-09-01

    In the social interaction test of anxiety, bilateral microinjections of morphine sulphate (10 microgram) into the central nucleus of the amygdala counteracted the reduction in social interaction normally seen when the test arena is unfamiliar to rats. However, these injections did not counteract the decrease in social interaction that is observed as illuminance of the arena is increased. Morphine injections into the medial site depressed social interaction below the levels shown by control animals. In the open field test, morphine produced a facilitation of peripheral activity when injected into the central nucleus whilst a decrease in rearing was observed following similar injections into the medial nucleus. Overall, these data indicate a partial anxiolytic action of morphine in the central amygdaloid nucleus. Results are discussed in relation to possible differences in opioid peptide innervation of these two amygdaloid nuclei.

  9. Partial synchronization and partial amplitude death in mesoscale network motifs.

    PubMed

    Poel, Winnie; Zakharova, Anna; Schöll, Eckehard

    2015-02-01

    We study the interplay between network topology and complex space-time patterns and introduce a concept to analytically predict complex patterns in networks of Stuart-Landau oscillators with linear symmetric and instantaneous coupling based solely on the network topology. These patterns consist of partial amplitude death and partial synchronization and are found to exist in large variety for all undirected networks of up to 5 nodes. The underlying concept is proved to be robust with respect to frequency mismatch and can also be extended to larger networks. In addition it directly links the stability of complete in-phase synchronization to only a small subset of topological eigenvalues of a network.

  10. Designing successful removable partial dentures.

    PubMed

    Daher, Tony; Hall, Dan; Goodacre, Charles J

    2006-03-01

    In today's busy dental offices, removable partial denture design is often abdicated by dentists, both as a result of a lack of experience and consensus of design and because of educational failure on the part of dental schools. The result is delegation of the clinical design process to the lab technician. The lack of clinical data provided to the dental technician jeopardizes the quality of care. This article will focus on a logical and simple approach to this problem, making removable partial denture design simple and predictably achievable. The clinical evidence related to removable partial denture design will be described, along with a checklist to simplify the process and make it practical and applicable to everyday clinical practice.

  11. Partial Priapism Treated with Pentoxifylline

    PubMed Central

    Cooper, Meghan A.; Carrion, Rafael E.; Yang, Christopher

    2015-01-01

    ABSTRACT Main findings: A 26-year-old man suffering from partial priapism was successfully treated with a regimen including pentoxifylline, a nonspecific phosphodiesterase inhibitor that is often used to conservatively treat Peyronie's disease. Case hypothesis: Partial priapism is an extremely rare urological condition that is characterized by thrombosis within the proximal segment of a single corpus cavernosum. There have only been 36 reported cases to date. Although several factors have been associated with this unusual disorder, such as trauma or bicycle riding, the etiology is still not completely understood. Treatment is usually conservative and consists of a non-steroidal anti-inflammatory and anti-thrombotic. Promising future implications: This case report supports the utilization of pentoxifylline in patients with partial priapism due to its anti-fibrogenic and anti-thrombotic properties. PMID:26401875

  12. Landsliding in partially saturated materials

    USGS Publications Warehouse

    Godt, J.W.; Baum, R.L.; Lu, N.

    2009-01-01

    [1] Rainfall-induced landslides are pervasive in hillslope environments around the world and among the most costly and deadly natural hazards. However, capturing their occurrence with scientific instrumentation in a natural setting is extremely rare. The prevailing thinking on landslide initiation, particularly for those landslides that occur under intense precipitation, is that the failure surface is saturated and has positive pore-water pressures acting on it. Most analytic methods used for landslide hazard assessment are based on the above perception and assume that the failure surface is located beneath a water table. By monitoring the pore water and soil suction response to rainfall, we observed shallow landslide occurrence under partially saturated conditions for the first time in a natural setting. We show that the partially saturated shallow landslide at this site is predictable using measured soil suction and water content and a novel unified effective stress concept for partially saturated earth materials. Copyright 2009 by the American Geophysical Union.

  13. Biomechanical investigation of two plating systems for medial column fusion in foot

    PubMed Central

    Simons, Paul; Sommerer, Theresia; Zderic, Ivan; Wahl, Dieter; Lenz, Mark; Skulev, Hristo; Knobe, Matthias; Gueorguiev, Boyko; Richards, R. Geoff; Klos, Kajetan

    2017-01-01

    Background Arthrodesis of the medial column (navicular, cuneiform I and metatarsal I) is performed for reasons such as Charcot arthropathy, arthritis, posttraumatic reconstruction or severe pes planus. However, the complication rate is still high and mainly resulting from inadequate fixation. Special plates, designed for medial column arthrodesis, seem to offer potential to reduce the complication rate. The aim of this study was to investigate biomechanically plantar and dorsomedial fusion of the medial column using two new plating systems. Methods Eight matched pairs of human cadaveric lower legs were randomized in two groups and medial column fusion was performed using either plantar or dorsomedial variable-angle locking compression plates. The specimens were biomechanically tested under cyclic progressively increasing axial loading with physiological profile of each cycle. In addition to the machine data, mediolateral x-rays were taken every 250 cycles and motion tracking was performed to determine movements at the arthrodesis site. Statistical analysis of the parameters of interest was performed at a level of significance p = 0.05. Results Displacement of the talo-navicular joint after 1000, 2000 and 4000 cycles was significantly lower for plantar plating (p≤0.039) while there was significantly less movement in the naviculo-cuneiform I joint for dorsal plating post these cycle numbers (p<0.001). Displacements in all three joints of the medial column, as well as angular and torsional deformations between the navicular and metatarsal I increased significantly for each plating technique between 1000, 2000 and 4000 cycles (p≤0.021). The two plating systems did not differ significantly with regard to stiffness and cycles to failure (p≥0.171). Conclusion From biomechanical point of view, although dorsomedial plating showed less movement than plantar plating in the current setup under dynamic loading, there was no significant difference between the two plating

  14. Epidemiologic study of dogs with the displacement or deformity of the medial and lateral fabellae in Japan.

    PubMed

    Yasukawa, Shinji; Edamura, Kazuya; Tanegashima, Koji; Kai, Hirotaka; Higuchi, Go; Nagasawa, Momoyo; Teshima, Kenji; Asano, Kazushi; Nakayama, Tomohiro

    2016-02-01

    The prevalences of displacement and deformity of the medial and lateral fabellae in dogs were investigated. This was a retrospective epidemiologic study. Radiographs of canine stifle joints (1022 limbs, 534 dogs) were obtained. The images were taken at the Nihon University Animal Medical Center and three private animal hospitals from January 2003 to July 2012. The position and morphology of the medial or lateral fabella were evaluated on the radiographs. The prevalence of displacement of the medial and lateral fabellae was 1.7% and 0.3%, respectively. The prevalence of deformity of the medial and lateral fabellae was 6.9% and 4.6%, respectively. Aplasia or hypoplasia of the fabella was detected more frequently in the medial fabella. On the other hand, a bipartite or multipartite fabella was observed more frequently in the lateral fabella. Nearly all cases of displacement or deformity of the fabella occurred in dogs weighing less than 10 kg. Abnormalities of the fabella were observed in the medial and lateral fabella. We found that abnormal fabellae were closely associated with medial patellar luxation and to a lesser extent with cranial cruciate ligament rupture. No clinical signs were associated with an abnormality of the fabella, with the exception of two dogs with traumatic avulsion of the lateral head of the gastrocnemius muscle.

  15. A More Informed Evaluation of Medial Compartment Loading: the Combined Use of the Knee Adduction and Flexor Moments

    PubMed Central

    Manal, Kurt; Gardinier, Emily; Buchanan, Thomas S.; Snyder-Mackler, Lynn

    2015-01-01

    Objective To evaluate if the peak knee flexor moment provides unique and meaningful information about peak medial compartment loading above and beyond what is obtained from the peak knee adduction moment. Methods Standard video-based motion capture and EMG recordings were collected for 10 ACL reconstructed subjects walking at a self-selected speed. Knee joint moments were obtained using inverse dynamics and medial contact force was computed using an EMG-driven musculoskeletal model. Linear regression with the peak adductor moment entered first was implemented to isolate the unique contribution of the peak flexor moment to peak medial loading. Results Peak moments and medial contact force occurred during weight acceptance at approximately 23% of stance. The peak adduction moment (pKAM) was a significant predictor of peak medial loading (p = 0.004) accounting for approximately 63% of the variance. The peak knee flexor moment (pKFM) was also a significant predictor (p = 0.009) accounting for an additional 22% of the variance. When entered together pKAM and pKFM accounted for more than 85% of the variance in peak medial compartment loading. Conclusion The combined use of the peak knee flexor and adductor moments provides a significantly more accurate estimate of peak medial joint loading than the peak adduction moment alone. More accurate inferences of joint contact force will assist clinicians and researchers investigating relationships between joint loading and the onset and progression of knee OA. PMID:25862486

  16. Partially coherent vectorial nonparaxial beams.

    PubMed

    Duan, Kailiang; Lü, Baida

    2004-10-01

    Generalized vectorial Rayleigh-Sommerfeld diffraction integrals are developed for the cross-spectral-density matrices of spatially partially coherent beams. Using the Gaussian Schell-model (GSM) beam as an example, we derive the expressions for the propagation of cross-spectral-density matrices and intensity of partially coherent vectorial nonparaxial beams, and the corresponding far-field asymptotic forms, beyond the paraxial approximation. The propagation of the vectorial nonparaxial GSM beams are evaluated and analyzed. It is shown that a 3 x 3 cross-spectral-density matrix or a vector theory is required for the exact description of nonparaxial GSM beams.

  17. Apparatus for generating partially coherent radiation

    DOEpatents

    Naulleau, Patrick P.

    2005-02-22

    Techniques for generating partially coherent radiation and particularly for converting effectively coherent radiation from a synchrotron to partially coherent EUV radiation suitable for projection lithography.

  18. Assessment of the Medial Dorsal Cutaneous, Dorsal Sural, and Medial Plantar Nerves in Impaired Glucose Tolerance and Diabetic Patients With Normal Sural and Superficial Peroneal Nerve Responses

    PubMed Central

    Im, Sun; Kim, Sung-Rae; Park, Joo Hyun; Kim, Yang Soo; Park, Geun-Young

    2012-01-01

    OBJECTIVE This study evaluated the nerve conduction study (NCS) parameters of the most distal sensory nerves of the lower extremities—namely, the medial dorsal cutaneous (MDC), dorsal sural (DS), and medial plantar (MP) nerves—in diabetic (DM) and impaired glucose tolerance (IGT) patients who displayed normal findings on their routine NCSs. RESEARCH DESIGN AND METHODS Standard NCSs were performed on healthy control (HC), DM, and IGT groups (N = 147). The bilateral NCS parameters of the MDC, DS, and MP nerves were investigated. The Toronto Clinical Scoring System (TCSS) was assessed for the DM and IGT groups. RESULTS The mean TCSS scores of the IGT and DM groups were 2.5 ± 2.3 and 2.8 ± 2.2, respectively. No significant differences between the two groups were observed. After adjustment of age and BMI, the DM group showed significant NCS differences in DS and MDC nerves compared with the HC group (P < 0.05). These differences were also exhibited in the left DS of the IGT group (P = 0.0003). More advanced NCS findings were observed in the DM group. Bilateral abnormal NCS responses in these distal sensory nerves were found in 40 and 16% of DM and IGT patients, respectively. CONCLUSIONS These results showed that the simultaneous assessment of the most distal sensory nerves allowed the detection of early NCS changes in the IGT and DM groups, even when the routine NCS showed normal findings. PMID:22100966

  19. Deep Brain Stimulation of Medial Dorsal and Ventral Anterior Nucleus of the Thalamus in OCD: A Retrospective Case Series

    PubMed Central

    Lenartz, Doris; Kuhn, Jens; Sturm, Volker

    2016-01-01

    Background The current notion that cortico-striato-thalamo-cortical circuits are involved in the pathophysiology of obsessive-compulsive disorder (OCD) has instigated the search for the most suitable target for deep brain stimulation (DBS). However, despite extensive research, uncertainty about the ideal target remains with many structures being underexplored. The aim of this report is to address a new target for DBS, the medial dorsal (MD) and the ventral anterior (VA) nucleus of the thalamus, which has thus far received little attention in the treatment of OCD. Methods In this retrospective trial, four patients (three female, one male) aged 31–48 years, suffering from therapy-refractory OCD underwent high-frequency DBS of the MD and VA. In two patients (de novo group) the thalamus was chosen as a primary target for DBS, whereas in two patients (rescue DBS group) lead implantation was performed in a rescue DBS attempt following unsuccessful primary stimulation. Results Continuous thalamic stimulation yielded no significant improvement in OCD symptom severity. Over the course of thalamic DBS symptoms improved in only one patient who showed “partial response” on the Yale-Brown Obsessive Compulsive (Y-BOCS) Scale. Beck Depression Inventory scores dropped by around 46% in the de novo group; anxiety symptoms improved by up to 34%. In the de novo DBS group no effect of DBS on anxiety and mood was observable. Conclusion MD/VA-DBS yielded no adequate alleviation of therapy-refractory OCD, the overall strategy in targeting MD/VA as described in this paper can thus not be recommended in DBS for OCD. The magnocellular portion of MD (MDMC), however, might prove a promising target in the treatment of mood related and anxiety disorders. PMID:27504631

  20. Decreased synaptic plasticity in the medial prefrontal cortex underlies short-term memory deficits in 6-OHDA-lesioned rats.

    PubMed

    Matheus, Filipe C; Rial, Daniel; Real, Joana I; Lemos, Cristina; Ben, Juliana; Guaita, Gisele O; Pita, Inês R; Sequeira, Ana C; Pereira, Frederico C; Walz, Roger; Takahashi, Reinaldo N; Bertoglio, Leandro J; Da Cunha, Cláudio; Cunha, Rodrigo A; Prediger, Rui D

    2016-03-15

    Parkinson's disease (PD) is characterized by motor dysfunction associated with dopaminergic degeneration in the dorsolateral striatum (DLS). However, motor symptoms in PD are often preceded by short-term memory deficits, which have been argued to involve deregulation of medial prefrontal cortex (mPFC). We now used a 6-hydroxydopamine (6-OHDA) rat PD model to explore if alterations of synaptic plasticity in DLS and mPFC underlie short-term memory impairments in PD prodrome. The bilateral injection of 6-OHDA (20μg/hemisphere) in the DLS caused a marked loss of dopaminergic neurons in the substantia nigra (>80%) and decreased monoamine levels in the striatum and PFC, accompanied by motor deficits evaluated after 21 days in the open field and accelerated rotarod. A lower dose of 6-OHDA (10μg/hemisphere) only induced a partial degeneration (about 60%) of dopaminergic neurons in the substantia nigra with no gross motor impairments, thus mimicking an early premotor stage of PD. Notably, 6-OHDA (10μg)-lesioned rats displayed decreased monoamine levels in the PFC as well as short-term memory deficits evaluated in the novel object discrimination and in the modified Y-maze tasks; this was accompanied by a selective decrease in the amplitude of long-term potentiation in the mPFC, but not in DLS, without changes of synaptic transmission in either brain regions. These results indicate that the short-term memory dysfunction predating the motor alterations in the 6-OHDA model of PD is associated with selective changes of information processing in PFC circuits, typified by persistent changes of synaptic plasticity.

  1. Dorsal hippocampus and medial prefrontal cortex each contribute to the retrieval of a recent spatial memory in rats.

    PubMed

    Cholvin, Thibault; Loureiro, Michaël; Cassel, Raphaelle; Cosquer, Brigitte; Herbeaux, Karin; de Vasconcelos, Anne Pereira; Cassel, Jean-Christophe

    2016-01-01

    Systems-level consolidation models propose that recent memories are initially hippocampus-dependent. When remote, they are partially or completely dependent upon the medial prefrontal cortex (mPFC). An implication of the mPFC in recent memory, however, is still debated. Different amounts of muscimol (MSCI 0, 30, 50, 80 and 250 ng in 1 µL PBS) were used to assess the impact of inactivation of the dorsal hippocampus (dHip) or the mPFC (targeting the prelimbic cortex) on a 24-h delayed retrieval of a platform location that rats had learned drug-free in a water maze. The two smallest amounts of MSCI (30 and 50 ng) did not affect recall, whatever the region. 80 ng MSCI infused into the dHip disrupted spatial memory retrieval, as did the larger amount. Infusion of MSCI into the mPFC did not alter performance in the 0-80 ng range. At 250 ng, it induced an as dramatic memory impairment as after efficient dHip inactivation. Stereological quantifications showed that 80 ng MSCI in the dHip and 250 ng MSCI in the mPFC induced a more than 80% reduction of c-Fos expression, suggesting that, beyond the amounts infused, it is the magnitude of the neuronal activity decrease which is determinant as to the functional outcome of the inactivation. Because, based on the literature, even 250 ng MSCI is a small amount, our results point to a contribution of the mPFC to the recall of a recently acquired spatial memory and thereby extend our knowledge about the functions of this major actor of cognition.

  2. Altered structure and function in the hippocampus and medial prefrontal cortex in patients with burning mouth syndrome.

    PubMed

    Khan, Shariq A; Keaser, Michael L; Meiller, Timothy F; Seminowicz, David A

    2014-08-01

    Burning mouth syndrome (BMS) is a debilitating, idiopathic chronic pain condition. For many BMS patients, burning oral pain begins in late morning and becomes more intense throughout the day, peaking by late afternoon or evening. We investigated brain gray matter volume (GMV) with voxel-based morphometry (VBM), white matter fractional anisotropy (FA) with diffusion tensor imaging (DTI), and functional connectivity in resting state functional MRI (rsfMRI) in a tightly screened, homogeneous sample of 9 female, postmenopausal/perimenopausal BMS patients and 9 matched healthy control subjects. Patients underwent 2 scanning sessions in the same day: in the morning, when ongoing pain/burning was low, and in the afternoon, when pain/burning was significantly higher. Patients had increased GMV and lower FA in the hippocampus (Hc), and decreased GMV in the medial prefrontal cortex (mPFC). rsfMRI revealed altered connectivity patterns in different states of pain/burning, with increased connectivity between mPFC (a node in the default mode network) and anterior cingulate cortex, occipital cortex, ventromedial PFC, and bilateral Hc/amygdala in the afternoon compared with the morning session. Furthermore, mPFC-Hc connectivity was higher in BMS patients than control subjects for the afternoon but not the morning session. mPFC-Hc connectivity was related to Beck depression inventory scores both between groups and between burning states within patients, suggesting that depression and anxiety partially explain pain-related brain dysfunction in BMS. Overall, we provide multiple lines of evidence supporting aberrant structure and function in the mPFC and Hc, and implicate a circuit involving the mPFC and Hc in regulating mood and depressive symptoms in BMS.

  3. Post-traumatic pseudoaneurysm of the medial plantar artery combined with tarsal tunnel syndrome: two case reports.

    PubMed

    Park, Sang-Eun; Kim, Ji-Chang; Ji, Jong-Hun; Kim, Young-Yul; Lee, Hwan-Hee; Jeong, Jae-Jung

    2013-03-01

    Pseudoaneurysms in the foot are more often reported in the lateral plantar artery than the medial plantar artery, most likely because of its more superficial location. There are no reports of pseudoaneurysm of the medial plantar artery after trauma. We present two cases of pseudoaneurysm of the medial plantar artery after blunt foot trauma and foot laceration. This pseudoaneurysm compressed a posterior tibial nerve, resulting in tarsal tunnel syndrome. The patients were treated successfully using transcatheter embolization without the need for surgical intervention. The tarsal tunnel syndrome also subsided. Here, the authors report these cases and provide a review of literature.

  4. Neglected fracture of the medial humeral epicondyle that was entrapped into the elbow joint: a case report.

    PubMed

    Potenza, Vito; Farsetti, Pasquale; Caterini, Roberto; Bisicchia, Salvatore; De Luna, Vincenzo; Ippolito, Ernesto

    2010-11-01

    The objective of this paper is to report clinical and radiographic long-term results of a neglected fracture of the medial humeral epicondyle, which was entrapped into the elbow joint. At follow-up, 48 years after the trauma, the patient complained of occasional discomfort around the elbow, but the joint had a normal range of motion and good stability. Radiographs showed that the epicondylar fragment was fused to the medial border of the olecranon. The authors conclude that an old fracture of the medial humeral epicondyle, presenting a fusion of the fragment to the olecranon with normal range of motion and without pain, may be managed expectantly.

  5. Toxoplasma gondii infection reduces predator aversion in rats through epigenetic modulation in the host medial amygdala.

    PubMed

    Hari Dass, Shantala Arundhati; Vyas, Ajai

    2014-12-01

    Male rats (Rattus novergicus) infected with protozoan Toxoplasma gondii relinquish their innate aversion to the cat odours. This behavioural change is postulated to increase transmission of the parasite to its definitive felid hosts. Here, we show that the Toxoplasma gondii infection institutes an epigenetic change in the DNA methylation of the arginine vasopressin promoter in the medial amygdala of male rats. Infected animals exhibit hypomethylation of arginine vasopressin promoter, leading to greater expression of this nonapeptide. The infection also results in the greater activation of the vasopressinergic neurons after exposure to the cat odour. Furthermore, we show that loss of fear in the infected animals can be rescued by the systemic hypermethylation and recapitulated by directed hypomethylation in the medial amygdala. These results demonstrate an epigenetic proximate mechanism underlying the extended phenotype in the Rattus novergicus-Toxoplasma gondii association.

  6. Attentional modulation of medial olivocochlear inhibition: evidence for immaturity in children.

    PubMed

    Mishra, Srikanta K

    2014-12-01

    Efferent feedback shapes afferent auditory processing. Auditory attention has been shown to modulate medial olivocochlear (MOC) efferent activity in human adults. Since auditory attention continues to develop throughout childhood, the present study explored whether attentional control of medial-efferent inhibition in 5-10 year-old children is adult-like. MOC inhibition was measured in adults (n = 14) and children (n = 12) during no-task (contralateral broadband noise), passive (contralateral noise with tone-pips) and active listening conditions (attended tone-pips embedded in contralateral broadband noise). A stronger MOC inhibition was observed when measured during the active listening condition for adults which is consistent with past work. However, the effect of auditory attention on MOC inhibition in children was not robust and was significantly lower compared to that observed for adults. These findings suggest the potential immaturity of the attentional mediation of MOC inhibition in tested children.

  7. Medial antebrachial cutaneous nerve injury after brachial plexus block: two case reports.

    PubMed

    Jung, Mi Jin; Byun, Ha Young; Lee, Chang Hee; Moon, Seung Won; Oh, Min-Kyun; Shin, Heesuk

    2013-12-01

    Medial antebrachial cutaneous (MABC) nerve injury associated with iatrogenic causes has been rarely reported. Local anesthesia may be implicated in the etiology of such injury, but has not been reported. Two patients with numbness and painful paresthesia over the medial aspect of the unilateral forearm were referred for electrodiagnostic study, which revealed MABC nerve lesion in each case. The highly selective nature of the MABC nerve injuries strongly suggested that they were the result of direct nerve injury by an injection needle during previous brachial plexus block procedures. Electrodiagnostic studies can be helpful in evaluating cases of sensory disturbance after local anesthesia. To our knowledge, these are the first documented cases of isolated MABC nerve injury following ultrasound-guided axillary brachial plexus block.

  8. Myocutaneous flap (V-Y design) from the nasal bridge for medial canthal reconstruction.

    PubMed

    Moretti, E A; Gomez Garcia, F

    1998-07-01

    Repair of soft tissue loss of the medial canthal area is usually accomplished by using skin grafts or frontal flaps based on the glabellar vessels. However, skin grafts can provoke scar tissue contracture, or skin color chromatic changes (hypopigmentation or hyperpigmentation). On the other hand, frontal flaps are sometimes thicker than normal skin and lead to unsatisfactory aesthetic results. To avoid these disadvantages, the authors designed an alternative method for reconstruction of defects of the medical canthal area. The authors suggest using a myocutaneous flap (V-Y design) from the nasal bridge to repair soft tissue defects no larger than 2 cm in diameter (surface < 4 cm2) in the medial canthal area. The pedicle of this flap is based on supratrochlear and dorsal nasal vessels. This technique has proved safe and reliable and has led to good functional and cosmetic results.

  9. Thalamic neglect. Possible role of the medial thalamus and nucleus reticularis in behavior.

    PubMed

    Watson, R T; Valenstein, E; Heilman, K M

    1981-08-01

    A patient had an ischemic infarction of the right medial thalamus, with a resultant contralateral neglect syndrome. We propose that the medial thalamic nuclei, particularly centromedian and parafascicularis (CMPF), are normally involved in the arousal-activation process by which an organism can be aroused by and respond to novel or important stimuli. Specifically, we propose that (1) the mesencephalic reticular formation subserves tonic arousal to novel or painful stimuli by inhibiting the nucleus reticularis thalami (NR) and (2) that selective attention is mediated by cortical input to NR. The CMPF is closely associated with motor systems (basal ganglia, ventrolateral nucleus of the thalamus [VL], and frontal lobes). A pathway involving CMPF, the frontal cortex, and the portion of NR associated with VL may be important in preparing the tonically aroused organism for action. Unilateral lesions of CMPF therefore induce an asymmetric hypokinesia, and bilateral lesions may induce akinetic mutism.

  10. Challenges of High Resolution Diffusion Imaging of the Human Medial Temporal Lobe in Alzheimer's Disease

    PubMed Central

    Zeineh, Michael M.; Holdsworth, Samantha; Skare, Stefan; Atlas, Scott W.; Bammer, Roland

    2011-01-01

    The human medial temporal lobe performs an essential role in memory formation and retrieval. Diseases involving the hippocampus such as Alzheimer's disease present a unique opportunity for advanced imaging techniques to detect abnormalities at an early stage. In particular, it is possible that diffusion imaging may measure abnormal microarchitecture beyond the realm of macroscopic imaging. However, this task is formidable because of the detailed anatomy of the medial temporal lobe, the difficulties in obtaining high quality diffusion images of adequate resolution, and challenges in diffusion data processing. Moreover, it is unclear if any differences will be significant for an individual patient or simply groups of patients. Successful endeavors will need to address each of these challenges in an integrated fashion. The rewards of such analysis may be detection of microscopic disease in vivo, which could represent a landmark accomplishment for the field of neuroradiology. PMID:22158129

  11. Paediatric medial epicondyle fracture without elbow dislocation associated with intra-articular ulnar nerve entrapment.

    PubMed

    Elbashir, Mohamed; Domos, Peter; Latimer, Mark

    2015-11-05

    Elbow fractures are not uncommon in children, and some are associated with neurovascular injuries. Having a nerve injury in an elbow fracture without dislocation is rare and was not described in the literature. Here, we have reported probably the first case of an ulnar nerve injury in an elbow fracture without dislocation. A 9-year-old female presented to the emergency department after falling off a monkey bar. She had a painful, swollen and tender right elbow with no history or clinical signs of an elbow dislocation but had complete ulnar nerve palsy. She was managed initially with analgesia and plaster application and was taken directly to the operating theatre. Examination under anaesthesia revealed no elbow joint instability. The ulnar nerve was found entrapped between the trochlea and proximal ulna, intra-articularly. The medial epicondyle was also found avulsed from the humerus, with an incarcerated medial epicondylar fragment in the elbow joint.

  12. Endoscopic transnasal approach for treatment of the medial orbital blowout fracture using nasal septum graft.

    PubMed

    Ballin, Carlos R; Sava, Luiz C; Maeda, Carlos A S; Nogueira, Gustavo F; Jebahi, Yasser; Sava, Henrique W; Koladicz, Karyn R J

    2009-02-01

    We present the experience of the Ear, Nose, and Throat Department of Santa Casa de Misericórdia de Curitiba and Hospital Universitário Cajuru PUC-PR in the transnasal endoscopic approach to medial orbital blowout fractures using nasal septum grafts. Seventeen patients have undergone endoscopic repair since June 2005, and septum grafts were used to maintain the orbital contents in position. All 17 patients were treated with this method. Two patients had diplopia on immediate postoperative evaluation. This symptom was corrected with orthoptic exercises in one patient, and the other had a little residual diplopia. Postoperative computed tomography scans showed anatomic reduction in 14 of 17 cases. There were no complications in these surgeries. The transnasal endoscopic approach is a reasonable method for the treatment of medial orbital blowout fractures. Use of septum graft is another surgical alternative for this technique.

  13. Optogenetic activation of septal GABAergic afferents entrains neuronal firing in the medial habenula

    PubMed Central

    Choi, Kyuhyun; Lee, Youngin; Lee, Changwoo; Hong, Seokheon; Lee, Soonje; Kang, Shin Jung; Shin, Ki Soon

    2016-01-01

    The medial habenula (MHb) plays an important role in nicotine-related behaviors such as nicotine aversion and withdrawal. The MHb receives GABAergic input from the medial septum/diagonal band of Broca (MS/DB), yet the synaptic mechanism that regulates MHb activity is unclear. GABA (γ -aminobutyric acid) is a major inhibitory neurotransmitter activating both GABAA receptors and GABAB receptors. Depending on intracellular chloride concentration, however, GABAA receptors also function in an excitatory manner. In the absence of various synaptic inputs, we found that MHb neurons displayed spontaneous tonic firing at a rate of about ~4.4 Hz. Optogenetic stimulation of MS/DB inputs to the MHb evoked GABAA receptor-mediated synaptic currents, which produced stimulus-locked neuronal firing. Subsequent delayed yet lasting activation of GABAB receptors attenuated the intrinsic tonic firing. Consequently, septal GABAergic input alone orchestrates both excitatory GABAA and inhibitory GABAB receptors, thereby entraining the firing of MHb neurons. PMID:27703268

  14. Paediatric medial epicondyle fracture without elbow dislocation associated with intra-articular ulnar nerve entrapment

    PubMed Central

    Elbashir, Mohamed; Domos, Peter; Latimer, Mark

    2015-01-01

    Elbow fractures are not uncommon in children, and some are associated with neurovascular injuries. Having a nerve injury in an elbow fracture without dislocation is rare and was not described in the literature. Here, we have reported probably the first case of an ulnar nerve injury in an elbow fracture without dislocation. A 9-year-old female presented to the emergency department after falling off a monkey bar. She had a painful, swollen and tender right elbow with no history or clinical signs of an elbow dislocation but had complete ulnar nerve palsy. She was managed initially with analgesia and plaster application and was taken directly to the operating theatre. Examination under anaesthesia revealed no elbow joint instability. The ulnar nerve was found entrapped between the trochlea and proximal ulna, intra-articularly. The medial epicondyle was also found avulsed from the humerus, with an incarcerated medial epicondylar fragment in the elbow joint. PMID:26546588

  15. [A case of medial medullary infarction with persistent primitive hypoglossal artery].

    PubMed

    Jin, Kazutaka; Aihara, Naoto; Tsukamoto, Tetsuro

    2002-04-01

    A 66-year-old woman was admitted to our hospital because of vomiting, dizziness and vertigo. Neurological examination on admission revealed only upbeat nystagmus without cranial nerve symptoms, paresis, cerebellar signs or sensory disturbances. Magnetic resonance(MR) images demonstrated a new T 2 high intensity and T 1 iso-intensity signal lesion in the right upper medial medulla. This medial medullary infarction caused central vestibular dysfunction. MR angiography and digital subtraction angiography demonstrated a persistent primitive hypoglossal artery (PPHA) originating from the right internal carotid artery to the vertebrobasilar artery associated with the stenosis of the right internal carotid artery at the level of the cervical bifurcation. This is the first report of medullary infarction with persistent carotid-basilar anastomosis. We suspected this medullary infarction was caused by artery to artery embolism in the branch of the right vertebral artery through the PPHA distal originated from the stenosis of the right internal carotid artery.

  16. Shape similarity comparison of protein CPK models based on improved L₁-medial skeleton.

    PubMed

    Qin, S W; Li, Z; Jin, Y; Zhang, S P

    2014-01-01

    We propose a new method to analyse the similarity of protein CPK models. In the proposed method we first construct the skeleton of protein models by an improved L1-medial skeleton extraction. The skeleton information is then used to form a local radius descriptor. Finally, the shape similarity of protein models is compared by using the local radius descriptor based on the absolute degree of grey incidence. Experimental results show that the improved L1-medial skeleton of protein models can describe the shapes of the protein models well. The local descriptor based on the skeleton combined with the absolute degree of grey incidence shows satisfactory performance for comparing the shape similarity of protein CPK models.

  17. Acute bilateral cerebellar infarction in the territory of the medial branches of posterior inferior cerebellar arteries.

    PubMed

    Gurer, G; Sahin, G; Cekirge, S; Tan, E; Saribas, O

    2001-10-01

    The most frequent type of cerebellar infarcts involved the posterior inferior cerebellar artery (PICA) and superior cerebellar artery territories but bilateral involvement of lateral or medial branches of PICA is extremely rare. In this report, we present a 55-year-old male who admitted to hospital with vomiting, nausea and dizziness. On examination left-sided hemiparesia and ataxic gait were detected. Infarct on bilateral medial branch of PICA artery territories was found out with cranial magnetic resonance imaging (MRI) technique and 99% stenosis of the left vertebral artery was found out with digital subtraction arteriography. The patient was put on heparin treatment. After 3 weeks, his complaints and symptoms had disappeared except for mild gait ataxia.

  18. Transnasal, Transethmoidal Endoscopic Removal of a Foreign Body in the Medial Extraconal Orbital Space

    PubMed Central

    Sobrino Guijarro, Beatriz; Cenjor Español, Carlos

    2016-01-01

    Intraorbital foreign bodies are located within the orbit but outside the ocular globe. Though not uncommon, removal of these objects poses a challenge for surgeons. External approaches have been the most frequently used but are associated with increased complications and morbidity. An endoscopic endonasal approach can be an appropriate and less complicated technique in these cases. We report a case of a chronic intraorbital foreign body located within the medial extraconal space lateral to the lamina papyracea and behind the lacrimonasal duct, which was successfully removed using a transnasal, transethmoidal endoscopic technique. Neither postoperative complications nor ocular impairment was reported. The patient improved and remains asymptomatic. The transnasal transethmoidal endoscopic approach can be used as a safer and less invasive alternative when removing foreign bodies from the medial orbital compartment. PMID:27957368

  19. Partially molten magma ocean model

    SciTech Connect

    Shirley, D.N.

    1983-02-15

    The properties of the lunar crust and upper mantle can be explained if the outer 300-400 km of the moon was initially only partially molten rather than fully molten. The top of the partially molten region contained about 20% melt and decreased to 0% at 300-400 km depth. Nuclei of anorthositic crust formed over localized bodies of magma segregated from the partial melt, then grew peripherally until they coverd the moon. Throughout most of its growth period the anorthosite crust floated on a layer of magma a few km thick. The thickness of this layer is regulated by the opposing forces of loss of material by fractional crystallization and addition of magma from the partial melt below. Concentrations of Sr, Eu, and Sm in pristine ferroan anorthosites are found to be consistent with this model, as are trends for the ferroan anorthosites and Mg-rich suites on a diagram of An in plagioclase vs. mg in mafics. Clustering of Eu, Sr, and mg values found among pristine ferroan anorthosites are predicted by this model.

  20. Covert Reinforcement: A Partial Replication.

    ERIC Educational Resources Information Center

    Ripstra, Constance C.; And Others

    A partial replication of an investigation of the effect of covert reinforcement on a perceptual estimation task is described. The study was extended to include an extinction phase. There were five treatment groups: covert reinforcement, neutral scene reinforcement, noncontingent covert reinforcement, and two control groups. Each subject estimated…

  1. Leadership in Partially Distributed Teams

    ERIC Educational Resources Information Center

    Plotnick, Linda

    2009-01-01

    Inter-organizational collaboration is becoming more common. When organizations collaborate they often do so in partially distributed teams (PDTs). A PDT is a hybrid team that has at least one collocated subteam and at least two subteams that are geographically distributed and communicate primarily through electronic media. While PDTs share many…

  2. Glutamate co-transmission from developing medial nucleus of the trapezoid body - Lateral superior olive synapses is cochlear dependent in kanamycin-treated rats

    SciTech Connect

    Lee, Jae Ho; Pradhan, Jonu; Maskey, Dhiraj; Park, Ki Sup; Hong, Sung Hwa; Suh, Myung-Whan; Kim, Myeung Ju; Ahn, Seung Cheol

    2011-02-11

    Research highlights: {yields} Glutamate co-transmission is enhanced in kanamycin-treated rats. {yields} VGLUT3 expression is increased in kanamycin-treated rats. {yields} GlyR expression is decreased in kanamycin-treated rats. {yields} GlyR, VGLUT3 expression patterns are asymmetric in unilaterally cochlear ablated rat. -- Abstract: Cochlear dependency of glutamate co-transmission at the medial nucleus of the trapezoid body (MNTB) - the lateral superior olive (LSO) synapses was investigated using developing rats treated with high dose kanamycin. Rats were treated with kanamycin from postnatal day (P) 3 to P8. A scanning electron microscopic study on P9 demonstrated partial cochlear hair cell damage. A whole cell voltage clamp experiment demonstrated the increased glutamatergic portion of postsynaptic currents (PSCs) elicited by MNTB stimulation in P9-P11 kanamycin-treated rats. The enhanced VGLUT3 immunoreactivities (IRs) in kanamycin-treated rats and asymmetric VGLUT3 IRs in the LSO of unilaterally cochlear ablated rats supported the electrophysiologic data. Taken together, it is concluded that glutamate co-transmission is cochlear-dependent and enhanced glutamate co-transmission in kanamycin-treated rats is induced by partial cochlear damage.

  3. Bilateral combined resection and recession of the medial rectus muscle for convergence excess esotropia.

    PubMed

    Ramasamy, Balasubramanian; Rowe, Fiona; Whitfield, Kath; Nayak, Harish; Noonan, Carmel P

    2007-06-01

    Five patients with true convergence excess esotropia were surgically managed with combined resection and recession of the medial rectus muscles. This technique was chosen to address the near/distance angle disparity. The use of this surgical technique produced full asymptomatic binocular control at near and distance fixation in four patients. One patient developed a consecutive exotropia but regained full binocular control following a second surgical procedure.

  4. Synaptic Targets of Medial Septal Projections in the Hippocampus and Extrahippocampal Cortices of the Mouse.

    PubMed

    Unal, Gunes; Joshi, Abhilasha; Viney, Tim J; Kis, Viktor; Somogyi, Peter

    2015-12-02

    Temporal coordination of neuronal assemblies among cortical areas is essential for behavioral performance. GABAergic projections from the medial septum and diagonal band complex exclusively innervate GABAergic interneurons in the rat hippocampus, contributing to the coordination of neuronal activity, including the generation of theta oscillations. Much less is known about the synaptic target neurons outside the hippocampus. To reveal the contribution of synaptic circuits involving the medial septum of mice, we have identified postsynaptic cortical neurons in wild-type and parvalbumin-Cre knock-in mice. Anterograde axonal tracing from the septum revealed extensive innervation of the hippocampus as well as the subiculum, presubiculum, parasubiculum, the medial and lateral entorhinal cortices, and the retrosplenial cortex. In all examined cortical regions, many septal GABAergic boutons were in close apposition to somata or dendrites immunopositive for interneuron cell-type molecular markers, such as parvalbumin, calbindin, calretinin, N-terminal EF-hand calcium-binding protein 1, cholecystokinin, reelin, or a combination of these molecules. Electron microscopic observations revealed septal boutons forming axosomatic or axodendritic type II synapses. In the CA1 region of hippocampus, septal GABAergic projections exclusively targeted interneurons. In the retrosplenial cortex, 93% of identified postsynaptic targets belonged to interneurons and the rest to pyramidal cells. These results suggest that the GABAergic innervation from the medial septum and diagonal band complex contributes to temporal coordination of neuronal activity via several types of cortical GABAergic interneurons in both hippocampal and extrahippocampal cortices. Oscillatory septal neuronal firing at delta, theta, and gamma frequencies may phase interneuron activity.

  5. Calibrated fMRI in the Medial Temporal Lobe During a Memory Encoding Task

    PubMed Central

    Restom, Khaled; Perthen, Joanna E.; Liu, Thomas T.

    2008-01-01

    Prior measures of the blood oxygenation level dependent (BOLD) and cerebral blood flow (CBF) responses to a memory encoding task within the medial temporal lobe have suggested that the coupling between functional changes in CBF and changes in the cerebral metabolic rate of oxgyen (CMRO2) may be tighter in the medial temporal lobe as compared to the primary sensory areas. In this study, we used a calibrated functional magnetic resonance imaging (fMRI) approach to directly estimate memory-encoding-related changes in CMRO2 and to assess the coupling between CBF and CMRO2 in the medial temporal lobe. The CBF-CMRO2 coupling ratio was estimated using a linear fit to the flow and metabolism changes observed across subjects. In addition, we examined the effect of region-of-interest (ROI) selection on the estimates. In response to the memory encoding task, CMRO2 increased by 23.1% ± 8.8 to 25.3% ± 5.7 (depending upon ROI), with an estimated CBF-CMRO2 coupling ratio of 1.66 ± 0.07 to 1.75± 0.16. There was not a significant effect of ROI selection on either the CMRO2 or coupling ratio estimates. The observed coupling ratios were significantly lower than the values (2 to 4.5) that have been reported in previous calibrated fMRI studies of the visual and motor cortices. In addition, the estimated coupling ratio was found to be less sensitive to the calibration procedure for functional responses in the medial temporal lobe as compared to the primary sensory areas. PMID:18329291

  6. On the nature of medial temporal lobe contributions to the constructive simulation of future events

    PubMed Central

    Schacter, Daniel L.; Addis, Donna Rose

    2009-01-01

    A rapidly growing number of studies indicate that imagining or simulating possible future events depends on much of the same neural machinery as does remembering past events. One especially striking finding is that the medial temporal lobe (MTL), which has long been linked to memory function, appears to be similarly engaged during future event simulation. This paper focuses on the role of two MTL regions—the hippocampus and parahippocampal cortex—in thinking about the future and building mental simulations. PMID:19528005

  7. Medial abrasion syndrome: a neglected cause of knee pain in middle and old age.

    PubMed

    Lyu, Shaw-Ruey; Lee, Ching-Chih; Hsu, Chia-Chen

    2015-04-01

    Knee pain is a prevailing health problem of middle and old age. Medial plica-related medial abrasion syndrome (MAS), although a well-known cause of knee pain in younger individuals, has rarely been investigated in older individuals. This prospective study was conducted to investigate the prevalence and clinical manifestations of this syndrome as a cause of knee pain in middle and old age. The outcomes of arthroscopic treatment for this syndrome were also evaluated.A total of 232 knees of 169 patients >40 years of age (41-82, median: 63 years old) suffering from chronic knee pain were analyzed. The clinical diagnosis, predisposing factors, presenting symptoms, and physical signs were investigated. The sensitivity and specificity of each parameter of the clinical presentation for the diagnosis of MAS were evaluated after confirmation by arthroscopy. For patients with MAS, the roentgenographic and arthroscopic manifestations were investigated, and arthroscopic medial release (AMR) was performed. The outcomes were evaluated by the changes in the pain domain of the Knee Society scoring system and by patient satisfaction. The prevalence of medial plica was 95%, and osteoarthritis (OA) was the most common clinical diagnosis. Symptoms of pain and crepitus in motion and local tenderness during physical examination were the most sensitive parameters for the diagnosis. A history of a single knee injury combined with local tenderness and a palpable band found during physical examination were the most specific parameters for the diagnosis. The majority of patients suffering from this syndrome were successfully treated using AMR, yielding a satisfaction rate of 85.5% after a minimum of 3 years.MAS is a common cause of knee pain in middle and old age and can be effectively treated by AMR. Its concomitance with OA warrants further investigation.

  8. [Treatment of medial ventral hernias with the use of synthetic endoprosthesis].

    PubMed

    Pushkin, S Iu; Belokonev, V I

    2010-01-01

    350 patients with medial ventral hernias were operated on. 307 of them had various concurrent diseases; 177 required simultaneous surgery on that account. Endoprosthesis (synthetic mesh) was fixed using an "inlay-sub-lay" technique. Local complications were detected in 19.4% of patients, 5.4% developed common complications. 1.1% of patients had died. Long-term hernia recurrence was registered in 1.1%.

  9. Clinical results of single-session bilateral medial patellar luxation repair in 26 small breed dogs

    PubMed Central

    Balogh, Daniel G.; Kramek, Betty

    2016-01-01

    Medical records of 26 small breed dogs treated with single-session bilateral medial patellar luxation repair were reviewed. Excluding dogs with complications associated with cranial cruciate ligament disease, 20/21 dogs with long-term follow-up achieved a complete or acceptable clinical recovery. The complication rate was not increased compared to that previously reported for unilateral patellar luxation repair. PMID:27041762

  10. Treatment of Medial Epicondyle Fracture without Associated Elbow Dislocation in Older Children and Adolescents

    PubMed Central

    Park, Kun Bo

    2012-01-01

    Purpose Displaced medial humeral epicondyle fractures with or without elbow dislocation have been treated with open reduction and fixation using K-wires or screws. The purpose of this study is to evaluate the clinical and radiological outcomes of surgical treatments of medial humeral epicondyle fracture without elbow dislocation according to the fixation methods. Materials and Methods Thirty-one patients who had undergone open reduction and fixation of the displaced medial humeral epicondyle fracture without elbow dislocation were included. Group I consisted of 21 patients who underwent fixation with K-wires, and Group II comprised 10 patients who underwent fixation with cannulated screws. Immediate postoperative, final follow-up and normal anteroposterior radiographs were compared and the clinical outcome was assessed using the final Japanese Orthopaedic Association (JOA) elbow assessment score. Results On the immediate postoperative radiographs, the distal humeral width in Group II was larger than that in Group I. On the final follow-up radiographs, the epicondylar position in Group I was lower than that in Group II. There was no significant difference in the distal humeral width, epicondylar position and joint space tilt between the immediate postoperative, final follow-up radiographs and the normal side within each group. There was no significant difference in the final JOA score between groups. Conclusion Open reduction followed by K-wire fixation or screw fixation of the displaced medial humeral epicondyle fracture without elbow dislocation in older children and adolescents resulted in improved radiologic outcome and good elbow function in spite of diverse radiologic deformities. PMID:23074121

  11. Medial antebrachial cutaneous sensory studies in the evaluation of neurogenic thoracic outlet syndrome.

    PubMed

    Kothari, M J; Macintosh, K; Heistand, M; Logigian, E L

    1998-05-01

    Over 3 years, we studied 8 patients with neurogenic thoracic outlet syndrome (TOS) and tested the medial antebrachial sensory response (MASR) to determine its diagnostic value. The MASR and ulnar sensory response (USR) were abnormal in all 8 patients. Seven had a low median motor response (MMR) with a low USR. In 1, the MASR and USR were abnormal but the MMR was normal. We conclude that the MASR is of diagnostic value in patients with neurogenic TOS.

  12. Types and synaptic connections of hippocampal inhibitory neurons reciprocally connected with the medial septum.

    PubMed

    Takács, Virág T; Freund, Tamás F; Gulyás, Attila I

    2008-07-01

    The morphological properties and connectivity of gamma-aminobutyric acid (GABA)ergic hippocampal cells projecting to the medial septum (HS cells) were examined in the rat. Two types of HS cells are located in different layers of the hippocampus: sparsely-spiny cells are in CA1-3 str. oriens and CA3 str. radiatum, where recurrent axons of pyramidal cells arborize. Densely-spiny HS cells with spiny somata are located in the termination zone of granule cell axons. In the hilus, intermediate morphologies can also be found. HS cells receive GABAergic medial septal afferents in all layers where they occur, thus the connectivity of the septum and the hippocampus is reciprocal at cell level. HS cells receive extremely dense innervation, sparsely-spiny cells are innervated by approximately 19,000 excitatory inputs, while densely-spiny cells get an even larger number (approximately 37,000). While 14% of the inputs are inhibitory for the sparsely-spiny cells, it is only 2.3% in the case of densely-spiny cells. Because a high proportion (up to 54.5% on somata and 27.5% on dendrites) of their GABAergic inputs derived from labelled septal terminals, their predominant inhibitory input probably arises from the medial septum. CA1 area HS cells possessed myelinated projecting axons, as well as local collaterals, which targeted mostly pyramidal cell dendrites and spines in str. oriens and radiatum. The synaptic organization suggests that by sampling the activity of large populations of principal cells HS cells can reliably broadcast hippocampal activity level to the medial septum.

  13. Medial and lateral networks in anterior prefrontal cortex support metacognitive ability for memory and perception.

    PubMed

    Baird, Benjamin; Smallwood, Jonathan; Gorgolewski, Krzysztof J; Margulies, Daniel S

    2013-10-16

    Convergent evidence indicates that frontopolar Brodmann area 10, and more generally the anterior prefrontal cortex (aPFC), supports the human capacity to monitor and reflect on cognition and experience. An important unanswered question, however, is whether aPFC is a homogeneous region that supports a general-purpose metacognitive ability or whether there could be regional specialization within aPFC with respect to specific types of metacognitive processes. Previous studies suggest that the lateral and medial subdivisions within aPFC may support metacognitive judgments of moment-to-moment perceptual processes and assessments of information from memory stored over longer time scales, respectively. Here we directly compared intraindividual variability in metacognitive capacity for perceptual decisions and memorial judgments and used resting-state functional connectivity (rs-fcMRI) to relate this variability to the connectivity of the medial and lateral regions of aPFC. We found a behavioral dissociation in metacognitive ability for perceptual and memorial judgments. Furthermore, functional connectivity analysis revealed distinct patterns of connectivity that correlated with individual differences in each domain. Metacognitive ability for perceptual decisions was associated with greater connectivity between lateral regions of aPFC and right dorsal anterior cingulate cortex, bilateral putamen, right caudate, and thalamus, whereas metacognitive ability for memory retrieval predicted greater connectivity between medial aPFC and the right central precuneus and intraparietal sulcus/inferior parietal lobule. Together, these results suggest that an individual's capacity for accurate introspection in the domains of perception and memory is related to the functional integrity of unique neural networks anchored in the medial and lateral regions of the aPFC.

  14. Application of shear wave elastography for the gastrocnemius medial head to tennis leg.

    PubMed

    Yoshida, Keiichi; Itoigawa, Yoshiaki; Maruyama, Yuichiro; Saita, Yoshitomo; Takazawa, Yuji; Ikeda, Hiroshi; Kaneko, Kazuo; Sakai, Tatsuo; Okuwaki, Toru

    2017-01-01

    Muscle strain of the gastrocnemius medial head mainly occurs at the musculotendinous junction (MTJ), and stiffness is a risk factor. Shear wave elastography (SWE) measures elasticity by determining the propagation velocity. The aim of this study was to measure the elasticity of the normal muscle and aponeurosis in the MTJ of the gastrocnemius medial head using SWE, thus obtaining information relevant to muscle strain at this point. Forty-one volunteers (82 legs) were recruited and the gastrocnemius medial heads were examined at four points: three on the aponeurosis, namely at the center of the MTJ (Central), 10 mm proximal to it (Proximal) and 10 mm distal to it (Distal); and at one on the muscle belly (Muscle). The measurements were compared among the points, between males and females, and between younger and middle-aged subjects. Correlations between the elastic modulus and age were also examined. The elastic moduli at Proximal, Central, Distal, and Muscle were 2.82 ± 0.53 m/s, 3.43 ± 0.83 m/s, 4.83 ± 1.56 m/s, and 2.25 ± 0.43 m/s, respectively. These values differed significantly among the points of the aponeurosis, Distal having the highest modulus followed by Central. The elastic moduli were significantly greater in males than females at Distal and Muscle and in younger subjects than middle-aged subjects at Muscle. No significant correlations between elastic modulus and age were observed for any point. SWE could be a feasible method for quantifying the elasticity of muscle and aponeurosis in the MTJ of the gastrocnemius medial head. Clin. Anat. 30:114-119, 2017. © 2016 Wiley Periodicals, Inc.

  15. Contrast-enhanced harmonic ultrasonography of medial iliac lymph nodes in healthy dogs.

    PubMed

    Gaschen, Lorrie; Angelette, Nik; Stout, Rhett

    2010-01-01

    Herein, we describe the normal contrast-enhanced harmonic, color, and power Doppler ultrasonographic characteristics of the medial iliac lymph nodes in healthy dogs. Contrast-enhanced harmonic ultrasonography of the medial iliac lymph nodes was performed on 14 healthy dogs after intravenous administration of the lipoprotein-bound inert gas-filled microbubble contrast media Definity. Time-pixel intensity curves were generated for 1-min postinjection. Quantification of these curves was performed using Philips QLab software. Non-contrast-enhanced power and color Doppler examinations were performed in each node to assess vascular patterns subjectively. Normal lymph nodes exhibited a mean contrast wash-in phase beginning at 6.3 s from the time of injection with mean peak pixel intensity at 12.1s. Angioarchitecture was best visualized with contrast-enhanced harmonic ultrasound compared with power and color Doppler. Normal lymph nodes in dogs have a central artery with a centrifugal and uniform branching pattern. Contrast-enhanced harmonic ultrasonography is a noninvasive examination that demonstrates improved visibility of the intranodal architecture of healthy medial iliac lymph nodes in dogs compared with conventional, non-contrast-enhanced Doppler methods that may have future clinical applications.

  16. Maturational alterations in constitutive activity of medial prefrontal cortex kappa-opioid receptors in Wistar rats.

    PubMed

    Sirohi, Sunil; Walker, Brendan M

    2015-11-01

    Opioid receptors can display spontaneous agonist-independent G-protein signaling (basal signaling/constitutive activity). While constitutive κ-opioid receptor (KOR) activity has been documented in vitro, it remains unknown if KORs are constitutively active in native systems. Using [(35) S] guanosine 5'-O-[gamma-thio] triphosphate coupling assay that measures receptor functional state, we identified the presence of medial prefrontal cortex KOR constitutive activity in young rats that declined with age. Furthermore, basal signaling showed an age-related decline and was insensitive to neutral opioid antagonist challenge. Collectively, the present data are first to demonstrate age-dependent alterations in the medial prefrontal cortex KOR constitutive activity in rats and changes in the constitutive activity of KORs can differentially impact KOR ligand efficacy. These data provide novel insights into the functional properties of the KOR system and warrant further consideration of KOR constitutive activity in normal and pathophysiological behavior. Opioid receptors exhibit agonist-independent constitutive activity; however, kappa-opioid receptor (KOR) constitutive activity has not been demonstrated in native systems. Our results confirm KOR constitutive activity in the medial prefrontal cortex (mPFC) that declines with age. With the ability to presynaptically inhibit multiple neurotransmitter systems in the mPFC, maturational or patho-logical alterations in constitutive activity could disrupt corticofugal glutamatergic pyramidal projection neurons mediating executive function. Regulation of KOR constitutive activity could serve as a therapeutic target to treat compromised executive function.

  17. Making sense: Dopamine activates conscious self‐monitoring through medial prefrontal cortex

    PubMed Central

    Joensson, Morten; Thomsen, Kristine Rømer; Andersen, Lau M.; Gross, Joachim; Mouridsen, Kim; Sandberg, Kristian; Østergaard, Leif

    2015-01-01

    Abstract When experiences become meaningful to the self, they are linked to synchronous activity in a paralimbic network of self‐awareness and dopaminergic activity. This network includes medial prefrontal and medial parietal/posterior cingulate cortices, where transcranial magnetic stimulation may transiently impair self‐awareness. Conversely, we hypothesize that dopaminergic stimulation may improve self‐awareness and metacognition (i.e., the ability of the brain to consciously monitor its own cognitive processes). Here, we demonstrate improved noetic (conscious) metacognition by oral administration of 100 mg dopamine in minimal self‐awareness. In a separate experiment with extended self‐awareness dopamine improved the retrieval accuracy of memories of self‐judgment (autonoetic, i.e., explicitly self‐conscious) metacognition. Concomitantly, magnetoencephalography (MEG) showed increased amplitudes of oscillations (power) preferentially in the medial prefrontal cortex. Given that electromagnetic activity in this region is instrumental in self‐awareness, this explains the specific effect of dopamine on explicit self‐awareness and autonoetic metacognition. Hum Brain Mapp 36:1866–1877, 2015. © 2015 The Authors Human Brain Mapping Published by Wiley Periodicals, Inc.. PMID:25627861

  18. Biomechanical effects of lateral and medial wedge insoles on unilateral weight bearing

    PubMed Central

    Sawada, Tomonori; Kito, Nobuhiro; Yukimune, Masaki; Tokuda, Kazuki; Tanimoto, Kenji; Anan, Masaya; Takahashi, Makoto; Shinkoda, Koichi

    2016-01-01

    [Purpose] Lateral wedge insoles reduce the peak external knee adduction moment and are advocated for patients with knee osteoarthritis. However, some patients demonstrate adverse biomechanical effects with treatment. In this study, we examined the immediate effects of lateral and medial wedge insoles under unilateral weight bearing. [Subjects and Methods] Thirty healthy young adults participated in this study. The subjects were assessed by using the foot posture index, and were divided into three groups: normal foot, pronated foot, and supinated foot groups. The knee adduction moment and knee-ground reaction force lever arm under the studied conditions were measured by using a three-dimensional motion capture system and force plates. [Results] In the normal and pronated groups, the change in knee adduction moment significantly decreased under the lateral wedge insole condition compared with the medial wedge insole condition. In the normal group, the change in the knee-ground reaction force lever arm also significantly decreased under the lateral wedge insole condition than under the medial wedge insole condition. [Conclusion] Lateral wedge insoles significantly reduced the knee adduction moment and knee-ground reaction force lever arm during unilateral weight bearing in subjects with normal feet, and the biomechanical effects varied according to individual foot alignment. PMID:26957775

  19. Branching Patterns of Medial and Inferior Calcaneal Nerves Around the Tarsal Tunnel

    PubMed Central

    Kim, Beom Suk; Choung, Phil Woo; Kwon, Soon Wook; Rhyu, Im Joo

    2015-01-01

    Objective To demonstrate the bifurcation pattern of the tibial nerve and its branches. Methods Eleven legs of seven fresh cadavers were dissected. The reference line for the bifurcation point of tibial nerve branches was an imaginary horizontal line passing the tip of the medial malleolus. The distances between the reference line and the bifurcation points were measured. The bifurcation branching patterns were categorized as type I, the pattern in which the medial calcaneal nerve (MCN) branched most proximally; type II, the pattern in which the three branches occurred at the same point; and type III, in which MCN branched most distally. Results There were seven cases (64%) of type I, three cases (27%) of type III, and one case (9%) of type II. The median MCN branching point was 0.2 cm (range, -1 to 3 cm). The median bifurcation points of the lateral plantar nerves and inferior calcaneal nerves was -0.6 cm (range, -1.5 to 1 cm) and -2.5 cm (range, -3.5 to -1 cm), respectively. Conclusion MCN originated from the tibial nerve in most cases, and plantar nerves were bifurcated below the medial malleolus. In all cases, inferior calcaneal nerves originated from the lateral plantar nerve. These anatomical findings could be useful for performing procedures, such as nerve block or electrophysiologic studies. PMID:25750872

  20. Posterior sternoclavicular Salter-Harris fracture-dislocation in a patient with unossified medial clavicle epiphysis.

    PubMed

    Beckmann, Nicholas; Crawford, Lindsay

    2016-08-01

    Sternoclavicular injuries are relatively rare, composing less than 1 % of all musculoskeletal fractures or dislocations. When sternoclavicular injuries do occur, they typically present as an isolated dislocation of the sternoclavicular joint without associated fracture of the clavicle or manubrium. However, in patients with unfused medial clavicle physis, sternoclavicular joint injuries can present as a fracture-dislocation through the unfused physis. These physeal injuries are important to recognize as the displaced epiphysis can block reduction of the sternoclavicular joint. We present a case of a 15-year-old female basketball player presenting with suspected sternoclavicular joint injury after sustaining a direct blow to the left shoulder. An initial shoulder CT confirmed the presence of the clinically suspected posterior sternoclavicular dislocation without fracture identified. An MRI of the left sternoclavicular joint was then performed for suspected physeal fracture, which confirmed the presence of a fracture through the medial clavicle physis with anterior displacement of the unossified epiphysis, blocking reduction of the metaphysis. Given the findings on MRI, the pediatric orthropedic surgeon was able to counsel the family of the high likelihood of failed closed reduction of the sternoclavicular joint requiring conversion to open reduction and internal fixation. The patient underwent successful open reduction and internal fixation of the medial clavical physeal fracture after an initial gentle attempt at closed reduction was unsuccessful.

  1. Medial HOXA genes demarcate haematopoietic stem cell fate during human development

    PubMed Central

    Dou, Diana R.; Calvanese, Vincenzo; Sierra, Maria I.; Nguyen, Andrew T.; Minasian, Arazin; Saarikoski, Pamela; Sasidharan, Rajkumar; Ramirez, Christina M.; Zack, Jerome A.; Crooks, Gay M.; Galic, Zoran; Mikkola, Hanna K.A.

    2016-01-01

    Pluripotent stem cells (PSC) may provide a potential source of haematopoietic stem/progenitor cells (HSPCs) for transplantation; however, unknown molecular barriers prevent the self-renewal of PSC-HSPCs. Using two-step differentiation, human embryonic stem cells (hESCs) differentiated in vitro into multipotent haematopoietic cells that had CD34+CD38−/loCD90+CD45+GPI-80+ foetal liver (FL) HSC immunophenotype, but displayed poor expansion potential and engraftment ability. Transcriptome analysis of immunophenotypic hESC-HSPCs revealed that, despite their molecular resemblance to FL-HSPCs, medial HOXA genes remained suppressed. Knockdown of HOXA7 disrupted FL-HSPC function and caused transcriptome dysregulation that resembled hESC-derived progenitors. Overexpression of medial HOXA genes prolonged FL-HSPC maintenance but was insufficient to confer self-renewal to hESC-HSPCs. Stimulation of retinoic acid signalling during endothelial-to-haematopoietic transition induced the HOXA cluster and other HSC/definitive haemogenic endothelium genes, and prolonged HSPC maintenance in culture. Thus, retinoic acid signalling-induced medial HOXA gene expression marks the establishment of the definitive HSC fate and controls HSC identity and function. PMID:27183470

  2. Medial auditory thalamus is necessary for acquisition and retention of eyeblink conditioning to cochlear nucleus stimulation.

    PubMed

    Halverson, Hunter E; Poremba, Amy; Freeman, John H

    2015-05-01

    Associative learning tasks commonly involve an auditory stimulus, which must be projected through the auditory system to the sites of memory induction for learning to occur. The cochlear nucleus (CN) projection to the pontine nuclei has been posited as the necessary auditory pathway for cerebellar learning, including eyeblink conditioning. However, the medial auditory thalamic nuclei (MATN), consisting of the medial division of the medial geniculate, suprageniculate, and posterior interlaminar nucleus have also been implicated as a critical auditory relay to the pontine nuclei for cerebellum-dependent motor learning. The MATN also conveys auditory information to the amygdala necessary for avoidance and fear conditioning. The current study used CN stimulation to increase activity in the pontine nuclei, relative to a tone stimulus, and possibly provide sufficient input to the cerebellum for acquisition or retention of eyeblink conditioning during MATN inactivation. Primary and secondary effects of CN stimulation and MATN inactivation were examined using 2-deoxy-glucose autoradiography. Stimulation of CN increased activity in the pontine nuclei, however, this increase was not sufficient for cerebellar learning during MATN inactivation. Results of the current experiment provide additional evidence indicating the MATN may be the critical auditory relay for many associative learning tasks.

  3. Forensic age estimation by the Schmeling method: computed tomography analysis of the medial clavicular epiphysis.

    PubMed

    Ekizoglu, Oguzhan; Hocaoglu, Elif; Inci, Ercan; Sayin, Ibrahim; Solmaz, Dilek; Bilgili, Mustafa Gokhan; Can, Ismail Ozgur

    2015-01-01

    The variability of anthropometric measures, such as the degree of ossification, among societies should be taken into account when estimating age. The degree of ossification of the medial clavicle can be determined with thin-section computed tomography (CT), which is one of the methods recommended by the Study Group on Forensic Age Diagnostics of the German Association of Forensic Medicine. The purpose of this retrospective study was to investigate the applicability of thin-section CT analysis of the degree of ossification of the medial clavicle in a Turkish population. We evaluated the CT images (1-mm slice thickness) of 503 patients (362 male, 141 female; age, 10-35 years) using the Schmeling five-stage method. The Spearman's correlation analysis revealed a positive correlation between age and ossification stage in both male and female patients (total group: rho = 0.838, p < 0.001; male: rho = 0.831, p < 0.001; female: rho = 0.856, p < 0.001). The linear regression analysis results indicated that the ossification stage of the medial clavicle is a good predictor when estimating age (r (2) = 0.735 for all patients, 0.734 for male patients, 0.741 for female patients). Sex differences in ossification stages were observed only for stage 1 and 4 ossification. We believe that future research could expand the database on this topic and contribute to improvements in this measurement method.

  4. New Semantic Learning in Patients With Large Medial Temporal Lobe Lesions

    PubMed Central

    Bayley, P.J.; O'Reilly, R.C.; Curran, T.; Squire, L.R.

    2008-01-01

    Two patients with large lesions of the medial temporal lobe were given four tests of semantic knowledge that could only have been acquired after the onset of their amnesia. In contrast to previous studies of postmorbid semantic learning, correct answers could be based on a simple, nonspecific sense of familiarity about single words, faces, or objects. According to recent computational models (for example, Norman and O'Reilly (2003) Psychol Rev 110:611–646), this characteristic should be optimal for detecting the kind of semantic learning that might be supported directly by the neocortex. Both patients exhibited some capacity for new learning, albeit at a level substantially below control performances. Notably, the correct answers appeared to reflect declarative memory. It was not the case that the correct answers simply popped out in some automatic way in the absence of any additional knowledge about the items. Rather, the few correct choices made by the patients tended to be accompanied by additional information about the chosen items, and the available knowledge appeared to be similar qualitatively to the kind of factual knowledge that healthy individuals gradually acquire over the years. The results are consistent with the idea that neocortical structures outside the medial temporal lobe are able to support some semantic learning, albeit to a very limited extent. Alternatively, the small amount of learning detected in the present study could depend on tissue within the posterior medial temporal lobe that remains intact in both patients. PMID:18306299

  5. Aging of the medial olivocochlear reflex and associations with speech perception

    PubMed Central

    Abdala, Carolina; Dhar, Sumitrajit; Ahmadi, Mahnaz; Luo, Ping

    2014-01-01

    The medial olivocochlear reflex (MOCR) modulates cochlear amplifier gain and is thought to facilitate the detection of signals in noise. High-resolution distortion product otoacoustic emissions (DPOAEs) were recorded in teens, young, middle-aged, and elderly adults at moderate levels using primary tones swept from 0.5 to 4 kHz with and without a contralateral acoustic stimulus (CAS) to elicit medial efferent activation. Aging effects on magnitude and phase of the 2f1-f2 DPOAE and on its components were examined, as was the link between speech-in-noise performance and MOCR strength. Results revealed a mild aging effect on the MOCR through middle age for frequencies below 1.5 kHz. Additionally, positive correlations were observed between strength of the MOCR and performance on select measures of speech perception parsed into features. The elderly group showed unexpected results including relatively large effects of CAS on DPOAE, and CAS-induced increases in DPOAE fine structure as well as increases in the amplitude and phase accumulation of DPOAE reflection components. Contamination of MOCR estimates by middle ear muscle contractions cannot be ruled out in the oldest subjects. The findings reiterate that DPOAE components should be unmixed when measuring medial efferent effects to better consider and understand these potential confounds. PMID:25234884

  6. Estimation of forensic age using substages of ossification of the medial clavicle in living individuals.

    PubMed

    Ekizoglu, Oguzhan; Hocaoglu, Elif; Inci, Ercan; Can, Ismail Ozgur; Aksoy, Sema; Sayin, Ibrahim

    2015-11-01

    Forensic age estimation based on staging of ossification of the medial clavicular bone is one of the methods recommended by the Study Group on Forensic Age Diagnostics of the German Association of Forensic Medicine. In the present study, we analyzed the stages of ossification of the medial clavicular epiphyses on thin-sliced (1 mm) computed tomography (CT) images using the substages defined within stages 2 and 3. The retrospective CT analysis involved 193 subjects (129 males, 64 females) ranging in age from 13 to 28 years. Spearman's correlation analysis revealed a positive correlation between age and ossification stage in both male and female subjects. Stage 3c was first observed at 19 years of age in both sexes and may thus serve as a valuable forensic marker for determining an age of 18 years. Although further research is needed on the ossification stages of the medial clavicular epiphyses, the present findings could contribute to existing reports on observers' experiences using CT analysis of ossification combined with analysis of substages.

  7. Predicting dynamic knee joint load with clinical measures in people with medial knee osteoarthritis.

    PubMed

    Hunt, Michael A; Bennell, Kim L

    2011-08-01

    Knee joint loading, as measured by the knee adduction moment (KAM), has been implicated in the pathogenesis of knee osteoarthritis (OA). Given that the KAM can only currently be accurately measured in the laboratory setting with sophisticated and expensive equipment, its utility in the clinical setting is limited. This study aimed to determine the ability of a combination of four clinical measures to predict KAM values. Three-dimensional motion analysis was used to calculate the peak KAM at a self-selected walking speed in 47 consecutive individuals with medial compartment knee OA and varus malalignment. Clinical predictors included: body mass; tibial angle measured using an inclinometer; walking speed; and visually observed trunk lean toward the affected limb during the stance phase of walking. Multiple linear regression was performed to predict KAM magnitudes using the four clinical measures. A regression model including body mass (41% explained variance), tibial angle (17% explained variance), and walking speed (9% explained variance) explained a total of 67% of variance in the peak KAM. Our study demonstrates that a set of measures easily obtained in the clinical setting (body mass, tibial alignment, and walking speed) can help predict the KAM in people with medial knee OA. Identifying those patients who are more likely to experience high medial knee loads could assist clinicians in deciding whether load-modifying interventions may be appropriate for patients, whilst repeated assessment of joint load could provide a mechanism to monitor disease progression or success of treatment.

  8. Chronic Phencyclidine Increases Synapsin-1 and Synaptic Adaptation Proteins in the Medial Prefrontal Cortex

    PubMed Central

    Pickering, Chris; Ericson, Mia; Söderpalm, Bo

    2013-01-01

    Phencyclidine (PCP) mimics many aspects of schizophrenia, yet the underlying mechanism of neurochemical adaptation for PCP is unknown. We therefore used proteomics to study changes in the medial prefrontal cortex in animals with PCP-induced behavioural deficits. Male Wistar rats were injected with saline or 5 mg/kg phencyclidine for 5 days followed by two days of washout. Spontaneous alternation behaviour was tested in a Y-maze and then proteins were extracted from the medial prefrontal cortex. 2D-DIGE analysis followed by spot picking and protein identification with mass spectrometry then provided a list of differentially expressed proteins. Treatment with 5 mg/kg phencyclidine decreased the percentage of correct alternations in the Y-maze compared to saline-treated controls. Proteomics analysis of the medial prefrontal cortex found upregulation of 6 proteins (synapsin-1, Dpysl3, Aco2, Fscn1, Tuba1c, and Mapk1) and downregulation of 11 (Bin1, Dpysl2, Sugt1, ApoE, Psme1, ERp29, Pgam1, Uchl1, Ndufv2, Pcmt1, and Vdac1). A trend to upregulation was observed for Gnb4 and Capza2, while downregulation trends were noted for alpha-enolase and Fh. Many of the hits in this study concur with recent postmortem data from schizophrenic patients and this further validates the use of phencyclidine in preclinical translational research. PMID:23738220

  9. Consequences of temporary inhibition of the medial amygdala on social recognition memory performance in mice

    PubMed Central

    Noack, Julia; Murau, Rita; Engelmann, Mario

    2015-01-01

    Different lines of investigation suggest that the medial amygdala is causally involved in the processing of information linked to social behavior in rodents. Here we investigated the consequences of temporary inhibition of the medial amygdala by bilateral injections of lidocaine on long-term social recognition memory as tested in the social discrimination task. Lidocaine or control NaCl solution was infused immediately before learning or before retrieval. Our data show that lidocaine infusion immediately before learning did not affect long-term memory retrieval. However, intra-amygdalar lidocaine infusions immediately before choice interfered with correct memory retrieval. Analysis of the aggressive behavior measured simultaneously during all sessions in the social recognition memory task support the impression that the lidocaine dosage used here was effective as it—at least partially—reduced the aggressive behavior shown by the experimental subjects toward the juveniles. Surprisingly, also infusions of NaCl solution blocked recognition memory at both injection time points. The results are interpreted in the context of the importance of the medial amygdala for the processing of non-volatile odors as a major contributor to the olfactory signature for social recognition memory. PMID:25972782

  10. The nature of anterograde and retrograde memory impairment after damage to the medial temporal lobe.

    PubMed

    Smith, Christine N; Frascino, Jennifer C; Hopkins, Ramona O; Squire, Larry R

    2013-11-01

    The study of anterograde and retrograde amnesia (AA and RA) in the laboratory and the clinic has provided important information about the structure and organization of memory. The severity of AA is usually correlated with the severity of RA. Nevertheless, variations in the expression of AA and RA have been reported, which presumably reflect variation in the locus and extent of brain damage. The relationship between AA and RA has rarely been described quantitatively in groups of patients where detailed anatomical information is available. We have quantified the severity of AA and RA for factual information in 11 memory-impaired patients with bilateral medial temporal lobe lesions, including 5 for whom detailed post-mortem neurohistological information was available. The findings describe an orderly relationship between AA and RA, such that patients with more severe AA also had more extensive RA. In addition, RA was measurable only after AA reached a substantial level of severity. This relationship between AA and RA in patients with identified medial temporal lobe lesions appears to describe a general principle, which applies to a range of etiologies, including traumatic amnesia, where the locus and extent of brain damage is less well understood. Whenever patients deviate substantially from the relationship described here, one should be alert to the likelihood that significant damage has occurred outside or in addition to the structures in the medial temporal lobe.

  11. Phospholipase C beta 4 in the medial septum controls cholinergic theta oscillations and anxiety behaviors.

    PubMed

    Shin, Jonghan; Gireesh, Gangadharan; Kim, Seong-Wook; Kim, Duk-Soo; Lee, Sukyung; Kim, Yeon-Soo; Watanabe, Masahiko; Shin, Hee-Sup

    2009-12-09

    Anxiety is among the most prevalent and costly diseases of the CNS, but its underlying mechanisms are not fully understood. Although attenuated theta rhythms have been observed in human subjects with increased anxiety, no study has been done on the possible physiological link between these two manifestations. We found that the mutant mouse for phospholipase C beta 4 (PLC-beta 4(-/-)) showed attenuated theta rhythm and increased anxiety, presenting the first animal model for the human condition. PLC-beta 4 is abundantly expressed in the medial septum, a region implicated in anxiety behavior. RNA interference-mediated PLC-beta 4 knockdown in the medial septum produced a phenotype similar to that of PLC-beta 4(-/-) mice. Furthermore, increasing cholinergic signaling by administering an acetylcholinesterase inhibitor cured the anomalies in both cholinergic theta rhythm and anxiety behavior observed in PLC-beta 4(-/-) mice. These findings suggest that (1) PLC-beta 4 in the medial septum is involved in controlling cholinergic theta oscillation and (2) cholinergic theta rhythm plays a critical role in suppressing anxiety. We propose that defining the cholinergic theta rhythm profile may provide guidance in subtyping anxiety disorders in humans for more effective diagnosis and treatments.

  12. Activation of the medial septum reverses age-related hippocampal encoding deficits: a place field analysis.

    PubMed

    Sava, Simona; Markus, Etan J

    2008-02-20

    When a rat runs through a familiar environment, the hippocampus retrieves a previously stored spatial representation of the environment. When the environment is modified a new representation is seen, presumably corresponding to the hippocampus encoding the new information. The medial septum is hypothesized to modulate whether the hippocampus engages in retrieval or encoding. The cholinergic agonist carbachol was infused into the medial septum, and hippocampal CA1 place cells were recorded in freely moving rats. In a familiar environment, septal activation impaired the retrieval of a previously stored hippocampal place cell representation regardless of age. When the environment was changed, medial septal activation impaired the encoding process in young, but facilitated the encoding of the new information in aged rats. Moreover, the improved encoding was evident during a subsequent exposure to the modified environment 24 h later. The findings support the role the septum plays in modulating hippocampal retrieval/encoding states. Furthermore, our data indicate a mechanism of age-related cognitive impairment.

  13. Making sense: Dopamine activates conscious self-monitoring through medial prefrontal cortex.

    PubMed

    Joensson, Morten; Thomsen, Kristine Rømer; Andersen, Lau M; Gross, Joachim; Mouridsen, Kim; Sandberg, Kristian; Østergaard, Leif; Lou, Hans C

    2015-05-01

    When experiences become meaningful to the self, they are linked to synchronous activity in a paralimbic network of self-awareness and dopaminergic activity. This network includes medial prefrontal and medial parietal/posterior cingulate cortices, where transcranial magnetic stimulation may transiently impair self-awareness. Conversely, we hypothesize that dopaminergic stimulation may improve self-awareness and metacognition (i.e., the ability of the brain to consciously monitor its own cognitive processes). Here, we demonstrate improved noetic (conscious) metacognition by oral administration of 100 mg dopamine in minimal self-awareness. In a separate experiment with extended self-awareness dopamine improved the retrieval accuracy of memories of self-judgment (autonoetic, i.e., explicitly self-conscious) metacognition. Concomitantly, magnetoencephalography (MEG) showed increased amplitudes of oscillations (power) preferentially in the medial prefrontal cortex. Given that electromagnetic activity in this region is instrumental in self-awareness, this explains the specific effect of dopamine on explicit self-awareness and autonoetic metacognition.

  14. New semantic learning in patients with large medial temporal lobe lesions.

    PubMed

    Bayley, P J; O'Reilly, R C; Curran, T; Squire, L R

    2008-01-01

    Two patients with large lesions of the medial temporal lobe were given four tests of semantic knowledge that could only have been acquired after the onset of their amnesia. In contrast to previous studies of postmorbid semantic learning, correct answers could be based on a simple, nonspecific sense of familiarity about single words, faces, or objects. According to recent computational models (for example, Norman and O'Reilly (2003) Psychol Rev 110:611-646), this characteristic should be optimal for detecting the kind of semantic learning that might be supported directly by the neocortex. Both patients exhibited some capacity for new learning, albeit at a level substantially below control performances. Notably, the correct answers appeared to reflect declarative memory. It was not the case that the correct answers simply popped out in some automatic way in the absence of any additional knowledge about the items. Rather, the few correct choices made by the patients tended to be accompanied by additional information about the chosen items, and the available knowledge appeared to be similar qualitatively to the kind of factual knowledge that healthy individuals gradually acquire over the years. The results are consistent with the idea that neocortical structures outside the medial temporal lobe are able to support some semantic learning, albeit to a very limited extent. Alternatively, the small amount of learning detected in the present study could depend on tissue within the posterior medial temporal lobe that remains intact in both patients.

  15. [Linear accelerator-based stereotactic radiation treatment of patients with medial middle fossa meningiomas].

    PubMed

    Golanov, A V; Cherekaev, V A; Serova, N K; Pronin, I N; Gorlachev, G E; Kotel'nikova, T M; Podoprigora, A E; Kudriavtseva, P A; Galkin, M V

    2010-01-01

    Medial middle fossa meningiomas are challenging for neurosurgical treatment. Invasion of cranial nerves and vessels leads to high risk of complications after removal of such meningiomas. Currently methods of conformal stereotactic radiation treatment are applied wider and wider for the discussed lesions. During a 3.5-year period 80 patients with medial middle fossa meningiomas were treated in Burdenko Moscow Neurosurgical Institute using linear accelerator "Novalis". In 31 case radiation treatment was preceded by surgical resection. In majority of patients symptoms included cranial nerve dysfunction: oculomotor disturbances in 62.5%, trigeminal impairment--in 37.5%, visual deficit--in 43.8%, facial nerve palsy--in 1.25%. 74 patients underwent radiotherapy with classical fractioning, 2--in hypofractionated mode and 4 received radiosurgery. In cases of classical fractioning mean marginal dose reached 46.3 Gy during 28-33 fractions, in hypofractioning (7 fractions)--31.5 Gy, in radiosurgery--16.25 Gy. Mean follow-up period was 18.4 months (6-42 months). Control of tumor growth was achieved in 97.5% of cases (78 patients): in 42 (52.5%) lesion shrinked, in 36 (45%) stabilization was observed. Clinical examination revealed improvement of visual function in 15 patients (18%) and deterioration in 2 (2.5%). No new neuropathies were found. Stereotactic radiation treatment is the method of choice for medial anterior and middle fossa meningiomas due to effective control of tumor progression and minimal rate of complications.

  16. Processing of famous faces and medial temporal lobe event-related potentials: a depth electrode study.

    PubMed

    Dietl, T; Trautner, P; Staedtgen, M; Vannucci, M; Vannuchi, M; Mecklinger, A; Grunwald, T; Clusmann, H; Elger, C E; Kurthen, M

    2005-04-01

    The present study aims at analyzing the modulation of two types of event-related potentials originating from the human medial temporal lobe, the rhinal AMTL-N400 and the hippocampal P600 by the processing of famous faces. Therefore, we used a face recognition paradigm in which subjects had to discriminate the faces of famous persons from the faces of non-famous persons. Eleven patients with unilateral medial temporal lobe epilepsy undergoing intrahippocampal depth electrode recording for presurgical evaluation participated in this study. Event-related potentials (ERP) were recorded while a sequence of famous and non-famous faces was presented to the patients. The presentation of each face was repeated. The faces evoked N400-like potentials (anterior medial temporal lobe N400, AMTL-N400) in the rhinal cortex and P600-like potentials in the hippocampus. ERPs elicited by famous faces were contrasted with ERPs elicited by non-famous faces. The first presentation of famous faces elicited an enhanced AMTL-N400 and an enhanced hippocampal P600 in comparison to the second presentations of the famous faces or the (first and second presentation of the) non-famous faces. This findings are discussed in terms of associative semantic memory processes and the retrieval of person-specific information from long-term memory stores triggered by the processing of famous faces.

  17. Management of Acute Combined ACL-Medial and Posteromedial Instability of the Knee.

    PubMed

    Medvecky, Michael J; Tomaszewski, Paul

    2015-06-01

    Medial collateral ligament (MCL) injuries are the most common ligamentous injury of the knee. The extent of injury can range from a minor first-degree (1-degree) sprain to an extensive third-degree (3-degree) sprain that can propagate across the knee, rupturing one or both cruciate ligaments, and result in a knee subluxation or dislocation. A common pattern involves the combined anterior cruciate ligament (ACL) and MCL injury that is the focus of this chapter. The vast majority of these combined medial-sided injuries are treated nonoperatively with delayed reconstruction of the ACL injury in athletically active individuals. The MCL and associated medial structures are carefully assessed on physical examination, and classification of injury is based upon abnormal limits of joint motion. In vitro cadaveric biomechanical testing has given us a better understanding of ligament deficiency and altered joint motion. Consistency in terminology is necessary for proper classification of injury and reproducible categorization of injury patterns to be able to compare both nonoperative and operative treatment of various injury patterns.

  18. Damage to right medial temporal structures disrupts the capacity for scene construction-a case study.

    PubMed

    Irish, Muireann; Mothakunnel, Annu; Dermody, Nadene; Wilson, Nikki-Anne; Hodges, John R; Piguet, Olivier

    2017-02-28

    The medial temporal lobes (MTLs) are widely held to support a range of constructive endeavors including remembering the past, envisaging the future, and imagining hypothetical scenarios. While right MTL structures have been ascribed a prominent role in the construction of spatial contexts, lesion evidence to directly test this hypothesis is lacking. To this end, we assessed scene construction performance in two cases, GC and DF, who presented with left- and right-lateralized presentations of semantic dementia, respectively. GC displayed characteristic semantic processing difficulties in the context of marked left anterior and medial temporal lobe atrophy. Despite significant volume loss across the entire length of the left hippocampus, GC was capable of generating richly detailed, spatially coherent scenes, most likely reflecting the preservation of his right anterior MTL. In contrast, DF's cognitive profile was one of the dense prosopagnosia, with subjectively reported gaps in autobiographical memory and wayfinding difficulties. Formal testing on the scene construction task revealed striking deficits, with DF producing impoverished descriptions of spatially fragmented scenes. We attribute DF's inability to construct spatially contiguous scenes to the degeneration of right-sided MTL structures, most prominently the right anterior hippocampus (19% volume loss) and right parahippocampal cortex (23% volume loss). Our findings complement the extant fMRI literature to suggest a fundamental role for right medial temporal regions in the construction of rich detailed spatial arrays.

  19. Medial prefrontal cortex pathology in schizophrenia as revealed by convergent findings from multimodal imaging

    PubMed Central

    Pomarol-Clotet, E; Canales-Rodríguez, E J; Salvador, R; Sarró, S; Gomar, J J; Vila, F; Ortiz-Gil, J; Iturria-Medina, Y; Capdevila, A; McKenna, P J

    2010-01-01

    Neuroimaging studies have found evidence of altered brain structure and function in schizophrenia, but have had complex findings regarding the localization of abnormality. We applied multimodal imaging (voxel-based morphometry (VBM), functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI) combined with tractography) to 32 chronic schizophrenic patients and matched healthy controls. At a conservative threshold of P=0.01 corrected, structural and functional imaging revealed overlapping regions of abnormality in the medial frontal cortex. DTI found that white matter abnormality predominated in the anterior corpus callosum, and analysis of the anatomical connectivity of representative seed regions again implicated fibres projecting to the medial frontal cortex. There was also evidence of convergent abnormality in the dorsolateral prefrontal cortex, although here the laterality was less consistent across techniques. The medial frontal region identified by these three imaging techniques corresponds to the anterior midline node of the default mode network, a brain system which is believed to support internally directed thought, a state of watchfulness, and/or the maintenance of one's sense of self, and which is of considerable current interest in neuropsychiatric disorders. PMID:20065955

  20. D1 receptor-mediated inhibition of medial prefrontal cortex neurons is disrupted in adult rats exposed to amphetamine in adolescence.

    PubMed

    Kang, S; Paul, K; Hankosky, E R; Cox, C L; Gulley, J M

    2016-06-02

    Amphetamine (AMPH) exposure leads to changes in behavior and dopamine receptor function in the prefrontal cortex (PFC). Since dopamine plays an important role in regulating GABAergic transmission in the PFC, we investigated if AMPH exposure induces long-lasting changes in dopamine's ability to modulate inhibitory transmission in the PFC as well as whether the effects of AMPH differed depending on the age of exposure. Male Sprague-Dawley rats were given saline or 3 mg/kg AMPH (i.p.) repeatedly during adolescence or adulthood and following a withdrawal period of up to 5 weeks (Experiment 1) or up to 14 weeks (Experiment 2), they were sacrificed for in vitro whole-cell recordings in layer V/VI of the medial PFC. We found that in brain slices from either adolescent- or adult-exposed rats, there was an attenuation of dopamine-induced increases in inhibitory synaptic currents in pyramidal cells. These effects did not depend on age of exposure, were mediated at least partially by a reduced sensitivity of D1 receptors in AMPH-treated rats, and were associated with an enhanced behavioral response to the drug in a separate group of rats given an AMPH challenge following the longest withdrawal period. Together, these data reveal a prolonged effect of AMPH exposure on medial PFC function that persisted for up to 14 weeks in adolescent-exposed animals. These long-lasting neurophysiological changes may be a contributing mechanism to the behavioral consequences that have been observed in those with a history of amphetamine abuse.

  1. Effect of a pelvic wedge and belt on the medial and lateral hamstring muscles during knee flexion.

    PubMed

    Yoo, Won-Gyu

    2017-01-01

    [Purpose] This study developed a pelvic wedge and belt and investigated their effects on the selective activation of medial and lateral hamstring muscles during knee flexion. [Subjects and Methods] Nine adults were enrolled. The participants performed exercises without and with the pelvic wedge and belt, and the electromyographic activities of the medial and lateral hamstring muscles were recorded. [Results] The activity of the medial hamstring was increased significantly when using the pelvic wedge and belt, while the activity of the lateral hamstring did not differ significantly. [Conclusion] The pelvic wedge and belt provide a self-locked position during knee flexion in the prone position. Prone knee flexion in this position is an effective self-exercise for balanced strengthening of the medial hamstring.

  2. Medial temporal lobe activity at recognition increases with the duration of mnemonic delay during an object working memory task.

    PubMed

    Picchioni, Marco; Matthiasson, Pall; Broome, Matthew; Giampietro, Vincent; Brammer, Mick; Mathes, Birgit; Fletcher, Paul; Williams, Steven; McGuire, Philip

    2007-11-01

    Object working memory (WM) engages a disseminated neural network, although the extent to which the length of time that data is held in WM influences regional activity within this network is unclear. We used functional magnetic resonance imaging to study a delayed matching to sample task in 14 healthy subjects, manipulating the duration of mnemonic delay. Across all lengths of delay, successful recognition was associated with the bilateral engagement of the inferior and middle frontal gyri and insula, the medial and inferior temporal, dorsal anterior cingulate and the posterior parietal cortices. As the length of time that data was held in WM increased, activation at recognition increased in the medial temporal, medial occipito-temporal, anterior cingulate and posterior parietal cortices. These results confirm the components of an object WM network required for successful recognition, and suggest that parts of this network, including the medial temporal cortex, are sensitive to the duration of mnemonic delay.

  3. Effect of a pelvic wedge and belt on the medial and lateral hamstring muscles during knee flexion

    PubMed Central

    Yoo, Won-gyu

    2017-01-01

    [Purpose] This study developed a pelvic wedge and belt and investigated their effects on the selective activation of medial and lateral hamstring muscles during knee flexion. [Subjects and Methods] Nine adults were enrolled. The participants performed exercises without and with the pelvic wedge and belt, and the electromyographic activities of the medial and lateral hamstring muscles were recorded. [Results] The activity of the medial hamstring was increased significantly when using the pelvic wedge and belt, while the activity of the lateral hamstring did not differ significantly. [Conclusion] The pelvic wedge and belt provide a self-locked position during knee flexion in the prone position. Prone knee flexion in this position is an effective self-exercise for balanced strengthening of the medial hamstring. PMID:28210048

  4. Medial thalamic 18-FDG uptake following inescapable shock correlates with subsequent learned helpless behavior

    SciTech Connect

    Mirrione,M.M.; Mirrione, M.M.; Schulz, D.; Dewey, S.L.; Henn, F.A.

    2009-12-06

    The learned helplessness paradigm has been repeatedly shown to correlate with neurobiological aspects of depression in humans. In this model, rodents are exposed inescapable foot-shock in order to reveal susceptibility to escape deficit, defined as 'learned helplessness' (LH). Few methods are available to probe the neurobiological aspects underlying the differences in susceptibility in the living animal, thus far being limited to studies examining regional neurochemical changes with microdialysis. With the widespread implementation of small animal neuroimaging methods, including positron emission tomography (PET), it is now possible to explore the living brain on a systems level to define regional changes that may correlate with vulnerability to stress. In this study, 12 wild type Sprague-Dawley rats were exposed to 40 minutes of inescapable foot-shock followed by metabolic imaging using 2-deoxy-2[{sup 18}F]fluoro-D-glucose (18-FDG) 1 hour later. The escape test was performed on these rats 48 hours later (to accommodate radiotracer decay), where they were given the opportunity to press a lever to shut off the shock. A region of interest (ROI) analysis was used to investigate potential correlations (Pearson Regression Coefficients) between regional 18-FDG uptake following inescapable shock and subsequent learned helpless behavior (time to finish the test; number of successful lever presses within 20 seconds of shock onset). ROI analysis revealed a significant positive correlation between time to finish and 18-FDG uptake, and a negative correlation between lever presses and uptake, in the medial thalamic area (p=0.033, p=0.036). This ROI included the paraventricular thalamus, mediodorsal thalamus, and the habenula. In an effort to account for possible spillover artifact, the posterior thalamic area (including ventral medial and lateral portions) was also evaluated but did not reveal significant correlations (p=0.870, p=0.897). No other significant correlations were

  5. Dynamic Simulation of the Effects of Graft Fixation Errors During Medial Patellofemoral Ligament Reconstruction

    PubMed Central

    Elias, John J.; Kelly, Michael J.; Smith, Kathryn E.; Gall, Kenneth A.; Farr, Jack

    2016-01-01

    Background: Medial patellofemoral ligament (MPFL) reconstruction is performed to prevent recurrent instability, but errors in femoral fixation can elevate graft tension. Hypothesis: Errors related to femoral fixation will overconstrain the patella and increase medial patellofemoral pressures. Study Design: Controlled laboratory study. Methods: Five knees with patellar instability were represented with computational models. Kinematics during knee extension were characterized from computational reconstruction of motion performed within a dynamic computed tomography (CT) scanner. Multibody dynamic simulation of knee extension, with discrete element analysis used to quantify contact pressures, was performed for the preoperative condition and after MPFL reconstruction. A standard femoral attachment and graft resting length were set for each knee. The resting length was decreased by 2 mm, and the femoral attachment was shifted 5 mm posteriorly. The simulated errors were also combined. Root-mean-square errors were quantified for the comparison of preoperative patellar lateral shift and tilt between computationally reconstructed motion and dynamic simulation. Simulation output was compared between the preoperative and MPFL reconstruction conditions with repeated-measures Friedman tests and Dunnett comparisons against a control, which was the standard MPFL condition, with statistical significance set at P < .05. Results: Root-mean-square errors for simulated patellar tilt and shift were 5.8° and 3.3 mm, respectively. Patellar lateral tracking for the preoperative condition was significantly larger near full extension compared with the standard MPFL reconstruction (mean differences of 8 mm and 13° for shift and tilt, respectively, at 0°), and lateral tracking was significantly smaller for a posterior femoral attachment (mean differences of 3 mm and 4° for shift and tilt, respectively, at 0°). The maximum medial pressure was also larger for the short graft with a

  6. Decreased vascular smooth muscle cell density in medial degeneration of human abdominal aortic aneurysms.

    PubMed Central

    López-Candales, A.; Holmes, D. R.; Liao, S.; Scott, M. J.; Wickline, S. A.; Thompson, R. W.

    1997-01-01

    Abdominal aortic aneurysms (AAAs) are characterized by structural deterioration of the aortic wall leading to progressive aortic dilatation and eventual rupture. The histopathological changes in AAAs are particularly evident within the elastic media, which is normally dominated by vascular smooth muscle cells (SMCs). To determine whether a decrease in vascular SMCs contributes to medial degeneration, we measured SMC density in 21 normal and pathological human abdominal aortic tissue specimens using immunohistochemistry for alpha-SMC actin and direct cell counts (medial SMCs per high-power field (HPF)). Medial SMC density was not significantly different between normal aorta (n = 5; 199.5 +/- 14.9 SMCs/HPF) and atherosclerotic occlusive disease (n = 6; 176.4 +/- 13.9 SMCs/HPF), but it was reduced by 74% in AAA (n = 10; 50.9 +/- 6.1 SMCs/HPF; P < 0.01 versus normal aorta). Light and electron microscopy revealed no evidence of overt cellular necrosis, but SMCs in AAAs exhibited ultrastructural changes consistent with apoptosis. Using in situ end-labeling (ISEL) of fragmented DNA to detect apoptotic cells, up to 30% of aortic wall cells were ISEL positive in AAAs. By double-labeling techniques, many of these cells were alpha-actin-positive SMCs distributed throughout the degenerative media. In contrast, ISEL-positive cells were observed only within the intimal plaque in atherosclerotic occlusive disease. The amount of p53 protein detected by immunoblotting was increased nearly fourfold in AAA compared with normal aorta and atherosclerotic occlusive disease (P < 0.01), and immunoreactive p53 was localized to lymphocytes and residual SMCs in the aneurysm wall. Using reverse transcription polymerase chain reaction assays a substantial amount of p53 mRNA expression was observed in AAAs. These results demonstrate that medial SMC density is significantly decreased in human AAA tissues associated with evidence of SMC apoptosis and increased production of p53, a potential

  7. Evidence for a medial K+ recycling pathway from inner hair cells.

    PubMed

    Spicer, S S; Schulte, B A

    1998-04-01

    K+ effluxed from outer hair cells and their nerves is thought to flow laterally to strial marginal cells for recycling into scala media. Observations reported here provide evidence that K+ effluxed from inner hair cells and inner radial nerves travels medially through border cells, inner sulcus cells (ISCs), limbal fibrocytes and interdental cells (IDCs) for return to endolymph. Morphologic features of ISCs in the medial route resembled those of Hensen and Claudius cells in the lateral indicating an ion transport role for ISCs like that of Hensen and Claudius cells. Na,K-ATPase in plasmalemma of IDCs testified to their capacity to resorb and transport K+ through their known gap junctions. IDCs were differentiated into three subgroups. The most lateral IDCs formed short and long columns. Long columns contacted the medialmost ISC inferiorly and the undersurface of the tectorial membrane superiorly providing thereby a potential transcellular route for K+ transit from ISCs to endolymph. Short columns faced inner sulcus below and tectorial membrane above and accordingly possessed cells with opposite polarity at the bottom and top of the column. Short columns thus appeared situated to resorb electrolytes from limbal stroma for release into inner sulcus and beneath tectorial membrane at opposite ends of the column. The central IDCs were positioned for resorbing and transporting K+ effluxing from the Na,K-ATPase-rich stellate fibrocytes which spread toward the IDCs from near the inner sulcus. The most medial IDCs lined cuplike invaginations near the attachment of Reissner's membrane and lay apposed to light fibrocytes located between supralimbal fibrocytes and the medial IDCs. Content of Na,K-ATPase and position in the K+ transport route likened the limbal stellate fibrocytes to the spiral ligament type II fibrocytes and supralimbal fibrocytes to suprastrial fibrocytes in the lateral wall. From content of creatine kinase and position in the transport path, limbal light

  8. Bilateral Medial Tibiofemoral Joint Stiffness in Full Extension and 20° of Knee Flexion

    PubMed Central

    Aronson, Patricia A; Rijke, Arie M; Ingersoll, Christopher D

    2008-01-01

    Context: The valgus stress test is used clinically to assess injury to the medial knee structures in 2 positions: full extension and some degree of flexion. The amount of flexion used to “isolate” the medial collateral ligament is not consistent in the literature, but most studies have shown that stiffness of the ligaments was consistent between the limbs. Objective: To determine (1) if the stiffness of the medial knee structures was the same bilaterally, and (2) if the stiffness was different in full extension compared with 20° of knee flexion. Design: Criterion standard, before-after design. Setting: University research laboratory. Patients or Other Participants: Both knees of 45 healthy and active volunteers (26 females, 19 males; age  =  23.2 ± 3.96 years, height  =  170.6 ± 7.75 cm, mass  =  74.2 ± 15.14 kg) were studied. Intervention(s): A valgus force of 60 N was applied to the lateral aspect of both knees in full extension and in 20° of flexion. Main Outcome Measure(s): The slope of the force-strain line of the medial knee during a valgus force was calculated using the LigMaster arthrometer. Results: Slope means in full extension were 16.1 ± 3.3 (right knee) and 15.8 ± 3.1(left knee). Means for 20° of flexion were 12.2 ± 3.1 (right) and 11.7 ± 2.8 (left). Stiffness was greater when the knee was in full extension versus 20° of flexion (t44  =  12.04, P < .001). No difference was noted between the slopes of the 2 knees in extension (t44  =  0.74, P  =  .46) or in flexion (t44  =  1.2, P  =  .27). Conclusions: These findings support the use of the contralateral knee as a control. Further, the valgus stress test should be performed in full extension and in some degree of flexion to assess the different restraining structures of the medial tibiofemoral joint. PMID:18345340

  9. Relationship between neurotoxic kynurenine metabolites and reductions in right medial prefrontal cortical thickness in major depressive disorder.

    PubMed

    Meier, Timothy B; Drevets, Wayne C; Wurfel, Brent E; Ford, Bart N; Morris, Harvey M; Victor, Teresa A; Bodurka, Jerzy; Teague, T Kent; Dantzer, Robert; Savitz, Jonathan

    2016-03-01

    Reductions in gray matter volume of the medial prefrontal cortex (mPFC), especially the rostral and subgenual anterior cingulate cortex (rACC, sgACC) are a widely reported finding in major depressive disorder (MDD). Inflammatory mediators, which are elevated in a subgroup of patients with MDD, activate the kynurenine metabolic pathway and increase production of neuroactive metabolites such as kynurenic acid (KynA), 3-hydroxykynurenine (3HK) and quinolinic acid (QA) which influence neuroplasticity. It is not known whether the alterations in brain structure and function observed in major depressive disorders are due to the direct effect of inflammatory mediators or the effects of neurotoxic kynurenine metabolites. Here, using partial posterior predictive distribution mediation analysis, we tested whether the serum concentrations of kynurenine pathway metabolites mediated reductions in cortical thickness in mPFC regions in MDD. Further, we tested whether any association between C-reactive protein (CRP) and cortical thickness would be mediated by kynurenine pathway metabolites. Seventy-three unmedicated subjects who met DSM-IV-TR criteria for MDD and 91 healthy controls (HC) completed MRI scanning using a pulse sequence optimized for tissue contrast resolution. Automated cortical parcellation was performed using the PALS-B12 Brodmann area atlas as implemented in FreeSurfer in order to compare the cortical thickness and cortical area of six PFC regions: Brodmann areas (BA) 9, 10, 11, 24, 25, and 32. Serum concentrations of kynurenine pathway metabolites were determined by high performance liquid chromatography (HPLC) with tandem mass spectrometry (MS/MS) detection, while high-sensitivity CRP concentration was measured immunoturbidimetrically. Compared with HCs, the MDD group showed a reduction in cortical thickness of the right BA24 (p<0.01) and BA32 (p<0.05) regions and MDD patients with a greater number of depressive episodes displayed thinner cortex in BA32 (p<0

  10. Partial polarization by quantum distinguishability

    NASA Astrophysics Data System (ADS)

    Lahiri, Mayukh; Hochrainer, Armin; Lapkiewicz, Radek; Lemos, Gabriela Barreto; Zeilinger, Anton

    2017-03-01

    We establish that a connection exists between wave-particle duality of photons and partial polarization of a light beam. We perform a two-path lowest-order (single photon) interference experiment and demonstrate both theoretically and experimentally that the degree of polarization of the light beam emerging from an output of the interferometer depends on path distinguishability. In our experiment, we are able to change the quantum state of the emerging photon from a pure state to a fully mixed state without any direct interaction with the photon. Although most lowest-order interference experiments can be explained by classical theory, our experiment has no genuine classical analog. Our results show that a case exists where the cause of partial polarization is beyond the scope of classical theory.

  11. Wettability of partially suspended graphene

    PubMed Central

    Ondarçuhu, Thierry; Thomas, Vincent; Nuñez, Marc; Dujardin, Erik; Rahman, Atikur; Black, Charles T.; Checco, Antonio

    2016-01-01

    The dependence of the wettability of graphene on the nature of the underlying substrate remains only partially understood. Here, we systematically investigate the role of liquid-substrate interactions on the wettability of graphene by varying the area fraction of suspended graphene from 0 to 95% by means of nanotextured substrates. We find that completely suspended graphene exhibits the highest water contact angle (85° ± 5°) compared to partially suspended or supported graphene, regardless of the hydrophobicity (hydrophilicity) of the substrate. Further, 80% of the long-range water-substrate interactions are screened by the graphene monolayer, the wettability of which is primarily determined by short-range graphene-liquid interactions. By its well-defined chemical and geometrical properties, supported graphene therefore provides a model system to elucidate the relative contribution of short and long range interactions to the macroscopic contact angle. PMID:27072195

  12. Wettability of partially suspended graphene

    DOE PAGES

    Ondarçuhu, Thierry; Thomas, Vincent; Nuñez, Marc; ...

    2016-04-13

    Dependence on the wettability of graphene on the nature of the underlying substrate remains only partially understood. We systematically investigate the role of liquid-substrate interactions on the wettability of graphene by varying the area fraction of suspended graphene from 0 to 95% by means of nanotextured substrates. We find that completely suspended graphene exhibits the highest water contact angle (85° ± 5°) compared to partially suspended or supported graphene, regardless of the hydrophobicity (hydrophilicity) of the substrate. Moreover, 80% of the long-range water-substrate interactions are screened by the graphene monolayer, the wettability of which is primarily determined by short-range graphene-liquidmore » interactions. By its well-defined chemical and geometrical properties, supported graphene therefore provides a model system to elucidate the relative contribution of short and long range interactions to the macroscopic contact angle.« less

  13. Wettability of partially suspended graphene

    SciTech Connect

    Ondarçuhu, Thierry; Thomas, Vincent; Nuñez, Marc; Dujardin, Erik; Rahman, Atikur; Black, Charles T.; Checco, Antonio

    2016-04-13

    Dependence on the wettability of graphene on the nature of the underlying substrate remains only partially understood. We systematically investigate the role of liquid-substrate interactions on the wettability of graphene by varying the area fraction of suspended graphene from 0 to 95% by means of nanotextured substrates. We find that completely suspended graphene exhibits the highest water contact angle (85° ± 5°) compared to partially suspended or supported graphene, regardless of the hydrophobicity (hydrophilicity) of the substrate. Moreover, 80% of the long-range water-substrate interactions are screened by the graphene monolayer, the wettability of which is primarily determined by short-range graphene-liquid interactions. By its well-defined chemical and geometrical properties, supported graphene therefore provides a model system to elucidate the relative contribution of short and long range interactions to the macroscopic contact angle.

  14. Matching games with partial information

    NASA Astrophysics Data System (ADS)

    Laureti, Paolo; Zhang, Yi-Cheng

    2003-06-01

    We analyze different ways of pairing agents in a bipartite matching problem, with regard to its scaling properties and to the distribution of individual “satisfactions”. Then we explore the role of partial information and bounded rationality in a generalized Marriage Problem, comparing the benefits obtained by self-searching and by a matchmaker. Finally we propose a modified matching game intended to mimic the way consumers’ information makes firms to enhance the quality of their products in a competitive market.

  15. Tree reconstruction from partial orders

    SciTech Connect

    Kannan, S.K. ); Warnow, T.J. )

    1993-01-01

    The problem of constructing trees given a matrix of interleaf distances is motivated by applications in computational evolutionary biology and linguistics. The general problem is to find an edge-weighted tree which most closely approximates the distance matrix. Although the construction problem is easy when the tree exactly fits the distance matrix, optimization problems under all popular criteria are either known or conjectured to be NP-complete. In this paper we consider the related problem where we are given a partial order on the pairwise distances, and wish to construct (if possible) an edge-weighted tree realizing the partial order. In particular we are interested in partial orders which arise from experiments on triples of species, which determine either a linear ordering of the three pairwise distances (called Total Order Model or TOM experiments) or only the pair(s) of minimum distance apart (called Partial Order Model or POM experiments). The POM and TOM experimental model is inspired by the model proposed by Kannan, Lawler, and Warnow for constructing trees from experiments which determine the rooted topology for any triple of species. We examine issues of construction of trees and consistency of TOM and POM experiments, where the trees may either be weighted or unweighted. Using these experiments to construct unweighted trees without nodes of degree two is motivated by a similar problem studied by Winkler, called the Discrete Metric Realization problem, which he showed to be strongly NP-hard. We have the following results: Determining consistency of a set of TOM or POM experiments is NP-Complete whether the tree is weighted or constrained to be unweighted and without degree two nodes. We can construct unweighted trees without degree two nodes from TOM experiments in optimal O(n[sup 3]) time and from POM experiments in O(n[sup 4]) time.

  16. Tree reconstruction from partial orders

    SciTech Connect

    Kannan, S.K.; Warnow, T.J.

    1993-03-01

    The problem of constructing trees given a matrix of interleaf distances is motivated by applications in computational evolutionary biology and linguistics. The general problem is to find an edge-weighted tree which most closely approximates the distance matrix. Although the construction problem is easy when the tree exactly fits the distance matrix, optimization problems under all popular criteria are either known or conjectured to be NP-complete. In this paper we consider the related problem where we are given a partial order on the pairwise distances, and wish to construct (if possible) an edge-weighted tree realizing the partial order. In particular we are interested in partial orders which arise from experiments on triples of species, which determine either a linear ordering of the three pairwise distances (called Total Order Model or TOM experiments) or only the pair(s) of minimum distance apart (called Partial Order Model or POM experiments). The POM and TOM experimental model is inspired by the model proposed by Kannan, Lawler, and Warnow for constructing trees from experiments which determine the rooted topology for any triple of species. We examine issues of construction of trees and consistency of TOM and POM experiments, where the trees may either be weighted or unweighted. Using these experiments to construct unweighted trees without nodes of degree two is motivated by a similar problem studied by Winkler, called the Discrete Metric Realization problem, which he showed to be strongly NP-hard. We have the following results: Determining consistency of a set of TOM or POM experiments is NP-Complete whether the tree is weighted or constrained to be unweighted and without degree two nodes. We can construct unweighted trees without degree two nodes from TOM experiments in optimal O(n{sup 3}) time and from POM experiments in O(n{sup 4}) time.

  17. Microflora of partially processed lettuce.

    PubMed

    Magnuson, J A; King, A D; Török, T

    1990-12-01

    Bacteria, yeasts, and molds isolated from partially processed iceberg lettuce were taxonomically classified. The majority of bacterial isolates were gram-negative rods. Pseudomonas, Erwinia, and Serratia species were commonly found. Yeasts most frequently isolated from lettuce included members of the genera Candida, Cryptococcus, Pichia, Torulaspora, and Trichosporon. Comparatively few molds were isolated; members of the genera Rhizopus, Cladosporium, Phoma, Aspergillus, and Penicillium were identified.

  18. Individual Differences in Some (But Not All) Medial Prefrontal Regions Reflect Cognitive Demand While Regulating Unpleasant Emotion

    PubMed Central

    Urry, Heather L.; van Reekum, Carien M.; Johnstone, Tom; Davidson, Richard J.

    2009-01-01

    The present study investigated the premise that individual differences in autonomic physiology could be used to specify the nature and consequences of information processing taking place in medial prefrontal regions during cognitive reappraisal of unpleasant emotion. Neural (blood oxygenation level-dependent functional magnetic resonance imaging) and autonomic (electrodermal, pupil diameter, cardiac acceleration) signals were recorded simultaneously as twenty-six older people (ages 64-66 years) used reappraisal to increase, maintain, or decrease their responses to unpleasant pictures. EDA was higher when increasing and lower when decreasing compared to maintaining. This suggested modulation of emotional arousal by reappraisal. By contrast, pupil diameter and cardiac acceleration were higher when increasing and decreasing compared to maintaining. This suggested modulation of cognitive demand. Importantly, reappraisal-related activation (increase, decrease > maintain) in two medial prefrontal regions (dorsal medial frontal gyrus and dorsal cingulate cortex) was correlated with greater cardiac acceleration (increase, decrease > maintain) and monotonic changes in EDA (increase > maintain > decrease). These data indicate that these two medial prefrontal regions are involved in the allocation of cognitive resources to regulate unpleasant emotion, and that they modulate emotional arousal in accordance with the regulatory goal. The emotional arousal effects were mediated by the right amygdala. Reappraisal-related activation in a third medial prefrontal region (subgenual anterior cingulate cortex) was not associated with similar patterns of change in any of the autonomic measures, thus highlighting regional specificity in the degree to which cognitive demand is reflected in medial prefrontal activation during reappraisal. PMID:19486944

  19. Temporary Sternoclavicular Plating for an Unusual Double Clavicle Fracture (Medial Nonunion, Lateral Acute) Complicated by an Intraoperative Pneumothorax

    PubMed Central

    Skedros, John G.; Knight, Alex N.; Mears, Chad S.; Langston, Tanner D.

    2014-01-01

    Double (segmental) clavicle fractures, involving both the medial and lateral aspects of the clavicle, are very uncommon. Even less common is an asynchronous double fracture with one of the fractures being a nonunion. We report the case of a 30-year-old healthy male patient who had an unusual double clavicle fracture (medial nonunion, lateral acute) that occurred in separate traumatic events during motocross (motorcycle) racing. His fractures were treated surgically in two stages. In the first stage a long reconstruction plate was used that spanned onto the sternum and two transcortical screws were placed into the manubrium to enhance purchase for the deficient bone of the medial clavicle. In accordance with the preoperative plan, the medial one-third of the plate and the medial four screws (of the total 13 used) were removed. Although our patient had an excellent final result, he did have an intraoperative pneumothorax that was treated uneventfully with a chest tube. Medial clavicle fractures are difficult to treat, especially if they are nonunions and surgical complication rates can be high. Our case is one of the few that has been described where temporary sternoclavicular plating was successful in achieving an excellent long-term outcome. PMID:25258689

  20. Special function of nestin(+) neurons in the medial septum-diagonal band of Broca in adult rats.

    PubMed

    Zhao, Yuhong; Guo, Kaihua; Li, Dongpei; Yuan, Qunfang; Yao, Zhibin

    2014-02-01

    Nestin(+) neurons have been shown to express choline acetyltransferase (ChAT) in the medial septum-diagonal band of Broca in adult rats. This study explored the projection of nestin(+) neurons to the olfactory bulb and the time course of nestin(+) neurons in the medial septum-diagonal band of Broca in adult rats during injury recovery after olfactory nerve transection. This study observed that all nestin(+) neurons were double-labeled with ChAT in the medial septum-diagonal band of Broca. Approximately 53.6% of nestin(+) neurons were projected to the olfactory bulb and co-labeled with fast blue. A large number of nestin(+) neurons were not present in each region of the medial septum-diagonal band of Broca. Nestin(+) neurons in the medial septum and vertical limb of the diagonal band of Broca showed obvious compensatory function. The number of nestin(+) neurons decreased to a minimum later than nestin(-)/ChAT(+) neurons in the medial septum-diagonal band of Broca. The results suggest that nestin(+) cholinergic neurons may have a closer connection to olfactory bulb neurons. Nestin(+) cholinergic neurons may have a stronger tolerance to injury than Nestin(-)/ChAT(+) neurons. The difference between nestin(+) and nestin(-)/ChAT(+) neurons during the recovery process requires further investigations.

  1. A reduced progenitor pool population accounts for the rudimentary appearance of the septum, medial pallium and dorsal pallium in birds.

    PubMed

    Charvet, Christine J

    2010-01-01

    To date, most studies comparing birds and mammals have focused on the similarities in brain development, architecture and connectivity. However, major differences in size, anatomy and organization exist in the telencephalon of adult birds and mammals. For instance, the septum, medial pallium and dorsal pallium of birds appear rudimentary compared with those of mammals. To identify the developmental processes that give rise to this difference in size and anatomy of the septum, medial pallium and dorsal pallium, the thickness of the ventricular zone that encompasses these regions was measured in embryonic birds (i.e. chickens, sparrows) and mammals (i.e. rabbits, hedgehogs, shrews, platypus). Cumulative bromodeoxyuridine (BrdU) labeling in chickens at embryonic day 7 and 8 was also used to examine levels of cell proliferation in the ventricular zone of the septum, medial pallium and dorsal pallium. The study's main finding is that the ventricular zone of the septum, medial pallium and dorsal pallium is thinner in birds than in mammals. In chickens, the septum, medial pallium and dorsal pallium ventricular zone harbor few proliferating (i.e. BrdU+) cells. Collectively, these findings suggest that a reduced progenitor pool population account for the 'rudimentary' appearance of the avian septum, medial pallium and dorsal pallium.

  2. Effects of Prepubertal or Adult Site-Specific Knockdown of Estrogen Receptor β in the Medial Preoptic Area and Medial Amygdala on Social Behaviors in Male Mice123

    PubMed Central

    Nakata, Mariko; Sano, Kazuhiro; Musatov, Sergei; Sakamoto, Toshiro

    2016-01-01

    Abstract Testosterone, after being converted to estradiol in the brain, acts on estrogen receptors (ERα and ERβ) and controls the expression of male-type social behavior. Previous studies in male mice have revealed that ERα expressed in the medial preoptic area (MPOA) and medial amygdala (MeA) are differently involved in the regulation of sexual and aggressive behaviors by testosterone action at the time of testing in adult and/or on brain masculinization process during pubertal period. However, a role played by ERβ in these brain regions still remains unclear. Here we examined the effects of site-specific knockdown of ERβ (βERKD) in the MPOA and MeA on male social behaviors with the use of adeno-associated viral mediated RNA interference methods in ICR/Jcl mice. Prepubertal βERKD in the MPOA revealed that continuous suppression of ERβ gene expression throughout the pubertal period and adulthood decreased aggressive but not sexual behavior tested as adults. Because βERKD in the MPOA only in adulthood did not affect either sexual or aggressive behaviors, it was concluded that pubertal ERβ in the MPOA might have an essential role for the full expression of aggressive behavior in adulthood. On the other hand, although neither prepubertal nor adult βERKD in the MeA had any effects on sexual and aggressive behavior, βERKD in adulthood disrupted sexual preference of receptive females over nonreceptive females. Collectively, these results suggest that ERβ in the MPOA and MeA are involved in the regulation of male sexual and aggressive behavior in a manner substantially different from that of ERα. PMID:27066533

  3. Chemosensory and hormone information are relayed directly between the medial amygdala, posterior bed nucleus of the stria terminalis, and medial preoptic area in male Syrian hamsters

    PubMed Central

    Been, Laura E.; Petrulis, Aras

    2011-01-01

    In many rodent species, including Syrian hamsters, the expression of appropriate social behavior depends critically on the perception and identification of conspecific odors. The behavioral response to these odors is mediated by a network of steroid-sensitive ventral forebrain nuclei including the medial amygdala (Me), posterior bed nucleus of the stria terminalis (BNST) and medial preoptic area (MPOA). Although it is well-known that Me, BNST, and MPOA are densely interconnected and each uniquely modulates odor-guided social behaviors, the degree to which conspecific odor information and steroid hormone cues are directly relayed between these nuclei is unknown. To answer this question, we injected the retrograde tracer, cholera toxin B (CTB), into the BNST or MPOA of male subjects and identified whether retrogradely-labeled cells in Me and BNST 1) expressed immediate early genes (IEGs) following exposure to male and/or female odors or 2) expressed androgen receptor (AR). Although few retrogradely-labeled cells co-localized with IEGs, a higher percentage of BNST- and MPOA-projecting cells in the posterior Me (MeP) expressed IEGs in response to female odors than to male odors. The percentage of retrogradely-labeled cells that expressed IEGs did not, however, differ between and female- and male- odor-exposed groups in the anterior Me (MeA), posterointermediate BNST (BNSTpi), or posteromedial BNST (BNSTpm). Many retrogradely-labeled cells co-localized with AR, and a higher percentage of retrogradely-labeled MeP and BNSTpm cells expressed AR than retrogradely-labeled MeA and BNSTpi cells, respectively. Together, these data demonstrate that Me, BNST, and MPOA interact as a functional circuit to process sex-specific odor cues and hormone information in male Syrian hamsters. PMID:21316366

  4. Hebb-Williams performance and scopolamine challenge in rats with partial immunotoxic hippocampal cholinergic deafferentation.

    PubMed

    Marques Pereira, Patricia; Cosquer, Brigitte; Schimchowitsch, Sarah; Cassel, Jean-Christophe

    2005-01-15

    Recent studies suggested that the cholinergic innervation of the hippocampus is not crucial for spatial learning, but it might be important for other forms of learning. This study assessed the effects of partial immunotoxic cholinergic lesions in the medial septum and concurrent scopolamine challenge in a complex learning task, the Hebb-Williams maze. Long-Evans rats were given intraseptal injections of 192 IgG-saporin (SAPO). Rats injected with phosphate-buffered saline (PBS) served as controls. Starting 25 days after surgery, behavioural performance was assessed in the Hebb-Williams maze test without prior or after injection of scopolamine (0.17 or 0.5 mg/kg, i.p.). In SAPO rats, histochemical analysis showed a 40-45% decrease in the density of hippocampal AChE staining. The number of ChAT-positive cell bodies in the medial septum was also significantly decreased (-56%) and there was a non-significant reduction of the number of parvalbumine-positive neurons. The behavioural results demonstrated that the lesions induced small but significant learning deficits. At 0.17 mg/kg, scopolamine produced more impairments in SAPO rats than in PBS-injected rats, suggesting an additive effect between the partial lesion and the drug. These observations indicate that the Hebb-Williams test may be more sensitive to alterations of septohippocampal cholinergic function, than radial- or water-maze tasks. They also show that subtle learning deficits can be detected after partial lesions of the cholinergic septohippocampal pathways. Finally, the data from the scopolamine challenge are in keeping with clinical results showing higher sensitivity to muscarinic blockade in aged subjects in whom weaker cholinergic functions can be presumed.

  5. Laparoscopic radical and partial cystectomy

    PubMed Central

    Challacombe, Ben J.; Rose, Kristen; Dasgupta, Prokar

    2005-01-01

    Radical cystectomy remains the standard treatment for muscle invasive organ confined bladder carcinoma. Laparoscopic radical cystoprostatectomy (LRC) is an advanced laparoscopic procedure that places significant demands on the patient and the surgeon alike. It is a prolonged procedure which includes several technical steps and requires highly developed laparoscopic skills including intra-corporeal suturing. Here we review the development of the technique, the indications, complications and outcomes. We also examine the potential benefits of robotic-assisted LRC and explore the indications and technique of laparoscopic partial cystectomy. PMID:21206662

  6. Partial coalescence of soap bubbles

    NASA Astrophysics Data System (ADS)

    Harris, Daniel M.; Pucci, Giuseppe; Bush, John W. M.

    2015-11-01

    We present the results of an experimental investigation of the merger of a soap bubble with a planar soap film. When gently deposited onto a horizontal film, a bubble may interact with the underlying film in such a way as to decrease in size, leaving behind a smaller daughter bubble with approximately half the radius of its progenitor. The process repeats up to three times, with each partial coalescence event occurring over a time scale comparable to the inertial-capillary time. Our results are compared to the recent numerical simulations of Martin and Blanchette and to the coalescence cascade of droplets on a fluid bath.

  7. Medial prefrontal cortex activation is commonly invoked by reputation of self and romantic partners.

    PubMed

    Kawamichi, Hiroaki; Sasaki, Akihiro T; Matsunaga, Masahiro; Yoshihara, Kazufumi; Takahashi, Haruka K; Tanabe, Hiroki C; Sadato, Norihiro

    2013-01-01

    The reputation of others influences partner selection in human cooperative behaviors through verbal reputation representation. Although the way in which humans represent the verbal reputations of others is a pivotal issue for social neuroscience, the neural correlates underlying the representation of verbal reputations of others are unclear. Humans primarily depend on self-evaluation when assessing reputation of self. Likewise, humans might primarily depend on self-evaluation of others when representing their reputation. As interaction promotes the formation of more nuanced, individualized impressions of an interaction partner, humans tend to form self-evaluations of persons with whom they are intimate in their daily life. Thus, we hypothesized that the representation of reputation of others is modulated by intimacy due to one's own evaluation formation of that person. To test this hypothesis, we conducted a functional magnetic resonance imaging experiment with 11 pairs of romantic partners while they viewed an evaluation of a target person (self, partner [intimate other], or stranger [non-intimate other]), made by other evaluators. When compared with strangers, viewing evaluations of self and partner activated overlapping regions in the medial prefrontal cortex. Verbal reputation of self-specific activation was found in the precuneus, which represents self-related processing. The data suggest that midline structures represent reputation of self. In addition, intimacy-modulated activation in the medial prefrontal cortex suggests that the verbal reputation of intimate others is represented similarly to reputation of self. These results suggest that the reputation representation in the medial prefrontal cortex is engaged by verbal reputation of self and intimate others stemming from both own and other evaluators' judgments.

  8. Chronic shin splints. Classification and management of medial tibial stress syndrome.

    PubMed

    Detmer, D E

    1986-01-01

    A clinical classification and treatment programme has been developed for chronic medial tibial stress syndrome. Medial tibial stress syndrome has been reported to be either tibial stress fracture or microfracture, tibial periostitis, or distal deep posterior chronic compartment syndrome. Three chronic types exist and may coexist: Type I (tibial microfracture, bone stress reaction or cortical fracture); type II (periostalgia from chronic avulsion of the periosteum at the periosteal-fascial junction); and type III (chronic compartment syndrome syndrome). Type I disease is treated nonoperatively. Operations for resistant types II and III medial tibial stress syndrome were performed in 41 patients. Bilaterality was common (type II, 50% type III, 88%). Seven had coexistent type II/III; one had type I/II. Preoperative symptoms averaged 24 months in type II, 6 months in type III, and 33 months in types II/III. Mean age was 22 years (15 to 51). Resting compartment pressures were normal in type II (mean 12 mm Hg) and elevated in type III and type II/III (mean 23 mm Hg). Type II and type II/III patients received fasciotomy plus periosteal cauterisation. Type III patients had fasciotomy only. All procedures were performed on an outpatient basis using local anaesthesia. Follow up was complete and averaged 6 months (2 to 14 months). Improved performance was as follows: type II, 93%, type III, 100%; type II/III, 86%. Complete cures were as follows: type II, 78%; type III, 75%; and type II/III, 57%. This experience suggests that with precise diagnosis and treatment involving minimal risk and cost the athlete has a reasonable chance of return to full activity.

  9. Cardiovascular responses of the anterior claustrum; its mechanism; contribution of medial prefrontal cortex.

    PubMed

    Hatam, Masoumeh; Sheybanifar, Mehrnoosh; Nasimi, Ali

    2013-12-01

    The anterior claustrum (CLa) has bilateral connections with the areas involved in cardiovascular regulation, though its role in cardiovascular control is not yet understood. This study was performed to find the cardiovascular responsive region of the CLa by stimulating all parts of the CLa with l-glutamate, and to find the possible mechanisms mediating its responses in urethane-anesthetized rats. We also investigated the possible involvement of the medial prefrontal cortex in the cardiovascular responses of the CLa. The effect of microinjection of l-glutamate (50-100 nl, 0.25 M) was tested throughout the Cla and only in one area at 2.7 mm rostral to bregma, 1.8-2.0 midline and 4.5-5.6mm vertical, significant decreases in arterial pressure were elicited (-21.71±2.1 mmHg, P<0.001, t-test) with no significant change in heart rate. Administration (i.v.) of the muscarinic receptor blocker, atropine, had no effect on the change in mean arterial pressure in response to glutamate stimulation, suggesting that the parasympathetic system was not involved in this response. However, administration (i.v.) of the nicotinic receptor blocker, hexamethonium dichloride abolished the depressor response to glutamate, suggesting that CLa stimulation decreases sympathetic outflow to the cardiovascular system. In addition, microinjection of the reversible synaptic blocker, cobalt chloride, into the medial prefrontal cortex greatly attenuated the depressor response elicited by microinjection of glut into the CLa. Thus for the first time, we found the cardiovascular responsive region of the anterior claustrum. Also we showed that its response is mediated through the medial prefrontal cortex.

  10. Subject-specific knee joint geometry improves predictions of medial tibiofemoral contact forces.

    PubMed

    Gerus, Pauline; Sartori, Massimo; Besier, Thor F; Fregly, Benjamin J; Delp, Scott L; Banks, Scott A; Pandy, Marcus G; D'Lima, Darryl D; Lloyd, David G

    2013-11-15

    Estimating tibiofemoral joint contact forces is important for understanding the initiation and progression of knee osteoarthritis. However, tibiofemoral contact force predictions are influenced by many factors including muscle forces and anatomical representations of the knee joint. This study aimed to investigate the influence of subject-specific geometry and knee joint kinematics on the prediction of tibiofemoral contact forces using a calibrated EMG-driven neuromusculoskeletal model of the knee. One participant fitted with an instrumented total knee replacement walked at a self-selected speed while medial and lateral tibiofemoral contact forces, ground reaction forces, whole-body kinematics, and lower-limb muscle activity were simultaneously measured. The combination of generic and subject-specific knee joint geometry and kinematics resulted in four different OpenSim models used to estimate muscle-tendon lengths and moment arms. The subject-specific geometric model was created from CT scans and the subject-specific knee joint kinematics representing the translation of the tibia relative to the femur was obtained from fluoroscopy. The EMG-driven model was calibrated using one walking trial, but with three different cost functions that tracked the knee flexion/extension moments with and without constraint over the estimated joint contact forces. The calibrated models then predicted the medial and lateral tibiofemoral contact forces for five other different walking trials. The use of subject-specific models with minimization of the peak tibiofemoral contact forces improved the accuracy of medial contact forces by 47% and lateral contact forces by 7%, respectively compared with the use of generic musculoskeletal model.

  11. Increased Testosterone Decreases Medial Cortical Volume and Neurogenesis in Territorial Side-Blotched Lizards (Uta stansburiana)

    PubMed Central

    LaDage, Lara D.; Roth, Timothy C.; Downs, Cynthia J.; Sinervo, Barry; Pravosudov, Vladimir V.

    2017-01-01

    Variation in an animal's spatial environment can induce variation in the hippocampus, an area of the brain involved in spatial cognitive processing. Specifically, increased spatial area use is correlated with increased hippocampal attributes, such as volume and neurogenesis. In the side-blotched lizard (Uta stansburiana), males demonstrate alternative reproductive tactics and are either territorial—defending large, clearly defined spatial boundaries—or non-territorial—traversing home ranges that are smaller than the territorial males' territories. Our previous work demonstrated cortical volume (reptilian hippocampal homolog) correlates with these spatial niches. We found that territorial holders have larger medial cortices than non-territory holders, yet these differences in the neural architecture demonstrated some degree of plasticity as well. Although we have demonstrated a link among territoriality, spatial use, and brain plasticity, the mechanisms that underlie this relationship are unclear. Previous studies found that higher testosterone levels can induce increased use of the spatial area and can cause an upregulation in hippocampal attributes. Thus, testosterone may be the mechanistic link between spatial area use and the brain. What remains unclear, however, is if testosterone can affect the cortices independent of spatial experiences and whether testosterone differentially interacts with territorial status to produce the resultant cortical phenotype. In this study, we compared neurogenesis as measured by the total number of doublecortin-positive cells and cortical volume between territorial and non-territorial males supplemented with testosterone. We found no significant differences in the number of doublecortin-positive cells or cortical volume among control territorial, control non-territorial, and testosterone-supplemented non-territorial males, while testosterone-supplemented territorial males had smaller medial cortices containing fewer

  12. Increased Testosterone Decreases Medial Cortical Volume and Neurogenesis in Territorial Side-Blotched Lizards (Uta stansburiana).

    PubMed

    LaDage, Lara D; Roth, Timothy C; Downs, Cynthia J; Sinervo, Barry; Pravosudov, Vladimir V

    2017-01-01

    Variation in an animal's spatial environment can induce variation in the hippocampus, an area of the brain involved in spatial cognitive processing. Specifically, increased spatial area use is correlated with increased hippocampal attributes, such as volume and neurogenesis. In the side-blotched lizard (Uta stansburiana), males demonstrate alternative reproductive tactics and are either territorial-defending large, clearly defined spatial boundaries-or non-territorial-traversing home ranges that are smaller than the territorial males' territories. Our previous work demonstrated cortical volume (reptilian hippocampal homolog) correlates with these spatial niches. We found that territorial holders have larger medial cortices than non-territory holders, yet these differences in the neural architecture demonstrated some degree of plasticity as well. Although we have demonstrated a link among territoriality, spatial use, and brain plasticity, the mechanisms that underlie this relationship are unclear. Previous studies found that higher testosterone levels can induce increased use of the spatial area and can cause an upregulation in hippocampal attributes. Thus, testosterone may be the mechanistic link between spatial area use and the brain. What remains unclear, however, is if testosterone can affect the cortices independent of spatial experiences and whether testosterone differentially interacts with territorial status to produce the resultant cortical phenotype. In this study, we compared neurogenesis as measured by the total number of doublecortin-positive cells and cortical volume between territorial and non-territorial males supplemented with testosterone. We found no significant differences in the number of doublecortin-positive cells or cortical volume among control territorial, control non-territorial, and testosterone-supplemented non-territorial males, while testosterone-supplemented territorial males had smaller medial cortices containing fewer doublecortin

  13. Cellular properties of principal neurons in the rat entorhinal cortex. II. The medial entorhinal cortex.

    PubMed

    Canto, Cathrin B; Witter, Menno P

    2012-06-01

    Principal neurons in different medial entorhinal cortex (MEC) layers show variations in spatial modulation that stabilize between 15 and 30 days postnatally. These in vivo variations are likely due to differences in intrinsic membrane properties and integrative capacities of neurons. The latter depends on inputs and thus potentially on the morphology of principal neurons. In this comprehensive study, we systematically compared the morphological and physiological characteristics of principal neurons in all MEC layers of newborn rats before and after weaning. We recorded simultaneously from up to four post-hoc morphologically identified MEC principal neurons in vitro. Neurons in L(ayer) I-LIII have dendritic and axonal arbors mainly in superficial layers, and LVI neurons mainly in deep layers. The dendritic and axonal trees of part of LV neurons diverge throughout all layers. Physiological properties of principal neurons differ between layers. In LII, most neurons have a prominent sag potential, resonance and membrane oscillations. Neurons in LIII and LVI fire relatively regular, and lack sag potentials and membrane oscillations. LV neurons show the most prominent spike-frequency adaptation and highest input resistance. The data indicate that adult-like principal neuron types can be differentiated early on during postnatal development. The results of the accompanying paper, in which principal neurons in the lateral entorhinal cortex (LEC) were described (Canto and Witter,2011), revealed that significant differences between LEC and MEC exist mainly in LII neurons. We therefore systematically analyzed changes in LII biophysical properties along the mediolateral axis of MEC and LEC. There is a gradient in properties typical for MEC LII neurons. These properties are most pronounced in medially located neurons and become less apparent in more laterally positioned ones. This gradient continues into LEC, such that in LEC medially positioned neurons share some properties

  14. Conserved size and periodicity of pyramidal patches in layer 2 of medial/caudal entorhinal cortex.

    PubMed

    Naumann, Robert K; Ray, Saikat; Prokop, Stefan; Las, Liora; Heppner, Frank L; Brecht, Michael

    2016-03-01

    To understand the structural basis of grid cell activity, we compare medial entorhinal cortex architecture in layer 2 across five mammalian species (Etruscan shrews, mice, rats, Egyptian fruit bats, and humans), bridging ∼100 million years of evolutionary diversity. Principal neurons in layer 2 are divided into two distinct cell types, pyramidal and stellate, based on morphology, immunoreactivity, and functional properties. We confirm the existence of patches of calbindin-positive pyramidal cells across these species, arranged periodically according to analyses techniques like spatial autocorrelation, grid scores, and modifiable areal unit analysis. In rodents, which show sustained theta oscillations in entorhinal cortex, cholinergic innervation targeted calbindin patches. In bats and humans, which only show intermittent entorhinal theta activity, cholinergic innervation avoided calbindin patches. The organization of calbindin-negative and calbindin-positive cells showed marked differences in entorhinal subregions of the human brain. Layer 2 of the rodent medial and the human caudal entorhinal cortex were structurally similar in that in both species patches of calbindin-positive pyramidal cells were superimposed on scattered stellate cells. The number of calbindin-positive neurons in a patch increased from ∼80 in Etruscan shrews to ∼800 in humans, only an ∼10-fold over a 20,000-fold difference in brain size. The relatively constant size of calbindin patches differs from cortical modules such as barrels, which scale with brain size. Thus, selective pressure appears to conserve the distribution of stellate and pyramidal cells, periodic arrangement of calbindin patches, and relatively constant neuron number in calbindin patches in medial/caudal entorhinal cortex.

  15. Growth modulation with a medial malleolar screw for ankle valgus deformity

    PubMed Central

    Rupprecht, Martin; Spiro, Alexander S; Breyer, Sandra; Vettorazzi, Eik; Ridderbusch, Karsten; Stücker, Ralf

    2015-01-01

    Background and purpose Growth modulation with a medial malleolar screw is used to correct ankle valgus deformity in children with a wide spectrum of underlying etiologies. It is unclear whether the etiology of the deformity affects the angular correction rate with this procedure. Patients and methods 79 children (20 girls) with ankle valgus deformity had growth modulation by a medial malleolar screw (125 ankles). To be included, patients had to have undergone screw removal at the time of skeletal maturity or deformity correction, or a minimum follow-up of 18 months, and consistent radiographs preoperatively and at the time of screw removal and/or follow-up. The patients were assigned to 1 of 7 groups according to their underlying diagnoses. The lateral distal tibial angle (LDTA) was analyzed preoperatively, at screw removal, and at follow-up. Results Mean age at operation was 11.7 (7.4–16.5) years. The average lateral distal tibial angle normalized from 80° (67–85) preoperatively to 89° (73–97) at screw removal. The screws were removed after an average time of 18 (6–46) months, according to an average rate of correction of 0.65° (0.1–2.2) per month. No significant differences in the correction rate per month were found between the groups (p = 0.3). Interpretation Growth modulation with a medial malleolar screw is effective for the treatment of ankle valgus deformity in patients with a wide spectrum of underlying diagnoses. The individual etiology of the ankle valgus does not appear to affect the correction rate after growth modulation. Thus, the optimal timing of growth modulation mainly depends on the remaining individual growth and on the extent of the deformity. PMID:25909385

  16. Comparison of baroreceptive to other afferent synaptic transmission to the medial solitary tract nucleus.

    PubMed

    Andresen, Michael C; Peters, James H

    2008-11-01

    Cranial nerve visceral afferents enter the brain stem to synapse on neurons within the solitary tract nucleus (NTS). The broad heterogeneity of both visceral afferents and NTS neurons makes understanding afferent synaptic transmission particularly challenging. To study a specific subgroup of second-order neurons in medial NTS, we anterogradely labeled arterial baroreceptor afferents of the aortic depressor nerve (ADN) with lipophilic fluorescent tracer (i.e., ADN+) and measured synaptic responses to solitary tract (ST) activation recorded from dye-identified neurons in medial NTS in horizontal brain stem slices. Every ADN+ NTS neuron received constant-latency ST-evoked excitatory postsynaptic currents (EPSCs) (jitter < 192 micros, SD of latency). Stimulus-recruitment profiles showed single thresholds and no suprathreshold recruitment, findings consistent with EPSCs arising from a single, branched afferent axon. Frequency-dependent depression of ADN+ EPSCs averaged approximately 70% for five shocks at 50 Hz, but single-shock failure rates did not exceed 4%. Whether adjacent ADN- or those from unlabeled animals, other second-order NTS neurons (jitters < 200 micros) had ST transmission properties indistinguishable from ADN+. Capsaicin (CAP; 100 nM) blocked ST transmission in some neurons. CAP-sensitive ST-EPSCs were smaller and failed over five times more frequently than CAP-resistant responses, whether ADN+ or from unlabeled animals. Variance-mean analysis of ST-EPSCs suggested uniformly high probabilities for quantal glutamate release across second-order neurons. While amplitude differences may reflect different numbers of contacts, higher frequency-dependent failure rates in CAP-sensitive ST-EPSCs may arise from subtype-specific differences in afferent axon properties. Thus afferent transmission within medial NTS differed by axon class (e.g., CAP sensitive) but was indistinguishable by source of axon (e.g., baroreceptor vs. nonbaroreceptor).

  17. Statistics of single unit responses in the human medial temporal lobe: A sparse and overdispersed code

    NASA Astrophysics Data System (ADS)

    Magyar, Andrew

    The recent discovery of cells that respond to purely conceptual features of the environment (particular people, landmarks, objects, etc) in the human medial temporal lobe (MTL), has raised many questions about the nature of the neural code in humans. The goal of this dissertation is to develop a novel statistical method based upon maximum likelihood regression which will then be applied to these experiments in order to produce a quantitative description of the coding properties of the human MTL. In general, the method is applicable to any experiments in which a sequence of stimuli are presented to an organism while the binary responses of a large number of cells are recorded in parallel. The central concept underlying the approach is the total probability that a neuron responds to a random stimulus, called the neuronal sparsity. The model then estimates the distribution of response probabilities across the population of cells. Applying the method to single-unit recordings from the human medial temporal lobe, estimates of the sparsity distributions are acquired in four regions: the hippocampus, the entorhinal cortex, the amygdala, and the parahippocampal cortex. The resulting distributions are found to be sparse (large fraction of cells with a low response probability) and highly non-uniform, with a large proportion of ultra-sparse neurons that possess a very low response probability, and a smaller population of cells which respond much more frequently. Rammifications of the results are discussed in relation to the sparse coding hypothesis, and comparisons are made between the statistics of the human medial temporal lobe cells and place cells observed in the rodent hippocampus.

  18. Afferent projections to the different medial amygdala subdivisions: a retrograde tracing study in the mouse.

    PubMed

    Cádiz-Moretti, Bernardita; Otero-García, Marcos; Martínez-García, Fernando; Lanuza, Enrique

    2016-03-01

    The medial amygdaloid nucleus (Me) is a key node in the socio-sexual brain, composed of anterior (MeA), posteroventral (MePV) and posterodorsal (MePD) subdivisions. These subdivisions have been suggested to play a different role in reproductive and defensive behaviours. In the present work we analyse the afferents of the three Me subdivisions using restricted injections of fluorogold in female outbred CD1 mice. The results reveal that the MeA, MePV and MePD share a common pattern of afferents, with some differences in the density of retrograde labelling in several nuclei. Common afferents to Me subdivisions include: the accessory olfactory bulbs, piriform cortex and endopiriform nucleus, chemosensory amygdala (receiving direct inputs from the olfactory bulbs), posterior part of the medial bed nucleus of the stria terminalis (BSTM), CA1 in the ventral hippocampus and posterior intralaminar thalamus. Minor projections originate from the basolateral amygdala and amygdalo-hippocampal area, septum, ventral striatum, several allocortical and periallocortical areas, claustrum, several hypothalamic structures, raphe and parabrachial complex. MeA and MePV share minor inputs from the frontal cortex (medial orbital, prelimbic, infralimbic and dorsal peduncular cortices), but differ in the lack of main olfactory projections to the MePV. By contrast, the MePD receives preferential projections from the rostral accessory olfactory bulb, the posteromedial BSTM and the ventral premammillary nucleus. In summary, the common pattern of afferents to the Me subdivisions and their interconnections suggest that they play cooperative instead of differential roles in the various behaviours (e.g., sociosexual, defensive) in which the Me has been shown to be involved.

  19. Human orbital and anterior medial prefrontal cortex: Intrinsic connectivity parcellation and functional organization.

    PubMed

    Samara, Zoe; Evers, Elisabeth A T; Goulas, Alexandros; Uylings, Harry B M; Rajkowska, Grazyna; Ramaekers, Johannes G; Stiers, Peter

    2017-03-02

    The orbital and medial prefrontal cortex (OMPFC) has been implicated in decision-making, reward and emotion processing, and psychopathology, such as depression and obsessive-compulsive disorder. Human and monkey anatomical studies indicate the presence of various cortical subdivisions and suggest that these are organized in two extended networks, a medial and an orbital one. Attempts have been made to replicate these neuroanatomical findings in vivo using MRI techniques for imaging connectivity. These revealed several consistencies, but also many inconsistencies between reported results. Here, we use fMRI resting-state functional connectivity (FC) and data-driven modularity optimization to parcellate the OMPFC to investigate replicability of in vivo parcellation more systematically. By collecting two resting-state data sets per participant, we were able to quantify the reliability of the observed modules and their boundaries. Results show that there was significantly more than chance overlap in modules and their boundaries at the level of individual data sets. Moreover, some of these consistent boundaries significantly co-localized across participants. Hierarchical clustering showed that the whole-brain FC profiles of the OMPFC subregions separate them in two networks, a medial and orbital one, which overlap with the organization proposed by Barbas and Pandya (J Comp Neurol 286:353-375, 1989) and Ongür and Price (Cereb Cortex 10:206-219, 2000). We conclude that in vivo resting-state FC can delineate reliable and neuroanatomically plausible subdivisions that agree with established cytoarchitectonic trends and connectivity patterns, while other subdivisions do not show the same consistency across data sets and studies.

  20. Subject-specific knee joint geometry improves predictions of medial tibiofemoral contact forces

    PubMed Central

    Gerus, Pauline; Sartori, Massimo; Besier, Thor F.; Fregly, Benjamin J.; Delp, Scott L.; Banks, Scott A.; Pandy, Marcus G.; D’Lima, Darryl D.; Lloyd, David G.

    2013-01-01

    Estimating tibiofemoral joint contact forces is important for understanding the initiation and progression of knee osteoarthritis. However, tibiofemoral contact force predictions are influenced by many factors including muscle forces and anatomical representations of the knee joint. This study aimed to investigate the influence of subject-specific geometry and knee joint kinematics on the prediction of tibiofemoral contact forces using a calibrated EMG-driven neuromusculoskeletal model of the knee. One participant fitted with an instrumented total knee replacement walked at a self-selected speed while medial and lateral tibiofemoral contact forces, ground reaction forces, whole-body kinematics, and lower-limb muscle activity were simultaneously measured. The combination of generic and subject-specific knee joint geometry and kinematics resulted in four different OpenSim models used to estimate muscle-tendon lengths and moment arms. The subject-specific geometric model was created from CT scans and the subject-specific knee joint kinematics representing the translation of the tibia relative to the femur was obtained from fluoroscopy. The EMG-driven model was calibrated using one walking trial, but with three different cost functions that tracked the knee flexion/extension moments with and without constraint over the estimated joint contact forces. The calibrated models then predicted the medial and lateral tibiofemoral contact forces for five other different walking trials. The use of subject-specific models with minimization of the peak tibiofemoral contact forces improved the accuracy of medial contact forces by 47% and lateral contact forces by 7%, respectively compared with the use of generic musculoskeletal model. PMID:24074941