Performance of Seed Rate on Wheat Crop (Triticum aestivum L.) under Late Sown Condition

A study was conducted to investigate the “Performance of seed rate on wheat crop (Triticum aestivum L.) Under late Sown Condition.” This experiment was carried out during the Rabi seasons of 2018-2019 and 2019-2 020 at the Pili-Kothi Student Research Farm and in the Laboratory Department of Agronomy at T.D.P.G. College Jaunpur. Increasing seed rates demonstrated a significant influence on various growth parameters, including initial plant population, shoot numbers, plant height, and dry matter production, with the highest values consistently observed at 140 kg/ha. In terms of yield-contributing characteristics, the 140 kg/ha seed rate led to increased spike counts, longer spikes, more grains per spike, and heavier grains. Yield significantly favored the 140 kg/ha rate, averaging 4.25-4.21 Mg/ha, surpassing the 120 kg/ha rate (4.08-4.07 Mg/ha) and markedly exceeding the 100 kg/ha rate (3.85-3.84 Mg/ha). The straw and biological yields further echoed this trend, cementing the prominence of the 140 kg/ha seed rate in augmenting late-sown wheat productivity.

A study of the effect of changes in nasal tip prominence on the sense of anterior prominence of the upper lip / 口腔疾病防治

Objective@#The aim of this study was to investigate the effect of changes in nasal tip protrusion on the sense of upper lip protrusion in different populations and to provide a reference for the improvement of soft tissue beauty.@*Methods @# Informed consent and portrait authorization were obtained from the model. A female model whose face met the criteria was selected, and a 3D model of her was obtained using a 3D stereo camera. Based on the original model, ZBRUSH2019 software was used to simulate changes in nose tip protrusion. Then, 9 segments of facial dynamic rotation videos were produced, and an electronic questionnaire was created through a questionnaire website to evaluate the effect of different nose tip protrusions on perceived upper lip protrusion. Randomly selected orthodontic patients, orthodontics professionals and general adults completed the electronic questionnaire. In the questionnaire, a Visual Analog Scale was used to evaluate the perceived degree of protrusion of the upper lip. The higher the score, the more prominent the upper lip of the model in the image. The questionnaire data were statistically analyzed using a generalized linear mixed model. @*Results @#As the nasal tip position became progressively more retracted, the subjects' upper lip protrusion scores increased. Among male subjects, the results showed that the general population thought that the upper lip protrusion was higher than the patients did when the nasal tip protrusion was +6 mm and +4.5 mm (P = 0.023, P = 0.047). When the nasal tip protrusion was +6 mm, the scores of the general population were higher than those of the orthodontics professionals (P = 0.023). However, when the nasal tip variable was -6 mm, their score was lower than that of the patients (P = 0.003), and there was no significant difference in other retest distances between groups (P>0.05).@*Conclusion @#When the protrusion of the nasal tip decreased, the three groups experienced a visual illusion of upper lip protrusion. When the nasal tip protrusion is too large, the general population perceived the visual illusion of the upper lip protrusion as being more obvious.

3D aesthetic evaluation of lip position influenced by different malar prominences for facial attractiveness / 上海交通大学学报（医学版）

Objective • To research the effect of malar prominence on the attractiveness of lip position. Methods • A woman conforming to the Holdaway analysis method was selected and 28 3D head models with different malar prominences and lip positions were obtained by 3D MAX software. Then orthodontists (professional group, n=42) and laypeople (nonprofessional group, n=100) were chosen to score the head models by visual analogue scale (VAS). Results • In the case of different malar prominence, the highest scores in the professional group were -2 mm and 0 mm in lip position, but the lip position with high scores in the nonprofessional group varied with the increase of malar prominence; -2 mm in malar prominence was the highest score in the professional group and the nonprofessional group, and +4 mm scores in malar prominence were the lowest in both groups. In the concave profile, the scores of the nonprofessional group were higher than those of the professional group, while in the convex profile, the results reversed. Conclusion • The preference of lip positions among laypeople is affected by the increase of malar prominence; however, this will not affect the aesthetics of orthodontists. People prefer the slightly concave profile and dislike the protruding malar prominence.

Hey1 gene expression patterns during the development of branchial arches and facial prominences / Patrones de expresión del gen Hey1 durante el desarrollo de arcos branquiales y prominencias faciales

ABSTRACT Objective. The present study aimed to describe in detail the expression patterns of the gene Hey1, an effector of the Notch pathway, during the development of branchial arches and facial prominences. Materials and methods. Fertilized chicken (Gallus gallus) eggs obtained from a local egg farm were incubated at 37.5 -38.5ºC with 70% relative humidity until the embryos reached Hamilton-Hamburger stages HH14 through HH25. Digoxigenin-UTP labeled probes Hey1 were generated from linearized plasmids with either T3 polimerase for in vitro transcription. Whole-mount in situ hybridization was then performed. At least 3 replicates (n=3) were obtained for each stage. To confirm the results observed in whole embryos, sagittal and coronal cryosectioning was performed using a thickness of 10 µm. Results. During developmental stages HH14 and HH18, Hey1 gene expression was localized to the endoderm of branchial pouches. Hey1 gene expression was also observed in the epithelium that covers the maxillary and mandibular prominences during developmental stages HH19 and HH21, as well as in the nasal epithelium between HH19 and HH25. Transcripts were also detected in the epithelium that covers the frontonasal prominence during stage HH21. Conclusions. These expression patterns suggest the participation of this component of the Notch signaling pathway in craniofacial morphogenesis, possibly establishing pharyngeal segmentation patterns during early stages and/or regulating cell proliferation and differentiation during the late stages of facial development.

RESUMEN Objetivo. El presente estudio tuvo como objetivo describir detalladamente los patrones de expresión del gen Hey1, un efector de la vía Notch durante el desarrollo de arcos branquiales y prominencias faciales. Materiales y métodos. Se incubaron huevos fertilizados de pollo (Gallus gallus) obtenidos de una granja local entre 37.5-38.5ºC con humedad relativa del 70% hasta que los embriones alcanzaron los estadios HH14 hasta HH25 de Hamilton-Hamburger. Las sondas Hey1 marcadas con digoxigenina-UTP se generaron a partir de plásmidos linearizados con T3 polimerasa por transcripción in vitro. Luego se realizó hibridación in situ sobre embriones completos. Se obtuvieron al menos 3 repeticiones (n=3) para cada estadio. Para confirmar los resultados observados en embriones completos, se realizaron cortes sagitales y coronales de 10 µm. Resultados. Durante los estadios de desarrollo HH14 y HH18, la expresión del gen Hey1 se localizó en el endodermo de las bolsas branquiales. La expresión génica de Hey1 también se observó en el epitelio que cubre las prominencias maxilares y mandibulares durante las etapas de desarrollo HH19 y HH21, así como en el epitelio nasal entre HH19 y HH25. También se detectaron transcritos de Hey1 en el epitelio que cubre la prominencia frontonasal durante la etapa HH21. Conclusiones. Estos patrones de expresión sugieren la participación de este componente de la vía de señalización Notch en la morfogénesis craneofacial, posiblemente estableciendo patrones de segmentación faríngea durante las primeras etapas y / o regulando la proliferación y diferenciación celular durante las últimas etapas del desarrollo facial.

Microanatomy relation of carotid artery bifurcation with lateral branch of the superior laryngeal nerve / 中华神经医学杂志

Objective To discuss the microsurgical anatomy of carotid bifurcation and external branch of the superior laryngeal nerve (EBSLN),and to explore the operative techniques in carotid endarterectomy.Methods The carotid bifurcation (20 sides) of 10 cadaveric heads was studied by using microanatomy from January 2017 to January 2018.The distance between bifurcation of carotid artery to peripheral bone structure,and the distances between point of EBSLN to medial margin of the carotid artery to mandibular angle,most prominent point of the larynx,apex of the mastoid,and bifurcation of carotid artery were measured.Results (1) The vertical distance from carotid bifurcation to larynx point and mandibular angle was 24.32 (18.8-35.78) mm and 13.55 (9.26-19.60) mm.The straight distance from carotid bifurcation to mastoid tip was 68.59 (49.48-76.94) ram.According to the vertical distance of larynx point to carotid bifurcation,the height of bifurcation of the carotid artery was consistent with the results of wain measurement (K=0.90),and the difference was statistically significant (P＜0.05).(2) The distances between the point of EBSLN to medial margin of the carotid artery to carotid artery bifurcation,upper thyroid artery bifurcation,mandibular angle and mastoid process were 17.81 (15.24-25.58) mm,19.42 (17.08-29.12) mm,20.51 (17.98-22.20) mm,71.00 (69.00-74.50) mm in normal bifurcations.Those in the high bifurcation specimens were 6.40 (2.44-9.20) mm,8.84(4.74-10.88) mm,12.15(10.64-13.54),60.90 (59.80-66.50) mm,respectively.Conclusions The position of the laryngeal prominence is fixed,which can be used as a marker for surgical incision.When the vertical distance from the larynx point to the bifurcation of the carotid artery is greater than or equal to 2.5 cm,it is highly bifurcated;the bifurcation is normal when less than 2.5 cm.In patients with normal carotid bifurcation,1.5 cm of the carotid artery bifurcation can be used as a safety mark limit during the operation.For patients with high carotid artery,the EBSLN is almost parallel to or down the superior thyroid artery,and it should be closely attached to the bifurcation of the carotid artery and the outer membrane of the superior thyroid artery,and there is no safety margin.

Influential factors of esthetic evaluation of mandibular prominence in orthodontic patients / 中华医学美学美容杂志

Objective To explore the influential factors of esthetic evaluation of mandibular prominence by orthodontic patients from two dimensions (ideal value and tolerance range).Methods 226 orthodontic patients were investigated by an electronic questionnaire of esthetic evaluation of mandibular prominence.Binary logistic regression was adopted to analyze the influential factors.Results The tolerable boundary value for female mandibular retrognathism was affected by age (OR1.360) and orthodontic history (OR2.849).The tolerable boundary value for female mandibular prognathism and male mandibular retrognathism were found to be affected by orthodontic history (OR2.557 and 2.845,respectively).The tolerable boundary value for male mandibular prognathism was affected by age (OR1.347) and orthodontic history (OR2.310).The ideal value of male mandibular prominence was affected by age (OR1.420).Conclusions Orthodontic patients' esthetic evaluation of mandibular prominence is influenced by age and treatment condition,but not by sex,education level,marital status and personal profile.

EXPRESIÓN DE LOS GENES Serrate1 Y Notch1 DURANTE EL DESARROLLO DEL TERCIO MEDIO FACIAL DEL EMBRIÓN DE POLLO / Expression of Serrate1 and Notch1 Genes During Chicken Embryo Midface Development

La via de senalización Notch se caracteriza por mediar la comunicación célula-célula, regulando diferentes procesos celulares como proliferación, apoptosis y definición del destino celular. Esta via ha sido implicada en el desarrollo de estructuras craneofaciales como paladar, diente y bóveda craneal. El objetivo de esta investigación fue identificar los patrones de expresión de los genes componentes de la via Notch, Serrate1 y Notch1, durante el desarrollo del tercio medio facial. Se utilizaron embriones de pollo (Callus gallus) seleccionados de acuerdo a los criterios de Hamilton y Hamburger y sobre los cuales se realizó hibridación in situ con ribosondas marcadas con Digoxigenina (DIG), para luego ser detectadas con anticuerpos Anti-Dig. Los resultados mostraron expresión de los genes evaluados, en las prominencias maxilares (pmx) y frontonasal (pfn) durante el desarrollo del tercio medio facial. Estos resultados sugieren una probable participación de la via Notch a través de estos genes, en los diferentes procesos celulares que determinan la morfogénesis y el desarrollo del tercio medio facial.

The Notch signaling pathway is characterized by mediate cell-cell communication, regulating different cellular processes as proliferation, apoptosis and cell fate definition. This pathway has been implicated in craniofacial structures development as palate, teeth and cranial vault. The objective of this research was to identify the genes expression patterns of some Notch signaling pathway components, Serrate1 and Notch1, during the midface development. It was used chicken embryos (Callus gallus) selected according to Hamilton and Hamburger criteria. We performed in situ hybridization with Digoxigenin (DIG)-labeled riboprobes and detected with the antibody Anti-Dig. The results showed the expression of the evaluated genes in the maxillary (pmx) and frontonasal (pfn) prominences during the midface development. These results suggest a probable involvement of the Notch pathway through these genes in different cellular processes that determine midface morphogenesis and development.

Application of gastric tube interposition by touching laryngeal prominence in postoperative oral cancer patients / 华西口腔医学杂志

<p><b>OBJECTIVE</b>This study explores the application of gastric tube interposition by touching laryngeal prominence in postoperative oral cancer patients.</p><p><b>METHODS</b>This trial includes 66 patients treated in the West China Hospital of Stomatology from August 2014 to December 2014. These patients were randomly divided into two groups: the test group included 33 patients who underwent gastric tube interposition by touching laryngeal prominence; the 33 other patients, who served as control group, underwent regular gastric tube interposition. The two groups were compared in terms of the occurrence rate of bucking, success rate of one-time gastric tube placement, and interposition time.</p><p><b>RESULTS</b>Compared with those in the control group, the occurrence rate of bucking and the interposition time in the test group decreased while the success rate of one-time gastric tube placement increased (P<0.05).</p><p><b>CONCLUSIONS</b>Gastric tube interposition by touching laryngeal prominence can improve the success rate of one-time gastric tube interposition; moreover, it can reduce the average interposition time and the pain experienced by patients.</p>

Facial profile parameters and their relative influence on bilabial prominence and the perceptions of facial profile attractiveness: A novel approach / 대한치과교정학회지

OBJECTIVE: To evaluate the relative importance of bilabial prominence in relation to other facial profile parameters in a normal population. METHODS: Profile stimulus images of 38 individuals (28 female and 10 male; ages 19-25 years) were shown to an unrelated group of first-year students (n = 42; ages 18-24 years). The images were individually viewed on a 17-inch monitor. The observers received standardized instructions before viewing. A six-question questionnaire was completed using a Likert-type scale. The responses were analyzed by ordered logistic regression to identify associations between profile characteristics and observer preferences. The Bayesian Information Criterion was used to select variables that explained observer preferences most accurately. RESULTS: Nasal, bilabial, and chin prominences; the nasofrontal angle; and lip curls had the greatest effect on overall profile attractiveness perceptions. The lip-chin-throat angle and upper lip curl had the greatest effect on forehead prominence perceptions. The bilabial prominence, nasolabial angle (particularly the lower component), and mentolabial angle had the greatest effect on nasal prominence perceptions. The bilabial prominence, nasolabial angle, chin prominence, and submental length had the greatest effect on lip prominence perceptions. The bilabial prominence, nasolabial angle, mentolabial angle, and submental length had the greatest effect on chin prominence perceptions. CONCLUSIONS: More prominent lips, within normal limits, may be considered more attractive in the profile view. Profile parameters have a greater influence on their neighboring aesthetic units but indirectly influence related profile parameters, endorsing the importance of achieving an aesthetic balance between relative prominences of all aesthetic units of the facial profile.

Effect of Decannulation on Pharyngeal and Laryngeal Movement in Post-Stroke Tracheostomized Patients

OBJECTIVE: To investigate effects of tracheostomy tube on the movement of the hyoid bone and larynx during swallowing by quantitative analysis of videofluoroscopic swallowing study. METHOD: 19 adult stroke patients with tracheostomies, who met the criteria of decannulation participated. Serial videofluroscopic swallowing studies were done over 14 days before decannulation, within 24 hours before decannulation, within 24 hours after decannulation, and over 14 days after decannulation. The kinematic parameter such as pharyngeal transition time, stage transition duration, maximal hyoid bone movement, and maximal laryngeal prominence movement were obtained by 2-D quantitative analysis of videofluoroscopic swallowing study. RESULTS: Pharyngeal transition time and stage transition duration were not significantly changed all the time. The maximal hyoid bone movement and maximal laryngeal prominence just after decannulation were improved significantly compared to just before decannulation (p<0.05), especially on vertical movement. CONCLUSION: The hypothesis that a tracheostomy tube disturbs the hyoid bone and laryngeal movement during swallowing may be supported by this study.

Lateral Closing Wedge Supracondylar Osteotomy of the Humerus in Children with Cubitus Varus Deformity / 대한정형외과학회잡지

PURPOSE: To evaluate the effectiveness, cosmetic and functional improvement of a supracondylar lateral closing wedge osteotomy of the humerus as a treatment for cubitus varus deformity in children. MATERIALS AND METHODS: Forty-eight children with cubitus varus underwent a lateral closing wedge osteotomy, and were followed up for at least 1 year. RESULTS: There were no complications such as a loss of correction, infection, or neurapraxia. The immediate postoperative lateral condylar prominence and secondary lazy S deformity was in proportion to the preoperative severity of the cubitus varus. However, it was lower at the last follow-up, and was related to the extent of preoperative cubitus varus, length of follow-up and age. CONCLUSION: A supracondylar lateral closing wedge osteotomy of humerus is an easy and effective surgical treatment for a posttraumatic cubitus varus of children. In addition, it shows good cosmetic results with good remodeling of the lateral condylar prominence of children.

A judicialização da política na Colômbia: casos, potencialidades e riscos / La judicializacion de la política en Colombia: casos, potencialidades y riesgos / Judicialization of politics in Colombia: cases, merits and risks

Na Colômbia, a judicialização da política parece ter adquirido uma intensidade maior do que em muitos países do Terceiro Mundo nos quais se generalizou o protagonismo judicial. O que pôde motivar o desenvolvimento desse fenômeno? Qual é seu impacto sobre a democratização da sociedade colombiana? Quais são as potencialidades democráticas e os riscos da judicialização? Além de tentar oferecer respostas a essas perguntas, pretende-se analisar o caso colombiano, com exemplos ilustrativos e uma discussão teórica da evolução do fenômeno.

In Colombia, the judicialization of politics has assumed greater proportions than in many other Third World countries where judicial prominence has become mainstream. What can have prompted the development of this phenomenon? What is its impact on the democratization of Colombian society? What are the democratic merits and the risks of judicialization? Besides attempting to provide answers to these questions, I also propose to analyze the Colombian case, through illustrative examples and a theoretical discussion on the evolution of the phenomenon.

En Colombia la judicialización de la política parece haber adquirido una intensidad mayor que en muchos países del Tercer Mundo en los cuales se ha generalizado el protagonismo judicial. ¿Qué pudo motivar el desarrollo de este fenómeno? ¿Cuál es su impacto sobre la democratización de la sociedad colombiana? ¿Cuáles son las potencialidades democráticas y los riesgos de la judicialización?. Además de intentar ofrecer respuestas a esas preguntas, se pretende analizar en el artículo el caso colombiano, con ejemplos ilustrativos y una discusión teórica de la evolución del fenómeno.

Development of the face.

The human face develops between the fourth and eighth week after conception. Its development can be traced to five facial primordia appearing around the stomodeum in the fourth week. They are, namely, one frontonasal prominence, two maxillary and two mandibular prominences. Two nasal placodes develop on each side of the lower part of the frontonasal prominence at the end of the fourth week and further develop into the medial and lateral nasal prominences. The early development of the human face is similar to that of other mammals, such as pigs, rats and rabbits; all of which acquire branchial arches in the early stage of development. The rabbit branchial arches develop at the 4-5 mm stage and nearly disappear at the 12-14 mm stage, as the second one grows dorsally and obliterates the cervical sinus. The medial and lateral nasal prominences appear at the 4-5 mm stage. At the 12-14 mm stage the nasal cavities are more extensive than those of a 10 mm pig embryo and are of the same stage of development as a 15 mm pig embryo. Currently, we use 10 and 15 mm pig embryos as models in this study of human facial development. However, in the future, it will be more suitable to use 4-12 mm rabbit embryos because they are obtained more easily.

Surface Anatomical Landmark and Optimal Insertion Angle in Cervical Epidural Block

OBJECTIVE: The aim of this study is to evaluate the surface anatomical landmark for the cervical epidural block by investigating the proportion of patient's prominence in the 7th cervical vertebra. And the most optimal insertion angle over the mid point between the 6th and the 7th cervical spinous process is also measured. METHOD: Patients who did a plane x-ray examination of cervical spine were selected. We performed plane x-ray after marking on cervical vertebra prominence that was assumed as the spinous process of the 7th cervical vertebra by inspection and palpation. We identified where the marker were located on the spinous process. Moreover, we measured optimal insertion angle in the plane x-ray of cervical spine lateral. RESULTS: A total 100 cases were identified. The vertebra prominence was on the 7th cervical vertebra in 62 cases and the 6th cervical vertebra in 29 cases. The 1st thoracic vertebra was in the 2 cases and the 6th and 7th cervical vertebra in the 7 cases. CONCLUSION: The vertebra prominence was identified as the spinous process of the 7th cervical vertebra in sixty two percent of the cases. And the most optimal insertion angle is a -25.28 degree angle from the perpendicular line of the skin.

Scapholunate Dissociation Associated with Distal Radius Fracture / 대한정형외과학회잡지

PURPOSE: To analyze the relationship of fracture patterns in cases diagnosed as scapholunate dissociation after treatment for distal radius fracture. MATERIALS AND METHODS: Forty-six cases were analyzed clinically and radiographically. Twenty-four cases were treated by closed reduction and percutaneous k-wire fixation, twelve cases by closed reduction, k-wire and external fixator application, and ten cases by open reduction and plate fixation. For radiological evaluation, scapholunate gap, scapholunate angle, and radiolunate angle were analyzed to detect scapholunate dissociation and dorsal intercalated segmental instability. RESULTS: In the 7 cases with a borderline scapholunate gap (>2 mm), 3 cases with an initial fracture line involving the interfacet prominence progressed to static scapholunate dissociation. CONCLUSION: Initial scapholunate gap and fracture line geometry of the distal radius were helpful for predicting progression to static scapholunate dissociation

Lateral Condyle Prominence Following Lateral Closing Wedge Osteotomy for Cubitus Varus Deformity / 대한정형외과학회잡지

PURPOSE: To define the significant factors for lateral condyle prominence following the lateral closing wedge osteotomy for cubitus varus. MATERIALS AND METHODS: Analyzed the 15 cases performed lateral closing wedge osteotomy for cubitus varus. We measured the carrying angle by the arm and forearm axis lines of soft tissues, lateral condyle prominence index, the distance from center of rotation to osteotomy site and the distance from center of rotation to elbow joint. RESULTS: The lateral condyle prominence group with lateral condyle prominence index (LCPI) over 300% was 5 cases (33%), and no prominence group was 10 cases (67%). The distance between CORA and osteotomy site in lateral condyle prominence group was mean 44 mm (range, 35-52) and no prominence group was mean 21 mm (range, 17-27). The distance between CORA and elbow joint was mean -3 mm (range -15~7) and 16 mm (range, 8-24) respectively. CONCLUSION: Lateral condyle prominence was developed in case of the increased preoperative LCPI, increased distance between CORA and osteotomy site, and decreased distance between CORA and elbow joint.

Intraoral approach for the correction of prominent mandibular angle with masseter muscle hypertrophy / 中华医学美学美容杂志

Objective To evaluate the surgical corrective results of prominent mandibular angle with masseter muscle hypertrophy by using intraoral approach. Methods One hundred and twenty three cases with various degrees of prominent mandibular angle with masseter muscle hypertrophy were treated through intraoral approach. The basic surgical procedures included masseter muscle reduction (type Ⅰ), mandibular angle osteotomy (type Ⅱ) and angle-splitting osteotomy (type Ⅲ). The type Ⅰ was completed in 4 cases, type Ⅱin 16 cases, type Ⅲ + type Ⅰ in 56 cases, type Ⅲ in 19 cases, type Ⅲ + type Ⅰ in 9 cases, type Ⅲ + type II in 12 cases, type Ⅲ + type Ⅱ+ type Ⅰ in 7 cases. Genioplasty was simultaneously performed in 69 cases.Results The overwidth of the lower face was effectively corrected. The cosmetic results, as determined by both patients and surgeons, were good. No complications, such as facial never injury, or inferior alveolar never injury, occurred in any patients. Conclusions In order to reach good cosmetic results at the patients' lateral view and frontal view, considerations should be determined according to the degrees of the deformities and patient's desires, to choose suitable surgical procedures.

The Study of Projection Position of Cervical Articular Facet / 实用放射学杂志

Objective To study the best projection position of cervical articular facet.Methods The cervical facet angle(FA) which was the joint angle between sagittal plane of body and the continual line of cervical facet was measured on cervical CT images in 63 healthy people.Results The FA was 70?~75?,during projection,the coronal plane of body in the form of 70?~75? to the film,this projection position was called cervical facet position.Conclusion Cervical facets and its interspace of joint can be showed clearly in the cervical facet position of projection.

On the Accuracy of Cervicothoracic Vertebral Level Determination by Palpation of Spinous Processes / 대한마취과학회지

BACKGROUND: The C7-T1 interspinous space is commonly chosen for cervical epidural blockade, usually regarding the vertebral prominence as C7. But determining the vertebral prominence itself is confusing and unreliable because of individual variances. For this reason, we decided to look into the accuracy of estimating segmental level from palpating the surface anatomy. METHODS: 1. When the neck was flexed in the sitting position, cervical spinous processes were palpated and the first and most prominent spinous processes were marked. 2. In the same position, the estimated location of the C7 vertebral spinous process was marked, counting cephalads from the lower end of scapular (known to be at the T7 level, customarily). 3. By using the radiologic imaging method, actual cervical vertebral levels were confirmed and the results were compared with the vertebral spinous processes palpated and marked by the above methods. RESULTS: The first prominent spinous process was most commonly the C6 spinous process in both male and female subjects. The most prominent spinous processes palpated were C7 in males and C6 in females in the largest number of subjects. Estimates from the lower end of the scapular were correct in only 47.2% of cases. CONCLUSIONS: Because of considerable individual variances, estimates from the surface references can be incorrect in many circumstances, and radiologic imaging methods are suggested for the correct determination of the cervical vertebral levels.

On the Accuracy of Cervicothoracic Vertebral Level Determination by Palpation of Spinous Processes / 대한마취과학회지

BACKGROUND: The C7-T1 interspinous space is commonly chosen for cervical epidural blockade, usually regarding the vertebral prominence as C7. But determining the vertebral prominence itself is confusing and unreliable because of individual variances. For this reason, we decided to look into the accuracy of estimating segmental level from palpating the surface anatomy. METHODS: 1. When the neck was flexed in the sitting position, cervical spinous processes were palpated and the first and most prominent spinous processes were marked. 2. In the same position, the estimated location of the C7 vertebral spinous process was marked, counting cephalads from the lower end of scapular (known to be at the T7 level, customarily). 3. By using the radiologic imaging method, actual cervical vertebral levels were confirmed and the results were compared with the vertebral spinous processes palpated and marked by the above methods. RESULTS: The first prominent spinous process was most commonly the C6 spinous process in both male and female subjects. The most prominent spinous processes palpated were C7 in males and C6 in females in the largest number of subjects. Estimates from the lower end of the scapular were correct in only 47.2% of cases. CONCLUSIONS: Because of considerable individual variances, estimates from the surface references can be incorrect in many circumstances, and radiologic imaging methods are suggested for the correct determination of the cervical vertebral levels.