Predetermining glenoid dimensions using the scapular dimensions.

BACKGROUND: Variations of morphology of the glenoid cavity have been previously reported. These influence the surgical reconstruction or arthroplasty of the shoulder. This study aims to study the variation of the shape of suprascapular notch, shape of glenoid cavity, dimensions of both the scapular and the glenoid cavity, and predict the glenoid dimensions from the scapular dimension parameters. MATERIALS AND METHODS: Adult-dried scapulae were collected. The shapes of each suprascapular notch and glenoid cavity were evaluated. The scapular height, scapular width, glenoid superoinferior distance, and glenoid anteroposterior distance were measured using a digital vernier caliper, and statistical analysis was conducted on the data that were obtained. RESULTS: There were 264 scapulae included in this study (166 male and 98 female). Most of the glenoid cavities were pear shaped (69.7%). The two most common types of suprascapular notches were small depression notches (31.8%) and the absence of notches (25.8%). The mean ± SD of scapular height, scapular width, glenoid superoinferior distance, and glenoid anteroposterior distance were 148.2 ± 10.0, 108.1 ± 6.4, 37.1 ± 2.2, and 27.4 ± 2.1 mm, respectively, in the male samples and 133.0 ± 7.0, 97.0 ± 5.2, 33.2 ± 1.9, and 23.7 ± 1.7 mm, respectively, in the female samples. The male scapulae were significantly larger than the female scapulae (p value < 0.05). However, there were no differences between the male and female scapulae in terms of scapular index or glenoid index (p value > 0.05). Scapular height and width were significantly associated with both the glenoid superoinferior distance (p = 0.0001) and glenoid anteroposterior distance (p value = 0.0001). CONCLUSION: Scapular height and width can predict the dimensions of the glenoid. In cases of glenoid bone loss or shoulder arthroplasty, the native normal glenoid dimensions can be determined from the scapular dimensions as visualized using a true scapular anteroposterior radiograph. The surgeon can use these preoperative parameters when performing glenoid reconstruction or shoulder arthroplasty.

Classification and incidence of pterion patterns of Thai skulls / Clasificación e incidencia de los patrones de pterion en cráneos de Tailandia

SUMMARY: The pterion, a landmark for neurosurgery, is the weakest part of the skull owing to relatively thin bone. Variant patterns of pterion can confuse the clinicians during diagnosis of the lateral skull fractures in emergency situations. Thedifferent pterion types of many races have been reported but not of Thais. In this study; therefore, we investigated the incidence of sutural pterion patterns on of Thai skulls. The infratemporal fossa of 110 sides from 55 dried skulls identified as Thais were observed and classified for individual pterion types. The results showed that the pterion patterns can be classified into 4 types; spheno-parietal (87.27 %), fronto-temporal (4.55 %), uni-epipteric (6.36 %), and multi-epipteric (1.82 %) types. It was found that the spheno-parietal type was dominant in males (61.81 %) than in females (25.45 %). The majority of the skulls showed bilateral symmetry (85.45 %) in all types and the unilateral ones were far less (14.55 %). In bilateral pterion incidence, the spheno-parietal type was approximately 93.61 % while the uni-epipteric type was not found. Moreover, the bilateral multi-epipteric type was found only in one female skull (2.13 %). These findings will be useful for the radiologists and the neurosurgeons concerning lateral skull fractures in emergency diagnosis.

RESUMEN: El pterion es un punto de referencia para la neurocirugía, y es la parte más débil del cráneo debido a estar conformado por hueso relativamente delgado. Los diversos patrones de pterion pueden confundir a los clínicos durante el diagnóstico de fracturas laterales de cráneo en situaciones de emergencia. Con excepción de los tailandeses, diferentes tipos de pterion se han reportado en muchas razas. hemos investigado la incidencia de diversos patrones de pterion en cráneos de Tailandia. Analizamos 110 fosas infratemporales, correspondientes a 55 cráneos secos del Noreste de Tailandia y se clasificaron de acuerdo al tipo de pterion. Los resultados mostraron que el pterion puede clasificarse en 4 tipos: esfeno-parietal (87,27 %), fronto-temporal (4,55 %), epiptérico (3,63 %) y multi-epiptérico (1,81 %). Se encontró que el tipo esfeno-parietal tuvo mayor incidencia en hombres (61,81 %) que en mujeres (25,45 %). Además, la incidencia de simetría bilateral (85,45 %) fue mayor que la unilateral (14,55 %). A nivel bilateral, el tipo esfeno-parietal fue de 93,61 %, mientras que el tipo epiptérico no se observó. Por otra parte, el tipo multiepiptérico fue encontrado bilateralmente en un solo cráneo femenino (2,13 %). Esta incidencia puede ser utilizada como un conocimiento básico para los radiólogos tailandeses sobre las fracturas laterales del cráneo en un diagnóstico de emergencia.

Asiatic acid protects against cognitive deficits and reductions in cell proliferation and survival in the rat hippocampus caused by 5-fluorouracil chemotherapy.

The chemotherapy drug, 5-fluorouracil (5-FU), has been reported to cause cognitive impairments in cancer patients. The drug also reduces cell proliferation and survival in the brain. Asiatic acid (AA) is a triterpene compound found in Centella asiatica that can protect against reduction of neurogenesis in the hippocampus and memory deficits induced by valproic acid (VPA). In the present study, we investigated the preventive effects of AA on the deficits in spatial working memory and cell proliferation and survival caused by 5-FU chemotherapy in a rat model. Male Sprague Dawley rats received 5-FU (5 i.v. injections, 25 mg/kg) on day 8, 11, 14, 17 and 20 of the study. This was co-administered with AA (30 mg/kg, oral gavage tube) either 20 days before receiving 5-FU (preventive), after receiving 5-FU (recovery), or for the entire period of the experiment (throughout). Spatial working memory was determined using the novel object location (NOL) test and hippocampal cell proliferation and survival of dividing cells were quantified using immunohistochemistry. Rats in the 5-FU alone and recovery groups showed memory deficits in the NOL test and reductions in cell proliferation and cell survival in the subgranular zone (SGZ) of the hippocampal dentate gyrus. Rats in the control, AA alone, and both preventive and throughout co-administration groups, however, did not exhibit these characteristics. The results showed that 5-FU chemotherapy impaired memory and reduced cell proliferation and cell survival in the SGZ of the hippocampal dentate gyrus. However, these impairments in the animals receiving 5-FU chemotherapy were restored to control levels when AA was co-administered before and during 5-FU treatment. These data demonstrate that AA can prevent the spatial working memory and hippocampal neurogenesis impairments caused by 5-FU chemotherapy.

Effects of Aged Garlic Extract on Cholinergic, Glutamatergic and GABAergic Systems with Regard to Cognitive Impairment in Aß-Induced Rats.

Alzheimer's disease (AD) has been linked to the degeneration of central cholinergic and glutamatergic transmission, which correlates with progressive memory loss and the accumulation of amyloid-ß (Aß). It has been claimed that aged garlic extract (AGE) has a beneficial effect in preventing neurodegeneration in AD. Therefore, the objective of this study was to investigate the effects of AGE on Aß-induced cognitive dysfunction with a biochemical basis in the cholinergic, glutamatergic, and GABAergic systems in rats. Adult male Wistar rats were orally administered three doses of AGE (125, 250, and 500 mg/kg) daily for 65 days. At day 56, they were injected with 1 µL of aggregated Aß (1-42) into each lateral ventricle, bilaterally. After six days of Aß injection, the rats' working and reference memory was tested using a radial arm maze. The rats were then euthanized to investigate any changes to the cholinergic neurons, vesicular glutamate transporter 1 and 2 proteins (VGLUT1 and VGLUT2), and glutamate decarboxylase (GAD) in the hippocampus. The results showed that AGE significantly improved the working memory and tended to improve the reference memory in cognitively-impaired rats. In addition, AGE significantly ameliorated the loss of cholinergic neurons and increased the VGLUT1 and GAD levels in the hippocampus of rat brains with Aß-induced toxicity. In contrast, the VGLUT2 protein levels did not change in any of the treated groups. We concluded that AGE was able to attenuate the impairment of working memory via the modification of cholinergic neurons, VGLUT1, and GAD in the hippocampus of Aß-induced rats.

Incidence of unusual formation of the median nerve in Thai-Northeast embalmed cadavers / Incidencia de la formación inusual del nervio mediano en cadáveres embalsamados del noreste de Tailandia

This study aimed to investigate the incidence of unusual formation of the median nerve in Thai cadavers. Two hundred and ninety-two upper limbs were dissected and observed. The results showed that 5 out of 292 (1.71 %) arms had unusual splitting of median nerve that supplied the flexor arm muscles. Concomitantly, the musculocutaneous nerve was absent. In 4 out of 5 variant arms (80 % or 1.37 % of total upper limbs), each median nerve was unusually formed by 3 roots; the first and second roots were from lateral cord and the third one from medial cord. The union of the second lateral and medial roots to become a median nerve distantly extended in the arm. The second lateral roots gave off small muscular branches to the upper part of flexor arm muscles. Knowledge of such anatomical variations is helpful for surgeons in performing of brachial plexus surgery.

Este estudio tuvo como objetivo investigar la incidencia en la formación inusual del nervio mediano en cadáveres tailandeses. Se disecaron y observaron 292 miembros superiores. En 5 casos (1,71 %) se presentó una división inusual del nervio mediano que suministraba los nervios para los músculos flexores del brazo. Concomitantemente, el nervio musculocutáneo estaba ausente. En 4 de los 5 casos (80 % o 1,37 % del total de los miembros superiores), cada nervio mediano se formó por 3 raíces; la primera y segunda raíces procedían del fascículo lateral y la tercera del fascículo medial. La unión de la segundas raíces lateral y medial formaban el nervio mediano distalmente en el brazo. Las segundas raíces laterales daban pequeños ramos musculares a la parte superior de los músculos flexores del brazo. El conocimiento de tales variaciones anatómicas es útil para los cirujanos en la realización de la cirugía del plexo braquial.

Neuroprotective Effects of Aged Garlic Extract on Cognitive Dysfunction and Neuroinflammation Induced by ß-Amyloid in Rats.

Neuroinflammation is pathological evidence of Alzheimer's disease (AD) that likely starts as a host defense response to the damaging effects of the ß-amyloid (Aß) deposits in the brain. The activation of microglia may promote the neurodegenerative process through the release of proinflammatory cytokines, such as interleukin-1ß (IL-1ß) and tumor necrosis factor-α (TNFα), which may lead to neuronal damage and eventual death. Aged garlic extract (AGE) has been reported to have multiple biological activities, including anti-inflammatory effects. Therefore, the objective of this study was to investigate the effect of AGE on Aß (1-42)-induced cognitive dysfunction and neuroinflammation. Adult male Wistar rats were given AGE (125, 250, and 500 mg/kg BW, body weight), orally administered, daily for 56 days. They were then injected with 1 µL of aggregated Aß (1-42) into the lateral ventricles; bilaterally. Seven days later, their recognition memory was evaluated using a novel object recognition (NOR) test. Then the rats were sacrificed to investigate the alteration of microglia cells, IL-1ß and TNFα in the cerebral cortex and hippocampus. The results indicated that AGE at doses of 250 and 500 mg/kg BW significantly improved short-term recognition memory in cognitively impaired rats. In addition, AGE significantly minimized the inflammatory response by reducing the activation of microglia and IL-1ß to the levels found in the control, which is similar to the results found in Celebrex-treated rats. In conclusion, AGE may be useful for improving the short-term recognition memory and relieve the neuroinflammation in Aß-induced rats.

Fluoxetine prevents the memory deficits and reduction in hippocampal cell proliferation caused by valproic acid.

Valproic acid (VPA), a commonly used antiepileptic drug, has been reported to cause cognitive impairments in patients. In a previous study, using a rodent model, we showed that VPA treatment impaired cognition which was associated with a reduction in the cell proliferation required for hippocampal neurogenesis. The antidepressant fluoxetine has been shown to increase hippocampal neurogenesis and to reverse the memory deficits found in a number of pathological conditions. In the present study we investigated the protective effects of fluoxetine treatment against the impairments in memory and hippocampal cell proliferation produced by VPA. Male Sprague Dawley rats received daily treatment with fluoxetine (10mg/kg) by oral gavage for 21days. Some rats were co-administered with VPA (300mg/kg, twice daily i.p. injections) for 14days from day 8 to day 21 of the fluoxetine treatment. Spatial memory was tested using the novel object location (NOL) test. The number of proliferating cells present in the sub granular zone of the dentate gyrus was quantified using Ki67 immunohistochemistry at the end of the experiment. Levels of the receptor Notch1, the neurotrophic factor BDNF and the neural differentiation marker DCX were determined by Western blotting. VPA-treated rats showed memory deficits, a decrease in the number of proliferating cells in the sub granular zone and decreases in the levels of Notch1 and BDNF but not DCX compared to control animals. These changes in behavior, cell proliferation and Notch1 and BDNF were prevented in animals which had received both VPA and fluoxetine. Rats receiving fluoxetine alone did not show a significant difference in the number of proliferating cells or behavior compared to controls. These results demonstrated that the spatial memory deficits and reduction of cell proliferation produced by VPA can be ameliorated by the simultaneous administration of the antidepressant fluoxetine.

Kaempferia parviflora extract ameliorates the cognitive impairments and the reduction in cell proliferation induced by valproic acid treatment in rats.

Kaempferia parviflora is a herbal plant whose rhizomes are used in traditional medicine. Investigations of this plant have shown it to have antidepressant activity and to improve learning and memory in animal models. The aim of the present investigation was to determine whether K. parviflora could protect the brain from the impairments in cognition and hippocampal neurogenesis which are caused by valproic acid (VPA). Male Sprague Dawley rats (180-200g) were given once daily K. parviflora extract (100mg/kg) via oral gavage for 21 days. Rats received twice daily intraperitoneal injections of valproic acid (300mg/kg) from days 8 to 21 of the experiment. Spatial memory was tested using the novel object location (NOL) test five days after the end of treatment. Cell proliferation in the sub granular zone (SGZ) of the dentate gyrus was quantified by immunohistochemistry and levels of doublecortin (DCX) were determined by Western blotting. Co-treatment of VPA and K. parviflora prevented the cognitive decline and reduction in proliferating cells caused by VPA. Furthermore, co-treatment significantly increased DCX protein levels within the hippocampus. These findings demonstrate that K. parviflora is able to prevent the brain from VPA-induced the impairments of spatial memory and proliferating cells within the SGZ.

Asiatic Acid Prevents the Deleterious Effects of Valproic Acid on Cognition and Hippocampal Cell Proliferation and Survival.

Valproic acid (VPA) is commonly prescribed as an anticonvulsant and mood stabilizer used in the treatment of epilepsy and bipolar disorder. A recent study has demonstrated that VPA reduces histone deacetylase (HDAC) activity, an action which is believed to contribute to the effects of VPA on neural stem cell proliferation and differentiation which may explain the cognitive impairments produced in rodents and patients. Asiatic acid is a triterpenoid derived from the medicinal plant Centella asiatica. Our previous study has shown that Asiatic acid improves working spatial memory and increases cell proliferation in the sub granular zone of the hippocampal dentate gyrus. In the present study we investigate the effects of Asiatic acid in preventing the memory and cellular effects of VPA. Male Spraque-Dawley rats were orally administered Asiatic acid (30 mg/kg/day) for 28 days, while VPA-treated animals received injections of VPA (300 mg/kg) twice a day from Day 15 to Day 28 for 14 days. Spatial memory was determined using the novel object location (NOL) test and hippocampal cell proliferation and survival was quantified by immuostaining for Ki-67 and Bromodeoxyuridine (BrdU), respectively. The results showed that VPA-treated animals were unable to discriminate between objects in familiar and novel locations. Moreover, VPA significantly reduced numbers of Ki-67 and BrdU positive cells. These results indicate that VPA treatment caused impairments of spatial working memory, cell proliferation and survival in the subgranular zone (SGZ) of the hippocampal dentate gyrus (DG). However, these abnormalities were restored to control levels by co-treatment with Asiatic acid. These data demonstrate that Asiatic acid could prevent the spatial memory and neurogenesis impairments caused by VPA.

Effects of Asiatic Acid on Spatial Working Memory and Cell Proliferation in the Adult Rat Hippocampus.

Asiatic acid is a pentacyclic triterpene from Centella asiatica. Previous studies have reported that asiatic acid exhibits antioxidant and neuroprotective activities in cell culture. It also prevents memory deficits in animal models. The objective of this study was to investigate the relationship between spatial working memory and changes in cell proliferation within the hippocampus after administration of asiatic acid to male Spraque-Dawley rats. Control rats received vehicle (propylene glycol) while treated rats received asiatic acid (30 mg/kg) orally for 14 or 28 days. Spatial memory was determined using the novel object location (NOL) test. In animals administered asiatic acid for both 14 and 28 days, the number of Ki-67 positive cells in the subgranular zone of the dentate gyrus was significantly higher than in control animals. This was associated with a significant increase in their ability to discriminate between novel and familiar object locations in a novel object discrimination task, a hippocampus-dependent spatial memory test. Administration of asiatic acid also significantly increased doublecortin (DCX) and Notch1 protein levels in the hippocampus. These findings demonstrate that asiatic acid treatment may be a potent cognitive enhancer which improves hippocampal-dependent spatial memory, likely by increasing hippocampal neurogenesis.

Origin of the dorsal scapular artery and its relation to the brachial plexus in Thais.

We investigated the variations of the origin of the dorsal scapular artery (DSA) and its relation to the brachial plexus in 252 sides of the posterior cervical triangles of Thais. The origin of this artery on each part of the subclavian artery or other arterial branches was examined with special reference to their course in relation to the brachial plexus. The results show that the DSA originated from three sites; most commonly from the transverse cervical artery (69%) followed by the direct branching from the second (2.8%) or the third part (28.2%) of the subclavian artery. When the DSA was branched from the transverse cervical artery, its course was always posterior or above the brachial plexus. When the DSA arose from the second or the third part of the subclavian artery, it always ran in the branches of the brachial plexus in various sites. The most frequent course was to pass between the upper and middle trunks of the brachial plexus (63.2%). Other courses were far less frequent and found to pass between the anterior division of the upper trunk and the middle trunk of brachial plexus or between the roots of C8 and T1 with the frequency of 1.3 and 2.6%, respectively.

Occipitalization of the atlas: its incidence and clinical implications.

OBJECTIVE: The aim of the present study was to investigate the incidence of occipitalization of the atlas among Thai dried skulls, in order to contribute to baseline awareness of this condition. MATERIALS AND METHODS: The skulls of 633 adult Thais from the collection maintained in the Department of Anatomy, Faculty of Medicine, Khon Kaen University, Thailand, were examined for evidence of occipitalization of the atlas. The skulls were well-preserved and did not show any traits of craniofacial deformation. The skulls for which the age and sex were unknown were excluded from the analysis. From the cadaveric records on each individual, we learned that the skulls belonged to 373 men (age of decease between 25 and 90 years), and 260 women (age of decease between 28 and 92 years). RESULTS: Occipitalization of the atlas was detected in 2 skulls (0.32%). The first case was a male skull (54 years of age at decease), where the atlas was partially fused to the occipital bone. The second case was also a male skull (59 years of age at decease) showing complete fusion of the anterior arch of the atlas. CONCLUSION: The incidence of occipitalization of the atlas is low; however, if present this abnormality may cause a wide range of neurological problems. Knowledge of occipitalization of the atlas may be of substantial importance to orthopedists, neurosurgeons, physiotherapists and radiologists dealing with abnormalities of the cervical spine. Mistaken diagnoses have led to delayed treatment and at times adverse results.

A rare variation of posterior cord brachial plexus branching coexisting with the intercalated ectopic muscle.

During a dissection of the brachial plexus we found a rare variation of left posterior cord branching coexisting with an unusual intercalated ectopic muscle. This muscle originated from the shoulder joint capsule at the lesser tubercle on insertion of the subscapularis then pierced between the brachial plexus, enclosed by two roots of the radial nerve, and inserted into the upper part of the latissimus dorsi muscle. The variant posterior cord divided into two roots; a thin lateral and thick medial root. The lateral root gave off the thoracodorsal nerve that penetrated and also innervated the ectopic muscle. The medial root gave off five nerve branches; two upper subscapular, one lower subscapular, one axillary and one terminal branch. A terminal branch fused with the lateral root to form a loop enclosing the ectopic muscle then continued as the radial nerve. This type of variation may be useful to interpret unexplained clinical signs and symptoms and provided additional knowledge to surgeons who perform brachial plexus surgery.

Curcumin prevents bile canalicular alterations in the liver of hamsters infected with Opisthorchis viverrini.

Opisthorchis viverrini infection causes inflammation and liver injury leading to periductal fibrosis. Little is known about the pathological alterations in bile canaliculi in opisthorchiasis. This study aimed to investigate bile canalicular alterations in O. viverrini-infected hamsters and to examine the chemopreventive effects of curcumin on such changes. Hamsters were infected with O. viverrini and one group of animals was fed with 1% dietary curcumin supplement. Animals were examined during the acute infection phase, days 21 and 30 post-infection (PI) and chronic infection phase (day 90 PI). Scanning electron microscopy revealed that in the infected group fed with a normal diet, bile canaliculi became slightly tortuous by 30 day PI and more tortuous at day 90 PI. Transmission electron microscopy showed a reduction in microvilli density of canaliculi starting at day 30 PI, with a marked loss of microvilli at day 90 PI. These ultrastructral changes were slightly seen at day 21 PI, which was similar to that found in infected animals fed with 1% curcumin-supplemented diet. Notably, curcumin treatment prevented the reduction of microvilli density, reduced the dilation of bile canaliculi, and decreased the tortuosity of the bile canaliculi relative to non-infected animals on a normal diet at days 30 and 90 PI. These results suggest that curcumin reduces alteration of bile canaliculi and may be a promising agent to prevent the onset of bile duct abnormalities induced by O. viverrini infection.

Organization of the nervous system in Opisthorchis viverrini investigated by histochemical and immunohistochemical study.

The structure and organization of the nervous system has been documented for various helminth parasites. However, the neuroanatomy of the carcinogenic liver fluke, Opisthorchis viverrini has not been described. This study therefore investigated the organization of the nervous system of this fluke using cholinesterase activity, aminergic and peptidergic (FMRFamide-like peptides) immunostaining to tag major neural elements. The nervous system, as detected by acetylcholinesterase (AchE) reaction, was similar in newly excysted metacercariae, migrating juveniles and adult parasites. In these stages, there were three pairs (dorsal, ventral and lateral) of bilaterally symmetrical longitudinal nerve cords and two cerebral ganglia. The ventral nerve cords and the cerebral ganglia were well-developed and exhibited strong AchE reactivity, as well as aminergic and FMRFamide-like immunoreactivity. Numerous immunoreactive nerve cell bodies were observed around the inner surface of the ventral sucker. Fine FMRFamide-like peptides immunopositive nerve fiber was rarely observed. Overall, the organization of the nervous system of O. viverrini is similar to other trematodes.

Incidence of the accessory internal thoracic artery and its safety area in the thoracic wall.

OBJECTIVE: To provide the incidence, origin, size and the safety area of the accessory internal thoracic artery (AITA) in the fourth intercostal space. MATERIAL AND METHOD: One hundred and thirty two thoracic cages were dissected and examined for the presence of AITA. The origin, course, diameter and location in the fourth intercostal space of detected AITA were investigated. RESULTS: AITA with diameter ranging from 0.6 to 3.05 (mean = 1.76 +/- 0.69) millimeters existed in 10 of 132 (7.58%) cadavers. They originated from the upper part of the internal thoracic artery, close and inferior to the subclavian artery (0-3 cm, mean = 2.4 +/- 0.78) and ran inferolaterally on the deep surface of the thoracic wall and ended in the second to the sixth intercostal spaces. Most of them ended in the fifth intercostal spaces (28.57%). The artery was present bilaterally in 4 cases (3.03%) and unilaterally in 6 cases (4.55%). Most of these arteries were located close to the midaxillary line (0-3 cm, mean = 1.73 +/- 1.18) in the fourth intercostal space which is endangered in several surgical procedures such as thoracoscopy. CONCLUSION: Even the incidence of AITA is low (7.57%) but when present, it is endangered in thoracic surgical procedures. The safety area of AITA for surgical procedures in the fourth intercostal space is at least 3 centimeters anterior to the midaxillary line.