High-resolution 3T magnetic resonance imaging and histological analysis of capsuloligamentous complex of the first metatarsophalangeal joint.

BACKGROUND: There are discrepancies in the understanding of the structure of the capsuloligamentous complex of the first metatarsophalangeal joint (MTPJ); this study aims to investigate the differences with previous anatomical reports of high-resolution 3T magnetic resonance imaging (MRI) and histological analysis in illustrating the structure of the capsuloligamentous complex of the first MTPJ. METHODS: Nine fresh frozen cadaveric feet specimens (from two women and three men; aged 32 to 58 years) were used in this study. All specimens underwent MR examination with T1-weighted imaging and T2-weighted spectral attenuated inversion recovery in three planes. Subsequently, all cadaveric feet specimens were sliced into 2-mm-thick sections. The MRI features of the capsuloligamentous complex of the first MTPJ were analyzed in these specimens. Hematoxylin-eosin and Masson's trichrome staining methods were used to explore the histologic features of the capsuloligamentous complex of the first MTPJ. RESULTS: Different from most previous studies, our results showed that the plantar plate could be divided into four portions including the central portion of the plantar plate, the intersesamoid, the sesamoid phalangeal and the metatarsosesamoid ligaments. The normal central portion of the plantar plate could be clearly visualized in the sagittal and coronal plane MR images. The intersesamoid ligament is a continuation of the central portion of the plantar plate on the sagittal plane on the gross specimen, the MR imaging, and the histological examination. On the coronal plane of the gross specimen and MR imaging, the sesamoid phalangeal ligaments and the central portion of the plantar plate can be seen as separate ligaments, but they appeared interwoven with the same continuous collagenous fibers on the histological analysis. CONCLUSION: High-resolution 3T MRI allows accurate demonstration of the different anatomical details of the capsuloligamentous complex of the first MTPJ from previous anatomical reports. The histological analysis provides further understanding of the structures of the capsuloligamentous complex of the first MTPJ from previous studies.

Anatomic study of the femur-vastus intermedius muscle-anterolateral thigh osteomyocutaneous free flap.

INTRODUCTION: Resection of head and neck malignancy usually causes facial defects and esthetic deformities. Among the wide range of free flaps available for reconstruction, a novel chimeric free flap-the femur-vastus intermedius muscle-anterolateral thigh osteomyocutaneous free flap (FVATLO flap)-has been demonstrated for clinical use. In this study, we illustrate the anatomy and harvest of the FVATLO flap. METHODS: Eighteen fresh cadavers without damage to either thigh were recruited for dissection. Blood supply to the vastus intermedius muscle and femur were traced and recorded. The diameter, circumference of the middle part of the femur, and thickness of the femoral cortex were measured. RESULTS: The major blood supply to the vastus intermedius muscle showed two patterns of origin. The first arising from the descending branch of the lateral circumflex femoral artery (LCFA-db) accounts for 78% of the cases (28/36), and the second arising from the transverse branch of the lateral circumflex femoral artery (LCFA-tb) accounts for 22% (8/36). Blood supply to the femur consists of two major sources: one from branches penetrating through the nutrient foramen on the posteromedial surface of the femur to the medullary cavity, and the other from the periosteum branches spreading over on the femoral surface. No visible branch from the vastus intermedius muscle to the underlying periosteum was found. The mean diameter, femoral circumference, and mean cortical thickness were 26.30 mm, 85.58 mm, and 6.85 mm, respectively. CONCLUSION: Considering that there is only one injured donor site, the FVALTO flap is an alternative chimeric flap for cases with a large amount of soft tissue loss together with small bony defects.

Sports Injury-Related Fingers and Thumb Deformity Due to Tendon or Ligament Rupture.

BACKGROUND: Hand injuries are very common in sports, such as skiing and ball sports. One of the major reasons causing hand and finger deformity is due to ligament and tendon injury. The aim of this study was to investigate if the high-resolution 3T magnetic resonance imaging (MRI) can demonstrate the complex anatomy of the fingers and thumb, especially the tendons and ligaments, and provide the accurate diagnosis of clinically important fingers and thumbs deformity due to ligamentous and tendinous injuries during sport activities. METHODS: Sixteen fresh un-embalmed cadaveric hands were harvested from eight cadavers. A total of 20 healthy volunteers' hands and 44 patients with fingers or thumb deformity due to sports-related injuries were included in this study. All subjects had MR examination with T1-weighted images and proton density-weighted imaging with fat suppression (PD FS) in axial, coronal, and sagittal plane, respectively. Subsequently, all 16 cadaveric hands were sliced into 2-mm thick slab with a band saw (six in coronal plane, six in sagittal plane, and four in axial plane). The correlation of anatomic sections and the MRI characteristics of tendons of fingers and the ulnar collateral ligament (UCL) at the metacarpal phalangeal joint (MCPJ) of thumb between 20 healthy volunteers and 44 patients (confirmed by surgery) were analyzed. RESULTS: The normal ligaments and tendons in 16 cadaveric hands and 20 volunteers' hands showed uniform low-signal intensity on all the sequences of the MRI. Among 44 patients with tendinous and ligamentous injuries in the fingers or thumb, 12 cases with UCL injury at MCPJ of the thumb (Stener lesion = 8 and non-Stener lesion = 4), 6 cases with the central slip injury, 12 cases with terminal tendon injury, and 14 cases with flexor digitorum profundus injury. The ligaments and tendons disruption manifested as increased signal intensity and poor definition, discontinuity, and heterogeneous signal intensity of the involved ligaments and tendons. CONCLUSIONS: Sports injury-related fingers and thumb deformity are relatively common. MRI is an accurate method for evaluation of the anatomy and pathologic conditions of the fingers and thumb. It is a useful tool for accurate diagnosis of the sports-related ligaments and tendons injuries in hand.

A rare diaphragm in the common carotid artery: A first case report and literature review.

RATIONALE: We present a case of common carotid artery (CCA) diaphragm. To our knowledge, this is the first reported case in the imaging literature. PATIENT CONCERNS: A 33-year-old woman presented herself to an annual health examination without any report of ill health. DIAGNOSES: A stenosis with aneurysm dilation on the proximal part of the right CCA was revealed on ultrasound and CTA, by which a diaphragm-like structure on the stenosis lesion was clearly identified. An anatomic variant of artery was first considered. INTERVENTIONS: The patient was followed up closely. OUTCOMES: There was no progression of her CCA stonosis 1 year later. LESSONS: This unusual and previously unreported case is presented to alert vascular sonographers and radiologists to its existence.

High-resolution 3T Magnetic Resonance Imaging of the Triangular Fibrocartilage Complex in Chinese Wrists: Correlation with Cross-sectional Anatomy.

BACKGROUND: The injury of the triangular fibrocartilage complex (TFCC) is a common cause of ulnar-sided wrist pain. The aim of this study was to investigate if the high-resolution 3T magnetic resonance imaging (MRI) could demonstrate the detailed complex anatomy of TFCC in Chinese. METHODS: Fourteen Chinese cadaveric wrists (from four men and three women; age range at death from 30 to 60 years; mean age at 46 years) and forty healthy Chinese wrists (from 20 healthy volunteers, male/female: 10/10; age range from 21 to 53 years with a mean age of 32 years) in Beijing Jishuitan Hospital from March 2014 to March 2016 were included in this study. All cadavers and volunteers had magnetic resonance (MR) examination of the wrist with coronal T1-weighted and proton density-weighted imaging with fat suppression in three planes, respectively. MR arthrography (MRAr) was performed on one of the cadaveric wrists. Subsequently, all 14 cadaveric wrists were sliced into 2 mm thick slab with band saw (six in coronal plane, four in sagittal plane, and four in axial plane). The MRI features of normal TFCC were analyzed in these specimens and forty healthy wrists. RESULTS: Triangular fibrocartilage, the ulnar collateral ligament, and the meniscal homolog could be best observed on images in coronal plane. The palmar and dorsal radioulnar ligaments were best evaluated in transverse plane. The ulnotriquetral and ulnolunate ligaments were best visualized in sagittal plane. The latter two structures and the volar and dorsal capsules were better demonstrated on MRAr. CONCLUSION: High-resolution 3T MRI is capable to show the detailed complex anatomy of the TFCC and can provide valuable information for the clinical diagnosis in Chinese.

Three new triterpenoid saponins from the roots of Ardisia crenata and their cytotoxic activities.

Three new triterpenoid saponins, ardisicrenoside O (1), ardisicrenoside P (2) and ardisicrenoside Q (3) together with three known compounds, 3ß,16α-dihydroxy-30-methoxy-28, 30-epoxy-olean-12-en, cyclamiretin A 3-O-ß-d-glucopyranosyl-(1→2) -α-l-arabinopyranoside and cyclamiretin A 3-O-ß-d-glucopyranosyl-(1→4) -α-l-arabinopyranoside were isolated from the roots of Ardisia crenata Sims. Their structures were determined by one- and two-dimensional NMR techniques, including HSQC, HMBC and TOCSY experiments, as well as acid hydrolysis and GC analysis. All isolates were evaluated for the cytotoxic activities on two human cancer cell lines and compounds 3, 5 and 6 showed significant cytotoxicity.

[Applied anatomy of cervico-acromial crossing skin flap].

OBJECTIVE: To investigate the applied anatomy of the blood supply of the cervicoacromial crossing flap and its feasibility in clinical application. METHODS: 5 fresh adult and 10 forman fixed adult cadaver specimens were used. The arteries, veins, cutaneous arteries, subdermal vascular network, and vascular network of the superficial layer of deep fascia in the cervico-acromial area were observed and studied under the microscope. The frontier border of the cervico-acromial area is clavicle, the posterior border is the spine of scapula, the outer border is acromion and the inner border is cervical base. RESULTS: (1) The perforator branches concentrate at the front edge of trapezius muscle; (2) The vessel network around the front edge of trapezius muscle is abundant. Among the anastomosis, two or three anastomosis which across the area from the base of the neck to acromion can be observed in the axial of every cervico-acromial area. Abundant vessel network can be observed in the superficial layer of deep fascia. CONCLUSIONS: The blood supply of the cervico-acromial flap is abundant, which constains constant perforator point. The cervico-acromial crossing skin flap can be applied with the rich blood supply and abundant vessel network in the superficial layer of deep fascia.

New 3',8''-linked biflavonoids from Selaginella uncinata displaying protective effect against anoxia.

Seven 3',8''-linked bioflavonoids, including one new compound, (2''S)-2'', 3''-dihydroamentoflavone-4'-methyl ether and six known compounds: (2S)-2,3- dihydroamentoflavone-4'-methyl ether, (2S,2''S)-2,3,2'',3''-tetrahydroamento- flavone-4'-methyl ether, (2S,2''S)-tetrahydroamentoflavone, (2S)-2,3-dihydro- amentoflavone and (2''S)-2'',3''-dihydroamentoflavone (6) and amentoflavone, were isolated from the 60% ethanolic extract of Selaginella uncinata (Desv.) Spring. The structures of these compounds were elucidated mainly by analysis of their 1D and 2D NMR spectroscopic data, and their absolute configurations were determined by circular-dichroism (CD) spectroscopy. All the seven compounds showed protective effect against anoxia in the anoxic PC12 cells assay, in which compound 6 displayed particularly potent activity.

Maohuoside A promotes osteogenesis of rat mesenchymal stem cells via BMP and MAPK signaling pathways.

Osteoporosis is becoming a more prevalent health problem with the aging of the population around the world. Epimedium koreanum Nakai is one of the most used herbs in East Asia for curing osteoporosis, with its major ingredient, icariin, mostly explored by researchers. In this article, maohuoside A (MHA), a single isolated compound from the herb, was identified to be more potent than icariin in promoting osteogenesis of rat bone marrow-derived mesenchymal stem cells (rMSCs) (increasing by 16.6, 33.3, and 15.8% on D3, D7, and D11, respectively). Alkaline phosphatase (ALP) assay and calcium content measurement were assigned to quantify the promoted osteogenesis and alizarin red S (ARS) staining was conducted to visualize it. Quantitative real-time PCR (Q-PCR) was assayed to evaluate the mRNA expression of marker genes in osteogenesis and master regulators in BMP pathway. Moreover, PD98059 (PD) and SB203580 (SB), inhibitor of ERK1/2 and p38 MAPK pathway, were administered to assess the involvement of MAPK pathway in the promotion process. In conclusion, MHA pronouncedly enhanced the osteogenesis of rMSC, plausibly via the BMP and MAPK signaling pathways.

Phenylpropanoid and flavonoids from osteoprotective fraction of Drynaria fortunei.

A new phenylpropanoid (1), 12-O-caffeoyl-12-hydroxyldodecanoic acid, and a new chalcone (2), 3'-lavandulyl-4-methoxyl-2,2',4',6'-tetrahydroxylchalcone, together with eight known compounds including one chalcone (3), five flavanones (4-8) and two flavonols (9, 10), have been isolated from one of the osteoprotective fractions of Drynaria fortunei (Kunze) J. Sm., which is used as a folk medicine for the treatment of osteoporosis. All these compounds were found for the first time from the genus Drynaria. The structures of the new compounds were elucidated on the basis of spectroscopic analysis.

New phenanthrenes and stilbenes from Dendrobium loddigesii.

New phenanthrenes, loddigesiinols A (1) and B (7), and stilbenes, loddigesiinols C (8) and D (9), were isolated from 80% ethanol extract of Dendrobium loddigesii ROLFE (Orcharedceae) along with known compounds, including five phenanthrenes, three stilbenes, two lignans, and three sterols. Their structures were determined by spectroscopic studies. These compounds were evaluated for their inhibitory activities against nitric oxide (NO) production and 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging. Phenanthrenes (1-3, 7) and dihydrophenanthrenes (4-6) showed significant inhibitory activity against NO production. In particular, 2 showed stronger inhibitory activity against NO production than 5 and 6. This suggested that this phenanthrene is a stronger inhibitor of NO production than dihydrophenanthrene. The new phenanthrenes, loddigesiinols A (1) and B (7), significantly inhibited NO production with IC(50) values of 2.6 and 10.9 muM, respectively. One new dihydrostilbene, loddigesiinol D (9), showed weak inhibitory activity against NO production with an IC(50) value of 69.7 microM, but the other new dihydrostilbene, loddigesiinol C (8), did not show this activity at 100 microM.

Estrogen receptor mediates the effects of pseudoprotodiocsin on adipogenesis in 3T3-L1 cells.

Estrogen receptors (ERs) play a pivotal role in adipogenesis; therefore, compounds targeting ERs may also affect fat formation. Recent studies have shown that the Dioscorea plant (commonly called yam) exhibits an antiobesity effect on rodents. However, the active compounds and underlying mechanisms responsible for this effect are not yet fully understood. We evaluated the effects of pseudoprotodiocsin (PPD), a steroid saponin from Dioscorea nipponica Makino (a type of Dioscorea), on adipogenesis and the mechanisms underlying this effect. Treatment with PPD at the onset of adipogenic differentiation resulted in significantly decreased adipogenesis in both in vitro and in vivo experimental systems. An increased amount of ERalpha mRNA, protein, and the accumulation of ERalpha in the nucleus were also observed. However, the expression pattern of ERbeta was not altered. Furthermore, the antiadipogenic effect of PPD was found to be ER dependent. It was also accompanied by the decreased expression of several genes involved in adipogenesis, including lipoprotein lipase (LPL), leptin, CCAAT/enhancer-binding-protein-alpha (C/EBPalpha), and peroxisome proliferator-activated receptor-gamma (PPARgamma), as well as the increased expression of some negative factors of adipogenesis, including preadipocyte factor 1 (Pre-1), GATA-binding protein 2 (GATA-2), GC-induced leucine-zipper protein (GILZ), and C/EBP homologous protein (CHOP-10). In addition to its estrogenic action, PPD also abolished the p38 mitogen-activated protein kinase (p38 MAPK) activation. Our results suggest that PPD inhibits adipogenesis in an ER-dependent manner and induces the expression of ERalpha. These findings may provide a lead toward a novel agent that can be used to treat obesity.

[Anatomic study of anterolateral thigh perforators flap and its clinical significance in reconstruction of head and neck defects].

OBJECTIVE: To study the anatomy of the anterolateral thigh perforators flap and explore its clinical application in the reconstruction of head and neck defects. METHODS: Five adult fresh cadavers were prepared, and morphosis and blood supply of anterolateral thigh flap perforators were examined by microsurgery anatomy. During dissections, the following parameters were recorded: number and type of perforators vessels, diameter of perforators, pedicle length, diameter of the original vessels, route (infra fascia and supra fascia); its position were located by anatomical landmark. RESULTS: There were an average of (4.4 +/- 1.8) anterolateral thigh perforators flaps (ALTP flap) in each specimen with 68.2% musculocutaneous perforator and 31.8% septocutaneous perforator. The mean pedicle length of the largest perforator was (10.86 +/- 1.18) cm (8.29-14.44) cm, and its location was constantly concentrated in the superolateral region of the midpoint of the line linking the anterosuperior iliac spine and superolateral border of the patella. The distance between surface location of the largest perforator and the midpoint was (3.25 +/- 0.69) cm. Original vessel was mostly descend branch of lateral circumflex femoral artery/vein with average diameter of (3.16 +/- 0.59) / (3.08 +/- 0.02) mm. CONCLUSION: ALTP flap has constant position, large caliber, and long pedicle and therefore is useful for operation and option in reconstruction of head neck defects.

Isolation of a new glycoside from starfish, Asterias amurensis Lutken, and its stimulation activity on the proliferation of the UMR106 cell.

A new glycoside compound (1) was isolated from the starfish Asteria amurensis Lutken. The structure for compound 1 was identified as 1-O-{beta-D-quinovopyranosyl-(1-2)-beta-D-fucopyranosyl-(1-4)-[beta-D-fucopyranosyl(1-2)] beta-D-quinovopyranosyl}-butanol by extensive NMR experiments as well as chemical evidence. The effects of compound 1 on UMR106 cell proliferation were screened by MTT assay. The results indicate that compound 1 (0.01-100 microM) significantly promotes osteoblastic proliferation.

New oxidized sterols from Aspergillus awamori and the endo-boat conformation adopted by the cyclohexene oxide system.

Two new oxidized sterols 1 and 2 were obtained from the active fraction of a mangrove fungus Aspergillus awamori isolated from the soils around the mangrove plant Acrostichum speciosum. Their structures were elucidated using spectroscopic methods as 22E-7alpha-methoxy-5alpha,6alpha-epoxyergosta-8(14),22-dien-3beta-ol (1) and 22E-3beta-hydroxy-5alpha,6alpha,8alpha,14alpha-diepoxyergosta-22-en-7-one (2). The NMR data and complete assignments for both DMSO-d(6) and CDCl(3) were given. Their cytotoxic activity against A549 cell line was evaluated. Furthermore, the detailed conformation analysis for ring B (cyclohexene oxide system) of sterol 1 was given on the basis of NOEs. The endo-boat conformation was considered as the preferred conformation for ring B rather than half-chair conformation.

[Study on absorption mechanism of puerarin and its nanoparticles across Caco-2 cell model].

OBJECTIVE: To study the absorption mechanism of puerarin and its nanoparticles across Caco-2 cell model. METHODS: The Caco-2 monolayer model was used to explore the effect of time and drug concentration on the absorption of puerarin and its nanoparticeles. The drug concentration was determined by high-performance liquid chromatography and the Papp was caculated. RESULTS: The puerarin-PLGA-NP could significantly improve the absorption of puerarin. Puerarin was not only absorbed simply through passive diffusion, but also had relations with high dispersion of nanoparticles, increase of affinity and interaction with intestinal mucous membrane. CONCLUSION: The main mechanism of puerarin and its nanoparticles across Caco-2 monolayer model is passive transference. Puerarin-NP could increase the absorption of the drug in intestinal epithlial.

[Anatomic study on internal mammary artery perforator flap].

OBJECTIVE: To study the anatomy of internal mammary artery perforator (IMAP) flap. METHODS: Five fresh cadavers were used, the morphology and blood supply of IMAP flap were examined by the method of microsurgical anatomy. During dissections, following parameters were recorded: number, type and diameter of perforators vessels, course (infra fascia and supra fascia) and location of perforators vessels. RESULTS: All 1st-4th IMAPs were found in 10 specimen. Average diameter of 1st-4th IMAP artery/vein was as follows (x +/- s): (1.29 +/- 0.28) mm, (1.46 +/- 0.22) mm; (1.1 +/- 0.27) mm, (1.41 +/- 0.39) mm; (0.87 +/- 0.23) mm, (1.17 +/- 0.15) mm; (0.92 +/- 0.22) mm, (1.12 +/- 0.14) mm. The largest perforator was mostly first or second IMAP. The angiosomal territory of IMAPs extended from the clavicle superiorly to the xiphisternum inferiorly, from the midline medially to anterior axillary fold laterally. CONCLUSION: IMAP flap offers an option in reconstruction of head neck defects and should be considered as an alternative to the deltopectoral flap and pectoralis major flap in some patients.

[Clinical anatomic study on ischial spinous fascia fixation].

OBJECTIVE: The study was to explore the safety, firmness and convenience of the fascia around the ischial spine as a new fixation site for the vaginal fornix. METHODS: Between June 2007 and January 2008, detailed dissections and related measurements of the regions around the ischial spine were performed on 10 Chinese female cadavers (3 unembalmed and 7 embalmed cadavers). At the same time, the sacrospinous ligament, the fascia on the ischial spine, the iliococcygeus fascia as well as the vaginal fornix were exposed and the pull-out strength sequentially tested using a digital push-pull force gauge. RESULTS: The fascia on the ischial spine was firm and strong, with a thickness of 3 about mm. No major vessels or nerves were observed on the ischial spine. The greatest pullout strengths of the sacrospinous ligament, the fascia on the ischial spine, the iliococcygeus fascia as well as the vaginal fornix were (102 +/- 26), (64 +/- 15), (33 +/- 8) and (32 +/- 6) N, respectively. CONCLUSION: The fascia at 1 cm from anterior lateral ischial spine, free of major vessels and nerves, is safe and strong and could be used as a new site for suspension in vaginal prolapse.

Two new flavonol glycosides from Epimedium koreanum Nakai.

Two new flavonol glycosides, named icarisid B (1) and icarisid C (2), along with seven known flavonol glycosides were isolated from the bioassay-directed fractions of the aqueous extract of Epimedium koreanum Nakai. The structures of the two new compounds were established on the basis of chemical and spectroscopic methods (ESI-MS, 1D, and 2D NMR) as 5-hydroxyl-4'-methoxy-8-(gamma-hydroxyl-gamma,gamma-dimethyl)-propyl-3-O-alpha-L-rhamnopyranosyl-flavonol-7-O-beta-D-glucopyranoside (1) and 5-hydroxyl-4'-methoxy-8-(gamma-methoxy-gamma,gamma-dimethyl)-propyl-3-O-beta-D-glucopyranosyl(1 --> 3)-alpha-L-rhamnopyranosyl-flavonol-7-O-beta-D-glucopyranoside (2), respectively. All the nine compounds were tested for their effects on proliferation and alkaline phosphatase (ALP) activity using UMR106 cells. As a result, five compounds showed stimulating effects on both the proliferation and ALP activity, which suggested that they might be used as potential leading compounds to cure osteoporosis.

Two new steroidal saponins from Allium macrostemon bunge and their cytotoxity on different cancer cell lines.

Two new steroidal saponins (1 and 2) were isolated from the dried bulbs of Allium macrostemon Bunge. Their structures were elucidated by the spectral data as 26-O-beta-D-glucopyranosyl-5alpha-furost-25 (27)-ene-3beta, 12beta, 22, 26-tetraol-3-O-beta-D-glucopyranosyl (1-->2) [beta-D-glucopyranosyl (1-->3)]-beta-D-glucopyranosyl (1-->4)-beta-D-galactopyranoside (1) and 26-O-beta-D-glucopyranosyl-5beta-furost-20 (22)-25 (27)-dien-3beta, 12beta, 26-triol-3-O-beta-D-glucopyranosyl (1-->2)-beta-D-galactopyranoside (2), respectively. Their cytotoxic activities on several cancer cell lines (MCF-7, NCI-H460, SF-268 and HepG2) were tested. 1 showed special cytotoxity on SF-268, while 2 showed cytotoxity on NCI-H460 and SF-268 cell lines, respectively.