Anatomical variations of the superficial ulnar artery: case series observed on historical specimens prepared by Ludwik Karol Teichmann.

BACKGROUND: This report presents a series of cases representing variant origin and course of the ulnar artery, namely the superficial ulnar artery (SUA), observed during the review of collection of historical specimens prepared in the 19th century by the prominent Polish anatomist Ludwik Karol Teichmann and his collaborators, exhibited in the Anatomy Museum of Jagiellonian University Medical College. RESULTS: Three distinct variants of the SUA were found on anatomical specimens of the upper limb with arteries injected by using Teichmann's method. In case no. 1, the SUA originated from the brachial artery slightly above the interepicondylar line of the humerus. This aberrant vessel gave off the common interosseous artery in the upper half of the cubital fossa and then ran superficially to the bicipital aponeurosis and over the muscles arising from the medial epicondyle of the humerus. The cases no. 2 and 3 involved two similar variants of the superficial artery in which the common interosseous artery arose from the radial artery. In the unique case no. 4, the SUA arose from the radial artery. CONCLUSIONS: The SUA shows diverse anatomy regarding its topography and blood supply territory. Orthopaedic, hand, and plastic surgeons should be aware of anatomic variations of the SUA both in planning and in conducting surgeries of the upper limb.

Thoracic osteophyte as a cause of symptomatic greater splanchnic nerve compression. Case report.

Thoracic osteophytes are a common feature of degenerative spine disease. However, it is rare that osteophytes overgrowth on the anterior surface of thoracic spine results in the compression of vital structures and causes symptoms. A 39-year old man with a two-year history of thoracic and upper abdominal pain was admitted to the neurosurgery ward after having been seen by several specialists. Thoracic spine MRI and CT scans were analyzed. Osteophytes were identified on the anterolateral right side at level T8-T9 and were indicated as a possible cause of the symptoms. After obtaining patient consent, surgery was performed with transthoracic access to the anterolateral surface of the spine. Intraoperatively, the greater splanchnic nerve was released by osteophyte removal. The patient reported improvement of the preoperative symptoms at the six-month and two-year follow-up visit. Postoperative MRI indicated complete osteophyte excision. To the best of our knowledge, this is the first report of symptomatic sympathetic trunk branch compression by thoracic osteophytes.

Raman imaging and statistical methods for analysis various type of human brain tumors and breast cancers.

Spectroscopic methods provide information on the spatial localization of biochemical components based on the analysis of vibrational spectra. Raman spectroscopy and Raman imaging can be used to analyze various types of human brain tumors and breast cancers. The objective of this study is to evaluate the Raman biomarkers to distinguish tumor types by Raman spectroscopy and Raman imaging. We have demonstrated that bands characteristic for carotenoids (1156 cm-1, 1520 cm-1), proteins (1004 cm-1), fatty acids (1444 cm-1, 1655 cm-1) and cytochrome (1585 cm-1) can be used as universal biomarkers to assess aggressiveness of human brain tumors. The sensitivity and specificity obtained from PLS-DA have been over 73%. Only for gliosarcoma WHO IV the specificity is lower and takes equal 50%. The presented results confirm clinical potential of Raman spectroscopy in oncological diagnostics.

Unusual formation of the musculocutaneous and median nerves: a case report refined by intraneural dissection and literature review.

This report presents a detailed anatomical investigation of an upper limb specimen showing an atypical formation of the musculocutaneous nerve (MCN) and median nerve (MN). The study was refined by intraneural dissection, which supplements earlier descriptions of similar anatomical variations and allows for revision of the accepted classification. The case described in this report was an incidental finding during routine dissection of a fixed isolated upper limb. Intraneural dissection revealed partial fusion between the MCN and aberrant bundles of the MN. Those aberrant bundles joined the main steam of the MN at the level at which the MCN branched off as an independent nerve. The procedure allowed the aberrant fibres of the MN to be differentiated from the MCN. The presence of separate bundles in a territory corresponding to the MCN was confirmed, although those bundles and the aberrant MN bundles were covered by a common epineurium. The aberrant MN bundles running within the MCN did not contribute to innervation of the forearm muscles. They rejoined the main nerve trunk in the arm. A comprehensive understanding of the diverse anatomical variations of the upper limb nerves could be crucial for the safety and success of surgical procedures, especially procedures for reconstructing the brachial plexus or its branches.

PD-1, PD-L1 and PD-L2 Expression in Mantle Cell Lymphoma and Healthy Population.

Cell surface expression of PD-1, PD-L1 and PD-L2 immune checkpoints on B and T cells obtained from patients with mantle cell lymphoma shows ambiguous results across many studies and creates obstacles for the implementation of immune checkpoint inhibitors into the therapy of mantle cell lymphoma. Using multiparameter flow cytometry we analysed surface expression of PD-1, PD-L1 and PD-L2 molecules on B and T cells of 31 newly diagnosed mantle cell lymphomas and compared it with the results of 26 newly diagnosed chronic lymphocytic leukaemias and 20 healthy volunteers. To gain insight into the age-dependent changes of surface expression of these immune checkpoints, flow cytometric subanalysis of 30 healthy volunteers of 25-93 years of age was conducted. Overall, we demonstrated weak surface expression of PD-1, PD-L1 and PD-L2 on B and T cells of mantle cell lymphoma patients (< 10 % when compared to healthy individuals). A significant age-dependent increase in the expression of PD-1 and its ligand PD-L2 was observed in healthy volunteers. Our results suggest that neither PD-1 nor its ligands represent relevant druggable targets for the therapy of mantle cell lymphoma. The observed age-dependent changes in healthy population could impact efficiency of immune checkpoint inhibitors and could be at least partly connected with increased incidence of cancer with age.

Analysis of medium-range order based on simulated segmented ring detector STEM-images: amorphous Si.

Properties of amorphous materials are connected to the local structure at the nanoscale, which is typically described in terms of short- and medium-range order (SRO, MRO). Variable resolution fluctuation electron microscopy (VR-FEM) is a sensitive method to characterize the underlying characteristic length scale of MRO of amorphous samples (Voyles, Gibson and Treacy, J. Electron Microsc. 49 (2000) 259). VR-FEM data was acquired using scanning transmission electron microscopy (STEM), collecting a large number of nano-beam diffraction patterns (NBDPs) with various probe sizes. Here we present an advanced method to accelerate the calculation of simulated FEM normalized variance profiles using a newly developed simulation and analysis approach with segmented ring detectors using the program STEMcl (Radek et al., Ultramicroscopy 188 (2018) 24). VR-FEM simulations are based on structures obtained from molecular dynamics (MD) simulations. A comparison between simulated and experimental VR-FEM profiles with respect to peak position, ratio and shape (and intensity) show good agreement. Moreover, a crystalline cluster of 1 nm in size was embedded into the MD box to test the validity of the paracrystalline approximation with the pair-persistence analysis suggested by Gibson et al. (Gibson, Treacy and Voyles, Ultramicroscopy 83 (2000) 169). The corresponding VR-FEM simulation and calculation of MROs yield close results to the size of the initially embedded crystalline cluster, which supports both the paracrystalline approach and the validity of the segmented detector simulation. Additionally, we conclude that continuous random network (CRN) amorphous silicon models contain a higher degree of MRO than experimentally expected.

Self-Diffusion in Amorphous Silicon by Local Bond Rearrangements.

Experiments on self-diffusion in amorphous silicon (Si) were performed at temperatures between 460 to 600° C. The amorphous structure was prepared by Si ion implantation of single crystalline Si isotope multilayers epitaxially grown on a silicon-on-insulator wafer. The Si isotope profiles before and after annealing were determined by means of secondary ion mass spectrometry. Isothermal diffusion experiments reveal that structural relaxation does not cause any significant intermixing of the isotope interfaces whereas self-diffusion is significant before the structure recrystallizes. The temperature dependence of self-diffusion is described by an Arrhenius law with an activation enthalpy Q=(2.70±0.11) eV and preexponential factor D_{0}=(5.5_{-3.7}^{+11.1})×10^{-2} cm^{2} s^{-1}. Remarkably, Q equals the activation enthalpy of hydrogen diffusion in amorphous Si, the migration of bond defects determining boron diffusion, and the activation enthalpy of solid phase epitaxial recrystallization reported in the literature. This close agreement provides strong evidence that self-diffusion is mediated by local bond rearrangements rather than by the migration of extended defects as suggested by Strauß et al. (Phys. Rev. Lett. 116, 025901 (2016)PRLTAO0031-900710.1103/PhysRevLett.116.025901).

STEMcl-A multi-GPU multislice algorithm for simulation of large structure and imaging parameter series.

Electron microscopy images are interference patterns and can generally not be interpreted in a straight forward manner. Typically, time consuming numerical simulations have to be employed to separate specimen features from imaging artifacts. Directly comparing numerical predictions to experimental results, realistic simulation box sizes and varying imaging parameters are needed. In this work, we introduce an accelerated multislice algorithm, named STEMcl, that is capable of simulating series of large super cells typical for defective and amorphous systems, in addition to parameter series using the massive parallelization accessible in today's commercial PC-hardware, e.g. graphics processing units (GPUs). A new numerical approach is used to overcome the memory constraint limiting the maximum computable system size. This approach creates the possibility to study systematically the contrast formation arising by structural differences. STEM simulations of structure series of a crystalline Si and an amorphous CuZr system are presented and the contrast formation of vacancies/voids are studied. The detectability of vacancies/voids in STEM experiments is discussed in terms of density changes.

MULTIDIRECTIONAL ASSESSMENT OF BONE STRUCTURE INCLUDING RADIOISOTOPIC ANALYSIS IN PERIMENOPAUSAL WOMEN.

OBJECTIVE: In postmenopausal period, changes in bone turnover markers (BTM), vitamin D3, cytokines and parathyroid hormone (PTH) are frequently observed. The study was to assess bone mineral density (BMD) and bone metabolism index (IBM) in the perimenopausal women. DESIGN YEARS: 2013-2014. SUBJECTS AND METHODS: One hundred and thirteen women were divided into four groups: group I (35 not menstruating 50 - 60 years old with osteoporosis), II (23 not menstruating 50 - 60 years old without osteoporosis), III (30 menstruating 40 - 49 years old with osteoporosis), IV (25 menstruating 40 - 49 years old without osteoporosis). The following parameters were measured: IL-1ß, IL-6, TNF-α, hormone oestradiol (E2), PTH, FSH, TSH, calcium (Ca2+), phosphates (P), alkaline phosphatase (bALP), C-terminal telopeptide of type I collagen alpha 1 chain (α1CTX), osteocalcin (OC), BMD, IBM. RESULTS: IBM and BMD were significantly lower in premenopausal than in postmenopausal women. The concentration of OC, CTX, 25OH D3 and PTH levels differed significantly between group I vs. II, group I vs. III and group II vs. IV. CONCLUSIONS: The levels of BTM, D3, PTH differed significantly between groups. This study demonstrated that bone metabolism depended mainly on processes related with menopause state and changes in D3, PTH and cytokines levels.

Rheumatoid atlantoaxial instability treated by anterior transarticular C1-C2 fixation. Case report.

The authors present a case that demonstrates the usefulness of anterior transarticular screw fixation in the treatment of instability due to rheumatoid arthritis. The surgical technique of this infrequently used procedure is presented. A 35-year-old female patient with medical history significant for rheumatoid arthritis complained of persistent headache and upper neck pain. Examination revealed a decreased range of cervical rotational motion. Magnetic resonance imaging of the cervical spine revealed anterior displacement of C1, destruction of the left lateral atlantoaxial articulation and bony erosion of the C2 vertebral body below the base of the odontoid. Dynamic radiographs showed increased C1-C2 mobility. The authors used a right anterolateral approach to the cervical spine to perform fixation of lateral atlantoaxial articulations by means of titanium cannulated compressive screws. On 4-month follow-up examination, successful C1-C2 stabilization was documented. Despite restriction of neck rotation, the patient reported satisfactory improvement and re-turned to work.

Oxalates in some Indian green leafy vegetables.

The soluble and total oxalate contents of 11 leafy vegetables grown in India were determined. Spinach, purple and green amaranth and colocasia contained high levels of total oxalates, which ranged from 5,138.0 +/- 37.6 mg/100 g dry matter up to 12,576.1 +/- 107.9 mg/100 g dry matter. Seven other leafy vegetables (curry, drumstick, shepu, fenugreek, coriander, radish and onion stalks) contained only insoluble oxalate, which ranged from 209.0 +/- 5.0 mg/100 g dry matter to 2,774.9 +/-18.4 mg/100 g dry matter. In vitro digestion of the samples showed that the gastric available oxalate was 10% lower than the values obtained from acid extraction and that intestinal available oxalate was 20% lower than the values obtained following hot water extraction. The percentage calcium bound in the insoluble oxalate fraction of the dried leafy vegetables ranged from 3.3% to 86.7% of the total calcium. Addition of four different sources of calcium (low fat milk, whole milk, calcium carbonate and calcium sulphate) resulted in a range of 32-100% reductions of intestinal available oxalate in the mixture.

Neural correlates of a clinical continuous performance test.

Functional magnetic resonance imaging (fMRI) was performed in 30 healthy adults to identify the location, magnitude, and extent of activation in brain regions that are engaged during the performance of Conners' Continuous Performance Test (CPT). Performance on the task during fMRI was highly correlated with performance on the standard Conners' CPT in the behavioral testing laboratory. An extensive neural network was activated during the task that included the frontal, cingulate, parietal, temporal, and occipital cortices; the cerebellum and the basal ganglia. There was also a network of brain regions which were more active during fixation than task. The magnitude of activation in several regions was correlated with reaction time. Among regions that were more active during task, the overall volume of supratentorial activation and cerebellar activation was greater in the left hemisphere. Frontal activation was greater in dorsal than in ventral regions, and dorsal frontal activation was bilateral. Ventral frontal region and parietal lobe activation were greater in the right hemisphere. The volume of clusters of activation in the extrastriate ventral visual pathway was greater in the left hemisphere. This network is consistent with existing models of motor control, visual object processing and attentional control and may serve as a basis for hypothesis-driven fMRI studies in clinical populations with deficits in Conners' CPT performance.

Effects of somatostatin-14 and the receptor-specific somatostatin analogs on chromogranin A and alpha-subunit (alpha-SU) release from "clinically nonfunctioning" pituitary adenoma cells incubated in vitro.

The aim of the study was to examine the effect of somatostatin (SST) and its analogs on the release of chromogranin A (CgA) and alpha-subunit (alpha-SU) from clinically non-functioning pituitary adenomas incubated in vitro. Seven pituitary macroadenomas surgically removed were investigated. All of the tumors were diagnosed before surgery as non-functioning, but they expressed either gonadotropins or their subunits as detected by immunohistochemistry. Two tumors additionally expressed prolactin and growth hormone. All adenomas also expressed chromogranin A (CgA) and at least 3 of 5 subtypes of somatostatin receptors. The cells isolated from the examined tumors were exposed in vitro to either native SST-14 or the following receptor-specific SST analogs: BIM-23926 (agonist of sst1 receptor), BIM-23120 (agonist of sst2 receptor), BIM-23206 (agonist of sst5 receptor) and BIM23A387 (somatostatin/dopamine chimera). The concentration of CgA was measured by means of ELISA method and of alpha-SU was measured by an immunoradiometric method. It was found that the exposure on SST-14 resulted in the decrease of CgA and alpha-SU release from tumor cells in majority of samples, and the effect on CgA was positively correlated with the expression of sst3 and also with the sst2A/sst2B expressions ratio. The inhibitory effect of SST-14 on CgA and alpha-SU seems also to correlate negatively with the expression of sst2B. CgA inhibition also correlates positively with sst5 expression. Among the other compounds studied, only the sst2 agonist decreased the release in all the investigated samples. The remaining substances (agonists of sst1 and sst5 and SST/DA chimera) produced the divergent changes (increased or decreased release, depending on the sample). The data suggest that the inhibition of CgA (and possibly of alpha-SU) release by SST is mediated via subtypes sst2A, sst3 and sst5, whereas sst2B subtype may induce the opposite effect.

Alveolar rhabdomyosarcoma of the clivus with intrasellar expansion: Case report.

Rhabdomyosarcomas are common tumors of the head and neck region in children. However, a primarily intracranial localization of this tumor entity is rare. We report on a 3-year-old boy presenting with double vision due to left VI (th) nerve palsy. No other neurological deficits were recognized by clinical inspection. MRI scans visualized an enhancing mass lesion in the upper clivus compressing the cavernous sinus and the pituitary gland. Transsphenoidal biopsy was performed and histopathological examination as well as molecular diagnostics confirmed the diagnosis of an alveolar rhabdomyosarcoma (ARMS). Staging identified a metastatic lesion in the fourth thoracic vertebra resulting in the diagnosis of stage IV disease. Treatment modality included stereotactic radio- and chemotherapy.

Effects of EPI readout bandwidth on measured activation map and BOLD response in fMRI experiments.

The purpose of this study was to evaluate the effects of echo planar imaging (EPI) readout bandwidth and its interaction with data processing procedures on the measured blood oxygenation level dependent (BOLD) response and activation in fMRI experiments. Seventeen healthy subjects were scanned during a brief visual stimulation paradigm with two EPI pulse sequences having 'high' (1953 Hz/pixel) and 'low' (780 Hz/pixel) readout bandwidth. Functional data were analyzed with a general linear model including temporal filtering and a basic correlation model following (1) no preprocessing, (2) realignment, or (3) realignment and spatial smoothing. A range of statistical thresholds were used to generate activation maps. Despite slightly higher BOLD signal detected with the high bandwidth sequence from matched ROIs in the primary visual cortex, results showed that the low bandwidth pulse sequence was more sensitive under most conditions evaluated. That is, the low bandwidth sequence detected greater numbers of activated voxels with lower cluster average BOLD signal (e.g., low bandwidth detected 1.4 times more voxels, with average BOLD signal 30% lower compared to high bandwidth for P = 0.05 (corrected) with the 3rd preprocessing procedure using the general linear model). However, there was significant interaction between bandwidth and data preprocessing procedures. Of particular interest, the sensitivity advantage of the low bandwidth pulse sequence decreased for the smoothed data as the activation threshold became less conservative. For the frequently used threshold of P = 0.001 (uncorrected) and cluster size of at least 5 voxels, the bandwidth advantage became insignificant. These findings demonstrate that the effects of bandwidth should be considered carefully in the design, analysis, and interpretation of BOLD fMRI studies.

[Anterior interbody fusion of cervical spine with case-plate PCB]. / Przednia stabilizacja miedzytrzonowa kregoslupa szyjnego implantem typu cage-plytka PCB--prezentacja przypadków.

Two cases with cervical discopathy and radiculopathy are presented. Discectomy and anterior interbody fusion with cage-plate PCB manufactured by French company Scient'x was performed. Authors present the shape of the implant and technical details of implantation. The paper discusses the advantages of the PCB which simplifies and shortens the operation procedure, minimizes the risk of traditional bone graft harvesting and provides immediate stabilization of the operated segment.

Immediate stiffness of the C5-C6 segment after discectomy with the Cloward technique: an in vitro biomechanical study on a human cadaveric model.

OBJECTIVE: To determine whether the Cloward technique of cervical discectomy and fusion increases immediate postoperative stiffness of single cervical motion segment after application of interbody dowel bone graft. METHODS: We measured and compared the stiffness of single-motion segments in cadaveric cervical spines before and immediately after interbody fusion with the Cloward technique. Changes in range of motion and stiffness of the C5-C6 segment were measured in a bending flexibility test (flexion, extension, lateral bending and axial rotation) before and after a Cloward procedure in 11 fresh-frozen human cadaveric specimens from the 4th through the 7th vertebrae. RESULTS: The Cloward procedure produced a statistically significant increase in stiffness of the operated segment in flexion and lateral bending when compared with the intact spine. The less stiff the segment before the operation, the greater the increase in its postoperative flexural stiffness (statistically significant). The Cloward procedure produced nonuniform changes in rotational and extensional stiffness that increased in some specimens and decreased in others. CONCLUSION: Our data demonstrate that Cloward interbody fusion increases immediate postoperative stiffness of an operated segment only in flexion and lateral bending in cadaveric specimens in an in vitro environment. Thus, Cloward fusion seems a relatively ineffective method for increasing the stiffness of a construct. This may add to discussion on the use of spinal instrumentation and postoperative management of patients after cervical discectomy, which varies from bracing in hard collars through immobilization in soft collars to no external orthosis.

[Peridural fibrosis in lumbar disc surgery--pathogenesis, clinical problems and prophylactic attempts]. / Blizna oponowa w operacjach odcinka ledzwiowego kregoslupa--mechanizm powstawania, problemy kliniczne i próby profilaktyki.

Postoperative peridural fibrosis is unavoidable adverse effect of lumbar disc surgery. This process is disadvantageous both to the patient and to the surgeon. It is assumed that peridural fibrosis is responsible for as much as 25% of all Failed Back Surgery Syndrome. In case of reherniated discs requiring reoperation epidural scar may cause technical difficulties. Thus the prevention or inhibition of postoperative peridural fibrosis and adhesions is an essential goal for successful lower back surgery. The authors review new opinions on pathophysiology of peridural fibrosis, clinical aspects of the process, results of experimental approaches for limiting peridural fibrosis and perspective of anti-adhesion gel Adcon-L.

[Posttraumatic ectopic calcification as an additional pathologic factor of brachial plexus palsy]. / Pourazowe wapnienie ektopowe jako dodatkowy czynnik patologiczny porazenia splotu ramiennego.

The authors describe a case of a 54-year-old male, who was attacked with a broken bottle and wounded in left supraclavicular region. No neurologic deficit was observed immediately after injury. Some days later signs of upper trunk brachial plexus palsy were detected. Gradually symptoms of the Erb syndrome have developed. He was operated on 5 months after injury. During surgery no discontinuity of the brachial plexus was found. Unexpectedly there were an inner scar and free bony fragment compressing the upper trunk and the suprascapular nerve. Both the scar and bony fragment were carefully dissected and removed. Result of surgery: pain relief, restoration of normal sensation and partial restoration of biceps function.