Retinal nerve fiber evaluation in neuro-ophthalmic diseases of the anterior visual pathway

Retinal nerve fiber evaluation is important in the diagnosis and management of several diseases of the anterior visual pathway. In this report we review the clinical findings and the current techonologies avalilable to analyse the retinal nerve fiber layer. We furthermore review the main findings in several disease of the anterior visual pathways including inflammatory, ischemic, toxics, hereditary, compressive and traumatic optic neuropathies as well as lesion of the optic chiasm, optic tract and lateral geniculate body.

Complications of misdiagnosis of maxillary canine ectopic eruption

Ectopic eruption of maxillary canines can be associated with root resorption of adjacent teeth. This case report describes and discusses an interesting case of a 15-year-old girl with a Class III malocclusion and an impacted maxillary canine. Because of the unfavorable position of the ectopic canine and the severe root resorption of the maxillary left central and lateral incisors, the treatment options included extraction of the maxillary permanent canines. The mandibular first premolars were extracted to compensate for the Class III malocclusion. A panoramic radiograph taken earlier in the mixed dentition already indicated a possible eruption disturbance of the maxillary left permanent canine. The importance of early diagnosis of maxillary canine ectopic eruption is highlighted in this case report. The early identification of radiographic signs of an ectopic pathway of eruption should be followed by deciduous canine extraction to prevent canine retention and maxillary incisor root resorption. (Am J Orthod Dentofacial Orthop 2012;142:256-63)

A SIMPLIFIED MODEL FOR EVALUATING TIRE WEAR DURING CONCEPTUAL DESIGN

In the field of vehicle dynamics, commercial software can aid the designer during the conceptual and detailed design phases. Simulations using these tools can quickly provide specific design metrics, such as yaw and lateral velocity, for standard maneuvers. However, it remains challenging to correlate these metrics with empirical quantities that depend on many external parameters and design specifications. This scenario is the case with tire wear, which depends on the frictional work developed by the tire-road contact. In this study, an approach is proposed to estimate the tire-road friction during steady-state longitudinal and cornering maneuvers. Using this approach, a qualitative formula for tire wear evaluation is developed, and conceptual design analyses of cornering maneuvers are performed using simplified vehicle models. The influence of some design parameters such as cornering stiffness, the distance between the axles, and the steer angle ratio between the steering axles for vehicles with two steering axles is evaluated. The proposed methodology allows the designer to predict tire wear using simplified vehicle models during the conceptual design phase.

Measurement of event background fluctuations for charged particle jet reconstruction in Pb-Pb collisions at root s(NN)=2.76 TeV

The effect of event background fluctuations on charged particle jet reconstruction in Pb-Pb collisions at root s(NN) = 2.76 TeV has been measured with the ALICE experiment. The main sources of non-statistical fluctuations are characterized based purely on experimental data with an unbiased method, as well as by using single high p(t) particles and simulated jets embedded into real Pb-Pb events and reconstructed with the anti-k(t) jet finder. The influence of a low transverse momentum cut-off on particles used in the jet reconstruction is quantified by varying the minimum track p(t) between 0.15 GeV/c and 2 GeV/c. For embedded jets reconstructed from charged particles with p(t) > 0.15 GeV/c, the uncertainty in the reconstructed jet transverse momentum due to the heavy-ion background is measured to be 11.3 GeV/c (standard deviation) for the 10% most central Pb-Pb collisions, slightly larger than the value of 11.0 GeV/c measured using the unbiased method. For a higher particle transverse momentum threshold of 2 GeV/c, which will generate a stronger bias towards hard fragmentation in the jet finding process, the standard deviation of the fluctuations in the reconstructed jet transverse momentum is reduced to 4.8-5.0 GeV/c for the 10% most central events. A non-Gaussian tail of the momentum uncertainty is observed and its impact on the reconstructed jet spectrum is evaluated for varying particle momentum thresholds, by folding the measured fluctuations with steeply falling spectra.

A New Species of Hypostomus (Siluriformes: Loricariidae) from the Upper Rio Paraguay Basin, Brazil

A new small Loricariidae, Hypostomus careopinnatus, is described from the Rio Taquari drainage, upper Rio Paraguay basin, Mato Grosso, Brazil. The new species can be easily distinguished from all congeners, except Hypostomus kids, by the absence of adipose fin. Hypostomus careopinnatus is distinguished from H. levis mainly by the presence of slender bifid teeth, with mesial cusp large and rounded, and lateral cusp small and pointed (vs. spoon-shaped teeth). The new species described herein completely lacks the adipose fin and also lacks the median pre-adipose plates in almost all specimens examined. The absence of adipose fin is probably an independent acquisition for Hypostomus careopinnatus and Hypostomus levis.

The periaqueductal gray as a critical site to mediate reward seeking during predatory hunting

Previous studies using morphine-treated dams reported a role for the rostral lateral periaqueductal gray (rIPAG) in the behavioral switching between nursing and insect hunting, likely to depend on an enhanced seeking response to the presence of an appetitive rewarding cue (i.e., the roach). To elucidate the neural mechanisms mediating such responses, in the present study, we first observed how the rIPAG influences predatory hunting in male rats. Our behavioral observations indicated that bilateral rIPAG NMDA lesions dramatically interfere with prey hunting, leaving the animal without chasing or attacking the prey, but do not seem to affect the general levels of arousal, locomotor activity and regular feeding. Next, using Phaseolus vulgaris-leucoagglutinin (PHA-L), we have reviewed the rIPAG connection pattern, and pointed out a particularly dense projection to the hypothalamic orexinergic cell group. Double labeled PHA-L and orexin sections showed an extensive overlap between PHA-L labeled fibers and orexin cells, revealing that both the medial/perifornical and lateral hypothalamic orexinergic cell groups receive a substantial innervation from the rIPAG. We have further observed that both the medial/perifornical and lateral hypothalamic orexinergic cell groups up-regulate Fos expression during prey hunting, and that rIPAG lesions blunted this Fos increase only in the lateral hypothalamic, but not in the medial/perifornical, orexinergic group, a finding supposedly associated with the lack of motivational drive to actively pursue the prey. Overall, the present results suggest that the rIPAG should exert a critical influence on reward seeking by activating the lateral hypothalamic orexinergic cell group. (C) 2011 Elsevier B.V. All rights reserved.

STUDY ON IMPLANT STABILITY IN CEMENTLESS TOTAL KNEE ARTHROPLASTY

Objetives: Determine the stability of tibial and femoral components of 20 cementless knee arthroplasties with rotating platform. Methods: The 20 patients (20 knees) underwent an analysis of dynamic radiographs with an image amplifier and maneuvers of varus and valgus which were compared to static frontal and lateral radiographs of the knees and analyzed by two experienced surgeons in a double-blind way. Results: We could observe in this study that both methods showed very similar results for the stability of the tibial and femoral components (p<0.001) using the Kappa method for comparison. Conclusion: The tibial component was more unstable in relation to the femoral component in both static and dynamic studies. Level of Evidence IV, Case Series.

Experimental diabetes modulates collagen remodelling of joints in rats

The aim of this study was to evaluate extracellular matrix components in articular cartilage, ligaments and synovia in an experimental model of diabetes. Young Wistar rats were divided into a streptozotocin-induced (STZ; 35 mg/kg) diabetic group (DG; n=15) and a control group (CG; n=15). Weight, blood glucose and plasma anti-carboxymethyllysine were measured 70 days after STZ infusions. Knee joints, patellar ligaments, and lateral and medial collateral ligaments were isolated and stained with hematoxylineosin and Picrosirius. The total collagen content was determined by morphometry. Immunofluorescence was employed to evaluate types I, III, and V collagen in ligaments and synovial tissues and types II and XI collagen in cartilage. Results: Higher blood glucose levels and plasma anti-carboxymethyllysine were observed in DG rats when compared to those in CG rats. The final weight was significantly lower in the DG rats than in the CG rats. Histomorphometric evaluation depicted a small quantity of collagen fibers in ligaments and articular cartilage in DG rats, as well as increased collagen in synovial tissue. There was a decrease in cartilage proteoglycans in DG rats when compared with CG rats. Immunofluorescence staining revealed an increase of collagen III and V in ligaments, collagen XI in cartilage, and collagen I in synovial tissue of DG rats compared with CG rats. Conclusion: The ligaments, cartilage and synovia are highly affected following STZ-induced diabetes in rats, due the remodeling of collagen types in these tissues. This process may promote the degradation of the extracellular matrix, thus compromising joint function. Our data may help to better understand the pathogenesis of joint involvement related to diabetes.

Implications of purinergic receptor-mediated intracellular calcium transients in neural differentiation

Purinergic receptors participate, in almost every cell type, in controlling metabolic activities and many physiological functions including signal transmission, proliferation and differentiation. While most of P2Y receptors induce transient elevations of intracellular calcium concentration by activation of intracellular calcium pools and forward these signals as waves which can also be transmitted into neighboring cells, P2X receptors produce calcium spikes which also include activation of voltage-operating calcium channels. P2Y and P2X receptors induce calcium transients that activate transcription factors responsible for the progress of differentiation through mediators including calmodulin and calcineurin. Expression of P2X2 as well as of P2X7 receptors increases in differentiating neurons and glial cells, respectively. Gene expression silencing assays indicate that these receptors are important for the progress of differentiation and neuronal or glial fate determination. Metabotropic receptors, mostly P2Y1 and P2Y2 subtypes, act on embryonic cells or cells at the neural progenitor stage by inducing proliferation as well as by regulation of neural differentiation through NFAT translocation. The scope of this review is to discuss the roles of purinergic receptor-induced calcium spike and wave activity and its codification in neurodevelopmental and neurodifferentiation processes.

Assessment of changes in smile after rapid maxillary expansion

INTRODUCTION: This study evaluated changes in the smile characteristics of patients with maxillary constriction submitted to rapid maxillary expansion (RME). METHODS: The sample consisted of 81 extraoral photographs of maximum smile of 27 patients with mean age of 10 years, before expansion and 3 and 6 months after fixation of the expanding screw. The photographs were analyzed on the software Cef X 2001, with achievement of the following measurements: Transverse smile area, buccal corridors, exposure of maxillary incisors, gingival exposure of maxillary incisors, smile height, upper and lower lip thickness, smile symmetry and smile arch. Statistical analysis was performed by analysis of variance (ANOVA), at a significance level of 5%. RESULTS: RME promoted statistically significant increase in the transverse smile dimension and exposure of maxillary central and lateral incisors; maintenance of right and left side smile symmetry and of the lack of parallelism between the curvature of the maxillary incisal edges and lower lip border. CONCLUSIONS: RME was beneficial for the smile esthetics with the increase of the transverse smile dimension and exposure of maxillary central and lateral incisors.

Subcutaneous Tissue Thickness is an Independent Predictor of Image Noise in Cardiac CT

Background: Few data on the definition of simple robust parameters to predict image noise in cardiac computed tomography (CT) exist. Objectives: To evaluate the value of a simple measure of subcutaneous tissue as a predictor of image noise in cardiac CT. Methods: 86 patients underwent prospective ECG-gated coronary computed tomographic angiography (CTA) and coronary calcium scoring (CAC) with 120 kV and 150 mA. The image quality was objectively measured by the image noise in the aorta in the cardiac CTA, and low noise was defined as noise < 30HU. The chest anteroposterior diameter and lateral width, the image noise in the aorta and the skin-sternum (SS) thickness were measured as predictors of cardiac CTA noise. The association of the predictors and image noise was performed by using Pearson correlation. Results: The mean radiation dose was 3.5 ± 1.5 mSv. The mean image noise in CT was 36.3 ± 8.5 HU, and the mean image noise in non-contrast scan was 17.7 ± 4.4 HU. All predictors were independently associated with cardiac CTA noise. The best predictors were SS thickness, with a correlation of 0.70 (p < 0.001), and noise in the non-contrast images, with a correlation of 0.73 (p < 0.001). When evaluating the ability to predict low image noise, the areas under the ROC curve for the non-contrast noise and for the SS thickness were 0.837 and 0.864, respectively. Conclusion: Both SS thickness and CAC noise are simple accurate predictors of cardiac CTA image noise. Those parameters can be incorporated in standard CT protocols to adequately adjust radiation exposure.

A Correlação entre diferentes temperaturas e períodos de preservação sobre as fibras colágenas de meniscos de coelhos

Objetivo: Quantificar as fibras colágenas de meniscos de coelhos submetidos à temperaturas e períodos de preservação variáveis. Métodos: Retirou-se assepticamente 120 meniscos (mediais e laterais) de 30 coelhos (Nova Zelândia), machos, idade entre 6/8 meses, peso médio de 3250g. Os meniscos foram congelados, de dois até trinta dias, a 7,2°Celsius negativos (n=60) e 73°Celsius negativos (n=60). A cada dois dias, de cada temperatura, foram descongelados quatro meniscos que foram encaminhados para o estudo histológico. A descrição morfológica foi feita com os cortes corados por HE, e para o estudo morfométrico os cortes foram corados pelo método de Picrosirius e posteriormente submetidos à polarização. A quntificação de área ocupada pelas fibras colágenas em cada lâmina foi calculada por subtração de imagens à partir do programa de software Image Pro Plus. Resultados: Na análise descritiva das médias percentuais de colágeno foram observadas diferenças maiores e estatisticamente significantes (p<0,001) à temperatura de 73ºCelsius negativos. A análise comparativa das médias percentuais de fibras colágenas ao longo dos períodos de preservação, embora com diferença de valores, apresentaram uma curva simétrica de variação. Também obervou-se que à partir do 14ºdia, em ambas temperaturas, a variação na porcentagem de fibras colágenas em relação aos demais períodos, não apresenta significância estatística, contudo a temperatura de 73ºCelsius negativos mostrou-se superior à 7,2ºCelsius negativos na preservação de fibras colágenas. A análise de regressão polinomial mostrou que a variação das médias percentuais de fibras colágenas é um polinômio de terceiro grau, sugerindo outras variáveis implicadas na preservação do colágeno. Conclusão: A temperatura de 73ºCelsius negativos mostrou médias percentuais de colágeno superiores em todos os períodos observados, porém à partir do 14º até o 30º dia de congelamento, a quantidade de fibras colágenas permanece estável em ambas temperaturas.

Biomeccanica del servizio e del diritto nel tennis: confronto fra atleti di livello di gioco differente

Il tennis è uno sport molto diffuso che negli ultimi trent’anni ha subito molti cambiamenti. Con l’avvento di nuovi materiali più leggeri e maneggevoli la velocità della palla è aumentata notevolmente, rendendo così necessario una modifica a livello tecnico dei colpi fondamentali. Dalla ricerca bibliografica sono emerse interessanti indicazioni su angoli e posizioni corporee ideali da mantenere durante le varie fasi dei colpi, confrontando i giocatori di altissimo livello. Non vi sono invece indicazioni per i maestri di tennis su quali siano i parametri più importanti da allenare a seconda del livello di gioco del proprio atleta. Lo scopo di questa tesi è quello di individuare quali siano le variabili tecniche che influenzano i colpi del diritto e del servizio confrontando atleti di genere differente, giocatori di livello di gioco diverso (esperti, intermedi, principianti) e dopo un anno di attività programmata. Confrontando giocatori adulti di genere diverso, è emerso che le principali differenze sono legate alle variabili di prestazione (velocità della palla e della racchetta) per entrambi i colpi. Questi dati sono simili a quelli riscontrati nel test del lancio della palla, un gesto non influenzato dalla tecnica del colpo. Le differenze tecniche di genere sono poco rilevanti ed attribuibili alla diversa interpretazione dei soggetti. Nel confronto di atleti di vario livello di gioco le variabili di prestazione presentano evidenti differenze, che possono essere messe in relazione con alcune differenze tecniche rilevate nei gesti specifici. Nel servizio i principianti tendono a direzionare l’arto superiore dominante verso la zona bersaglio, abducendo maggiormente la spalla ed avendo il centro della racchetta più a destra rispetto al polso. Inoltre, effettuano un caricamento minore degli arti inferiori, del tronco e del gomito. Per quanto riguarda il diritto si possono evidenziare queste differenze: l’arto superiore è sempre maggiormente esteso per il gruppo dei principianti; il tronco, nei giocatori più abili viene utilizzato in maniera più marcata, durante la fase di caricamento, in movimenti di torsione e di inclinazione laterale. Gli altri due gruppi hanno maggior difficoltà nell’eseguire queste azioni preparatorie, in particolare gli atleti principianti. Dopo un anno di attività programmata sono stati evidenziati miglioramenti prestativi. Anche dal punto di vista tecnico sono state notate delle differenze che possono spiegare il miglioramento della performance nei colpi. Nel servizio l’arto superiore si estende maggiormente per colpire la palla più in alto possibile. Nel diritto sono da sottolineare soprattutto i miglioramenti dei movimenti del tronco in torsione ed in inclinazione laterale. Quindi l’atleta si avvicina progressivamente ad un’esecuzione tecnica corretta. In conclusione, dal punto di vista tecnico non sono state rilevate grosse differenze tra i due generi che possano spiegare le differenze di performance. Perciò questa è legata più ad un fattore di forza che dovrà essere allenata con un programma specifico. Nel confronto fra i vari livelli di gioco e gli effetti di un anno di pratica si possono individuare variabili tecniche che mostrano differenze significative tra i gruppi sperimentali. Gli evoluti utilizzano tutto il corpo per effettuare dei colpi più potenti, utilizzando in maniera tecnicamente più valida gli arti inferiori, il tronco e l’arto superiore. I principianti utilizzano prevalentemente l’arto superiore con contributi meno evidenti degli altri segmenti. Dopo un anno di attività i soggetti esaminati hanno dimostrato di saper utilizzare meglio il tronco e l’arto superiore e ciò può spiegare il miglioramento della performance. Si può ipotizzare che, per il corretto utilizzo degli arti inferiori, sia necessario un tempo più lungo di apprendimento oppure un allenamento più specifico.

Sviluppo, implementazione e valutazione funzionale di un nuovo modello protesico di caviglia

Total ankle arthroplasty (TAA) is still not as satisfactory as total hip and total knee arthroplasty. For the TAA to be considered a valuable alternative to ankle arthrodesis, an effective range of ankle mobility must be recovered. The disappointing clinical results of the current generation of TAA are mostly related to poor understanding of the structures guiding ankle joint mobility. A new design (BOX Ankle) has been developed, uniquely able to restore physiologic ankle mobility and a natural relationship between the implanted components and the retained ligaments. For the first time the shapes of the tibial and talar components in the sagittal plane were designed to be compatible with the demonstrated ligament isometric rotation. This resulted in an unique motion at the replaced ankle where natural sliding as well as rolling motion occurs while at the same time full conformity is maintained between the three components throughout the flexion arc. According to prior research, the design features a spherical convex tibial component, a talar component with radius of curvature in the sagittal plane longer than that of the natural talus, and a fully conforming meniscal component. After computer-based modelling and preliminary observations in several trial implantation in specimens, 126 patients were implanted in the period July 2003 – December 2008. 75 patients with at least 6 months follow-up are here reported. Mean age was 62,6 years (range 22 – 80), mean follow-up 20,2 months. The AOFAS clinical score systems were used to assess patient outcome. Radiographs at maximal dorsiflexion and maximal plantar flexion confirmed the meniscalbearing component moves anteriorly during dorsiflexion and posteriorly during plantarflexion. Frontal and lateral radiographs in the patients, show good alignment of the components, and no signs of radiolucency or loosening. The mean AOFAS score was observed to go from 41 pre-op to 74,6 at 6 month follow-up, with further improvement at the following follow-up. These early results reveal satisfactory clinical scores, with good recovery of range of motion and reduction of pain. Radiographic assessment reveals good osteointegration. All these preliminary results confirm biomechanical studies and the validity of this novel ligamentcompatible prosthesis design. Surely it will be important to re-evaluate these patients later.

Evidenze micropaleontologiche e sedimentologiche di cicli deposizionali e climatici circa millenari nei Depositi Tardoquaternari della Piana dell'Arno e del Delta del Po

A multidisciplinary study was carried out on the Late Quaternary-Holocene subsurface deposits of two Mediterranean coastal areas: Arno coastal plain (Northern Tyrrhenian Sea) and Modern Po Delta (Northern Adriatic Sea). Detailed facies analyses, including sedimentological and micropalaeontological (benthic foraminifers and ostracods) investigations, were performed on nine continuously-cored boreholes of variable depth (ca. from 30 meters to100 meters). Six cores were located in the Arno coastal plain and three cores in the Modern Po Delta. To provide an accurate chronological framework, twenty-four organic-rich samples were collected along the fossil successions for radiocarbon dating (AMS 14C). In order to reconstruct the depositional and palaeoenvironmental evolution of the study areas, core data were combined with selected well logs, provided by local companies, along several stratigraphic sections. These sections revealed the presence of a transgressive-regressive (T-R) sequence, composing of continental, coastal and shallow-marine deposits dated to the Late Pleistocene-Holocene period, beneath the Arno coastal plain and the Modern Po Delta. Above the alluvial deposits attributed to the last glacial period, the post-glacial transgressive succession (TST) consists of back-barrier, transgressive barrier and inner shelf deposits. Peak of transgression (MFS) took place around the Late-Middle Holocene transition and was identified by subtle micropalaeontological indicators within undifferentiated fine-grained deposits. Upward a thick prograding succession (HST) records the turnaround to regressive conditions that led to a rapid delta progradation in both study areas. Particularly, the outbuilding of modern-age Po Delta coincides with mud-belt formation during the late HST (ca. 600 cal yr BP), as evidenced by a fossil microfauna similar to the foraminiferal assemblage observed in the present Northern Adriatic mud-belt. A complex interaction between allocyclic and autocyclic factors controlled facies evolution during the highstand period. The presence of local parameters and the absence of a predominant factor prevent from discerning or quantifying consequences of the complex relationships between climate and deltaic evolution. On the contrary transgressive sedimentation seems to be mainly controlled by two allocyclic key factors, sea-level rise and climate variability, that minimized the effects of local parameters on coastal palaeoenvironments. TST depositional architecture recorded in both study areas reflects a well-known millennial-scale variability of sea-level rising trend and climate during the Late glacial-Holocene period. Repeated phases of backswamp development and infilling by crevasse processes (parasequences) were recorded in the subsurface of Modern Po Delta during the early stages of transgression (ca. 11,000-9,500 cal yr BP). In the Arno coastal plain the presence of a deep-incised valley system, probably formed at OSI 3/2 transition, led to the development of a thick (ca. 35-40 m) transgressive succession composed of coastal plain, bay-head delta and estuarine deposits dated to the Last glacial-Early Holocene period. Within the transgressive valley fill sequence, high-resolution facies analyses allowed the identification and lateral tracing of three parasequences of millennial duration. The parasequences, ca. 8-12 meters thick, are bounded by flooding surfaces and show a typical internal shallowing-upward trend evidenced by subtle micropalaeontological investigations. The vertical stacking pattern of parasequences shows a close affinity with the step-like sea-level rising trend occurred between 14,000-8,000 cal years BP. Episodes of rapid sea-level rise and subsequent stillstand phases were paralleled by changes in climatic conditions, as suggested by pollen analyses performed on a core drilled in the proximal section of the Arno palaeovalley (pollen analyses performed by Dr. Marianna Ricci Lucchi). Rapid shifts to warmer climate conditions accompanied episodes of rapid sea-level rise, in contrast stillstand phases occurred during temporary colder climate conditions. For the first time the palaeoclimatic signature of high frequency depositional cycles is clearly documented. Moreover, two of the three "regressive" pulsations, recorded at the top of parasequences by episodes of partial estuary infilling in the proximal and central portions of Arno palaeovalley, may be correlated with the most important cold events of the post-glacial period: Younger Dryas and 8,200 cal yr BP event. The stratigraphic and palaeoclimatic data of Arno coastal plain and Po Delta were compared with those reported for the most important deltaic and coastal systems in the worldwide literature. The depositional architecture of transgressive successions reflects the strong influence of millennial-scale eustatic and climatic variability on worldwide coastal sedimentation during the Late glacial-Holocene period (ca. 14,000-7,000 cal yr BP). The most complete and accurate record of high-frequency eustatic and climatic events are usually found within the transgressive succession of very high accommodation settings, such as incised-valley systems where exceptionally thick packages of Late glacial-Early Holocene deposits are preserved.