Morphology and innervation of brachioradialis and flexor carpi radialis and their utility in tendon transfer surgeries: A Cadaveric Study

INTRODUCTION

The Brachioradialis (BR) muscle flap is easy to harvest, provides a stable coverage to the cubital fossa as it is well vascularized. The BR andflexor carpi radialis (FCR) tendons are utilized in tendon transfer to restore the normal hand function. Therefore, the present study describes the morphology of the muscle bellies and the tendons of BR and FCR along with their pattern of innervation.

MATERIALS AND METHODS

The study was carried out on 27 upper limbs of formalin-fixed, adult human cadavers. Length and width of the bellies of BR and FCR were measured. The number of motor branches and their distances from the bi-epicondylar line was measured.

RESULTS

The mean lengths of BR and FCR bellies were 21.22±2.18cm and 16.15±2.39cm, and the lengths of their tendons were, 12.67±1.13cm and 12.48±1.72cm respectively. BR received a single motor branch in 19 upper limbs. However, FCR received single motor branch in 25 limbs as a common trunk. One upper limb received three motor branches to BR, and two upper limbs received two motor branches to FCR. The most proximal and distal branches to the BR were ranged between 6.3-2.2cm proximal to the bi-epicondylar line. Those to the FCR were ranged between 3.5-6.9cm distal to the bi-epicondylar line.

CONCLUSION

The motor branches to the BR and FCR are variable in their origin, and the knowledge of such variations is essential for identifying them while performing selective neurotomy surgeries.

Identification of myocardial diffuse fibrosis by 11 heartbeat MOLLI T 1 mapping: averaging to improve precision and correlation with collagen volume fraction

OBJECTIVES

Our objectives involved identifying whether repeated averaging in basal and mid left ventricular myocardial levels improves precision and correlation with collagen volume fraction for 11 heartbeat MOLLI T 1 mapping versus assessment at a single ventricular level.

MATERIALS AND METHODS

For assessment of T 1 mapping precision, a cohort of 15 healthy volunteers underwent two CMR scans on separate days using an 11 heartbeat MOLLI with a 5(3)3 beat scheme to measure native T 1 and a 4(1)3(1)2 beat post-contrast scheme to measure post-contrast T 1, allowing calculation of partition coefficient and ECV. To assess correlation of T 1 mapping with collagen volume fraction, a separate cohort of ten aortic stenosis patients scheduled to undergo surgery underwent one CMR scan with this 11 heartbeat MOLLI scheme, followed by intraoperative tru-cut myocardial biopsy. Six models of myocardial diffuse fibrosis assessment were established with incremental inclusion of imaging by averaging of the basal and mid-myocardial left ventricular levels, and each model was assessed for precision and correlation with collagen volume fraction.

RESULTS

A model using 11 heart beat MOLLI imaging of two basal and two mid ventricular level averaged T 1 maps provided improved precision (Intraclass correlation 0.93 vs 0.84) and correlation with histology (R 2 = 0.83 vs 0.36) for diffuse fibrosis compared to a single mid-ventricular level alone. ECV was more precise and correlated better than native T 1 mapping.

CONCLUSION

T 1 mapping sequences with repeated averaging could be considered for applications of 11 heartbeat MOLLI, especially when small changes in native T 1/ECV might affect clinical management.

Femoral Neck Anteversion and Neck Shaft Angles: Determination and their Clinical Implications in Fetuses of Different Gestational Ages

Precise anatomical assessment of femoral neck anteversion (FNA) and the neck shaft angles (NSA) would be essential in diagnosing the pathological conditions involving hip joint and its ligaments. The present study was undertaken on 48 fetal femurs to calculate the NSA and FNA in fetuses digitally. End on images of upper end of the femurs were taken for the estimation of FNA and a photograph in a perpendicular plane was taken to calculate the NSA. Microsoft Paint software was used to mark the points and Image J software was used to calculate the angles digitally. The FNA ranged from 17.08º to 33.97 º on right and 17.32 º to 45.08 º on left. The NSA ranged from 139.33 º to 124.91 º on right and 143.98 º to 123.8 º on left. Unpaired t test showed the FNA and NSA of femur did not vary significantly during the third trimester.

In situ atomic force microscopy tip-induced deformations and Raman spectroscopy characterization of single-wall carbon nanotubes

In this work, an atomic force microscope (AFM) is combined with a confocal Raman spectroscopy setup to follow in situ the evolution of the G-band feature of isolated single-wall carbon nanotubes (SWNTs) under transverse deformation. The SWNTs are pressed by a gold AFM tip against the substrate where they are sitting. From eight deformed SWNTs, five exhibit an overall decrease in the Raman signal intensity, while three exhibit vibrational changes related to the circumferential symmetry breaking. Our results reveal chirality dependent effects, which are averaged out in SWNT bundle measurements, including a previously elusive mode symmetry breaking that is here explored using molecular dynamics calculations.

Long-term monitoring and proposed diffuse pollution control of a tropical reservoir

This paper presents the results of 30 years of water quality monitoring in a tropical water supply reservoir (Vargem das Flores, Brazil). This water body is subjected to eutrophication problems caused by point sources (discharge of untreated sewage) and diffuse pollution (agricultural use in the drainage basin). Emphasis is given here on the estimation of nutrient loads and on the study of the N/P ratio in the water body. In spite of the prevalence of high N/P values, there is a clear trend in the dominance of cyanobacteria in the phytoplankton, which contradicts results from research in temperate aquatic environments. Some restoration measures for Vargem das Flores Reservoir are currently being implemented: construction of wastewater treatment plants, control of recreational activities, erosion control by hydroseeding and use of natural wetlands. Finally some management strategies in order to prevent algae input in the water abstraction system are discussed. Examples of these techniques are the installation of plastic barriers and the construction of an air curtain device.

Digital image processing measurement of the upper eyelid contour in Graves disease and congenital blepharoptosis

OBJECTIVE

This study used image processing techniques to quantify the upper eyelid contour of patients with Graves upper eyelid retraction and congenital blepharoptosis.

DESIGN

The study design was a cross-sectional study.

PARTICIPANTS

A total of 29 patients with Graves disease, 22 patients with congenital blepharoptosis, and 50 patients with no history of eye disease participated.

INTERVENTION

The images of the palpebral fissure of all participants were transferred to a personal computer and processed with NIH Image 1.55 software.

MAIN OUTCOME MEASURES

The following parameters were analyzed: the curvature of the upper eyelid contour, the position of the contour peak relative to the midline, and the ratio between the temporal and nasal upper quadrant areas of the palpebral fissure.

RESULTS

All upper eyelid contours could be fitted with second-degree polynomial functions. The mean temporal/nasal area ratio was 1.33 mm in patients with Graves disease, 0.92 mm in patients with blepharoptosis, and 1.04 mm in control subjects. The peak of the upper eyelid contour was found to be lateral to the midline in control subjects (1.05 mm) and in patients with Graves disease (2.09 mm). In patients with blepharoptosis, the peak was 0.69 mm medial to the midline. Overall, the distance between the midpupil and the upper eyelid margin was correlated with several factors: the degree of curvature, the position of the peak of the eyelid contour, and the temporal/nasal area ratio.

CONCLUSIONS

In Graves eyelid retraction, the curvature of the upper eyelid is enhanced, the peak of the contour is displaced laterally, and the temporal upper quadrant area is increased. Conversely, in congenital blepharoptosis, the eyelid is almost flat, the peak of the contour is displaced medially, and the upper quadrant area is diminished. The lateral segment of the upper eyelid is more involved than the nasal segment in both Graves upper eyelid retraction and congenital blepharoptosis.