-
Frontiers in Neuroanatomy 2022Most of the studies on neurochemical mapping, connectivity, and physiology in the hypothalamic region were carried out in rats and under the columnar morphologic...
Most of the studies on neurochemical mapping, connectivity, and physiology in the hypothalamic region were carried out in rats and under the columnar morphologic paradigm. According to the columnar model, the entire hypothalamic region lies ventrally within the diencephalon, which includes preoptic, anterior, tuberal, and mamillary anteroposterior regions, and sometimes identifying dorsal, intermediate, and ventral hypothalamic partitions. This model is weak in providing little or no experimentally corroborated causal explanation of such subdivisions. In contrast, the modern prosomeric model uses different axial assumptions based on the parallel courses of the brain floor, alar-basal boundary, and brain roof (all causally explained). This model also postulates that the hypothalamus and telencephalon jointly form the secondary prosencephalon, separately from and rostral to the diencephalon proper. The hypothalamus is divided into two neuromeric (transverse) parts called peduncular and terminal hypothalamus (PHy and THy). The classic anteroposterior (AP) divisions of the columnar hypothalamus are rather seen as dorsoventral subdivisions of the hypothalamic alar and basal plates. In this study, we offered a prosomeric immunohistochemical mapping in the rat of hypothalamic cells expressing tyrosine hydroxylase (TH), which is the enzyme that catalyzes the conversion of L-tyrosine to levodopa (L-DOPA) and a precursor of dopamine. This mapping was also combined with markers for diverse hypothalamic nuclei [agouti-related peptide (), arginine vasopressin (), cocaine and amphetamine-regulated transcript (), corticotropin releasing Hormone (), melanin concentrating hormone (), neuropeptide Y (), oxytocin/neurophysin I (), proopiomelanocortin (), somatostatin (), tyrosine hidroxilase (), and thyrotropin releasing hormone ()]. TH-positive cells are particularly abundant within the periventricular stratum of the paraventricular and subparaventricular alar domains. In the tuberal region, most labeled cells are found in the acroterminal arcuate nucleus and in the terminal periventricular stratum. The dorsal retrotuberal region (PHy) contains the A13 cell group of TH-positive cells. In addition, some TH cells appear in the perimamillary and retromamillary regions. The prosomeric model proved useful for determining the precise location of TH-positive cells relative to possible origins of morphogenetic signals, thus aiding potential causal explanation of position-related specification of this hypothalamic cell type.
PubMed: 35601999
DOI: 10.3389/fnana.2022.868345 -
Hernia : the Journal of Hernias and... Dec 2022Laparoscopic techniques have been used and refined in hernia surgery for several years. The aim of this study was to compare an established method such as laparoscopic...
A propensity-score matched analysis of ventral-TAPP vs. laparoscopic IPOM for small and mid-sized ventral hernias. Comparison of perioperative data, surgical outcome and cost-effectiveness.
PURPOSE
Laparoscopic techniques have been used and refined in hernia surgery for several years. The aim of this study was to compare an established method such as laparoscopic intra-peritoneal onlay mesh repair (lap. IPOM) with ventral Transabdominal Preperitoneal Patch Plasty (ventral-TAPP) in abdominal wall hernia repair.
METHODS
Patient-related data of 180 laparoscopic ventral hernia repairs between June 2014 and August 2020 were extracted from our prospectively maintained database. Of these patients, 34 underwent ventral-TAPP and 146 lap. IPOM. After excluding hernias with a defect size > 5 cm and obtaining balanced groups with propensity-score matching, a comparative analysis was performed in terms perioperative data, surgical outcomes and cost-effectiveness.
RESULTS
Propensity-score matching suggested 27 patients in each of the two cohorts. The statistical evaluation showed that intake of opiates was significantly higher in the lap. IPOM group compared to ventral-TAPP patients (p = 0.001). The Visual Analogue Scale (VAS) score after lap. IPOM repair was significantly higher at movement (p = 0.008) and at rest (p = 0.023). Also, maximum subjective pain during hospital stay was significantly higher in the lap. IPOM group compared to ventral-TAPP patients (p = 0.004). No hernia recurrence was detected in either group. The material costs of ventral-TAPP procedure (34.37 ± 0.47 €) were significantly lower than those of the lap. IPOM group (742.57 ± 128.44 € p = 0.001). The mean operation time was 65.19 ± 26.43 min in the lap. IPOM group and 58.65 ± 18.43 min in the ventral-TAPP cohort. Additionally, the length of hospital stay in the lap. IPOM cohort was significantly longer (p = 0.043).
CONCLUSION
Ventral-TAPP procedures represent an alternative technique to lap. IPOM repair to reduce the risk of complications related to intra-peritoneal position of mesh and fixating devices. In addition, our study showed that postoperative pain level, material costs and hospital stay of the ventral-TAPP cohort are significantly lower compared to lap. IPOM patients.
Topics: Humans; Herniorrhaphy; Surgical Mesh; Cost-Benefit Analysis; Hernia, Ventral; Laparoscopy; Treatment Outcome
PubMed: 35320438
DOI: 10.1007/s10029-022-02586-x -
Frontiers in Neuroanatomy 2020The Subthalamic Nucleus (STh) is an oval-shaped diencephalic structure located ventrally to the thalamus, playing a fundamental role in the circuitry of the basal... (Review)
Review
The Subthalamic Nucleus (STh) is an oval-shaped diencephalic structure located ventrally to the thalamus, playing a fundamental role in the circuitry of the basal ganglia. In addition to being involved in the pathophysiology of several neurodegenerative disorders, such as Huntington's and Parkinson's disease, the STh is one of the target nuclei for deep brain stimulation. However, most of the anatomical evidence available derives from non-human primate studies. In this review, we will present the topographical and morphological organization of the nucleus and its connections to structurally and functionally related regions of the basal ganglia circuitry. We will also highlight the importance of additional research in humans focused on validating STh connectivity, cytoarchitectural organization, and its functional subdivision.
PubMed: 32390807
DOI: 10.3389/fnana.2020.00013 -
Cells Jan 2022The ventricular-subventricular zone (V-SVZ) is a postnatal germinal niche. It holds a large population of neural stem cells (NSCs) that generate neurons and...
The ventricular-subventricular zone (V-SVZ) is a postnatal germinal niche. It holds a large population of neural stem cells (NSCs) that generate neurons and oligodendrocytes for the olfactory bulb and (primarily) the corpus callosum, respectively. These NSCs are heterogeneous and generate different types of neurons depending on their location. Positional identity among NSCs is thought to be controlled in part by intrinsic pathways. However, extrinsic cell signaling through the secreted ligand Sonic hedgehog (Shh) is essential for neurogenesis in both the dorsal and ventral V-SVZ. Here we used a genetic approach to investigate the role of the transcription factors GLI2 and GLI3 in the proliferation and cell fate of dorsal and ventral V-SVZ NSCs. We find that while GLI3 is expressed in stem cell cultures from both dorsal and ventral V-SVZ, the repressor form of GLI3 is more abundant in dorsal V-SVZ. Despite this high dorsal expression and the requirement for other Shh pathway members, GLI3 loss affects the generation of ventrally-, but not dorsally-derived olfactory interneurons in vivo and does not affect trilineage differentiation in vitro. However, loss of GLI3 in the adult dorsal V-SVZ in vivo results in decreased numbers of OLIG2-expressing progeny, indicating a role in gliogenesis.
Topics: Adult Stem Cells; Animals; Cell Differentiation; Cells, Cultured; Interneurons; Lateral Ventricles; Mice; Nerve Tissue Proteins; Neural Stem Cells; Oligodendrocyte Transcription Factor 2; Smoothened Receptor; Zinc Finger Protein Gli3
PubMed: 35053334
DOI: 10.3390/cells11020218 -
The Journal of Neuroscience : the... Feb 2021Mossy cells (MCs) of the dentate gyrus (DG) are a major group of excitatory hilar neurons that are important for regulating activity of dentate granule cells. MCs are...
Mossy cells (MCs) of the dentate gyrus (DG) are a major group of excitatory hilar neurons that are important for regulating activity of dentate granule cells. MCs are particularly intriguing because of their extensive longitudinal connections within the DG. It has generally been assumed that MCs in the dorsal and ventral DG have similar patterns of termination in the inner one-third of the dentate molecular layer. Here, we demonstrate that axonal projections of MCs in these two regions are considerably different. MCs in dorsal and ventral regions were labeled selectively with Cre-dependent eYFP or mCherry, using two transgenic mouse lines (including both sexes) that express Cre-recombinase in MCs. At four to six weeks following unilateral labeling of MCs in the ventral DG, a dense band of fibers was present in the inner one-fourth of the molecular layer and extended bilaterally throughout the rostral-caudal extent of the DG, replicating the expected distribution of MC axons. In contrast, following labeling of MCs in the dorsal DG, the projections were more diffusely distributed. At the level of transfection, fibers were present in the inner molecular layer, but they progressively expanded into the middle molecular layer and, most ventrally, formed a distinct band in this region. Optical stimulation of these caudal fibers expressing ChR2 demonstrated robust EPSCs in ipsilateral granule cells and enhanced the effects of perforant path stimulation in the ventral DG. These findings suggest that MCs in the dorsal and ventral DG differ in the distribution of their axonal projections and possibly their function. Mossy cells (MCs), a major cell type in the hilus of the dentate gyrus (DG), are unique in providing extensive longitudinal and commissural projections throughout the DG. Although it has been assumed that all MCs have similar patterns of termination in the inner molecular layer of the DG, we discovered that the axonal projections of dorsal and ventral MCs differ. While ventral MC projections exhibit the classical pattern, with dense innervation in the inner molecular layer, dorsal MCs have a more diffuse distribution and expand into the middle molecular layer where they overlap and interact with innervation from the perforant path. These distinct locations and patterns of axonal projections suggest that dorsal and ventral MCs may have different functional roles.
Topics: Animals; Axons; Dentate Gyrus; Excitatory Postsynaptic Potentials; Female; Male; Mice; Mice, Inbred C57BL; Mice, Transgenic; Mossy Fibers, Hippocampal; Optogenetics
PubMed: 33268544
DOI: 10.1523/JNEUROSCI.2455-20.2020 -
International Wound Journal May 2023Repair of large midline ventral hernias still represents a challenge for general surgeons. As obesity is a key factor of this type of hernias, usually the patients are...
Repair of large midline ventral hernias still represents a challenge for general surgeons. As obesity is a key factor of this type of hernias, usually the patients are presented with abdominal wall laxity, excess skin and subcutaneous fat. Combined procedures has evolved over the last six decades to repair the hernias and to improve the shape of the abdomen, but was associated with high rate of wound complications. The components separation technique for ventral hernia repair was introduced in 1990 by Ramirez et al to avoid mesh repair was associated with a high rate of success. Until recently, the convenience of simultaneously performing ventral hernia repair and abdominal contouring surgery remains controversial. The aim of this study is to present our experience in the integration of the anterior component separation technique for repair of midline wide ventral defects, with the lipoabdominoplasty in selected patients with high body mass index, to achieve a functional abdominal wall repair and to provide a better aesthetic outcome. In this prospective case-control study, 15 adult female multiparous women, all were overweight and obese, presented with midline ventral hernias and abdominal deformity was operated upon where a comprehensive technique in the form of herniorapphy, anterior component separation technique and lipoabdominoplasty were performed. The patients were followed up for 3-6 months period to monitor incidence of complications, hernia recurrence and to assess the aesthetic outcome. All the 15 patients were overweight and obese with BMI ranged between 26.5 and 39.6 kg/m . The mean operative time was 184 ± 28.8 minutes (range 150-240 minutes). The mean postoperative length of hospital stay was 3 days ranging from 1 to 5 days. In addition to the hernia, all the patients suffered from diastasis of recti ranged from 9 to 15 cm in the transverse dimension. No mortality or major complications encountered, no hernia recurrence, only minor complications occurred in four patients (26.8%). Two patients developed seroma which resolved by aspiration, one patient suffered wound infection with partial loss of the umbilicus and one developed superficial skin necrosis at the central area of the flaps which healed uneventfully by secondary intention. All the patients were satisfied with the cosmetic outcome. In conclusion, this comprehensive approach is effective technique for reconstruction of large midline ventral defects and provide a good aesthetic appearance of the anterior and lateral abdomen in appropriately selected obese patients.
Topics: Adult; Humans; Female; Hernia, Ventral; Abdominal Muscles; Herniorrhaphy; Overweight; Case-Control Studies; Abdominoplasty; Obesity
PubMed: 36695339
DOI: 10.1111/iwj.14011 -
Laparoscopic ventral hernia repair in patients with obesity: should we be scared of body mass index?Surgical Endoscopy Mar 2022Obesity is a risk factor for ventral hernia development and affects up to 60% of patients undergoing ventral hernia repair. It is also associated with a higher rate of...
BACKGROUND
Obesity is a risk factor for ventral hernia development and affects up to 60% of patients undergoing ventral hernia repair. It is also associated with a higher rate of surgical site occurrences and an increased risk of recurrence after ventral hernia repair, but data is lacking on the differences between obesity classes.
METHODS
Between 2008 and 2018, 322 patients with obesity underwent laparoscopic ventral hernia repair in our department: class I n = 231 (72%), II n = 55 (17%), III n = 36 (11%). We compared short and long-term outcomes between the three classes.
RESULTS
Patients with class III obesity had a longer median length of hospital stay compared to I and II (5 days versus 4 days in the other groups, p = 0.0006), but without differences in postoperative complications or surgical site occurrences. After a median follow up of 49 months, there were no significant differences in the incidence of seroma, recurrence, chronic pain, pseudorecurrence and port-site hernia. At multivariate analysis, risk factors for recurrence were presence of a lateral defect and previous hernia repair; risk factors for seroma were immunosuppression, defect > 15 cm and more than one previous hernia repair; the only risk factor for postoperative complications was chronic obstructive pulmonary disease.
CONCLUSION
Class III obesity is associated with longer length of hospital stay after laparoscopic ventral hernia repair, but without differences in postoperative complications and long-term outcomes compared with class I and class II obesity.
Topics: Body Mass Index; Hernia, Ventral; Herniorrhaphy; Humans; Laparoscopy; Obesity; Postoperative Complications; Recurrence; Retrospective Studies; Surgical Mesh
PubMed: 33948716
DOI: 10.1007/s00464-021-08489-9 -
Hong Kong Medical Journal = Xianggang... Feb 2019
Topics: Aged; Hernia, Ventral; Humans; Lumbosacral Region; Male; Tomography, X-Ray Computed
PubMed: 30713147
DOI: 10.12809/hkmj187410 -
The Journal of Physiology Feb 2023Few studies in amyotrophic lateral sclerosis (ALS) measure effects of the disease on inhibitory interneurons synapsing onto motoneurons (MNs). However, inhibitory...
Few studies in amyotrophic lateral sclerosis (ALS) measure effects of the disease on inhibitory interneurons synapsing onto motoneurons (MNs). However, inhibitory interneurons could contribute to dysfunction, particularly if altered before MN neuropathology, and establish a long-term imbalance of inhibition/excitation. We directly assessed excitability and morphology of glycinergic (GlyT2 expressing) ventral lumbar interneurons from SOD1G93AGlyT2eGFP (SOD1) and wild-type GlyT2eGFP (WT) mice on postnatal days 6-10. Patch clamp revealed dampened excitability in SOD1 interneurons, including depolarized persistent inward currents (PICs), increased voltage and current threshold for firing action potentials, along with a marginal decrease in afterhyperpolarization duration. Primary neurites of ventral SOD1 inhibitory interneurons were larger in volume and surface area than WT. GlyT2 interneurons were then divided into three subgroups based on location: (1) interneurons within 100 μm of the ventral white matter, where Renshaw cells (RCs) are located, (2) interneurons interspersed with MNs in lamina IX, and (3) interneurons in the intermediate ventral area including laminae VII and VIII. Ventral interneurons in the RC area were the most profoundly affected, exhibiting more depolarized PICs and larger primary neurites. Interneurons in lamina IX had depolarized PIC onset. In lamina VII-VIII, interneurons were least affected. In summary, inhibitory interneurons show very early region-specific perturbations poised to impact excitatory/inhibitory balance of MNs, modify motor output and provide early biomarkers of ALS. Therapeutics like riluzole that universally reduce CNS excitability could exacerbate the inhibitory dysfunction described here. KEY POINTS: Spinal inhibitory interneurons could contribute to amyotrophic lateral sclerosis (ALS) pathology, but their excitability has never been directly measured. We studied the excitability and morphology of glycinergic interneurons in early postnatal transgenic mice (SOD1 GlyT2eGFP). Interneurons were less excitable and had marginally smaller somas but larger primary neurites in SOD1 mice. GlyT2 interneurons were analysed according to their localization within the ventral spinal cord. Interestingly, the greatest differences were observed in the most ventrally located interneurons. We conclude that inhibitory interneurons show presymptomatic changes that may contribute to excitatory/inhibitory imbalance in ALS.
Topics: Mice; Animals; Amyotrophic Lateral Sclerosis; Superoxide Dismutase-1; Motor Neurons; Spinal Cord; Mice, Transgenic; Interneurons; Disease Models, Animal; Superoxide Dismutase
PubMed: 36515374
DOI: 10.1113/JP284192 -
Diagnostics (Basel, Switzerland) Mar 2022Fetal hypospadias should be consider in a male fetus with a shortened penis, blunt bulbous tips, ventrally curved shaft with or without chordee and a typical fan shape...
Fetal hypospadias should be consider in a male fetus with a shortened penis, blunt bulbous tips, ventrally curved shaft with or without chordee and a typical fan shape stream of urinary jet under color Doppler under prenatal ultrasound examination. The more severe form is usually accompanied by other congenital abnormalities.
PubMed: 35453822
DOI: 10.3390/diagnostics12040774