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Seminars in Nuclear Medicine Jun 2024Recent advancements in PET technology have culminated in the development of total-body PET (TB-PET) systems, which overcome many limitations of traditional scanners.... (Review)
Review
Recent advancements in PET technology have culminated in the development of total-body PET (TB-PET) systems, which overcome many limitations of traditional scanners. These TB-PET scanners, while still becoming widely available, represent the forefront of clinical imaging across numerous medical institutions worldwide. Early clinical applications have demonstrated their enhanced image quality, precise lesion quantification, and overall superior performance relative to conventional scanners. The capabilities of TB-PET technology, including extended scan range, ultrahigh sensitivity, exceptional temporal resolution, and dynamic imaging, offer significant potential to tackle unresolved clinical challenges in medical imaging. In this discussion, we aim to explore the emerging applications, opportunities, and future perspectives of TB-PET/CT in musculoskeletal disorders (MSDs). Clinical applications for both oncologic and non-oncologic musculoskeletal diseases are discussed, including inflammatory arthritis, infections, osteoarthritis, osteoporosis, and skeletal muscle disorders. From the ability to visualize small musculoskeletal structures and the entire axial and appendicular skeleton, TB-PET shows significant potential in the diagnosis and management of MSD conditions as it becomes more widely available.
PubMed: 38944556
DOI: 10.1053/j.semnuclmed.2024.05.009 -
Acta Medica Philippina 2024Atypical cartilaginous tumor (ACT) refers to a low-grade cartilaginous neoplasm microscopically identical to grade 1 chondrosarcoma, affecting the appendicular skeleton....
Incidental Finding of an Atypical Cartilaginous Tumor in an Adult Female with Recurrent Patellar Dislocation: Single-stage Extended Curettage using Freezing Nitrogen Ethanol Composite followed by Medial Patello-Femoral Ligament Reconstruction.
Atypical cartilaginous tumor (ACT) refers to a low-grade cartilaginous neoplasm microscopically identical to grade 1 chondrosarcoma, affecting the appendicular skeleton. Treatment with intralesional curettage has been found to provide sufficient local control with less morbidity compared to wide resection. This is the first reported case of a simultaneous medial patello-femoral ligament (MPFL) reconstruction with extended curettage for ACT on the ipsilateral femur. A 45-year-old female presented with chronic recurrent patellar dislocation of the right knee. Magnetic resonance imaging revealed a tear of the MPFL, with an incidental epi-metaphyseal chondroid lesion. After biopsy confirmed an ACT, single-stage extended curettage using freezing nitrogen ethanol composite (FNEC) and MPFL reconstruction was performed, followed by augmentation with bone cement and a distal femoral plate. Currently, the patient is independently ambulatory, with full range of motion about the knee. Following histologic confirmation of an ACT in the setting of a concurrent MCL tear, a single-stage procedure to address both conditions is a viable option that can reduce complications associated with multiple surgeries. Extended curettage using FNEC has been shown to produce good short-term oncologic outcomes while maximizing function.
PubMed: 38939422
DOI: 10.47895/amp.vi0.7675 -
Journal of Visualized Experiments : JoVE May 2024Bone marrow mesenchymal stem cells (BMMSCs) are a type of stem cell with multi-directional differentiation potential. Compared with BMMSCs derived from appendicular...
Bone marrow mesenchymal stem cells (BMMSCs) are a type of stem cell with multi-directional differentiation potential. Compared with BMMSCs derived from appendicular bones, BMMSCs derived from the jaw have greater proliferative and osteogenic differentiation ability, gradually becoming important seed cells for jaw defect repair. However, the mandible has a complex bony structure and less cancellous content than appendicular bones. It is difficult to acquire a large number of high-quality jaw-derived marrow mesenchymal stem cells using traditional methods. This study presents a 'niche-based approach on stemness' for isolating and culturing rat jaw bone marrow mesenchymal stem cells (JBMMSCs). Primary rat JBMMSCs were isolated and cultured using the whole bone marrow adherent method combined with the bone slice digestion method. The isolated cells were identified as JBMMSCs through cell morphology observation, detection of cell surface markers, and multi-directional differentiation induction. The cells extracted by this method exhibit a 'fibroblast-like' spindle shape. The cells are long, spindle-shaped and fibroblast-like. The flow cytometry analysis shows these cells are positive for CD29, CD44, and CD90 but negative for CD11b/c, CD34, and CD45, which is congruent with BMMSCs characteristics. The cells show strong proliferation capacity and can undergo osteogenic, adipogenic, and chondrogenic differentiation. This study provides an effective and stable method for obtaining enough high-quality JBMMSCs with strong differentiation ability in a short time, which could facilitate further studies of the exploration of biological function, regenerative medicine, and related clinical applications.
Topics: Animals; Mesenchymal Stem Cells; Rats; Bone Marrow Cells; Cell Culture Techniques; Cell Differentiation; Jaw; Cytological Techniques
PubMed: 38884476
DOI: 10.3791/66765 -
Anatomical Record (Hoboken, N.J. : 2007) Jun 2024The morphological evolution of the appendicular skeleton may reflect the selective pressures specific to different environments, phylogenetic inheritance, or allometry....
The morphological evolution of the appendicular skeleton may reflect the selective pressures specific to different environments, phylogenetic inheritance, or allometry. Covariation in bone shapes enhances morphological integration in response to ecological specializations. In contrast to previous multivariate studies using classical linear morphometry, we use a geometric morphometric approach to explore the morphological diversity of long bones and examine relationships between ecological categories and morphological characters in a species-rich and ecomorphologically diverse group of rodents. We examined the humerus, ulna, femur, and tibiofibula of 19 sigmodontine species with different locomotor types (ambulatory, quadrupedal-saltatorial, natatorial, semifossorial and scansorial) to investigate the influence of locomotor type and phylogeny on limb bone shape and morphological integration of the appendicular skeleton. This study represents the most detailed examination of the morphological diversity of long bones in sigmodontines, employing geometric morphometrics within an ecomorphological framework. Our results indicate that functional demands and evolutionary history jointly influence the shape of forelimb and hindlimb bones. The main variation in bone shape is associated with a slenderness-robustness gradient observed across all ecological categories. Quadrupedal-saltatorial species, with their need for agility, possess slender and elongated limbs, while natatorial and semifossorial species exhibit shorter and more robust bone shapes, suited for their respective environments. This gradient also influences bone covariation within limbs, demonstrating interconnectedness between elements. We found functional covariation between the ulna-tibiofibula and humerus-tibiofibula, likely important for propulsion, and anatomical covariation between the humerus-ulna and femur-tibiofibula, potentially reflecting overall limb structure. This study demonstrates that the versatile morphology of long bones in sigmodontines plays a critical role in their remarkable ecological and phylogenetic diversification.
PubMed: 38877810
DOI: 10.1002/ar.25521 -
Journal of Hand and Microsurgery Mar 2024The limb-preserving excision is the standard of care in upper limb sarcoma management, but the resulting complex composite defects are exacting the expertise of the...
INTRODUCTION
The limb-preserving excision is the standard of care in upper limb sarcoma management, but the resulting complex composite defects are exacting the expertise of the reconstructive surgeons. This study was done to evaluate a novel single-stage reconstruction of these defects using an innate chimeric-free fibula flap (a nonfabricated, anatomically available multiple tissue components harvested on independent perforators arising from the same peroneal source vessel).
PATIENTS AND METHODS
Twenty patients (16 male/4 female) with an average age of 29.5 years with upper extremity sarcoma (Enneking IIA/IIB) were treated by wide local excision and innate chimeric-free fibula flap reconstruction from March 2012 to March 2020. All the patients were followed for an average period of 18.3 months. At the end of the follow-up, the outcome was assessed by musculoskeletal tumor score (MSTS).
RESULTS
The flow-through flap was done in five patients. Muscle-tendon unit defects were reconstructed with a vascularized peroneus longus muscle-tendon unit in 15 patients. Nerve gap reconstruction using vascularized superficial peroneal nerve was done in eight patients. All patients had a segmental defect in the appendicular skeleton that was reconstructed with the vascularized fibular strut component. Soleus chimeric muscle component was used as a void filler and for covering the hardware in seven patients. The average size of the chimeric cutaneous component paddle was 30.7 cm. The average length of fibula used for reconstruction was 16.6 cm. All flaps survived well, facilitating good hand function at the end of the follow-up. The average outcome score as per the MSTS was 22 ( = 0.035).
CONCLUSION
The innate chimeric-free fibula flap provides all tissue components facilitating a good functional outcome. The advantage is the restoration of a functional hand in a single-stage reconstruction.
PubMed: 38854364
DOI: 10.1055/s-0042-1751278 -
Journal of Morphology Jun 2024Leptocharias smithii has been poorly explored in anatomical terms. This species bears a mosaic of morphological characters and is considered to represent an intermediate... (Comparative Study)
Comparative Study
Leptocharias smithii has been poorly explored in anatomical terms. This species bears a mosaic of morphological characters and is considered to represent an intermediate condition between other carcharhiniform clades. In the present paper, the anatomy of the appendicular skeleton of the species is thoroughly investigated and compared with other representatives of the order Carcharhiniformes. Leptocharias bears exclusive characteristics, such as the visible separation of the pro- and mesopterygia but it also has an aplesodic pectoral fin, a condition shared with carcharhiniforms placed at the base of the phylogenetic tree and at the same time a chevron-shaped coracoid bar, a condition characteristic of charcharhiniforms placed at the apex of the phylogenetic tree. Additionally, in an attempt to understand the evolution of its appendicular skeleton and of other carcharhiniforms, 20 characters of the paired fins and girdles are explored and discussed in light of two recent phylogenetic hypotheses. Most of these characters were not previously explored and support not only the monophyly of Carcharhiniformes, such as the mesopterygium overlapping the metapterygium in ventral view, but also the monophyly of the less inclusive clade Hemigaleidae + (Galeocerdonidae + (Carcharhinidae+Sphyrnidae)), such as the morphology and arrangement of the distal radials, which are pointed and spaced.
Topics: Animals; Sharks; Phylogeny; Animal Fins; Male; Female; Biological Evolution
PubMed: 38850202
DOI: 10.1002/jmor.21744 -
Journal of Human Evolution Jul 2024An ape partial postcranial skeleton (KNM-NP 64631) was recovered during the 2015-2021 field seasons at Napudet, a Middle Miocene (∼13 Ma) locality in northern Kenya....
An ape partial postcranial skeleton (KNM-NP 64631) was recovered during the 2015-2021 field seasons at Napudet, a Middle Miocene (∼13 Ma) locality in northern Kenya. Bony elements representing the shoulder, elbow, hip, and ankle joints, thoracic and lumbar vertebral column, and hands and feet, offer valuable new information about the body plan and positional behaviors of Middle Miocene apes. Body mass estimates from femoral head dimensions suggest that the KNM-NP 64631 individual was smaller-bodied (c. 13-17 kg) than some Miocene taxa from eastern Africa, including Ekembo nyanzae, and probably Equatorius africanus or Kenyapithecus wickeri, and was more comparable to smaller-bodied male Nacholapithecus kerioi individuals. Similar to many Miocene apes, the KNM-NP 64631 individual had hip and hallucal tarsometatarsal joints reflecting habitual hindlimb loading in a variety of postures, a distal tibia with a large medial malleolus, an inflated humeral capitulum, probably a long lumbar spine, and a long pollical proximal phalanx relative to femoral head dimensions. The KNM-NP 64631 individual departs from most Early Miocene apes in its possession of a more steeply beveled radial head and deeper humeral zona conoidea, reflecting enhanced supinating-pronating abilities at the humeroradial joint. The KNM-NP 64631 individual also differs from Early Miocene Ekembo heseloni in having a larger elbow joint (inferred from radial head size) relative to the mediolateral width of the lumbar vertebral bodies and a more asymmetrical talar trochlea, and in these ways recalls inferred joint proportions for, and talocrural morphology of, N. kerioi. Compared to most Early Miocene apes, the KNM-NP 64631 individual likely relied on more forelimb-dominated arboreal behaviors, perhaps including vertical climbing (e.g., extended elbow, hoisting). Moreover, the Napudet ape partial postcranial skeleton suggests that an arboreally adapted body plan characterized by relatively large (here, based on joint size) forelimbs, but lacking orthograde suspensory adaptations, may not have been 'unusual' among Middle Miocene apes.
Topics: Animals; Kenya; Fossils; Hominidae; Male; Female; Anthropology, Physical; Biological Evolution
PubMed: 38843697
DOI: 10.1016/j.jhevol.2024.103519 -
Indian Journal of Nuclear Medicine :... 2024A 21-year-old male with embryonal rhabdomyosarcoma of the prostate was referred for F-fluorodeoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT)...
F-fluorodeoxyglucose Positron Emission Tomography/Computed Tomography and Ga-prostate-specific Membrane Antigen Positron Emission Tomography/Computed Tomography Imaging in the Evaluation of Rare Entity Adult Embryonal Rhabdomyosarcoma of Prostate.
A 21-year-old male with embryonal rhabdomyosarcoma of the prostate was referred for F-fluorodeoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT) and Ga-prostate-specific membrane antigen (PSMA) PET/CT for initial disease staging. The PET scans revealed hypermetabolic and PSMA expressing lobulated mass involving both lobes of the prostate and weakly metabolic and PSMA expressing few bilateral pararectal and external iliac nodes, multiple bilateral lung nodules scattered over the lung parenchyma and multiple bone marrow lesions in both axial and appendicular skeleton. Magnetic resonance imaging prostate showed gross prostatomegaly with large lobulated T2 hyperintense heterogeneously enhancing mass lesion showing restricted diffusion, involving both lobes of the prostate with extraprostatic spread along anterior, posterior, and left lateral margins with evidence of lymph nodal and osseous metastases. The demonstration of increased uptake of F-FDG and Ga-PSMA in the primary as well as bilateral pararectal and external iliac nodes, multiple bilateral lung nodules, and multiple bone marrow lesions in both axial and appendicular skeleton indicates a potential role of F-FDG PET/CT and Ga-PSMA PET/CT in disease staging in this rare aggressive tumor of the prostate.
PubMed: 38817716
DOI: 10.4103/ijnm.ijnm_110_23 -
Cureus Apr 2024Hallux valgus (HV) is a relatively frequent disease caused by a complicated structural malformation of the primary ray. The bunion or middle projection generated by the... (Review)
Review
Hallux valgus (HV) is a relatively frequent disease caused by a complicated structural malformation of the primary ray. The bunion or middle projection generated by the hallux's lateral displacement and pronation is merely one element of the three-dimensional abnormality. HV may trigger severe discomfort and affect joint kinematics. The specific kinematic cause is still unknown. Female age, gender, restrictive footwear, and heritage are risk indicators. HV frequently coexists along metatarsal adducts, equines contracture, hammertoe imperfection, and pes planus. HV is a frequent foot ailment with multiple, complicated, unknown etiology and course. HV has a preference for females. It is an ongoing condition for which there is no known treatment to reduce or prevent improvement. Fibrodysplasia ossificans progressiva (FOP) is distinguished by hereditary symmetrical HV deformities or symptoms that begin heterotopic calcification that is either idiopathic or caused by trauma, such as subcutaneous immunizations. Localized heterotopic calcification may be preceded by aggravating, recurring soft-tissue enlargements (flare-ups). Heterotopic calcification may happen anywhere; however, it most commonly impacts locations near the axial bone structure during the early/mild phases until advancing to the appendicular skeleton. As an effect of calcification affecting the flexibility of the joints, it might cause limitations in motion. The initial line of therapy focuses on non-surgical methods including night splinting, orthotics, and larger shoes. The next suggested line of action is surgical intervention if conservative therapy fails. Patients have good postoperative tolerance, and bone union often happens six to seven weeks after surgery. Stretching exercises help to restore function by extending shortened soft tissue and restoring range of motion (ROM). The goal of joint mobilization, a form of manual treatment method, is to extend the ligament, the soft tissue surrounding the limited joint, and the restricting joint capsule by applying modest amplitude passive movement to the joint components.
PubMed: 38779237
DOI: 10.7759/cureus.58750