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Bioengineering (Basel, Switzerland) Apr 2024Divided and subtracted MRI is a novel imaging processing technique, where the difference of two images is divided by their sum. When the sequence parameters are chosen...
Divided and subtracted MRI is a novel imaging processing technique, where the difference of two images is divided by their sum. When the sequence parameters are chosen properly, this results in images with a high T or T weighting over a small range of tissues with specific T and T values. In the T domain, we describe the implementation of the divided Subtracted Inversion Recovery Sequence (dSIR), which is used to image very small changes in T from normal in white matter. dSIR has shown widespread changes in otherwise normal-appearing white matter in patients suffering from mild traumatic brain injury (mTBI), substance abuse, and ischemic leukoencephalopathy. It can also be targeted to measure small changes in T from normal in other tissues. In the T domain, we describe the divided echo subtraction (dES) sequence that is used to image musculoskeletal tissues with a very short T*. These tissues include fascia, tendons, and aponeuroses. In this manuscript, we explain how this contrast is generated, review how these techniques are used in our research, and discuss the current challenges and limitations of this technique.
PubMed: 38790308
DOI: 10.3390/bioengineering11050441 -
Biology Open May 2024Skeletal muscles and the tendons that attach them to bone are structurally complex and deform non-uniformly during contraction. While these tissue deformations dictate...
Skeletal muscles and the tendons that attach them to bone are structurally complex and deform non-uniformly during contraction. While these tissue deformations dictate force production during movement, our understanding of this behaviour is limited due to challenges in obtaining complete measures of the constituent structures. To address these challenges, we present an approach for simultaneously measuring muscle, fascicle, aponeurosis, and tendon behaviour using sonomicrometry. To evaluate this methodology, we conducted isometric and dynamic contractions in in situ rabbit medial gastrocnemius. We found comparable patterns of strain in the muscle belly, fascicle, aponeurosis, and tendon during the isometric trials to those published in the literature. For the dynamic contractions, we found that our measures using this method were consistent across all animals and aligned well with our theoretical understanding of muscle-tendon unit behaviour. Thus, this method provides a means to fully capture the complex behaviour of muscle-tendon units across contraction types.
Topics: Tendons; Animals; Rabbits; Aponeurosis; Muscle, Skeletal; Muscle Contraction; Biomechanical Phenomena
PubMed: 38780905
DOI: 10.1242/bio.060383 -
Revista Do Colegio Brasileiro de... 2024severe abdominal sepsis, accompained by diffuse peritonitis, poses a significant challenge for most surgeons. It often requires repetitive surgical interventions,... (Comparative Study)
Comparative Study
INTRODUCTION
severe abdominal sepsis, accompained by diffuse peritonitis, poses a significant challenge for most surgeons. It often requires repetitive surgical interventions, leading to complications and resulting in high morbidity and mortality rates. The open abdomen technique, facilitated by applying a negative-pressure wound therapy (NPWT), reduces the duration of the initial surgical procedure, minimizes the accumulation of secretions and inflammatory mediators in the abdominal cavity and lowers the risk of abdominal compartment syndrome and its associated complications. Another approach is primary closure of the abdominal aponeurosis, which involves suturing the layers of the abdominal wall.
METHODS
the objective of this study is to conduct a survival analysis comparing the treatment of severe abdominal sepsis using open abdomen technique versus primary closure after laparotomy in a public hospital in the South of Brazil. We utilized data extracted from electronic medical records to perform both descriptive and survival analysis, employing the Kaplan-Meier curve and a log-rank test.
RESULTS
the study sample encompassed 75 laparotomies conducted over a span of 5 years, with 40 cases employing NPWT and 35 cases utilizing primary closure. The overall mortality rate observed was 55%. Notably, survival rates did not exhibit statistical significance when comparing the two methods, even after stratifying the data into separate analysis groups for each technique.
CONCLUSION
recent publications on this subject have reported some favorable outcomes associated with the open abdomen technique underscoring the pressing need for a standardized approach to managing patients with severe, complicated abdominal sepsis.
Topics: Humans; Laparotomy; Male; Female; Sepsis; Middle Aged; Abdominal Wound Closure Techniques; Open Abdomen Techniques; Aged; Retrospective Studies; Survival Analysis; Severity of Illness Index; Adult; Peritonitis; Negative-Pressure Wound Therapy
PubMed: 38716912
DOI: 10.1590/0100-6991e-20243595-en -
JSES International May 2024Because of the proximity of several ligaments, aponeuroses, and capsule in the limited area of the elbow joint, the precise anatomy is difficult to understand. In the... (Review)
Review
BACKGROUND
Because of the proximity of several ligaments, aponeuroses, and capsule in the limited area of the elbow joint, the precise anatomy is difficult to understand. In the current narrative review, we focused on two anatomical perspectives: the capsular attachment and structures consisting of ligaments.
METHODS
Based on the previously performed studies regarding the elbow anatomy, a narrative review was prepared in terms of the capsular attachment and structures consisting of ligaments.
RESULTS
At the tip of the coronoid process, the joint capsule attaches roughly 6 mm distal to its tip with 6-12 mm length. On the lateral epicondyle of the humerus, the capsular attachment at the anterior part of the extensor carpi radialis brevis origin is narrower than the one distal to it. A single interpretation of the lateral collateral ligament is the capsulo-aponeurotic membrane, which is composed of the joint capsule intermingling with the supinator aponeurosis. The anterior bundle of the ulnar collateral ligament could be interpreted as the grossly separated collagenous structure from the tendinous complex, which is composed of the tendinous septum between the flexor digitorum superficialis and pronator teres muscle, the medial part of the brachialis muscle, and deep aponeurosis of the flexor digitorum superficialis muscle.
DISCUSSION
Based on these perspectives, ligaments could function as a "static-dynamic" stabilizer rather than a simple static one.
PubMed: 38707559
DOI: 10.1016/j.jseint.2024.01.006 -
The American Journal of Sports Medicine Jun 2024Tumor-like distal femoral cortical irregularities (DFCIs) are a frequent incidental finding on knee magnetic resonance imaging (MRI) and are common in young competitive...
BACKGROUND
Tumor-like distal femoral cortical irregularities (DFCIs) are a frequent incidental finding on knee magnetic resonance imaging (MRI) and are common in young competitive athletes.
PURPOSE
To assess and compare the morphology and prevalence of DFCIs in competitive alpine skiers over 48 months during adolescence.
STUDY DESIGN
Case series; Level of evidence, 4.
METHODS
Adolescent competitive alpine skiers were prospectively recruited in 2018 and received bilateral 3-T MRI of the knee at baseline and after 48 months. All MRIs were evaluated for the presence and location of DFCIs, which were marked at 1 of 3 anatomic positions: (1) the femoral attachment of the medial head of the gastrocnemius muscle, (2) the lateral head of the gastrocnemius muscle, or (3) the attachment of the adductor magnus aponeurosis. The size of the DFCI was measured by 2 radiologists independently. The measurements were compared using the Wilcoxon signed-rank test, the interclass correlation coefficient (ICC), and Cohen Kappa.
RESULTS
A total of 63 athletes (mean age at follow-up, 19.6 ± 1.2 years; n = 25 female) were included in the study. At baseline, DFCIs were detected in 84 out of 126 knees (67%). At the 48-month follow-up, DFCIs were found in 88 out of 126 knees (70%), with multiple DFCIs in 3 knees and no significant difference between male and female patients (n = 24 male, n = 19 female; = .71). No significant increase was detected for the number ( = .21) and size of the DFCIs between the baseline and the 48-month follow-up (mean size: baseline, 3.7 ± 0.8 mm; 48-month follow-up: 3.6 ± 0.9 mm; = .66). The interrater agreement for the mean size measurements of DFCIs was good to excellent (ICC 0.88).
CONCLUSION
DFCIs remain a frequent finding on knee MRI in competitive alpine skiers after skeletal maturation and do not disappear during adolescence. The DFCI size was constant in athletes aged between 15 and 19 years. Moreover, DFCIs should not be mistaken for a pathologic finding.
Topics: Humans; Skiing; Male; Female; Magnetic Resonance Imaging; Adolescent; Femur; Longitudinal Studies; Young Adult; Prospective Studies; Knee Joint; Athletes
PubMed: 38655759
DOI: 10.1177/03635465241239868 -
BioRxiv : the Preprint Server For... Apr 2024Skeletal muscle architecture is a key determinant of muscle function. Architectural properties such as fascicle length, pennation angle, and curvature can be...
Skeletal muscle architecture is a key determinant of muscle function. Architectural properties such as fascicle length, pennation angle, and curvature can be characterized using Diffusion Tensor Imaging (DTI), but acquiring these data during a contraction is not currently feasible. However, an image registration-based strategy may be able to convert muscle architectural properties observed at rest to their contracted state. As an initial step toward this long-term objective, the aim of this study was to determine if an image registration strategy could be used to convert the whole-muscle average architectural properties observed in the extended joint position to those of a flexed position, following passive rotation. DTI and high-resolution fat/water scans were acquired in the lower leg of seven healthy participants on a 3T MR system in +20° (plantarflexion) and -10° (dorsiflexion) foot positions. The diffusion and anatomical images from the two positions were used to propagate DTI fiber-tracts from seed points along a mesh representation of the aponeurosis of fiber insertion. The -10° and +20° anatomical images were registered and the displacement fields were used to transform the mesh and fiber-tracts from the +20° to the -10° position. Student's paired -tests were used to compare the mean architectural parameters between the original and transformed fiber-tracts. The whole-muscle average fiber-tract length, pennation angle, curvature, and physiological cross-sectional areas estimates did not differ significantly. DTI fiber-tracts in plantarflexion can be transformed to dorsiflexion position without significantly affecting the average architectural characteristics of the fiber-tracts. In the future, a similar approach could be used to evaluate muscle architecture in a contracted state.
PubMed: 38645028
DOI: 10.1101/2024.04.11.589123 -
Case Reports in Dentistry 2024Mucogingival surgery is a procedure for the treatment of gingival recession, which is a shift of marginal gingival tissue to the cementoenamel junction (CEJ), exposing...
Mucogingival surgery is a procedure for the treatment of gingival recession, which is a shift of marginal gingival tissue to the cementoenamel junction (CEJ), exposing the surface of the root teeth. One treatment for gingival recession is the Langer and Langer bilaminar technique, which involves the use of the fascia lata (FL) membrane. This membrane is harvested from the aponeurosis of the external muscles. The purpose of this case report was to present the clinical results of a 2-year follow-up using the Langer and Langer bilaminar technique modified with FL in a patient with gingival recession. Recessions are a shift of marginal gingival tissue to the CEJ, which exposes the surface of the root teeth. At the 2-year follow-up, the patient presented with a gingival recession in tooth 41, which resulted in complete root coverage, reaching 83.3%; the amount of keratinized tissue increased to 3 mm in each tooth, changing the gingival biotype from thin to thick and scalloped. This case report supports the use of FL as a successful alternative treatment.
PubMed: 38633279
DOI: 10.1155/2024/9968705 -
The ISME Journal Jan 2024The gut microbiota of insects has been shown to regulate host detoxification enzymes. However, the potential regulatory mechanisms involved remain unknown. Here, we...
The gut microbiota of insects has been shown to regulate host detoxification enzymes. However, the potential regulatory mechanisms involved remain unknown. Here, we report that gut bacteria increase insecticide resistance by activating the cap "n" collar isoform-C (CncC) pathway through enzymatically generated reactive oxygen species (ROS) in Bactrocera dorsalis. We demonstrated that Enterococcus casseliflavus and Lactococcus lactis, two lactic acid-producing bacteria, increase the resistance of B. dorsalis to β-cypermethrin by regulating cytochrome P450 (P450) enzymes and α-glutathione S-transferase (GST) activities. These gut symbionts also induced the expression of CncC and muscle aponeurosis fibromatosis. BdCncC knockdown led to a decrease in resistance caused by gut bacteria. Ingestion of the ROS scavenger vitamin C in resistant strain affected the expression of BdCncC/BdKeap1/BdMafK, resulting in reduced P450 and GST activity. Furthermore, feeding with E. casseliflavus or L. lactis showed that BdNOX5 increased ROS production, and BdNOX5 knockdown affected the expression of the BdCncC/BdMafK pathway and detoxification genes. Moreover, lactic acid feeding activated the ROS-associated regulation of P450 and GST activity. Collectively, our findings indicate that symbiotic gut bacteria modulate intestinal detoxification pathways by affecting physiological biochemistry, thus providing new insights into the involvement of insect gut microbes in the development of insecticide resistance.
Topics: Animals; Reactive Oxygen Species; Gastrointestinal Microbiome; Pyrethrins; Insecticide Resistance; Tephritidae; Insecticides; Cytochrome P-450 Enzyme System; Lactococcus lactis; Lactobacillales; Insect Proteins; Enterococcus; Glutathione Transferase
PubMed: 38618721
DOI: 10.1093/ismejo/wrae058 -
JSLS : Journal of the Society of... 2024Spigelian hernias are an uncommon protrusion defect noted between the rectus abdominis and the transversus abdominis muscles, at the semilunar line, with a low incidence...
Spigelian hernias are an uncommon protrusion defect noted between the rectus abdominis and the transversus abdominis muscles, at the semilunar line, with a low incidence of approximately 0.12% to 2% of all ventral hernias. Furthermore, the incidence of bilateral cases is noted to be even lower in the general population. They are associated with bowel incarceration and strangulation; hence surgical repair is indicated. Therapeutic alternatives for Spigelian hernias include open repair, however laparoscopic repair stands as the standard of care in these cases. Feasible and successful robotic repair has been reported, with associated advantages in terms of visualization and surgical instrument dexterity. We present the first ever reported cases of bilateral Spigelian hernias repaired using robotic approach. Two female Puerto Rican patients referred to our institution complaining of abdominal pain, where imaging studies found bilateral Spigelian hernias. In both cases, a transabdominal preperitoneal repair was performed using the Da Vinci Surgical System. Both patients were discharged home tolerating oral intake with adequate wound healing. On follow up visits, patients denied abdominal discomfort and had adequate wound healing. Robotic surgery for Spigelian hernias poses an advantage over laparoscopic repair as improved visualization, mobility, and precision in movements allow for more gentle tissue manipulation. Furthermore, this is the first evidence of safe and effective repair in the uncommon entity of bilateral cases, providing a newer alternative in the setting of such presentation.
Topics: Humans; Female; Robotic Surgical Procedures; Surgical Mesh; Hernia, Ventral; Laparoscopy; Abdominal Muscles
PubMed: 38562951
DOI: 10.4293/JSLS.2023.00055 -
Wearable Technologies 2023B-mode ultrasound (US) is often used to noninvasively measure skeletal muscle architecture, which contains human intent information. Extracted features from B-mode...
B-mode ultrasound (US) is often used to noninvasively measure skeletal muscle architecture, which contains human intent information. Extracted features from B-mode images can help improve closed-loop human-robotic interaction control when using rehabilitation/assistive devices. The traditional manual approach to inferring the muscle structural features from US images is laborious, time-consuming, and subjective among different investigators. This paper proposes a clustering-based detection method that can mimic a well-trained human expert in identifying fascicle and aponeurosis and, therefore, compute the pennation angle. The clustering-based architecture assumes that muscle fibers have tubular characteristics. It is robust for low-frequency image streams. We compared the proposed algorithm to two mature benchmark techniques: and The performance of the proposed approach showed higher accuracy in our dataset (frame frequency is 20 Hz), that is, similar to the human expert. The proposed method shows promising potential in automatic muscle fascicle orientation detection to facilitate implementations in biomechanics modeling, rehabilitation robot control design, and neuromuscular disease diagnosis with low-frequency data stream.
PubMed: 38487764
DOI: 10.1017/wtc.2022.30