Symmetrical anatomical variant of the anterior belly of the digastric muscle: clinical implicat

The digastric muscle is an important surgical landmark. Several anatomical variants of the digastric muscle are reported in literature and, in particular, the presence of accessory anterior bellies of the muscle is not uncommon. Here, an unreported symmetrical variant of the digastric muscle was found during a dissection of the suprahyoid region. The dissection showed digastric muscles with an accessory anterior belly, which originated from the anterior belly of muscles in proximity and anteriorly to the intermediate tendon. The accessory bellies were fused together on the midline and were attached with a unique tendon to the inner surface of the mental symphysis. These muscles completely filled the submental triangle. This unreported anatomical variant could be considered an additional contribution to description of the anatomical variants of the digastric muscle, with several implications in head and neck pathology, diagnosis and surgery.

The myloglossus in a human cadaver study: common or uncommon anatomical structure?

Background: Additional extrinsic muscles of the tongue are reported in literature and one of them is the myloglossus muscle (MGM). Since MGM is nowadays considered as anatomical variant, the aim of this study is to clarify some open questions by evaluating and describing the myloglossal anatomy (including both MGM and its ligamentous counterpart) during human cadaver dissections. Materials and methods: Twenty-one regions (including masticator space, sublingual space and adjacent areas) were dissected and the presence and appearance of myloglossus were considered, together with its proximal and distal insertions, vascularisation and innervation. Results: The myloglossus was present in 61.9% of cases with muscular, ligamentous or mixed appearance and either bony or muscular insertion. Facial artery provided myloglossal vascularisation in the 84.62% and lingual artery in the 15.38%; innervation was granted by the trigeminal system (buccal nerve and mylohyoid nerve), sometimes (46.15%) with hypoglossal component. Conclusions: These data suggest us to not consider myloglossus as a rare anatomical variant.

The Terracol and Ardouin developmental model of frontal sinus drainage pathway and surrounding spaces: a radiologic validation

The complexity of the frontal sinus drainage pathway (FSDP) can be challenging even for expert surgeons. Several classifications have been proposed to simplify the understanding of FSDP, whose anatomical variability can be simplified based on the knowledge of its developmental mechanisms

Expression of endothelial nitric oxide synthase in blood vessels and silicic acid consumption

NO produces by endothelial nitric oxide synthase (eNOS) represents one of the most representative vasoactive molecules able to regulate vascular tone; it is released by endothelial cells and it diffuses to adjacent vascular smooth muscle cells causing vasorelaxation. In addition, endothelium-derived NO is know to be involved in multiple ways to prevent the progression of age-related vascular diseases. Senescent endothelial cells are characterized by a decreased production of endothelium-derived NO due to a decrease of eNOS activity that could be attributable to a reduction in eNOS protein expression as well as in eNOS phosphorylation (Matsushita et al., 2001). Previous studies showed that silicon, mainly as silicic acid, plays an important role as protective factor against the development of age-related vascular diseases, maintaining integrity, stability and elastic properties of arterial walls (Schwarz et al., 1977). So, the aim of this study was to evaluate the relationship between the expression of eNOS and silicic acid consumption in a mouse model of early physiological aging. We evaluated qualitatively and quantitatively by immunohistochemical method, the expression of eNOS in the vessel wall of aorta and renal vessels in relation with the administration of silicic acid in drinking water. The results showed that loss of eNOS expression was prevented by regular consumption of silicic acid rich water, supporting the potential protective role of silicon against age related-vascular disorders

Peripheral Purinergic Modulation in Pediatric Orofacial Inflammatory Pain Affects Brainstem Nitroxidergic System: A Translational Research

Physiology of orofacial pain pathways embraces primary afferent neurons, pathologic changes in the trigeminal ganglion, brainstem nociceptive neurons, and higher brain function regulating orofacial nociception. The goal of this study was to investigate the nitroxidergic system alteration at brainstem level (spinal trigeminal nucleus), and the role of peripheral P2 purinergic receptors in an experimental mouse model of pediatric inflammatory orofacial pain, to increase knowledge and supply information concerning orofacial pain in children and adolescents, like pediatric dentists and pathologists, as well as oro-maxillo-facial surgeons, may be asked to participate in the treatment of these patients. The experimental animals were treated subcutaneously in the perioral region with pyridoxalphosphate-6-azophenyl-2′,4′-disulphonic acid (PPADS), a P2 receptor antagonist, 30 minutes before formalin injection. The pain-related behavior and the nitroxidergic system alterations in the spinal trigeminal nucleus using immunohistochemistry and western blotting analysis have been evaluated. The local administration of PPADS decreased the face-rubbing activity and the expression of both neuronal and inducible nitric oxide (NO) synthase isoforms in the spinal trigeminal nucleus. These results underline a relationship between orofacial inflammatory pain and nitroxidergic system in the spinal trigeminal nucleus and suggest a role of peripheral P2 receptors in trigeminal pain transmission influencing NO production at central level. In this way, orofacial pain physiology should be elucidated and applied to clinical practice in the future

Platelet preparations in neuronal cell differentiation

Concentrated Growth Factors (CGF) is a platelet rich preparation that has the important feature of a tight fibrin network and containing a large number of growth factors possessing great regenerative potentialities [1]. The regeneration of nervous system is one of the mail goal of regenerative medicine. The aim of this study is to test the in vitro CGF effects on both differentiated and undifferentiated SH-SY5Y cells, derived from human neuroblastoma. To induce differentiation, SH-SY5Y cells have been treated with Retinoic Acid (RA) 10µM, in both basal and complete medium and in the presence and absence of CGF. After 72 hours, different parameters have been investigated: the morphological characteristics of the cells, the cell proliferation, the cellular vitality using the MTT test, the CGF and/or RA differentiation property and the immunocytochemical analysis of neuronal specific markers (NeuN, Sinaptophisine, β-III-tubulin, Nestin). Moreover the NGF (Nerve Growth Factor) and BDNF (Brain Derived Growth Factor) release have been assayed by ELISA test. Our results obtained suggest that treatment with CGF, also used alone, positively affects cell differentiation and neuronal phenotype regulating the expression of the neuronal markers and improving the outgrowth of neurites. Taken together these results seems to be promised into new approaches for neuronal regeneration using platelet preparations

The frontoethmoidal architecture: a developmental point of view

The anatomy of frontal sinus drainage pathway (FSDP) and surrounding spaces is extremely complex and variable. Its anatomical variability can be simplified based on the knowledge of the developmental mechanism of the frontal recess. The frontal sinus develops from the 13th week of intrauterine life to the age of twenty through a number of well-known steps of progressive extension within the frontal bone. Its development results from an upward epithelial migration of the anterior ethmoidal cells that penetrate the inferior aspect of the frontal bone between its two diploic plates. Even though this developmental theory is almost universally accepted, only few Authors focused on the formation of FSDP prior to the extramural pneumatization (1-2). The results of the present study conducted on 14 human heads match with the developmental model proposed by Terracol and Ardouin (2), in fact a number of significant associations are conform to the process of growing of the frontal sinus from one out of the three primordial cells (i.e. orbital, nasal, or bullar cell). In this model, renewed in view of the observation of the present study, the hierarchical order of growing among primordial cells determines the final frontoethmoidal architecture

COVID-19 Outbreak and Cancer Radiotherapy Disruption in Lombardy, Northern Italy

none37nononeJereczek-Fossa B.A.; Palazzi M.F.; Soatti C.P.; Cazzaniga L.F.; Ivaldi G.B.; Pepa M.; Amadori M.; Antognoni P.; Arcangeli S.; Buffoli A.; Beltramo G.; Berlinghieri S.; Bignardi M.; Bracelli S.; Bruschieri L.; Castiglioni S.; Catalano G.; Di Muzio N.; Fallai C.; Fariselli L.; Filippi A.R.; Gramaglia A.; Italia C.; Lombardi F.; Magrini S.M.; Nava S.; Orlandi E.; Pasinetti N.; Sbicego E.L.; Scandolaro L.; Scorsetti M.; Stiglich F.; Tonoli S.; Tortini R.; Valdagni R.; Vavassori V.; Marvaso G.Jereczek-Fossa, B. A.; Palazzi, M. F.; Soatti, C. P.; Cazzaniga, L. F.; Ivaldi, G. B.; Pepa, M.; Amadori, M.; Antognoni, P.; Arcangeli, S.; Buffoli, A.; Beltramo, G.; Berlinghieri, S.; Bignardi, M.; Bracelli, S.; Bruschieri, L.; Castiglioni, S.; Catalano, G.; Di Muzio, N.; Fallai, C.; Fariselli, L.; Filippi, A. R.; Gramaglia, A.; Italia, C.; Lombardi, F.; Magrini, S. M.; Nava, S.; Orlandi, E.; Pasinetti, N.; Sbicego, E. L.; Scandolaro, L.; Scorsetti, M.; Stiglich, F.; Tonoli, S.; Tortini, R.; Valdagni, R.; Vavassori, V.; Marvaso, G

Re‐Thinking the Environment, Cities, and Living Spaces for Public Health Purposes, According with the COVID‐19 Lesson: The LVII Erice Charter

Urban planning is a key tool to promote health in cities. The COVID-19 emergency accelerated several social, environmental, and digital challenges, stressing the importance of some issues regarding housing, urban mobility, green areas, and health service networks, urban health policies, and actions. These issues were the subject of an intensive residential course (the 57th) held in Erice, Sicily, in June 2021 in the “International School of Epidemiology and Preventive Medicine G. D’Alessandro”, and the main findings are described here. Methods. Lectures presented the topics, subsequently developed them, and argued them in parallel practical sessions using the World Café technique, since it is well suited for the interaction of participants and the involvement of groups. Results. The World Café provides new insights into how to improve the livability and health of urban spaces, and a set of strategies and actions were proposed for each topic. Discussion and Conclusions. All attendees agreed on the importance of participation in the planning processes, but also on the need for strong political support to ensure the resources needed and a full integration of health with other local policies. A multidisciplinary approach to developing systemic operational capacities and health literacy is considered pivotal to raising awareness and participation

Italian consensus conference on guidelines for conservative treatment on lower limb muscle injuries in athlete.

Provide the state of the art concerning (1) biology and aetiology, (2) classification, (3) clinical assessment and (4) conservative treatment of lower limb muscle injuries (MI) in athletes. Seventy international experts with different medical backgrounds participated in the consensus conference. They discussed and approved a consensus composed of four sections which are presented in these documents. This paper represents a synthesis of the consensus conference, the following four sections are discussed: (i) The biology and aetiology of MIs. A definition of MI was formulated and some key points concerning physiology and pathogenesis of MIs were discussed. (ii) The MI classification. A classification of MIs was proposed. (iii) The MI clinical assessment, in which were discussed anamnesis, inspection and clinical examination and are provided the relative guidelines. (iv) The MI conservative treatment, in which are provided the guidelines for conservative treatment based on the severity of the lesion. Furthermore, instrumental therapy and pharmacological treatment were discussed. Knowledge of the aetiology and biology of MIs is an essential prerequisite in order to plan and conduct a rehabilitation plan. Another important aspect is the use of a rational MI classification on prognostic values. We propose a classification based on radiological investigations performed by ultrasonography and MRI strongly linked to prognostic factors. Furthermore, the consensus conference results will able to provide fundamental guidelines for diagnostic and rehabilitation practice, also considering instrumental therapy and pharmacological treatment of MI. Expert opinion, level IV