Microcorrosion Casts in the Microcirculation of Skeletal Muscle

The authors review the contribution of microcorrosion cast studies towards clarifying the structure of skeletal muscle microcirculation. Former studies performed on naturally contracted muscles show the presence of a primary and a secondary arterial network and a capillary network. At the level of the capillary network pericyte imprints are present. Muscles characterized by different types of metabolism show different features of the capillary pattern. Other authors have affirmed that the extended muscle is characterized by long and straight capillaries, while the contracted one features clusters of vessels all around a muscle fiber. The authors have made the present observations in order to determine how the capillary pattern of muscles with different metabolism is modified by extension and shortening of the muscle belly. The capillary pattern observed appears very similar to that observed in former studies. The differences between the oxidative and the glycolytic muscle are evident in every condition of the muscle belly. These data confirm the theory that there is a permanent endogenous difference in microcirculation between oxidative and glycolytic muscle, determined by muscle fiber metabolism

A Three-Dimensional Study of the Morphology and Topography of Pericytes in the Microvascular Bed of Skeletal Muscle

Digested tissue specimens and corrosion casts of rat soleus and tibialis anterior muscles were employed for this Scanning Electron Microscopy (SEM) study. The shape, morphology, and position of pericytes were compared to corresponding imprints on the cast surfaces. Pericytes, observed in digested tissue specimens, showed a typical morphological pattern: a central body with two primary processes that run along the capillary in opposite directions. From these primary processes, secondary ones arise and often encircle the vessel almost completely. On the surface of corrosion casts, roundish imprints were found in the microvascular tree at the same level where digested tissue specimens showed the presence of pericyte bodies. Along and around the cast surface, shallow grooves reproduced the course of the primary and secondary processes. The peculiar tridimensional arrangement of pericytes at the level of capillary bifurcations underlines their role in red cell flow regulation. However, if the mechanical linkage of the pericytes to the endothelium and their contractability is taken into account, additional roles of these perivascular cells may be hypothesized

Microcorrosion Casting in Normal and Pathological Biliary Tree Morphology

The organization of the intrahepatic biliary tree was studied in three dimensions by scanning electron microscopic (SEM) corrosion casts, in normal and cholestatic rat liver. In the normal liver the observation revealed the features of the biliary passages from the bile canaliculi to the canaliculo-ductular junction, to the ductules and the bile ducts, confirming previous SEM observations. In cholestatic liver, the modifications and the proliferation of bile ductules appear clearly. Resin flow from canalicular to sinusoidal network was never observed. The method was found to be very useful in the evaluation of the architecture of the intrahepatic biliary tree, under normal as well as under pathological conditions

The Hepatic Microcirculation in Experimental Cirrhosis a Scanning Electron Microscopy Study of Microcorrosion Casts

The experimental model of liver cirrhosis induced by intragastric administration of CCl4 reproduces not only the histological picture of the postnecrotic cirrhosis but also its pathophysiological features. Corrosion casts of livers affected by CCl4-induced cirrhosis show the loss of the lobular pattern. Once the cirrhosis has completely developed, the whole microvascular bed appears to be composed of groups of sinusoid nodules of diameters varying between 0.3 and 1.5 mm.. Pre- and post-sinusoidal vessels and anastomoses between the former and the latter are mainly located at the perinodular spaces. This microvascular situation modifies the normal perfusion gradient within the parenchyma. Nevertheless, it can allow a still viable function

The art of rhinoplasty: researching technical and cultural foundations of western world rhinosurgery, from the middle ages to the renaissance

The analysis of the written sources allowed to follow the gradual development of every new technique in the field of rhinoplasty but also to understand the value of this surgery in those ancient times, highlighting a deep connection between traumatologic surgery of the nose and the development of modern ‘‘aesthetic and reconstructive’’ Rhinosurgery. Specifically, we analyzed the techniques described by less known surgeons to emphasize their cultural and surgical value. As a matter of fact, the descriptions offered by these authors clearly show the importance of rhinoplasty as a cardinal and autonomous practice since Antiquity, also clarifying the persistence and development of specific techniques for this surgical practice in the History of medicine. In the manuscript, the contributions of the Italian surgeons, such as Brancas and Vianeos families, are highlighted, demonstrating their influence on the progress of this surgical specialty in the Early Modern Age. Finally, we deepen the description of Gaspare Tagliacozzi’s work, pointing out the topics and controversial debates arising from his techniques and innovations in ‘‘rhinosurgery’’ and also in the field of tissue transplantation, laying the foundations of modern Plastic Surgery. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine Ratings, please refer to Table of Contents or online Instructions to Authors www.springer.com/00266

Muscle Oxygen Delivery in the Forearm and in the Vastus Lateralis Muscles in Response to Resistance Exercise: A Comparison Between Nepalese Porters and Italian Trekkers

Altitude ascending represents an intriguing experimental model reproducing physiological and pathophysiological conditions sharing hypoxemia as the denominator. The aim of the present study was to investigate fractional oxygen extraction and blood dynamics in response to hypobaric hypoxia and to acute resistance exercises, taking into account several factors including different ethnic origin and muscle groups. As part of the “Kanchenjunga Exploration & Physiology” project, six Italian trekkers and six Nepalese porters took part in a high altitude trek in the Himalayas. The measurements were carried out at low (1,450 m) and high altitude (HA; 4,780 m). Near-infrared spectroscopy (NIRS)-derived parameters, i.e., Tot-Hb and tissue saturation index (TSI), were gathered at rest and after bouts of 3-min resistive exercise, both in the quadriceps and in the forearm muscles. TSI decreased with altitude, particularly in forearm muscles (from 66.9 to 57.3%), whereas the decrement was less in the quadriceps (from 62.5 to 57.2%); Nepalese porters were characterized by greater values in thigh TSI than Italian trekkers. Tot-Hb was increased after exercise. At altitude, such increase appeared to be higher in the quadriceps. This effect might be a consequence of the long-term adaptive memory due to the frequent exposures to altitude. Although speculative, we suggest a long-term adaptation of the Nepalese porters due to improved oxygenation of muscles frequently undergoing hypoxic exercise. Muscle structure, individual factors, and altitude exposure time should be taken into account to move on the knowledge of oxygen delivery and utilization at altitude

The use of mercury against pediculosis in the Renaissance: tha case of Ferdinand of Aragon, King of Naples (1467-1496)

Pediculosis seems to have afflicted humans since the most ancient times and lice have been found in several ancient human remains. Examination of the head hair and pubic hair of the artificial mummy of Ferdinand II of Aragon (1467-1496), King of Naples, revealed a double infestation with two different species of lice, Pediculus capitis, the head louse, and Pthirus pubis, the pubic louse. The hair samples were also positive for the presence of mercury, probably applied as an anti-pediculosis therapy. This is the first time that these parasites have been found in the hair of a king, demonstrating that even members of the wealthy classes in the Renaissance were subject to louse infestation

Modular versus monoblock stem in revision total hip arthroplasty: a systematic review and meta-analysis

Background: Total hip arthroplasty (THA) is estimated to grow in the following decades with a consequent increase of THA revisions (rTHA). This systematic review and meta-analysis aims to compare modular and monoblock stem in rTHA surgery, focusing on clinical and radiological outcomes and complication rates. Methods: A literature search was performed using the following search strategy: ((Modular stem) OR (monolithic stem)) AND (hip review) on PubMed, Scopus, and Cochrane. Randomized controlled trials (RCTs) and observational studies (OS) compared clinical and radiological outcomes, and complication rates for monoblock and modular revision femoral stem were included. The risk of bias was assessed through the Methodological Index for Non-Randomized Studies (MINORS) score. The Review Manager (RevMan) software was used for the meta-analysis. The rate of complications was assessed using odds ratio (OR) with 95% confidence intervals (CIs). Results: The authors included 11 OS and one RCT with 3,671 participants (mean age: 68.4 years old). The mean follow-up was 46.9 months. There was no prevalence of subsidence for one type of stem. Mean subsidence was from 0.92 to 10 mm for modular stem and from 1 to 15 mm for monoblock stem. Postoperative Harris Hip Score (HHS) showed better results with modular stems without statistical significance [mean difference (MD) =1.32; 95% CI: −1.62 to 4.27; P=0.38]. No statistically significant difference was found for dislocations (OR =2.48; 95% CI: 0.67 to 9.14; P=0.17), infections (OR =1.07; 95% CI: 0.51 to 2.23; P=0.86), intraoperative fractures (OR =1.62; 95% CI: 0.42 to 6.21; P=0.48), and postoperative fractures (OR =1.60; 95% CI: 0.55 to 4.64; P=0.39). Conclusions: Modular and monoblock stems show comparable and satisfactory clinical and radiological outcomes for rTHA. Both stems are valid and effective options for managing femoral bone deficit in hip revision surgery. The main limitation of this study is the small number and low quality of enclosed studies that compared the two stems. Moreover, the modular stem is usually used for more complex cases with lower quality femoral bone stock

An objective, markerless videosystem for staging facial palsy

Background: The clinical classification of unilateral peripheral facial palsy (UPFP) is still based on subjective conventional methodology, leaving several missing points for an exact depiction of face deformity. Aim of the study: To propose a new objective, video recording method that relies on mathematical algorithms allowing the software to recognize numerical points on the face surface that would be indicative of facial nerve impairment, without positioning of markers on the face. Material and methods: Patients with UPFP of different House-Brackman (HB) degrees, from II to V, have been evaluated after video recording during two selected facial movements (forehead frowning and smiling) by a software trained to recognize the face points as numbers. Numerical parameters in millimeters have been obtained as indicative values of the shifting of the face points, and the shifting ratio between the healthy (denominator) and the affected side (numerator), i.e. the asymmetry index for the two movements taken into consideration. Results: For each HB grade, specific ranges of asymmetry index have been identified with a positive correlation for shift differences and negative correlation for asymmetry indexes. Conclusions: The use of the present objective system enabled the identification of numerical ranges of asymmetry index between the healthy and the affected side, that were found to be consistent with the outcome from the subjective methods currently in use

Dynamic features of the selective pressure on the human immunodeficiency virus type 1 (HIV-1) gp120 CD4-binding site in a group of long term non progressor (LTNP) subjects.

Abstract The characteristics of intra-host human immunodeficiency virus type 1 (HIV-1) env evolution were evaluated in untreated HIV-1-infected subjects with different patterns of disease progression, including 2 normal progressor [NP], and 5 Long term non-progressor [LTNP] patients. High-resolution phylogenetic analysis of the C2-C5 env gene sequences of the replicating HIV-1 was performed in sequential samples collected over a 3–5 year period; overall, 301 HIV-1 genomic RNA sequences were amplified from plasma samples, cloned, sequenced and analyzed. Firstly, the evolutionary rate was calculated separately in the 3 codon positions. In all LTNPs, the 3rd codon mutation rate was equal or even lower than that observed at the 1st and 2nd positions (p = 0.016), thus suggesting strong ongoing positive selection. A Bayesian approach and a maximum-likelihood (ML) method were used to estimate the rate of virus evolution within each subject and to detect positively selected sites respectively. A great number of N-linked glycosylation sites under positive selection were identified in both NP and LTNP subjects. Viral sequences from 4 of the 5 LTNPs showed extensive positive selective pressure on the CD4-binding site (CD4bs). In addition, localized pressure in the area of the IgG-b12 epitope, a broad neutralizing human monoclonal antibody targeting the CD4bs, was documented in one LTNP subject, using a graphic colour grade 3-dimensional visualization. Overall, the data shown here documenting high selective pressure on the HIV-1 CD4bs of a group of LTNP subjects offers important insights for planning novel strategies for the immune control of HIV-1 infection.</p