Endovascular Treatment of Brain Arteriovenous Malformations mainly fed by the Anterior Cerebral Artery

Background: There have been few studies on endovascular treatment (EVT) of the brain arteriovenous malformations (BAVMs) involving the anterior cerebral artery (ACA). Methods and materials: This study continuously enrolled 60 patients with ACA-BAVMs treated with EVT. ACA-BAVMs were divided into three types: type I BAVMs were those located below and in front of the corpus callosum genu, type II BAVMs were those located in the upper area of the corpus callosum from the genu to the anterior trunk, and type III BAVMs were those located in the upper area from the anterior trunk to the splenium of the corpus callosum. Results: The patients were aged 10 to 72 years (mean, 35.4 ±17.0 years) and included 28 females (46.7%, 28/60). BAVMs were type I (15%, 9/60), type II (25%, 15/60), and type III (60%, 36/60). Statistical analysis showed that posterior cerebral artery (PCA) tended to be involved in type II and III BAVMs. For EVT, immediate complete or nearly complete embolization was achieved in 34 (56.7%, 34/60) cases. During EVT, there were 3 cases of intraoperative bleeding (5%, 3/60), which tended to occur in type I and II ACA-BAVMs. At discharge, 80% of patients had a GOS score of 5. During the follow-up, 89.3% of patients had mRS scores of 0 and 1. Conclusion: This study showed that EVT carries a risk of intraoperative bleeding for type I and II BAVMs, for type II and III BAVMs, the PCA can often be involved in EVT. In general, EVT can result in a good prognosis for ACA-BAVMs.

Dermoscopy of early melanomas: variation according to the anatomic site

To date, is yet to be elucidated whether the body location of cutaneous melanoma can significantly affect an early dermoscopic diagnosis and, consequently, if it can be regarded as a prognostic factor. To investigate the dermoscopic appearance of early melanomas (EMs) at different body sites; to test the ability of dermoscopists in recognizing specific dermoscopic features in EMs. A pool of 106 experienced dermoscopists evaluated the presence of 10 dermoscopic features assumed as suggestive of malignancy among 268 images of EMs with ambiguous appearance located at 16 body sites. According to 720 evaluations, EMs of the “upper extremities” showed a prevalence of early atypical lentiginous features. EMs of the “anterior trunk” exhibited the lower rate of recognition for all features. EMs of the “rear trunk” can be regarded as an intermediate area, showing high recognition rates of regression-related and chronic-traumatism-related features.

Weighted Baseball Training Affects Arm Speed without Increasing Elbow and Shoulder Joint Kinetics

Long-term training effects of weighted ball throwing programs have been well documented. However, the mechanisms by which these effects are facilitated are poorly understood due to the difficulty of measuring biomechanics in the baseball throwing motion. The purpose of this study is to replicate previous methods investigating within-session effects of throwing overload and underload baseballs to provide mechanistic evidence for weighted baseball training methods. We hypothesized that varying the pitched ball weight between three, four, five, six, and seven ounces will affect pitched ball velocity, upper body kinematics, lower body kinematics, kinematic velocities, and throwing arm joint kinetics during a maximum intent throwing workout. Twenty-six collegiate and professional level baseball pitchers ages 20-30 (mean age 23.5 ± 2.7 years) participated in a pitch velocity and biomechanical evaluation while pitching a series of leather weighted baseballs from a regulation pitching mound. A one-way repeated measures ANOVA was used to evaluate the within-subject effect of ball weight on a total of 15 parameters: pitch velocity, five kinematic positions, four kinematic velocities, and five kinetics. We found that as ball weight increased, pitch velocity, maximum elbow flexion, maximum pelvis rotation velocity, maximum shoulder internal rotation velocity, and maximum elbow extension velocity decreased, while anterior trunk tilt at ball release increased. Training with three- to seven-ounce baseballs can be used to work on increasing pitching velocity without increasing throwing arm joint kinetics or changing pitching mechanics in a practically significant way.

Eccrine Hidradenoma of the Nasal Vestibule: A Rare Clinical Entity

Eccrine hidradenoma is a relatively rare benign tumor of sweat gland origin but with possible malignant transformation. It usually consists of solitary, well-demarcated papules or nodules covered with normal skin. Common sites of involvement are the scalp, face, limbs, and anterior trunk. Although the lining of the nasal vestibule includes hair follicles, sebaceous glands, and sweat glands, an eccrine hidradenoma originating in the nasal vestibule has yet to be reported. Herein, we describe a rare clinical presentation of nasal eccrine hidradenoma, treated successfully using a transnasal endoscopic approach.

Bacterial Profile of Nurses’ Uniforms: A Descriptive Cross-sectional Study

Background: The bacterial profile associated with nurses’ uniforms have not been empirically ascertained within the Ghanaian setting. Objective: To evaluate the bacterial profile of scrubs worn by nurses over a 24-hour period. Methods: A descriptive cross-sectional approach was used with 20 conveniently recruited Registered Nurses spread across a 24-hour shift period. Sterile scrubs were provided and at the end each shift, four zones were swabbed (axilla, anterior trunk, posterior trunk, and posterior aspects of the trousers). The laboratory isolation processes proceeded through colony identification, gram staining, catalase test (Gram-positive), lactose fermenter (Gram-negative), Triple Sugar Iron and Motility Indole Ornithine (Enterobacteria). Results: Both Gram-negative and Gram-positive bacteria were identified which may suggest that irrespective of the unit in which nurses worked, their uniforms served as surfaces of bacterial habitation. At least, one organism was isolated at all the areas swabbed suggesting that nurses’ uniforms are contaminated at the end of their shift.Conclusion: The findings suggest a need for collective efforts to ensure that uniforms are not worn beyond the confines of the healthcare setting as well as strict adherence to infection prevention and control policies within the hospital.

Stigmatopora harastii, a new species of pipefish in facultative associations with finger sponges and red algae from New South Wales, Australia (Teleostei, Syngnathidae)

A new species of pipefish, Stigmatopora harastiisp. nov., is described based on the male holotype and two female paratypes, 136.3–145.5 mm SL, collected from red algae (sp.?) at 12 meters depth in Botany Bay, New South Wales (NSW), Australia. The new taxon shares morphological synapomorphies with the previously described members of Stigmatopora, including principle body ridges, fin placement, slender tail, and absence of a caudal fin. It is morphologically and meristically similar to Stigmatopora nigra, including snout length and shape, dorsal-fin origin on 6th–7th trunk ring, and lateral trunk ridge terminating on the first tail ring. Stigmatopora harastiisp. nov. is distinguished from its congeners, however, by characters of the head and first trunk ring, distinct sexual dimorphic markings on sides and venter of anterior trunk rings, and red background coloration in life. The new taxon can be further differentiated by genetic divergence in the mitochondrial COI gene (uncorrected p-distances of 9.8%, 10.1%, 10.7%, and 14.6%, from S. argus, S. macropterygia, S. narinosa, and S. nigra, respectively). The type locality is characterised by semi-exposed deep-water sandy areas interspersed with boulders, flat reefs, and an absence of seagrass beds, in which S. harastii has been observed living in facultative associations with a finger sponge and red algae at depths of 10–25 meters, compared to the shallow coastal and estuarine habitats preferred by the fucoid algae and seagrass-associating members of Stigmatopora. Stigmatopora harastiisp. nov. represents the fourth species of Stigmatopora recorded in temperate southern Australia.

Light-sheet fluorescence imaging charts the gastrula origin of vascular endothelial cells in early zebrafish embryos

It remains challenging to construct a complete cell lineage map of the origin of vascular endothelial cells in any vertebrate embryo. Here, we report the application of in toto light-sheet fluorescence imaging of embryos to trace the origin of vascular endothelial cells (ECs) at single-cell resolution in zebrafish. We first adapted a previously reported method to embryo mounting and light-sheet imaging, created an alignment, fusion, and extraction all-in-one software (AFEIO) for processing big data, and performed quantitative analysis of cell lineage relationships using commercially available Imaris software. Our data revealed that vascular ECs originated from broad regions of the gastrula along the dorsal–ventral and anterior–posterior axes, of which the dorsal–anterior cells contributed to cerebral ECs, the dorsal–lateral cells to anterior trunk ECs, and the ventral–lateral cells to posterior trunk and tail ECs. Therefore, this work, to our knowledge, charts the first comprehensive map of the gastrula origin of vascular ECs in zebrafish, and has potential applications for studying the origin of any embryonic organs in zebrafish and other model organisms.

Anatomical Variations and Relationships of the Infratemporal Fossa: Foundation of a Novel Endonasal Approach to the Foramen Ovale

Objective Access to the infratemporal fossa (ITF) is complicated by its complex neurovascular relationships. In addition, copious bleeding from the pterygoid plexus adds to surgical challenge. This study aims to detail the anatomical relationships among the internal maxillary artery (IMA), pterygoid plexus, V3, and pterygoid muscles in ITF. Furthermore, it introduces a novel approach that displaces the lateral pterygoid plate (LPP) to access the foramen ovale. Design and Main Outcome Measures Six cadaveric specimens (12 sides) were dissected using an endonasal approach to the ITF modified by releasing and displacing the LPP and lateral pterygoid muscle (LPTM) as a unit. Subperiosteal elevation of the superior head of LPTM revealed the foramen ovale. The anatomic relationships among the V3, pterygoid muscles, pterygoid plexus, and IMA were surveyed. Results In 9/12 sides (75%), the proximal IMA ran between the temporalis and the LPTM, whereas in 3/12 sides (25%), the IMA pierced the LPTM. The deep temporal nerve was a consistent landmark to separate the superior and inferior heads of LPTM. An endonasal approach displacing the LPP in combination with a subperiosteal elevation of the superior head of LPTM provided access to the posterior trunk of V3 and foramen ovale while sparing injury of the LPTM and exposing the pterygoid plexus. The anterior trunk of V3 traveled anterolaterally along the greater wing of sphenoid in all specimens. Conclusion Displacement of the LPP and LPTM provided direct exposure of foramen ovale and V3 avoiding dissection of the muscle and pterygoid plexus; thus, this maneuver may prevent intraoperative bleeding and postoperative trismus.