Long-term results of dorsal neuroma/nerve transposition in the surgical management of Morton’s neuroma and correlation with intraoperative anatomical variations

Background Morton's neuroma (MN) is a common cause of forefoot pain. After failure of conservative management, surgical procedures include neurectomy or neuroma preserving procedures; resection of deep transverse intermetatarsal ligament only (DTIML), dorsal neurolysis, dorsal nerve transposition (DNT). Objectives This retrospective study evaluates the long-term results of open DNT, and it also reports anatomical variants in the plantar interdigital nerve. Material and methods The study included 39 patients (30 females and 9 males) who were treated for MN between 2002 and 2016. Results The mean pre-operative Giannini score of 13 (0–30) improved to 61 (20–80) (p < .0001), with only 6 patients scoring less than 50 (poor). Using Coughlin’s criterion for overall satisfaction, 9 patients (23%) reported excellent, 18 patients (46%) good, 6 patients (15%) fair and 6 patients (15%) reported poor results. In the long term, 25 patients (64%) had no pain, 8 patients (20%) had mild pain, and 6 patients (16%) had severe pain. Ten patients (26%) reported normal sensitivity in their toes, 26 patients (66%) had numbness, and 3 patients (8%) reported dysesthesia in their toes. Twenty-two patients (56%) could wear fashionable shoes, 11 patients (28%) comfortable shoes, and 6 patients (16%) modified shoes. Regarding walking distance, 30 patients (77%) had no limitation, and 9 patients (23%) reported some limitation. Nineteen per cent regretted having surgery. Around 40% (17 out of 43 web spaces) showed anatomical variations in either the nerve or in the web space and we could not identify any specific risk factors in relation to the outcome. Conclusion Dividing the DTIML or dorsal neurolysis should be considered as the primary surgical treatment and, if this fails, neurectomy would be an option. DNT can be considered if one is concerned about stump neuroma, but this may be technically demanding and in some patients it may not be possible. Level of Evidence: Level IV - Case Control Retrospective study.

Consonance perception in congenital amusia: behavioral and brain responses to harmonicity and beating cues

Congenital amusia is a neurodevelopmental disorder characterized by difficulties in the perception and production of music, including the perception of consonance and dissonance, or the judgment of certain combinations of pitches as more pleasant than others. Two perceptual cues for dissonance are inharmonicity (the lack of a common fundamental frequency between components) and beating (amplitude fluctuations produced by close, interacting frequency components). In the presence of inharmonicities or beats, amusics have previously been reported to be insensitive to inharmonicity, but to exhibit normal sensitivity to beats. In the present study, we measured adaptive discrimination thresholds in amusic participants and found elevated thresholds for both cues. We recorded EEG and measured the mismatch negativity (MMN) in evoked potentials to consonance and dissonance deviants in an oddball paradigm. The amplitude of the MMN response was similar overall for amusics and controls, but while control participants showed a stronger MMN to harmonicity cues than to beating cues, amusic participants showed a stronger MMN to beating cues than to harmonicity cues. These findings suggest that initial encoding of consonance cues may be intact in amusia despite impaired behavioral performance, but that the relative weight of non-spectral cues may be increased for amusic individuals.

Treatment of large and ptotic breasts

The breasts have always been considered a sign of femininity. The correction of breast deformities is therefore important from a physical and psychological point of view, improving greatly the quality of life. Many surgical techniques have been proposed to correct the shape and volume of the breast, and in recent decades techniques have been proposed to preserve the nipple sensitivity and increase the vascular safety of the procedure. Templates (such as the Wise pattern) have been proposed to improve planning and different pedicles for the areola have been described. During the last 20 years, new techniques have been introduced to minimize scars, leaving normal sensitivity in almost all cases, the possibility of lactation, and a pleasing shape. The periareolar scar is, unfortunately, always necessary to reposition the nipple–areolar complex. The vertical scar is necessary to resect the excess of skin of the lower pole of the breast. Effort has been directed to reduce or eliminate the horizontal submammary scar, leading to a vertical scar only, even in large reductions.

PolB1 Is Sufficient for DNA Replication and Repair Under Normal Growth Conditions in the Extremely Thermophilic Crenarchaeon Sulfolobus acidocaldarius

The thermophilic crenarchaeon Sulfolobus acidocaldarius has four DNA polymerases (DNAPs): PolB1, PolB2, PolB3, and Dbh (PolY). Previous in vitro studies suggested that PolB1 is the main replicative DNAP of Sulfolobales whereas PolB2 and Y-family polymerases Dpo4 (Saccharolobus solfataricus) or Dbh are involved in DNA repair and translesion DNA synthesis. On the other hand, there are various opinions about the role of PolB3, which remains to be clearly resolved. In order to examine the roles of the DNAPs of S. acidocaldarius through in vivo experiments, we constructed polB2, polB3, and dbh deletion strains and characterized their phenotypes. Efforts to construct a polB1 deletion strain were not successful; in contrast, it was possible to isolate triple gene-deletion strains lacking polB2, polB3, and dbh. The growth of these strains was nearly the same as that of the parent strains under normal growth conditions. The polB2, polB3, and dbh single-deletion strains were sensitive to some types of DNA-damaging treatments, but exhibited normal sensitivity to UV irradiation and several other damaging treatments. Overall, the genotype which exhibited the greatest sensitivity to the DNA-damaging treatments we tested was the ΔpolB2 ΔpolB3 combination, providing the first evidence of overlapping function for these two DNAPs in vivo. The results of our study strongly suggest that PolB1 is responsible for the DNA replication of both the leading and lagging strands and is sufficient to complete the repair of most DNA damage under normal growth conditions in S. acidocaldarius.

COVID-CT-Mask-Net: Prediction of COVID-19 from CT Scans Using Regional Features

We present COVID-CT-Mask-Net model that predicts COVID-19 from CT scans. The model works in two stages: first, it detects the instances of ground glass opacity and consolidation in CT scans, then predicts the condition from the ranked bounding box detections. To develop the solution for the three-class problem (COVID, common pneumonia and control), we used the COVIDx-CT dataset derived from the dataset of CT scans collected by China National Center for Bioinformation. We use about 5% of the training split of COVIDx-CT to train the model, and without any complicated data normalization, balancing and regularization, and training only a small fraction of the model’s parameters, we achieve a 90.80% COVID sensitivity, 91.62% common pneumonia sensitivity and 92.10% normal sensitivity, and an overall accuracy of 91.66% on the test data (21182 images), bringing the ratio of test/train data to 7.06, which implies a very high capacity of the model to generalize to new data. We also establish an important result, that ranked regional predictions (bounding boxes with scores) in Mask R-CNN can be used to make accurate predictions of the image class. The full source code, models and pretrained weights are available on https://github.com/AlexTS1980/COVID-CT-Mask-Net.

COVID-CT-Mask-Net: Prediction of COVID-19 from CT Scans Using Regional Features

We present COVID-CT-Mask-Net model that predicts COVID-19 from CT scans. The model works in two stages: first, it detects the instances of ground glass opacity and consolidation in CT scans, then predicts the condition from the ranked bounding box detections. To develop the solution for the three-class problem (COVID, common pneumonia and control), we used the COVIDx-CT dataset derived from the dataset of CT scans collected by China National Center for Bioinformation. We use about 5% of the training split of COVIDx-CT to train the model, and without any complicated data normalization, balancing and regularization, and training only a small fraction of the model’s parameters, we achieve a 90.80% COVID sensitivity, 91.62% common pneumonia sensitivity and 92.10% normal sensitivity, and an overall accuracy of 91.66% on the test data (21182 images), bringing the ratio of test/train data to 7.06, which implies a very high capacity of the model to generalize to new data. We also establish an important result, that ranked regional predictions (bounding boxes with scores) in Mask R-CNN can be used to make accurate predictions of the image class. The full source code, models and pretrained weights are available on https://github.com/AlexTS1980/COVID-CT-Mask-Net.

Less is more: Light sampling via throttled visual phototransduction robustly synchronizes the Drosophila circadian clock in the absence of Cryptochrome

SummaryThe daily changes of light and dark exemplify a prominent cue for the synchronization of internal circadian clocks to external time. The match between external and internal time is crucial for the fitness of organisms and desynchronization has been linked to numerous physical and mental health problems in humans. Organisms therefore developed complex and not fully understood mechanisms to synchronize their circadian clock to light. In mammals and in Drosophila both the visual system and dedicated non-image forming photoreceptors contribute to light resetting of the circadian clock. In the fruit fly, light-dependent degradation of the clock protein TIMELESS (TIM) by the blue light photoreceptor Cryptochrome is considered the main mechanism for clock synchronization, although the visual system also contributes. In order to understand the nature of the visual system contribution, we generated a genetic variant exhibiting extremely slow phototransduction kinetics, yet normal sensitivity. We show that in this variant the visual system is able to contribute its full share to circadian clock entrainment, both with regard to behavioral and molecular synchronization to light:dark cycles. This function depends on an alternative Phospholipase C-ß enzyme, encoded by PLC21C, presumably playing a dedicated role in clock resetting by light. We show that this pathway requires the ubiquitin ligase CULLIN-3, presumably mediating CRY-independent degradation of TIM during light:dark cycles. Our results suggest that visual system contribution to circadian clock entrainment operates on a drastically slower time scale compared with fast, visual and image forming phototransduction. Our findings are therefore consistent with the general idea that the visual system samples light over prolonged periods of time (hours) in order to reliably synchronize their internal clocks with the external time.

Successful Microneurovascular Penile Replantation Using Loupe Magnification Following Self Amputation in A Young Patient

Amputation of the penis is a rare condition reported from various parts of the world. They reported as isolated cases or small series of patients in scientific research. The common etiology is self amputation by sharp weapon or an avulsion or crush injury in an industrial accident or following violence. Complete reconstruction of anatomical structures should be done in one stage which provides the best chance for full rehabilitation of the patient. We report here a single case of sub-total amputation of the penis at it's proximal third in a schizophrenic patient. The penis was successfully replanted using a microsurgical technique. After surgery, near-normal appearance and function including a good urine flow and absence of urethral stricture, capabilities of erection and near normal sensitivity were observed. Journal of Surgical Sciences (2013) Vol. 17 (1) : 54-57

Mechanical nociceptive thresholds in endurance horses

BackgroundAlteration of limb sensitivity is forbidden in equine sports but difficult to enforce. We aimed to develop an objective field method to assess mechanical nociceptive threshold (MNT) in endurance horses.MethodsA remotely controlled pneumatic actuator (1 mm tip) was used to measure forelimb pastern MNT in 108 endurance horses.ResultsMedian (IQR) MNT at rest was 1.9 N (0.9–3.5). Icing had no significant effect on limb sensitivity. MNT measured at weekly intervals increased from week 1 (1.2 N (0.6–1.8)) to week 3 (1.9 N (1.2–2.8)) (P<0.05). In 17 horses without impaired sensitivity, MNT increased from 1.2 N (0.6–2.3) before to 2.4 N (1.2–5.2) after racing (P=0.0017). In desensitised horses, MNT after racing was higher (8 limbs—23.1 N (21.4 to >25)) than in horses without impaired sensitivity (42 limbs—2.2 N (1.2–4.3)) (P<0.0001). Desensitisation with mepivacaine increased MNT to above the safety cut-off (25 N) at 10 minutes; sensitivity return to baseline varied between individuals but was restored by 330 minutes. None of the horses became averse to the technique.ConclusionMNT was practical, non-traumatic, repeatable and well tolerated under field conditions in endurance horses. The technique differentiated postracing MNT in horses with normal sensitivity from those with impaired sensitivity.

THE EXPERIENCE WITH THE APPLICATION OF THE «EKZARTA» (REDCORD) KINESIOTHERAPEUTIC EQUIPMENT FOR THE REHABILITATION OF THE PATIENTS WITH SPINAL CORD PATHOLOGY AT THE CERVICAL LEVEL

The patients suffering a traumatic spinal cord injury (TSCI) at the cervical level need motor rehabilitation the adequate achievement of which is hampered due to the development of tetraparesis up to and including tetraplegia. For this reason, they require creation of the special conditions for making the prescribed physical exercises. The objective of the present study was to evaluate the influence of exercises performed with the use of the “Ekzarta” (Redcord) kinesiotherapeutic equipment on the neurological status of the patients with spinal cord pathology at the cervical level. A total of 102 patients referred to group 1 disability were available for the observation before, during the intermediate and late rehabilitation periods after the traumatic spinal cord injury at the cervical level representing the A, B, C, and D neurological types as estimated based on the ASIA/ISCSCI scale. The examination included gathering complaints, assessment of the neurological status with the evaluation of the motor, manual, locomotor functions, estimation of the inferior segment with normal sensitivity, and the presence of sensitivity in the paralyzed parts of the body. Spastic syndrome intensity was assessed based on the Ashworth scale, and the intensity of pain syndrome with the application of the visual analogue scale. The treatment resulted in the elevation of arterial pressure, reduction of the intensity of spastic and pain syndrome, and significant increase of the motor scores. The statistically significant increase of the locomotor scores was also documented in the patients with types C and D neurological deficit while the patients with neurological deficit of types A, B, C exhibited the significant increase of the manual scores.