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Establishing the cause of unilateral leg pain is difficult in the settings of tibial diaphyseal sclerosis. This patient, a 36-year-old woman presented with unilateral pretibial leg pain for past 7 months without history of trauma, infections, systemic or metabolic disease. Besides local deep tenderness, other clinical findings and blood investigations were normal. Radiograph and CT scan showed both periosteal and endosteal cortical thickening with obliteration of medulla of the tibial midshaft. MRI scan detected marrow oedema and bone scan revealed increased tracer uptake at the affected site of tibia. She was treated by saucerisation and re-establishment of the medullary canal. Biopsy of the harvested tissue had trabecular bone without any sign of inflammation. Patient was pain free after 3 months of operation and was able to perform her activity of daily living without any difficulties. Ribbing disease is a disease of exclusion and need high degree of suspicion for its diagnosis.

В ходе представленной работы было проведено изучение гендерных различий билатеральной асимметрии мозжечка.Для исследования были использованы данные размеров длины червя мозжечка, полушарий мозжечка, моста, продолговатого мозга, высоты червя мозжечка, моста, продолговатого мозга на уровне верхней и нижней границы, полушарий мозжечка, ширины мозжечка, полушарий мозжечка. Исследования проводились посредством изучения архивных материалов, полученных с помощью метода магнитно-резонансной томографии. Проведённый статистический анализ выявил гендерные различия в высоте левого полушария мозжечка и в высоте моста: высота левого полушария мозжечка у мальчиков оказалась на 4,45% больше, чему у девочек; высота моста больше на 6,4%.По данным некоторых авторов у мужчин выявлены большие значения параметров мозжечка, чем у женщин. Разница размеров мозжечка мужчин и женщин объясняется разницей среднестатистических размеров черепа. По сведениям других авторов в результате исследований была установлена взаимосвязь длины тела и величины мозжечка. Если брать в пример исследования, которые проводились с помощью магнитно-резонансной томографии, то было установлено, что поперечный и правый продольный размеры мозжечка у мужчин характеризуется статистически достоверным преобладанием параметров в сравнении с женщинами. Результаты нашего исследования выявили гендерные различия в высоте левого полушария мозжечка и моста. Наибольшее значение показателя имели мальчики, что, в свою очередь, не противоречит результатам других исследований.Таким образом, в результате данного исследования были установлены гендерные различия в размерах мозжечка и моста, а также наличие билатеральной асимметрии полушарий мозжечка у мальчиков девятилетнего возраста., The presented work examined gender differences in the bilateral asymmetry of the cerebellum.Data on the dimensions of cerebellar vermis length, cerebellar hemispheres, bridge, medulla oblongata, cerebellar vermis height, bridge, medulla oblongata at upper and lower border level, cerebellar hemispheres, cerebellar width, and cerebellar hemispheres were used for the study. The research was carried out by examining archival materials obtained by magnetic resonance imaging.A statistical analysis showed gender differences in the height of the left cerebellar hemisphere and the height of the bridge: the height of the left cerebellar hemisphere was 4.45% higher in boys than in girls; the height of the bridge was 6.4% higher.According to some authors, males have been found to have larger cerebellar parameters than females. The difference in the size of the cerebellum between males and females is due to differences in the average skull size. According to other authors, research has established a correlation between body length and cerebellar size. Taking magnetic resonance imaging studies as an example, it was found that the transverse and right longitudinal dimensions of the cerebellum were statistically significantly more prevalent in males than in females. The results of our study indicated gender differences in the height of the left cerebellar hemisphere and the pons. Boys had the highest value of the index, which, in turn, did not contradict the results of other studies.Thus, this study established gender differences in cerebellar and bridge size, as well as the presence of bilateral asymmetry of the cerebellar hemispheres in nine-year-old boys., Международный научно-исследовательский журнал, Выпуск 7 (133) 2023

An 8-year-old normal weight boy with a medical history of obstructive sleep apnoea since 4 years of age using a continuous positive airway pressure machine at night and with bronchial asthma was in his usual state of health until 1 month prior to presentation, when his mother noticed significant

The nociceptive network, responsible for transmission of nociceptive signals that generate the pain experience, is not fully developed at birth. Descending serotonergic modulation of spinal nociception, an important part of the pain network, undergoes substantial postnatal maturation and is suggested to be involved in the altered pain response observed in human newborns. This review summarizes preclinical data of the development of descending serotonergic modulation of the spinal nociceptive network across the life span, providing a comprehensive background to understand human newborn pain experience and treatment. Sprouting of descending serotonergic axons, originating from the rostroventral medulla, as well as changes in receptor function and expression take place in the first postnatal weeks of rodents, corresponding to human neonates in early infancy. Descending serotonergic modulation switches from facilitation in early life to bimodal control in adulthood, masking an already functional 5-HT inhibitory system at early ages. Specifically the 5-HT3 and 5-HT7 receptors seem distinctly important for pain facilitation at neonatal and early infancy, while the 5-HT1a, 5-HT1b, and 5-HT2 receptors mediate inhibitory effects at all ages. Analgesic therapy that considers the neurodevelopmental phase is likely to result in a more targeted treatment of neonatal pain and may improve both short- and long-term effects. Impact: The descending serotonergic system undergoes anatomical changes from birth to early infancy, as its sprouts and descending projections increase and the dorsal horn innervation pattern changes.Descending serotonergic modulation from the rostral ventral medulla switches from facilitation in early life via the 5-HT3 and 5-HT7 receptors to bimodal control in adulthood.A functional inhibitory serotonergic system mainly via 5-HT1a, 5-HT1b, and 5-HT2a receptors at the spinal level exists already at the neonatal phase but is masked by descending facilitation.

Близько 422 мільйонів людей у ​​світі хворіють на цукровий діабет. Серед захворювань цукровий діабет посідає третє місце, а серед ендокринних захворювань — перше. Деякі питання щодо патогенезу цього захворювання залишаються неясними. Основною причиною ураження діабетом є високий рівень глюкози в крові. Гіперглікемія чинить токсичну дію на судини нирок. Метою цього дослідження є вивчення впливу цукрового діабету, індукованого алоксаном, на ремоделювання кори нирок. Матеріали та методи. Ми розділили двадцять чотири статевозрілих білих щурів-самців на контрольну та експериментальну групи. Експериментальним тваринам алоксан вводили внутрішньоочеревинно одноразово в дозі 40 мг/кг. Рівень глюкози в крові вимірювали через 2, 12 і 24 години після ін'єкції алоксану, а потім щотижня. Середній рівень глюкози залишався 11,0 ± 2,0 ммоль/л. Тварин забивали на 14, 21 та 45 добу. Фарбували гістологічні препарати нирок гематоксиліном та еозином. Підібрана доза алоксану та спосіб його введення викликали у щурів стійку гіперглікемію і не призводили до їх загибелі. Результати. На 14-ту добу в хворій нирці потовщення стінок клубочкових капілярів. Нефрони мали сферичну форму зі злегка нерівною поверхнею. На 21 добу спостереження відрізнити кору від довгастого було важче. На 45-ту добу дистальні канальці втратили звичну форму, стоншилися, їх важко відрізнити від інших канальців на гістологічному препараті. Кора стала губчастою внаслідок кістозного розширення канальців. Висновки. Усі компоненти кори нирки зазнавали щоденних змін. На ранніх етапах експерименту він виглядав значно щільнішим порівняно з корковим шаром нирок тварин контрольної групи. Візуально збільшилася кількість субкапсулярних нефронів, потовщилася ниркова капсула. У подальшому періоді експерименту спостерігали розширення та кровонаповнення клубочкових капілярів з їх лейкоцитарною інфільтрацією. Крім того, спостерігалося кістозне розширення канальців, через що кортикальний шар нирки мав вигляд губки. Abstract About 422 million people in the world suffer from diabetes mellitus. Among diseases, diabetes ranks third, and among endocrine disorders, it ranks first. Some issues concerning the pathogenesis of this disease are unclear. The main reason for diabetes damage is high blood glucose levels. Hyperglycaemia has a toxic effect on the vessels of the kidneys. The present study aims to investigate the impact of alloxan-induced diabetes mellitus on the remodeling of the renal cortex. Materials and methods. We divided twenty-four mature white male rats into the control and experimental groups. We administered alloxan to experimental animals intraperitoneally at a single dose of 40 mg/kg. Blood glucose levels were measured 2, 12, and 24 hours after injection of alloxan and then weekly. The average glucose level remained 11.0 ± 2.0 mmol/l. Animals were sacrificed on days 14, 21, and 45. We stained histological preparations of kidneys with hematoxylin and eosin. The selected dose of alloxan and the method of its administration caused persistent hyperglycemia in rats and did not lead to their death. Results. On the 14th day, the diseased kidney had a thickening of the glomerular capillary walls. Nephrons had a spherical shape with a slightly uneven surface. On the 21st day of the observation, it was more difficult to distinguish the cortex from the medulla. On the 45th day, the distal tubules lost their usual shape, became thinner, and were difficult to distinguish from other tubules by histological preparation. The cortex became spongy due to cystic dilation of the tubules. Conclusions. All components of the renal cortex underwent daily changes. At the early stages of the experiment, it looked much denser compared to the cortical layer of the kidneys of animals in the control group. The number of subcapsular nephrons visually increased, and the renal capsule thickened. In the later period of the experiment, dilatation and blood fullness of glomerular capillary with their leukocyte infiltration were observed. In addition, there was a cystic expansion of the tubules, due to which the cortical layer of the kidney looked like a sponge.

The neuropeptide Pigment-Dispersing Factor (PDF) plays a prominent role in the circadian clock of many insects including honey bees. In the honey bee brain, PDF is expressed in about 15 clock neurons per hemisphere that lie between the central brain and the optic lobes. As in other insects, the bee PDF neurons form wide arborizations in the brain; but certain differences are evident. For example, they arborize only sparsely in the accessory medulla (AME), which serves as important communication center of the circadian clock in cockroaches and flies. Furthermore, all bee PDF neurons cluster together, which makes it impossible to distinguish individual projections. Here, we investigated the developing bee PDF network and found that the first three PDF neurons arise in the 3rd larval instar and form a dense network of varicose fibers at the base of the developing medulla that strongly resembles the AME of hemimetabolous insects. In addition, they send faint fibers toward the lateral superior protocerebrum. In last larval instar, PDF cells with larger somata appear and send fibers toward the distal medulla and the medial protocerebrum. In the dorsal part of the medulla serpentine layer, a small PDF knot evolves from which PDF fibers extend ventrally. This knot disappears during metamorphosis and the varicose arborizations in the putative AME become fainter. Instead a new strongly stained PDF fiber hub appears in front of the lobula. Simultaneously, the number of PDF neurons increases and the PDF neuronal network in the brain gets continuously more complex. This article is protected by copyright. All rights reserved.

Single intradermal injections of nerve growth factor (NGF) evoke prolonged but temporally distinct sensitization patterns to somatosensory stimuli. Focal administration of the non-histaminergic pruritogen cowhage but not histamine resulted in elevated itch at day 21 after NGF administration. Here, we injected bovine adrenal medulla peptide 8–22 (BAM8–22), β-alanine (β-ALA) and endothelin-1 (ET-1) into NGF-treated skin of 11 healthy volunteers and investigated the corresponding itch/pain and flare reactions. β-ALA was the weakest pruritogen, while BAM8–22 and ET-1 were equally potent as histamine. NGF did not sensitize itch or flare reactions induced by any compound, but injection and evoked pain were increased at day 21 and 49. The involvement of histamine H1 receptors in itch was explored in eight subjects after oral cetirizine. ET-1-induced itch and flare were significantly reduced. BAM8–22 and β-ALA itch were not affected, but flare responses after BAM8–22 reduced by 50%. The results indicate that a single NGF injection does not sensitize for experimentally induced itch but increases pain upon pruritogen injection. In healthy humans, pruritic and algetic processing appear differentially regulated by NGF. However, in patients suffering chronic itch, prolonged elevation of NGF-levels under inflammatory conditions may contribute to elevated itch.

The postinspiratory complex (PiCo) is a region located in the ventromedial medulla involved with the post-inspiratory activity. PiCo neurons are excitatory (VGlut2+) and express the enzyme choline acetyl transferase (ChAT+). Evidence also suggests that PiCo is coupled to two additional groups of neurons involved in breathing process, i.e. the pre-Botzinger complex (preBotC, inspiration) and the retrotrapezoid nucleus (RTN, active expiration), composing all together, the hypothesized triple respiratory oscillator. Here, our main objective is to demonstrate the afferent connections to PiCo region. We mapped projecting-neurons to PiCo by injecting Fluorogold (FG) retrograde tracer into the PiCo of adult Long-Evans Chat-cre male rats. We reported extensive projections from periaqueductal grey matter and Kolliker-Fuse regions and mild projections from the nucleus of the solitary tract, ventrolateral medulla and hypothalamus. We also injected a cre-dependent vector expressing channelrhodopsin 2 (AAV5-ChR2) fused with enhanced mCherry into the PiCo of ChAT-cre rats to optogenetic activate those neurons and investigate the role of PiCo for inspiratory/postinspiratory activity. Both in urethane-anesthetized and unrestrained conscious rats the response of ChR2-transduced neurons to light induced an increase in postinspiratory activity. Our data confirmed that PiCo seems to be dedicated to postinspiratory activity and represent a site of integration for autonomic and motor components of respiratory and non-respiratory pathways.

Background: Braak and others have proposed that Lewy-type α-synucleinopathy in Parkinson’s disease (PD) may arise from an exogenous pathogen that passes across the gastric mucosa and then is retrogradely transported up the vagus nerve to the medulla. Objective: We tested this hypothesis by immunohistochemically staining, with a method specific for p-serine 129 α-synuclein (pSyn), stomach and vagus nerve tissue from an autopsy series of 111 normal elderly subjects, 33 with incidental Lewy body disease (ILBD) and 53 with PD. Methods: Vagus nerve samples were taken adjacent to the carotid artery in the neck. Stomach samples were taken from the gastric body, midway along the greater curvature. Formalin-fixed paraffin-embedded sections were immunohistochemically stained for pSyn, shown to be highly specific and sensitive for α-synuclein pathology. Results: Median disease duration for the PD group was 13 years. In the vagus nerve none of the 111 normal subjects had pSyn in the vagus, while 12/26 ILBD (46%) and 32/36 PD (89%) subjects were pSyn-positive. In the stomach none of the 102 normal subjects had pSyn while 5/30 (17%) ILBD and 42/52 (81%) of PD subjects were pSyn-positive. Conclusion: As there was no pSyn in the vagus nerve or stomach of subjects without brain pSyn, these results support initiation of pSyn in the brain. The presence of pSyn in the vagus nerve and stomach of a subset of ILBD cases indicates that synucleinopathy within the peripheral nervous system may occur, within a subset of individuals, at preclinical stages of Lewy body disease.

Objectives Despite the growing concern regarding the adverse effects related to problematic smartphone use (PSU), little is known about underlying morphologic changes in the brain. The brainstem is a deep brain structure that consists of several important nuclei associated with emotions, sensations, and motor functions. In this study, we sought to examine the difference in the volume of brainstem substructures among adolescents with and without PSU. Methods A total of 87 Korean adolescents participated in this study. The PSU group (n=20, age=16.2±1.1, female:male=12:8) was designated if participants reported a total Smartphone Addiction Proneness Scale (SAPS) score of ≥42, whereas the remaining participants were assigned to the control group (n=67, age=15.3±1.7, female:male=19:48). High-resolution T1 magnetic resonance imaging was performed, and the volume of each of the four brainstem substructures [midbrain, pons, medulla, and superior cerebellar peduncle (SCP)] was measured. Analysis of covariance was conducted to reveal group differences after adjusting for effects of age, gender, whole brain-stem volume, depressive symptoms, and impulsivity. Results The PSU group showed a significantly smaller volume of the SCP than the control group (F=8.273, p=0.005). The volume of the SCP and the SAPS score were negatively correlated (Pearson's r=-0.218, p=0.047). Conclusion The present study is the first to reveal an altered volume of the brainstem substructure among adolescents with PSU. This finding suggests that the altered white matter structure in the brainstem could be one of the neurobiological mechanisms underlying behavioral changes in PSU.

The aim of our study was to examine whether slow or rapid cryopreservation of adrenal xenografts affected xenotransplant outcome. Adrenal xenografts were got from newborn piglets (24 h after birth). Receptor rats were randomly divided into four groups: a bilateral adrenalectomy group, fresh xenotransplantation group, rapid cryopreservation xenotransplantation group, and a slow cryopreservation xenotransplantation group. 30 days after xenotransplantation, the survival rates of rats in the fresh xenotransplantation group, rapid cryopreservation xenotransplantation group and slow cryopreservation xenotransplantation group were 80 %, 60 % and 60 %, respectively, which were significantly higher than 40 % of the bilateral adrenalectomy group. In addition, the survival rate of rats in the slow cryopreservation group was consistently significantly higher than that in the rapid cryopreservation group at 29 days after xenotransplantation. Morphological observation showed that there were a few medulla cells existed in the adrenal glands in the slow cryopreservation group after 30 days of xenotransplantation, but no medulla cells were found in the rapid cryopreservation group. The plasma cortisol level of rats in the fresh xenotransplantation group and the slow xenotransplantation group 30 days after xenotransplantation was significantly higher than that of the rapid cryopreservation group and bilateral adrenalectomy group (P 0.05). The levels of liver glycogen and cholesterol in the xenotransplantation rats were increased relative to those of the bilateral adrenalectomy rats, and close to normal level. In conclusion, compared with rapidly frozen preserved grafts, slowly frozen preserved grafts not only ensure the structural integrity of adrenal tissues, but also have corresponding physiological functions, which provid a basic research opportunities for the preservation of xenografts and the treatment of adrenal corticosteroid deficiency. Moreover, these findings can provide evidence for xenotransplantation in the treatment of Addison's disease (adrenal cortex hormone deficiency).

Intracranial neurenteric cyst at the anterior craniocervical junction is very rare, and its treatment and prognosis have not been established. We report a case of neurenteric cyst at the anterior craniocervical junction and review the relevant literature. A 16-year-old girl presented with a 2-month history of slowly progressive headache. MRI revealed a well-defined intradural extramedullary cyst in the anterior medulla and brain stem with C1 cord compression. We performed gross total resection of the cyst using a far-lateral transcondylar approach. Surgical resection is the treatment of choice for neurenteric cysts at anterior craniocervical junction, the far-lateral transcondylar approach might be the optimal surgical approach.

Since H63D syndrome was first described, the authors of this paper systematically investigated for the first time to what extent the adrenal glands, as an integral part of the HPA and SAM axes, are also affected by damage caused by non-transferrin bound iron (NTBI), a hallmark of H63D syndrome. Due to the rarity of the H63D syndrome, the representatives of a number of institutions that regularly deal with the topic in the context of their clinical and research activities have come together for this purpose. Thus, a small but significant amount of patient data could be collected worldwide, analyzed and evaluated, with surprisingly clear pathological results. A secondary aspect is that after reviewing the currently available literature, the team of authors came to the conclusion that the issue of HPA and SAM axes dysfunctions and adrenal synthesis activity seems to be also more frequent in other iron metabolic disorders than it is addressed to in everyday’s clinical practice. The result of this work is a warning call to closely monitor the catecholamine balance, the synthesis and control of all "stress hormones", the condition of the adrenal glands as well as other axis structures very early in the course of the H63D syndrome, in order to make unnecessary organ damages at least a little less likely, if not to prevent it to a large extent if detected early.

Since the market launch of alprazolam (in many countries under the brand name Xanax), this highly potent benzodiazepine has had a disastrous public reputation. Even in media, entertainment and pop culture, its very powerful effects have made it emblematic of a sinister psychodrug that drags its users into an abyss of dependence and suffering. Indeed, the substance has certain specific properties (mood elevating, extremely fast acting, very short half-life, effects on adrenaline), but at its core it is a benzodiazepine like any other. How Xanax came to be demonized is therefore an important question to be discussed. On the other hand, the substance alprazolam possesses a unique property that is hardly known even among experts to this day and can be life-saving for people whose body's own adrenaline synthesis and regulation is disturbed by certain (often hereditary, auto-immune, or toxic) rare diseases. For these patients, there is virtually no other medication available than alprazolam, which quickly, specifically and highly effectively inhibits pathological adrenaline surges, for example due to disorders of the SAM axis, effectively at the site of adrenaline (epinephrine) synthesis by up to 50%. Logically, this also gives rise to the legendary reputation that alprazolam is more effective than any other benzodiazepine, especially in patients with panic disorders. This paper, a source-supported opinion piece, is intended to remind the worldwide community of medical professionals that alprazolam is a legitimate, and often the only available, treatment option for abnormal adrenaline balance involving the adrenal gland and/or the SAM axis. Demonizing alprazolam in a clinically well regulated setting is therefore immoral and detrimental to the patients health and compliance.

Background. When lung cancer develops a solitary metastasis at the pontomedullary junction, due to surgical risk, the current oncologic treatment is radiosurgery and chemotherapy. Case Description. We describe a patient with a single intrinsic metastasis at the pons and medulla. Removal was successful, without complication. Conclusion. Surgery can provide excellent results, and in selected patients, it should be considered a first-line treatment in experienced hands.

Background A synchrotron-based Fourier transform infrared micro-spectrometer (μ-FTIR) allows the spatial determination of lipids across the different layers of ethnic hairs and differentiates between the lipid order arrangement and quantity. Materials and methods The three ethnic fibers were delipidized, the lipid extracts were characterized, and the delipidized fibers were studied by dynamic vapor sorption experiments (DVS) and FTIR-synchrotron techniques. Results The average spectra from the different hair regions exhibited the most intense CH2 sym peaks on the medulla, followed by those from the cuticle and cortex for all hairs of different ethnicities. Differences in the lipid fraction of the three hair types have been observed, and they can explain some barrier properties. African virgin hair was demonstrated to have more lipids mainly in the medulla, which implies an important hydrophobicity with low hysteresis between absorption and desorption water vapor processes. In addition, these lipids are highly disordered, mainly in the cuticle, which can be related to its high water vapor diffusion. Asian and Caucasian virgin hairs presented a similar lipid order in all regions, with similar diffusion coefficients. Results indicate that the higher order of the lipid bilayer hinders water permeation kinetics in some way. Conclusion The differences in the presence and organization of the lipids in the different regions of the African hair can account for its differentiation with regards to moisturization and swelling from the other types of fibers., Support for this work from CTQ CTQ2018-094014-B-100 is gratefully acknowledged. Moreover the authors acknowledge the MIRAS beamline at ALBA Synchrotron for the grant and the ALBA staff for their expert assistance.

Mice and rats are among the most used laboratory animals. They share numerous similarities along with differences, some yet unexplored. One of them is the morphometry of their adrenal glands, whose characteristics may be related to differences in energy management, immune response, drug metabolism, behaviour and temperament. The present study tries to fill this knowledge gap with the evaluation and comparison of adrenal gland anatomical/morphometric parameters of mice and rats. In groups of 10 ( n = 10) adult, male and female BALB/c mice and Wistar rats, one in every 20 sections transverse to the longitudinal axis of the gland was used for measuring entire gland area, capsule, entire cortex, cortex zones and medulla with the aid of an image analysis system and subjected to statistical analysis. Quotients of the individual areas were calculated and comparison between the resulting ratios was performed. Gland length and volume were also calculated. Statistically significant differences were revealed between the rat female and male cortex area, rat and mouse medulla/cortex, medulla/gland, zona glomerulosa/cortex and cortex/gland ratios, male and female rats’ medulla/cortex, medulla/gland, capsule/gland, zona glomerulosa/cortex, zona reticularis/cortex and zona glomerulosa/zona fasciculata ratios, length and volume. The correlation evaluation revealed that in male rats and in female mice the larger medulla area was accompanied by a larger cortex area and vice versa. In general, a larger cortex area was accompanied by larger areas of cortex zones. The collected data and the revealed differences can possibly contribute to the understanding of the physiology of the two species.

The neurological complications of coronavirus disease 2019 (SARS-CoV-2, COVID-19) have so far included a range of para- and post-infectious neuroinflammatory syndromes inclusive of all components of the neuraxis and peripheral neuromuscular system. In comparison to the para-infectious manifestations of anosmia, ageusia, encephalopathy, and encephalitis, cases of post-infectious ADEM have rarely been reported and have most commonly affected the supratentorial component with or without spinal cord involvement. In this report, we describe a case of isolated involvement of the cervicothoracic spinal cord and medulla, occurring in association with microhemorrhages and hemosiderin deposition in the medulla, that presented fulminantly and required aggressive immunotherapy to control the inflammatory attack. We compare and contrast this case against prior reports of acute hemorrhagic leukoencephalitis (Weston Hurst syndrome) and review the atypical features of neuroinflammation reported to occur following COVID-19 infection.

The development of metanephros is a complex and gradual process. The number, size and distribution of nephrons provide important information about the organization of the kidney. Stereology is the current gold-standard technique for the morphometrical evaluation of kidney structures. This study describes morphometric features of the kidney development in sheep using design-based stereological techniques aimed to introduce the sheep as a translational model in human nephrogenesis. Left kidneys of 16 sheep fetuses in four groups at 9–11, 12–14, 15–17, and 18–20 weeks of gestation were used in the present study. Systematic uniform random sections were obtained. The kidney volume, volume fraction of nephrogenic zone, cortex and medulla, and glomerular volume were estimated using point counting and Cavalieri's estimator. The total glomerular number was estimated using a physical disector/fractionator technique. The kidney and its compartments presented gradual changes with aging, with differences found in the last fetal ages. The kidney volume increased from 0.94 ± 0.22 cm3 to 8.6 ± 0.88 cm3 during development. The volume of cortex increased from 406 ± 85 mm3 to 5,151 ± 309 mm3 and the volume of medulla showed increase from 301 ± 91 mm3 to 3,426 ± 599 mm3. The total glomerular volume increased from 13.8 ± 1.6 mm3 to 235 ± 44 mm3. The total glomerular number increased from 4,683 ± 757 to 639 × 103 ± 11.6 × 103. Our data might contribute to the knowledge of embryological urology and promote future experimental investigations in this field.

In case of acute urinary tract obstruction, only a few of the patients could restore full renal function if the obstruction is relieved after a long period of time. Therefore, to introduce an effective method to evaluate the residual renal function in obstructive nephropathy is very important for optimizing treatment and predicting the prognosis. To investigate the longitudinal variation of split renal function in unilateral ureteral obstruction (UUO) rats by dynamic contrast-enhanced (DCE) MRI. Twenty one rats were randomly divided into seven groups who underwent low dose Gd-DTPA (0.04 mmol/kg) DCE MR at 6 h, 12 h, 24 h, 72 h, 1w and 2ws after UUO operation or sham operation as well. The volume of each kidney was measured. The time signal intensity curves (namely MR nephrogram, MRR) of renal parenchyma were plotted. The Baumann–Rudin model was used to calculate the clearance rate (kcl) of Gd-DTPA from cortex to medulla. All rats were then scarified for pathological examination. The size of obstructive kidney was increased along with the obstruction time. The average kcl of obstructive kidneys of sham operation group and 6 h, 12 h, 24 h, 72 h and 1 week after UUO were 3.53 ± 0.31, 3.45 ± 1.06, 2.43 ± 0.35, 2.36 ± 0.23, 2.13 ± 0.42 and 1.73 ± 0.45/min, respectively. The kcl of obstructive kidney 2 weeks after the UUO couldn’t be calculated because of renal parenchyma atrophy. Similarly, the kcl of contralateral kidneys at the above time points after UUO were 3.33 ± 0.32, 3.15 ± 0.07, 3.20 ± 0.26, 3.90 ± 0.70, 2.87 ± 0.15, 2.97 ± 0.40 and 2.90 ± 0.68/min, respectively. The kcl of obstructive kidney was declined progressively over obstruction time and declined rapidly since the time point of 12 h (P

Cavity surgery and, in particular, surgery of the skull with its contents are losing their origins in the distant past of mankind.

Atomic force microscopy integrated with infrared spectroscopy (AFM‐IR) has been used to topographically and chemically examine the medulla of human hair fibres with nanometre scale lateral resolution. The mapping of cross‐sections of the medulla showed two distinct structural components which were subsequently characterised spectroscopically. One of these components was shown to be closely similar to cortical cell species, consistent with the fibrillar structures found in previous electron microscope (EM) investigations. The other component showed large chemical differences from cortical cells and was assigned to globular vacuole species, also confirming EM observations. Further characterisation of the two components was achieved through spectral deconvolution of the protein Amide‐I and ‐II bands. This showed that the vacuoles have a greater proportion of the most thermodynamically stable conformation, namely the antiparallel β‐sheet structures. This chimes with the observed lower cysteine concentration, indicating a lower proportion of restrictive disulphide cross‐link bonding. Furthermore, the large α‐helix presence within the vacuoles points to a loss of matrix‐like material as well as significant intermolecular stabilisation of the protein structures. By analysing the carbonyl stretching region, it was established that the fibrillar, cortical cell‐like components showed considerable stabilisation from H‐bonding interactions, similar to the cortex, involving amino acid side chains whereas, in contrast, the vacuoles were found to only be stabilised significantly by structural lipids.

Background: Lymphoid tissue is the first to react to stress, which manifests as characteristic morphological manifestations, based on which it is possible to study the duration of damage. Aims: Study of the dynamics of changes in the histomorphometric characteristics of the rat thymus during regeneration of the musculocutaneous tissue during mechanical thigh trauma. Material and methods: In total, 84 sexually mature rats were enrolled. These were divided into two groups (experiment and control), which were further classified into four subgroups depending on the time elapsed since the injury (1, 3, 15, and 25 days). Mechanical damage was simulated using a setup that transferred kinetic energy (comparable to a 5.6-mm rifle bullet) to tissues. Subsequently, the animals were removed from the experiment by decapitation; their thymus was removed and microscopically examined. In arbitrary units, the total area of the lobules as well as the area of the cortical and cerebral zones was determined. Results: Our research results indicate different phases of changes in the histomorphometric characteristics of the thymus, which correspond to the course of the wound and can be used in forensic practice to determine the duration of the injury. Conclusions: Mechanical trauma, considered as a stress reaction, causes involutive changes in the thymus and is characterized by changes in the area of the thymus cortex and medulla as well as regular dynamics of changes in the thymic lobules at different stages of wound regeneration.

Visual information is processed in the optic lobes, which consist of three retinotopic neuropils. These are the lamina, the medulla and the lobula. Biogenic amines play a crucial role in the control of insect responsiveness, and serotonin is clearly related to aggressiveness in invertebrates. Previous studies suggest that serotonin modulates aggression-related behaviours, possibly via alterations in optic lobe activity. The aim of this investigation was to immunohistochemically localize the distribution of serotonin transporter (SERT) in the optic lobe of moderate, docile and aggressive worker honeybees. SERT-immunoreactive fibres showed a wide distribution in the lamina, medulla and lobula; interestingly, the highest percentage of SERT immunoreactivity was observed across all the visual neuropils of the docile group. Although future research is needed to determine the relationship between the distribution of serotonin fibres in the honeybee brain and aggressive behaviours, our immunohistochemical study provides an anatomical basis supporting the role of serotonin in aggressive behaviour in the honeybee.

We performed 3D reconstruction of the microscopic structure of the adrenal medulla of the adult rats using serial histological sections with histochemical differentiation of adrenaline-storing (A) and noradrenaline-storing (NA) cells. Medulla volume is 1.18 ± 0.17 mm3 . Chromaffin tissue consists of 82.9 ± 2.6% of A and 17.1 ± 2.6% of NA cells. Cords of the chromaffinocytes run along the nerves in the adrenal cortex and form cones when merging with medulla bulk. There is no unambiguously greater prevalence of A cells over NA in the areas of the medulla bordering on the cortex as compared to deep layers of medulla. NA cells form a network of beams. Their concentration increases with distance from the entry site of the nerves and is maximal on the opposite side. This testifies to the fallacy of the point of view about the disordered distribution of NA cells in the medulla. Based on the polar asymmetric arrangement of the adrenal chromaffin tissue, if it is necessary to completely remove the medulla with the keeping or reimplantation of the cortex, the subcapsular cortex zone located on the pole opposite to the entrance of nerves should be chosen. In addition, comparable results in the stereological examination of the medulla can be obtained only if taking its areas similar in location. The pronounced relationship in the arrangement of A and NA cells with nerves clearly indicates that in vivo nerve factors play a key role in differentiation and stabilization of the A and NA cells phenotypes.

Cisplatin is a chemotherapeutic agent widely employed in the treatment of various solid tumors. However, its use is often restricted by acute kidney injury (AKI) which is the dose-limiting adverse effect of cisplatin. While numerous studies aiming to alleviate the AKI have been conducted, there are no effective remedies in clinical practice. In this paper, a targeted metabolomics study was performed to reveal the potential relationship between tryptophan metabolism and cisplatin-induced AKI. A chemical derivatization integrated liquid chromatography coupled tandem mass spectrometry (LC-MS/MS) approach was utilized to quantify 29 metabolites in the tryptophan pathway in rat kidney medulla and cortex after cisplatin administration. Results showed that tryptophan metabolism was remarkably disturbed both in the medulla and cortex after cisplatin administration. We also found that the tryptophan pathway in the medulla was more sensitive to cisplatin exposure compared with the cortex. Among these metabolites, indoxyl sulfate was focused for further study because it accumulated most significantly in the kidney cortex and medulla in a dose-dependent manner. A function verification study proved that chlormethiazole, a widely used CYP2E1 inhibitor, could reduce the production of indoxyl sulfate in the liver and attenuate cisplatin-induced AKI in rats. In conclusion, our study depicted the tryptophan pathway in cisplatin-induced AKI for the first time and demonstrated tryptophan metabolism is closely associated with the renal toxicity caused by cisplatin, which can be of great use for the discovery of renal toxicity attenuating remedies.

Fibroblasts have recently attracted attention as a key stromal component that controls the immune responses in lymphoid tissues. The thymus has a unique microenvironment comprised of a variety of stromal cells, including fibroblasts and thymic epithelial cells (TECs), the latter of which is known to be important for T cell development because of their ability to express self‐antigens. Thymic fibroblasts contribute to thymus organogenesis during embryogenesis and form the capsule and medullary reticular network in the adult thymus. However, the immunological significance of thymic fibroblasts has thus far only been poorly elucidated. In this review, we will summarize the current views on the development and functions of thymic fibroblasts as revealed by new technologies such as multicolor flow cytometry and single cell–based transcriptome profiling. Furthermore, the recently discovered role of medullary fibroblasts in the establishment of T cell tolerance by producing a unique set of self‐antigens will be highlighted.

Background Infarction of the medulla has been associated with prolongation of the QTc, severe arrhythmia, and sudden cardiac death, yet the precise anatomical substrate remains uncertain. Aims We sought to determine the possible anatomical structures relating to QTc-prolongation in patients with acute medullary infarction. Methods We included 12 subjects with acute ischemic medullary infarction on brain MRI, who presented within 4.5 h from the last known well time, with a 90-day follow-up. For an unbiased lesion analysis, medullary infarcts were manually outlined on diffusion weighted MRI and co-registered with an anatomical atlas. Results Nine out of 12 had QTc-prolongation. Qualitative and semi-quantitative comparisons were made between infarct location and QTc-prolongation. Among patients with QTc-prolongation, the greatest degree of congruence of the infarct location was over the dorsal vagal nucleus (DVN, 8 out of 9). There was a significant correlation between the number of sections showing infarction of the DVN and presence of QTc-prolongation (r = .582, p = .047). Among patients without QTc-prolongation, the maximum lesion overlap included the medial aspect of the gigantocelluar reticular nucleus of the reticular formation. Conclusion We found that the DVN is a key anatomical substrate related to QTc-prolongation. Further studies with more patients and high-resolution, volumetric MRI are needed to confirm our findings.

Immunosuppressive drugs such as cyclosporine A (CSA) can disrupt thymic structure and functions, ultimately inducing syngeneic/autologous graft-versus-host disease together with involuted medullas. To elucidate the effects of CSA on the thymus more precisely, we analyzed the effects of CSA on the thymus and T cell system using rats. In addition to confirming the phenomena already reported, we newly found that the proportion of recent thymic emigrants also greatly decreased, suggesting impaired supply. Immunohistologically, the medullary thymic epithelial cells (mTECs) presented with a relative decrease in the subset with a competent phenotype and downregulation of class II major histocompatibility complex molecules. In control rats, thymic dendritic cells (DCs) comprised two subsets, XCR1+SIRP1α−CD4− and XCR1−SIRP1α+CD4+. The former had a tendency to selectively localize in the previously-reported epithelium-containing areas of the rat medullas, and the number was significantly reduced by CSA treatment. The epithelium-free areas, another unique domains in the rat medullas, contained significantly more Foxp3+ thymic Tregs. With CSA treatment, the epithelium-free areas presented strong involution, and the number and distribution of Tregs in the medulla were greatly reduced. These results suggest that CSA inhibits the production of single-positive thymocytes, including Tregs, and disturbs the microenvironment of the thymic medulla, with a decrease of the competent mTECs and disorganization of epithelium-free areas and DC subsets, leading to a generation of autoreactive T cells with selective medullary involution.

Background The posterior spinal arteries (PSAs), branches of the intracranial segment of the vertebral artery or posterior inferior cerebellar artery, run bilaterally along the spinal cord and are integral to the blood supply primarily to the posterior one third of this structure. However, a less well-described distribution of the PSAs is their supply to the posterior medulla. The purpose of this study is to examine the medullary branches of the PSA anatomically. Methods We conducted a cadaveric study to evaluate for branches of the PSA supplying the medulla oblongata. Results All 14 sides had medullary branches arising from the PSAs. The average number of branches supplying the medulla oblongata on each side was 6. Most of these branches traveled laterally to anastomose with medullary branches arising from the anterior spinal artery. Additionally, lateral and ascending branches were noted. Conclusions Physicians who interpret imaging of the craniocervical junction, in particular arteriograms, should be aware of ascending medullary branches arising from the anterior spinal artery. Additionally, neurosurgeons operating this region must be careful in dissecting over the posterior medulla and manipulating the cerebellar tonsils, as in telovelar approaches to the fourth ventricle, in order to avoid iatrogenic injury to these vessels. Additionally, variable stroke patterns involving the vertebral artery or posterior inferior cerebellar artery might include ischemia to the medulla oblongata via PSA branches, and this anatomy should be kept in mind by interventionalists, radiologists, and neurologists alike.

Background: Adrenal gland is a lifesaving endocrine gland of the human body. Knowledge of normal microscopic anatomy of the Adrenal gland facilitates Pathologists to correlate and make the differential diagnosis of various adrenal glands associated clinical conditions on histopathological examination. Aims and Objective: To study histological features of human adrenal gland in the post-natal period at different ages. Materials and Methods: Present study is conducted with 98 human adrenal glands from 49 unclaimed dead bodies during an autopsy and 22 human adrenal glands from 11 cadavers during routine dissection in S.V Medical College, Tirupati, which were utilized after obtaining consent from the close kith and kin. During the autopsy/dissection, the samples collected were from 2 Years to 64 years of age individuals of both sex with typical external features and divided into three groups. The first group consisted of less than 25 years of age. The second group consists of ages between 26 years to 50 years. The third group included 51 years and above, and all the specimens are processed for histological staining and observed under the microscope. Results: At 2 years well-developed capsule with large vessels and well-differentiated zones of definitive cortex and medulla were identified. The thick muscular coat of the central vein was identified at 20 years. At 36 years & 45 years, cellular architecture in various zones is very well differentiated. At 65 years, the cortico-medullary demarcation was irregular, and vascularity decreased. Conclusion: Histological features of pre-pubertal, adult, and old age group sections helps in the understanding of post-natal changes in the growth of the Suprarenal gland and its functions.

Anatomical differences between the renal cortex and medulla may influence inflam matory responses. Owing to the difficulty in diagnosing rejections from the medulla, rejection is usually diagnosed through the cortex. However, previous studies have shown that there are no significant differences in renal cortical and medullary lesions in acute allograft rejection. A 60-year-old man with a history of diabetic nephropathy underwent kidney transplant from a living unrelated donor at our hospital in August 2019. Three days after surgery, his urine output suddenly decreased, whereas the serum creatinine levels increased. A kidney biopsy showed only medullary lesions with positive C4d-stain ing and a Banff score of PTC grade 3. He was diagnosed with acute antibody-mediated rejection (AMR) and treatment was initiated. He did not respond to conventional treat ments, including plasma exchange and intravenous immunoglobulin, but his general condition improved after bortezomib administration. There have been a few cases of acute AMR limited to medullary lesions. We consider that rejection cannot be excluded even if the lesions are confined to the medulla.

This is a clinical case of a 24-year-old woman with the unrescetable cystic tumor of the medulla because of eloquent area involved and severe neurological symptoms caused by the recurrent cystic component. The patient underwent emptying the cyst twice previously by means of safe entry zone myelotomy. Later there was a recurrence of the cyst with a significant neurological and oweral deterioration which is typical for such neoplasms. Recurrent cystic mass-effect was resolved with the help of newly designed device implanted. It provided simultaneous stable cisternal drainage and an opportunity for active aspiration via Ommaya reservoir.

Two different strands of hair taken from Beethoven's head after his death were examined for heavy metals using scanning electron microscopy (SEM) and laser ablation-ICP-MS (inductively coupled plasma-mass spectroscopy). The results revealed the presence of small lead particles on the surface of Beethoven's hairs and fluctuating lead levels in hair medulla along the length of the hair due to alternating lead exposure, with an average lead exposure of 100 times the normal value. The time-line attached to the peaks of these fluctuating values correlate with the pneumonia treatment and the paracenteses performed, including the subsequent treatment of the procedure wounds. While the administration of lead-containing drugs and treatments had been proven to resolve the pneumonia, it had simultaneously caused massive liver failure, accelerated by pre-existing cirrhosis. The question as to whether Beethoven's death was a case of malpractice can only be answered from a forensic point of view ex ante, since the state of the medical knowledge of the time has to be taken into account.Zwei verschiedene Haarsträhnen, die postmortal vom Kopf Beethovens entnommen worden waren, wurden mittels REM (Rasterelektronenmikroskop) und Laserablation-ICP-MS („inductively coupled plasma–mass spectroscopy“) auf Schwermetalle untersucht. Die Ergebnisse zeigten das Vorhandensein kleinster Bleipartikel auf der Oberfläche der Haare und eine Bleibelastung des Haarmarks aufgrund fluktuierender Bleiexposition, wobei die durchschnittliche Bleiexposition das 100-fache des Normalwerts betrug. Der zeitliche Verlauf der Spitzenwerte dieser ondulierenden Messergebnisse korreliert mit der Behandlung der Lungenentzündung und den durchgeführten Parazentesen sowie den anschließenden Wundbehandlungen. Während die Anwendung bleihaltiger Medikamente und Behandlungen die Pneumonie nachweislich zum Abklingen brachte, bewirkte sie gleichzeitig ein schweres Leberversagen, das durch die bereits vorbestehende Zirrhose beschleunigt wurde. Die Frage, ob Beethovens Tod die Folge ärztlichen Fehlverhaltens war, kann aus forensischer Sicht nur ex ante beantwortet werden, da der Stand des medizinischen Wissens der damaligen Zeit zu berücksichtigen ist.

Various lymph node functions are regulated by the sympathetic nervous system as shown in rodent studies. If human lymph nodes show a comparable neural regulation, their afferent nerves could represent a potential therapeutic target to treat, for example, infectious or autoimmune disease. Little information is available on human lymph node innervation and the aim of this study is to establish a comprehensive and accurate representation of the presence and location of sympathetic nerves in human lymph nodes. Since previous studies mention sympathetic paravascular nerves to occasionally extent into T cell‐rich regions, the relation of these nerves with T cells was studied as well. A total number of 15 inguinal lymph nodes were resected from six donated human cadavers. Lymph node sections were stained with HE and a double T/B cell staining for evaluation of their morphology and to screen for general pathologies. A triple stain was used to identify blood vessels, sympathetic nerves and T cells, and, to study the presence and location of sympathetic nerves and their relation to T cells. To evaluate whether the observed nerves were en route to other structures or were involved in local processes, adjacent slides were stained with a marker for varicosities (synaptophysin), which presence is suggestive for synaptic activity. All lymph nodes contained sympathetic nerves, both as paravascular and discrete structures. In 15/15 lymph nodes, nerves were observed in their capsule, medulla and hilum, whereas only 13/15 lymph nodes contained nerves in their cortex. The amount of sympathetic nerves varied between compartments and between and within individuals. In general, if a lymph node contained more paravascular nerves in a specific compartment, more discrete nerves were observed as well. Occasionally, discrete nerves were observed in relation to T cells in lymphoid tissues of the cortex and medulla. Furthermore, discrete nerves were frequently present in the capsule and hilum. The presence of varicosities in a portion of these nerves, independently to their compartment, suggested a local regulatory function for these nerves. Human lymph nodes contain sympathetic nerves in their capsule, trabeculae, cortex, medulla and hilum, both as paravascular or as discrete structures. Discrete nerves were observed in relation to T cells and non‐T cell‐rich areas such as the hilar and capsular connective tissue. The presence of discrete structures suggests neural regulation of structures other than blood vessels, which was further supported by the presence of varicosities in a portion of these nerves. These observations are of relevance in further understanding neural regulation of lymph node immune responses and in the development of neuromodulatory immune therapies., Human lymph nodes contain a significant number of sympathetic nerves (black encircled, pink stained TH positive structures). These nerves can be observed surrounding vascular structures, but also as discrete entities in the capsule, cortex, medulla and hilum. In the medulla, these nerves are frequently observed in proximity with immune cells such as T lymphocytes (CD3 positive cells as shown in the right images). Sympathetic nerves in lymph nodes might contribute to neuro immune regulation of lymph node immune function.

Background: The human adrenal gland shows a distinct proportion of two histological zones, named the cortex and the medulla, from outer inwards, in its histological appearance with differences in its cellular components and functions. Objective: The present study aims to see the variation in the proportion of the cortex and the medulla of the adrenal glands with age in a Bangladeshi population. Methods: A cross-sectional, descriptive study was done in the Department of Anatomy, Dhaka Medical College, Dhaka, from July 2008 to June 2009, based on collection of 140 postmortem human adrenal glands from 70 unclaimed dead bodies, in the Department of Forensic Medicine, Dhaka Medical College, Dhaka. The samples were divided into four age-groups including A (11-20 years), B (21-30 years), C (31-40 years) & D (41-60 years). Histological slides were prepared by using routine haematoxylin and eosin stain (H & E). Five best prepared slides from each group were examined under light compound microscope with low magnification. The thickness of adrenal cortex and medulla were measured by using ocular and stage micrometer and then converted into percentage volume. Results: The mean volume of the right adrenal cortex were found 83.64±3.71% in group A, 83.90±1.75% in group B, 83.74±5.78% in group C, 84.80±3.82% in group D, while the mean volume of the corresponding medulla were found 18.16±3.23% in group A, 15.70±2.71% in group B, 16.26±3.97% in group C, 16.20±4.04% in group D. The mean volume of the left adrenal cortex were found 84.64±3.49%, 84.90±1.75%, 84.20±3.40%, 85.44±2.66% in group A, B, C and D respectively, while the mean volume of the corresponding medulla were found 17.26±3.84%, 17.00±2.37%, 16.00±3.20% and 14.36±2.33% in group A, B, C and D respectively. The differences among the groups were not statistically significant. Conclusion: No difference was found in the proportion of the cortex and the medulla of adrenal gland in different age-groups. Mediscope Vol. 8, No. 1: January 2021, Page 1-6

Peripheral chemoreflex is activated during short-term sustained hypoxia (SH), and the first synapse of these afferents is located in Nucleus Tractus Solitarius (NTS). NTS neurons projecting to the ventral lateral medulla (NTS-VLM) are part of the respiratory pathways of the chemoreflex. SH increases the magnitude of basal respiratory parameters in rats from Wistar-Hannover strain. In this study, we hypothesized that the observed changes in the respiratory pattern in response to SH were due to changes in the GABAergic modulation of the synaptic transmission of NTS-VLM neurons. We used an electrophysiological approach to record the synaptic activity of NTS neurons labeled with a retrograde tracer previously microinjected into VLM of Wistar-Hannover rats submitted to 24 h SH. The data are showing that: (a) the amplitude of evoked inhibitory currents in NTS-VLM neurons of SH rats was reduced and not accompanied by any change in rise-time and decay-time; (b) the 1/CV2 and the number of failures in response to evoked currents were also affected by SH; (c) the frequency of spontaneous inhibitory currents was reduced by SH without changes in amplitude and half-width. These effects of SH were observed in NTS-VLM neurons located in caudal and intermediate NTS, but not in NTS-VLM neurons located in the rostral NTS. We conclude that SH causes a reduction in inhibitory modulation onto NTS-VLM neurons by pre-synaptic mechanisms, which may contribute to the observed changes in the respiratory pattern of Wistar-Hannover rats submitted to SH.

Context: Truncal pulsion is a compelling sensation of being pulled to one side, in the context of normal motor and sensory functions and normal co-ordination. It is seen in a variety of ischemic strokes. Aims: This article aims at identifying ischemic stroke syndromes associated with truncal pulsion, with review of the neural substrate responsible, to help in recognition and reporting. Settings and Design: This was a prospective study conducted at Department of Neurology, at Pushpagiri institute of medical sciences and research centre, Thiruvalla, Kerala, India, over a period of 5 years, among patients with acute ischemic stroke. Methods and Material: We studied all patients with acute ischemic stroke, who were admitted to our department, over a five-year period. Patients presenting with truncal pulsion were shortlisted and were assessed by investigators independently. All patients underwent MRI brain, which was assessed by investigators 1 and 2, independently. The demographic profile, risk factors, clinical features, neuroimaging findings and outcomes were analysed using SPSSv21. Results: A total of 1456 patients with acute ischemic strokes were identified, of which 27 with truncal pulsion were included in the study. The common sites of infarction resulting in truncal pulsion were lateral medulla, cerebellum, thalamus, pons and midbrain. One patient had infarct involving anterior cingulate. Truncal pulsion was ipsilateral in infarcts involving medulla and cerebellum and contralateral in infarcts involving the pons, midbrain, mesencephalo-diencephalic junction, thalamus and cingulate. Conclusions: Truncal pulsion, a compelling sensation of falling, is a disabling symptom occurring in a variety of strokes and it poses significant challenge in neuro-rehabilitation.

The present study aimed to explain the mechanisms involved in cell-mediated immunotoxicity of atrazine (ATR) in rabbits and to evaluate the ameliorative role of glycyrrhizic acid (GA) against such toxic effects. Forty rabbits were assigned into 4 equal groups: control, ATR, GA, and ATR + GA groups. ATR (2475 ppm) and GA (60 μg of GA/ml of water) were administrated via food and drinking water, respectively, for 60 consecutive days. The cell-mediated immunotoxicity of ATR was clarified by the induced thymus immunotoxicity through downregulation of interleukin (IL)-9 gene and interferon-γ (IFN-γ) gene expression, upregulation in caspase-3, and significant decrease in the total leukocytic and lymphocyte counts. Histopathological investigations demonstrated severe depletion of lymphoid follicles in the medulla of the thymus gland. On the other hand, co-administration of GA for group 4 improved most of the undesirable impacts of ATR. In conclusion, the alteration in IL-9/IFN-γ expression may involve ATR-induced thymocyte apoptosis which may explain the mechanisms of ATR-induced cell-mediated immunotoxicity with a possible amelioration influence of GA administration.

Objective To elucidate the mechanism of hypertensive crisis during energy device ablation of the adrenal gland. Methods Electrocoagulation on the adrenal glands of six pigs was carried out with the same energy device (VIO300D) using four methods: (i) monopolar coagulation; (ii) monopolar soft coagulation using IO-advanced ball-type electrodes; (iii) bipolar soft coagulation by pinching; and (iv) bipolar soft coagulation by non-pinching (surface contact) using Bipolar forceps Premium. After electrocoagulation for 5 s, blood pressure and pulse changes were monitored, and adrenal hormones were measured from a central vein. The adrenal glands were removed, and the degree of tissue damage was scored histologically. Results Hypertensive crisis occurred with electrocoagulation of the adrenal gland by the monopolar coagulation, monopolar soft coagulation and bipolar soft coagulation pinching methods. Blood pressure did not change with the bipolar soft coagulation non-pinching method. Pathologically, tissue damage to the adrenal medulla was associated with elevated blood pressure and adrenaline and noradrenaline release. Conclusions Hypertensive crisis caused by energy device ablation to the adrenal gland is caused by the release of catecholamines due to heat damage to the adrenal medulla rather than the type of energy device. Proper use of an energy device that does not cause thermal degeneration of the medulla is required to prevent hypertensive crisis.

The importance of supplementary motor area (SMA) for motor function and compensation for primary motor area (M1) has received increased attention. We used diffusion tensor imaging (DTI) and transcranial magnetic stimulation (TMS) to evaluate structure and function of corticospinal projection originating from SMA. Fibers of corticospinal projection originating from M1 (CST) and SMA (ACST) were analyzed. ACST originating from mesial SMA area formed separate white matter bundles leaving the anterior part of M1 area, which then entered the posterior limb of the internal capsule. Projection and overlap of both CST and ACST were detected on medulla. Fibers of contralesional ACST were more than that of ipsilesional ACST in patients with SMA tumors (p

Behavioral and internal-state modulation of sensory processing has been described in several organisms. In insects, visual neurons in the optic lobe are modulated by locomotion, but the degree to which visual–motor feedback modulates these neurons remains unclear. Moreover, it also remains unknown whether self-generated and externally generated visual motion are processed differently. Here, we implemented a virtual reality system that allowed fine-scale control over visual stimulation in relation to animal motion, in combination with multichannel recording of neural activity in the medulla of a female honeybee (Apis mellifera). We found that this activity was modulated by locomotion, although, in most cases, only when the bee had behavioral control over the visual stimulus (i.e., in a closed-loop system). Moreover, closed-loop control modulated a third of the recorded neurons, and the application of octopamine (OA) evoked similar changes in neural responses that were observed in a closed loop. Additionally, in a subset of modulated neurons, fixation on a visual stimulus was preceded by an increase in firing rate. To further explore the relationship between neuromodulation and adaptive control of the visual environment of the bee, we modified motor gain sensitivity while locally injecting an OA receptor antagonist into the medulla. Whereas female honeybees were tuned to a motor gain of −2 to 2 (between the heading of the bee and its visual feedback), local disruption of the OA pathway in the medulla abolished this tuning, resulting in similar low levels of response across levels of motor gain. Our results show that behavioral control modulates neural activity in the medulla and ultimately impacts behavior.SIGNIFICANCE STATEMENTWhen moving, an animal generates the motion of the visual scene over its retina. We asked whether self-generated and externally generated optic flow are processed differently in the insect medulla. Our results show that closed-loop control of the visual stimulus modulates neural activity as early as the medulla and ultimately impacts behavior. Moreover, blocking octopaminergic modulation further disrupted object-tracking responses. Our results suggest that the medulla is an important site for context-dependent processing of visual information and that placing the animal in a closed-loop environment may be essential to understanding its visual cognition and processing.

Hallucinations, percepts in the absence of external stimuli, are a shared feature of visual hallucinations caused by eye-disease (Charles Bonnet Syndrome, CBS) or Parkinson’s disease (PD) which are thought to arise through pathophysiologically distinct mechanisms: deafferentation and attentional network dysfunction respectively. Recent studies have found an association between hallucinations and structural changes in the cerebellum without obvious link to either mechanism. Here, we employed Voxel Based Morphometry (VBM), optimised for the cerebellum using the Spatially Unbiased Infratentorial Template (SUIT), to characterise similarities and differences in cerebellar structure associated with visual hallucinations in PD and CBS. Grey and white matter volume (GMV & WMV) from patients with eye-disease (n = 12 hallucinators; n = 9 non-hallucinators) and PD (n = 7 hallucinators; n = 9 non-hallucinators) was examined in a 2-way ANOVA controlling for age, sex, and intracranial volume. Comparing hallucinators to controls across both groups, lower GMV was found bilaterally within cerebellar lobule VIII extending to IX/VII. GMV reductions were also found in Crus 1, greater in PD than eye-disease. Predominantly within PD, hallucination-related lower WMV was found in the medulla. No regions of increased GMV or WMV were found. A correlation was observed between brainstem WMV and lobule VIIIb GMV suggesting a functional association. Lobule VIII comprises a functional node within the Dorsal Attention Network (DAN), linking these findings to current attentional theories of hallucination, while Crus 1 is linked to cortical visual processing. These findings provide preliminary evidence of a cerebellar contribution to hallucinations that transcends clinical conditions.

Background: Alpha-synuclein (α-syn) is involved in pathology of Parkinson’s disease, and 90% of α-syn in Lewy bodies is phosphorylated at serine 129 (pS129 α-syn). Objective: To assess behavior impairments and brain levels of α-syn and pS129 α-syn in mice overexpressing human α-syn under Thy1 promoter (Thy1-α-syn) and wild type (wt) littermates. Methods: Motor and non-motor behaviors were monitored, brain human α-syn levels measured by ELISA, and α-syn and pS129 α-syn mapped by immunohistochemistry. Results: Male and female wt littermates did not show differences in the behavioral tests. Male Thy1-α-syn mice displayed more severe impairments than female counterparts in cotton nesting, pole tests, adhesive removal, finding buried food, and marble burying. Concentrations of human α-syn in the olfactory regions, cortex, nigrostriatal system, and dorsal medulla were significantly increased in Thy1-α-syn mice, higher in males than females. Immunoreactivity of α-syn was not simply increased in Thy1-α-syn mice but had altered localization in somas and fibers in a few brain areas. Abundant pS129 α-syn existed in many brain areas of Thy1-α-syn mice, while there was none or only a small amount in a few brain regions of wt mice. The substantia nigra, olfactory regions, amygdala, lateral parabrachial nucleus, and dorsal vagal complex displayed different distribution patterns between wt and transgenic mice, but not between sexes. Conclusion: The severer abnormal behaviors in male than female Thy1-α-syn mice may be related to higher brain levels of human α-syn, in the absence of sex differences in the altered brain immunoreactivity patterns of α-syn and pS129 α-syn.

Stopping opioid medications can result in a debilitating withdrawal syndrome in chronic users. Opioid withdrawal can occur at all ages, but mechanistic understanding of this condition is predominantly derived from adult studies. Here, we examined whether there are age-dependent differences in the behavioural phenotype and cellular indices of opioid withdrawal. We tested this by assessing the behavioural and cFos response (a surrogate marker for neuronal activation) to morphine withdrawal in C57BL/6J mice across key developmental stages—neonatal, adolescent, and adulthood. Mice in all age groups received escalating doses of morphine (10–50 mg/kg) over 5 days and withdrawal was precipitated by a single injection of the opioid receptor antagonist naloxone (2 mg/kg) two hours after the last morphine dose. In adult and adolescent mice, withdrawal behaviours were robust, with age-related differences in autonomic and somatic signs. In both groups, cFos expression was increased in spinally projecting neurons within the Periaqueductal Grey (PAG), Rostro-ventromedial Medulla (RVM), and Locus Coeruleus. Neonatal animals displayed both a distinct behavioural withdrawal and cFos expression profile. Notably, in young animals cFos expression was increased within the PAG and LC, but decreased in the RVM. In summary, naloxone challenge precipitated robust opioid withdrawal behaviours across all developmental stages with neonatal animals displaying differences in withdrawal behaviours and unique neuronal activation patterns within key brainstem regions.

The rostral ventrolateral medulla (RVLM) is a brain region involved in normal regulation of the cardiovascular system and heightened sympathoexcitatory states of cardiovascular disease (CVD). Among major risk factors for CVD, sedentary lifestyles contribute to higher mortality than other modifiable risk factors. Previous studies suggest excessive glutamatergic excitation of presympathetic neurons in the RVLM occurs in sedentary animals. Therefore, the purpose of this study was to examine neuroplasticity in the glutamatergic system in the RVLM of sedentary and physically active rats. We hypothesized that relative to active rats, sedentary rats would exhibit higher expression of glutamate N-methyl-d-aspartic acid receptor subunits (GluN), phosphoGluN1, and the excitatory scaffold protein postsynaptic density 95 (PSD95), while achieving higher glutamate levels. Male Sprague-Dawley rats (4 weeks old) were divided into sedentary and active (running wheel) conditions for 10-12 weeks. We used retrograde tracing/triple-labeling techniques, western blotting, and magnetic resonance spectroscopy. We report in sedentary versus physically active rats: 1) fewer bulbospinal non-C1 neurons positive for GluN1, 2) significantly higher expression of GluN1 and GluN2B but lower levels of phosphoGluN1 (pSer896) and PSD95, and 3) higher levels of glutamate in the RVLM. Higher GluN expression is consistent with enhanced sympathoexcitation in sedentary animals; however, a more complex neuroplasticity occurs within subregions of the ventrolateral medulla. Our results in rodents may also indicate that alterations in glutamatergic excitation of the RVLM contribute to the increased incidence of CVD in humans who lead sedentary lifestyles. Thus, there is a strong need to further pursue mechanisms of inactivity-related neuroplasticity in the RVLM.

Introduction: The posterior fossa is the most common intracranial location for pediatric ependymoma. While ependymoma usually arises from the ventricular lining of the fourth ventricle as a solid mass, it rarely originates from the brainstem. Grade II ependymomas also infrequently appear as a cavitary ring-enhancing lesion. Case Presentation: We describe a case of a 6-year-old boy with an ependymoma arising within the medulla with imaging features of a thick-walled rim-enhancing cavitary lesion. A stereotactic biopsy was obtained which confirmed a grade II ependymoma. The patient received focal proton beam radiation therapy and is doing well with no concerns for disease progression at 28 months after diagnosis. Conclusion: Posterior fossa ependymomas typically arise from ependymal cells within the fourth ventricle or foramina of Luschka. They rarely invade or arise within the brainstem parenchyma. Our case had atypical imaging findings in addition to the atypical tumor location. The lesion was described as a thick-walled rim-enhancing focal cystic necrotic lesion centered within the medulla with surrounding nonenhancing expansile infiltrative changes. Ring-enhancing lesions can be seen in patients with anaplastic ependymoma, but is not commonly reported in grade II ependymomas. In summary, this report highlights a unique case of a posterior fossa ependymoma in a pediatric patient arising in an atypical brainstem location as well as having unique imaging features.

Kidneys of six each of adult broiler chicken and broiler ducks were used in the present study. In the histological studies, the kidneys of all studied birds showed two zones, the cortex and medulla. The medulla occupied only a small portion of the kidney. In chicken a greater number of distinct cone-shaped medullary lobules were seen among cortical lobules while in duck they were lesser in number, more rounded in outline and were not cone shaped as in chicken. In the case of chicken more than one cortical lobule drained into a medullary lobule. Mammalian type of nephrons that occupied the juxta medullary region presented loop of Henle that was located within the medullary cone. Collecting ducts from different medullary lobules united together to form several large collecting ducts within the medulla which in turn united to form ureteral branches.