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Background: Aesthetic neuromodulator injections of the upper face are frequently performed to temporarily block muscular actions of the periorbital muscles to ultimately reduce skin rhytids. However, the adverse event rate in the literature for toxin‐induced blepharoptosis ranges from 0.51% to 5.4%. Objective: To identify access pathways by which injected neuromodulator product can travel from extra‐ to intra‐orbital and therefore affect the levator palpebrae superioris muscle. Methods: Nine non‐embalmed human body donors were investigated in this study with a mean age at death of 72.8 (16.1) years. The 18 supraorbital regions were injected in 28 times (14 for supratrochlear and 14 for supraorbital) with 0.5 cc, whereas eight cases (four for supratrochlear and four supraorbital) were injected with 0.1 cc of colored product. Anatomic dissections were conducted to identify structures stained by the injected color. Results: The results of this injection‐ and dissection‐based study revealed that both the supratrochlear and the supraorbital neurovascular bundles are access pathways for injected neuromodulator products to reach the intra‐orbital space and affect the levator palpebrea superioris muscle. Out of 36 conducted injection passes, seven (19.44%) resulted in affection of the sole elevator of the eyelid of which 100% occurred only at an injection volume of 0.5 cc and not at 0.1 cc. Conclusion: Clinically, the results indicate that a low injection volume, a superficial injection for the supraorbital location, and angling the needle tip away from the supratrochlear foramen (toward the contralateral temple) when targeting the corrugator supercilii muscles, can increase the safety profile of an aesthetic toxin glabellar treatment. [ABSTRACT FROM AUTHOR]

In the present communication, the painting La Carità (The Charity) by Francesco de Rossi, also known as Salviati (1510-1563), is examined from a multidisciplinary perspective, combining the following disciplines: human anatomy, palaeopathology and history of art. In the impossibility to establish a final diagnosis due to the artistic nature of the artwork, the anatomical alterations found on the iconographic representation are discussed in light of two alternative hypotheses, namely chronic mastitis or breast cancer. Once more the intersection between medicine and art can be found to be of excellent use both for increasing the ancient record of diseases and in an educational effort to train the eye of future physicians. [ABSTRACT FROM AUTHOR]

All allergic responses to food indicate the failure of immunological tolerance, but it is unclear why cow's milk and egg (CME) allergies resolve more readily than reactivity to peanuts (PN). We sought to identify differences between PN and CME allergies through constitutive immune status and responses to cognate and non-cognate food antigens. Children with confirmed allergy to CME (n = 6) and PN (n = 18) and non-allergic (NA) (n = 8) controls were studied. Constitutive secretion of cytokines was tested in plasma and unstimulated mononuclear cell (PBMNC) cultures. Blood dendritic cell (DC) subsets were analyzed alongside changes in phenotypes and soluble molecules in allergen-stimulated MNC cultures with or without cytokine neutralization. We observed that in allergic children, constitutively high plasma levels IL-1β, IL-2, IL-4, IL-5 and IL-10 but less IL-12p70 than in non-allergic children was accompanied by the spontaneous secretion of sCD23, IL-1β, IL-2, IL-4, IL-5, IL-10, IL-12p70, IFN-γ and TNF-α in MNC cultures. Furthermore, blood DC subset counts differed in food allergy. Antigen-presenting cell phenotypic abnormalities were accompanied by higher B and T cell percentages with more Bcl-2 within CD69+ subsets. Cells were generally refractory to antigenic stimulation in vitro, but IL-4 neutralization led to CD152 downregulation by CD4+ T cells from PN allergic children responding to PN allergens. Canonical discriminant analyses segregated non-allergic and allergic children by their cytokine secretion patterns, revealing differences and areas of overlap between PN and CME allergies. Despite an absence of recent allergen exposure, indication of in vivo activation, in vitro responses independent of challenging antigen and the presence of unusual costimulatory molecules suggest dysregulated immunity in food allergy. Most importantly, higher Bcl-2 content within key effector cells implies survival advantage with the potential to mount abnormal responses that may give rise to the manifestations of allergy. Here, we put forward the hypothesis that the lack of apoptosis of key immune cell types might be central to the development of food allergic reactions. [ABSTRACT FROM AUTHOR]

Membrane-cytoskeleton interaction regulates transmembrane currents through stretchactivated channels (SACs); however, the mechanisms involved have not been tested in living cells. We combined atomic force microscopy, confocal immunofluorescence, and patch-clamp analysis to show that stress fibers (SFs) in C2C12 myoblasts behave as cables that, tensed by myosin II motor, activate SACs by modifying the topography and the viscoelastic (Young's modulus and hysteresis) and electrical passive (membrane capacitance, Cm) properties of the cell surface. Stimulation with sphingosine 1-phosphate to elicit SF formation, the inhibition of Rho-dependent SF formation by Y-27632 and of myosin II-driven SF contraction by blebbistatin, showed that not SF polymerization alone but the generation of tensional forces by SF contraction were involved in the stiffness response of the cell surface. Notably, this event was associated with a significant reduction in the amplitude of the cytoskeleton-mediated corrugations in the cell surface topography, suggesting a contribution of SF contraction to plasma membrane stretching. Moreover, Cm, used as an index of cell surface area, showed a linear inverse relationship with cell stiffness, indicating participation of the actin cytoskeleton in plasma membrane remodeling and the ability of SF formation to cause internalization of plasma membrane patches to reduce Cm and increase membrane tension. SF contraction also increased hysteresis. Together, these data provide the first experimental evidence for a crucial role of SF contraction in SAC activation. The related changes in cell viscosity may prevent SAC from abnormal activation. actin remodeling; atomic force microscopy, Young's modulus; membrane capacitance; hysteresis

Soccer practice can induce marked changes in the lower limbs with dreaded short and long term consequences. We evaluated the possible effects of sport practice on lower limb posture and their relationships with ankle joint mobility (AJM). In 61 male Soccer players mean age 11.6±1.8 years, and in 50 Volleyball and Basketball players matched for age, sex and body mass index, lower limb posture and AJM in both plantar flexion and dorsiflexion were evaluated on the sagittal plane in supine position using, respectively, images analysis and an inclinometer. A multivariate analysis of variance was carried out to assess if the practice of different sports affects the leg posture (FP: angle between foot and leg) and foot posture (LP: angle between the foot and the line perpendicular to the ground). The sport practiced showed a significant multivariate effect on the lower limb posture. Soccer players showed a greater LP angle (169.2±4.3° vs 164.9±4.5°; p<0.001) and a lesser FP angle in both Basketball and Volleyball players (298.0±12.6° vs 305.6±10.9°; p<0.002). These differences were not present between the Basketball and Volleyball players. Soccer players showed a reduced AJM (127.6±15.7° vs. 138.8±21.6°; p<0.002) compared to the other subjects evaluated. The AJM was found directly correlated to the FP angle (p<0.005). The results of this study indicate that young Soccer players could show an altered posture of the leg and foot and a reduced AJM. The alterations of these parameters seem to be a consequence of the sport practice. [ABSTRACT FROM AUTHOR]

The study of the relationships between the different structures of the human locomotor system still raises great interest. In fact, the human body networks and in particular the "myofascial system network" underlie posture and movement and new knowledge could be useful and applied to many fields such as medicine and prosthetics. The hypothesis of this study was to verify the possibility of creating a structural network representing the human locomotor system as well as to study and describe the relationship between the different structures considered. The graph theory was applied to a network of 2339 body parts (nodes) and 7310 links, representing the locomotor system. The open source platform software Cytoscape was used for data entry (nodes and links) as well as for debugging. In addition, the "NetworkAnalyzer" plugin was used for the descriptive statistics of the network obtained. In order to achieve a better rendering, the results of the network parameters gained were then imported into Gephi graph platform. At the end of this procedure, we obtained an image of a human being in an orthostatic position with a precise distribution of the nodes and links. More specifically, "the shortest pathways analysis of the network" demonstrated that any two randomly selected nodes on the network were connected by pathways of 4 or at most 6-8 nodes. Moreover, the Edge Radiality Distribution analysis was carried out in order to define how a single node is functionally relevant for other nodes: the probability distribution ranged from 0.4 to 0.77. This indicates that the majority of nodes tend to be functionally relevant for the others, but none of these is predominant. As a whole, the Cluster Coefficient (0.260) demonstrates that the network is neither random nor "strongly organized". [ABSTRACT FROM AUTHOR]

Michelangelo's marble sculpture of David is one of the most admired works of art in the world. It is the most iconic symbol of the Florentine Renaissance, and a representation of the idealized human form in its perfection and proportion. The statue was examined in 2004 by two anatomists who observed the apparent absence of a single muscle. Our re-examination of the statue, from our perspective as clinical geneticists, shows unexpected and hitherto unpublished details of variations and disproportions within the overall context of exceptional harmony and beauty. This apparent contradiction raises the question as to what is considered to be morphologically "normal" and what "is not". [ABSTRACT FROM AUTHOR]

Introduction: vascular anatomy variations are important in academic, clinical and surgical areas as well as nephrology, urology, oncological and vascular surgery, among others. The main objective of this review is to know the real prevalence of multiple renal arteries in a wide, multiethnic population. Secondary objectives are to establish the prevalence of early branching of the renal artery and the prevalence of these variations in left and right kidneys. Methods: this study analyzes the renal arterial anatomy of 20.782 kidneys from 64 anatomical and radiological studies. Results: Multiple renal arteries (MRA) were present in 19,95% of the total kidneys, in number of 2 to 6 arteries arriving to the hilum. The most frequent number of MRA was 2 renal arteries (89,48%), followed by 3 (9,31%), 4 (1,06%), 5 (0,02%) and 6 (0,005%). This last one being found in only one kidney. Reported data on the lateralization of the MRA are rather poor, and among these no side's predilection was found: MRA were found in 49,83% on the right side and 50,17% of left kidneys. Early branching patterns were described in only one third of the published data, being present in 11,4% of the total kidneys from those data (corresponding in 4,23% of right kidney cases and in 4,52% of left kidney cases; 2,66% had no right/left information). Discussion: the most difficult part was to merge the results from the different studies due to the heterogeneity of their descriptions. A universally accepted medical nomenclature is needed in order to allow a more precise lecture and transmission of results in clinical practice. Renal anatomical variations have clinical and surgical implications in renal transplantation, correctable hydronephrosis, ablation treatment for refractory hypertension or endovascular reconstructions and should be taken into account by every physician. [ABSTRACT FROM AUTHOR]

The anatomical illustration of the human body is a topic rich in epistemological elements in the course of medical history. Since ancient times concerns about the real correspondence of the scientific and/or artistic representation of human anatomy with the original one arose. First of all, a static two-dimensional representation, the one typical of drawings, was not able to get the depth and complexity of dynamic three-dimensional anatomical morphology. In addition, the epistemic issue that a post-mortem illustration could not somehow correspond to living structures was present even in the past. For a long time the anatomical representation of the human body has been attracting the interest of medical doctors, artists, scholars and philosophers as a fact-finding technique of dissection of corpses preparatory to curative surgical practice in the living body. With regard to that, in the Western world the sixteenth century is often seen as the golden age of normal and macroscopic human anatomy. Major steps in the evolution of the anatomical discipline are the switch from the "normal" to the "pathological" area during the seventeenth century and the transition from the macroscopic to the microscopic level in the eighteenth century; that is true also from an illustrative and iconographic point of view. The tradition of setting up three-dimensional models for the study of the human body dates back to the eighteenth century too. Today's research techniques in the field of anatomical images are so advanced that they allow the full conformity of human representation, the continuous availability of preserved images, the complete multi-dimensionality of the rendering and the complete dynamism of the whole view. In this context, laser scanner could be the ideal tool to create a new Atlas of Human Anatomy composed of models which are rotatable, observable from every perspective, absolutely faithful to reality, analysable as in a real dissection and carefully measurable. [ABSTRACT FROM AUTHOR]

Even if physical activity plays a key role within diabetic foot treatment its use and the results obtained from this treatment seem to be still limited. Nowadays, new and even more advanced technologies for the long term daily physical activity monitoring are available and they are radically changing some aspects of physical activity such as its amount, features and monitoring. In spite of the past, the several electronic devices that are currently available can be integrated into routine care and provide essential information for management to both the healthcare providers and patients. In particular, since the end of the last century, an increasing number of studies have applied the movement monitoring to patients at risk or with history of ulceration. The questionnaires have been progressively replaced with modern technologies such as accelerometers or complex multisensory devices able to objectively measure the physical activity performed. The data collected through the use of such devices can allow a better assessment of patient's condition and provide useful information for the definition of a more complete treatment protocol. Daily physical activity monitoring devices provide to the Diabetes Units information on the typology, quantity, distribution and intensity of the daily physical activity performed by each patient concurring to the prevention of foot ulcers that represent the most dreadful diabetes complications. The different functions and modes of operation of monitoring devices can be integrated to provide a more comprehensive and intelligent monitoring system that provide valuable information on patients' ongoing health status and the physical activity performed during daily life. These devices can manage in real time or even in remote the physical activity performed in addition to calculate that to be performed in the following hours. As a result, they contribute to improve patients' lifestyle and reduce the costs for the treatment of such complications. The aim of this review is to define and emphasize the role of a long term daily physical activity monitoring in the prevention of diabetic foot ulcers. [ABSTRACT FROM AUTHOR]