Are enlarged peroneal tubercle and accessory anterolateral talar facet associated with calcaneal spur?

BACKGROUND: As the anatomical variations of the foot, enlarged peroneal tubercle (EPT) and accessory anterolateral talar facet (AALTF) have attracted the attention of foot surgeons in recent years. However, EPT and AALTF have not been examined for a relationship with calcaneus spur (CS) as a common osteophyte. METHODS: The subjects were 369 individuals who died in northeastern Thailand and were preserved as skeletal specimens. The authors examined for the presence of left and right EPT, AALTF, and calcaneus spur (CS). We divided the EPT (+) group with EPT and the EPT (-) group without it and also divided the AALTF (+) group with AALTF and the AALTF (-) group without it. The age at death and the presence of CS were compared statistically between the EPT (+) and EPT (-) groups and between the AATLF (+) and AALTF (-) groups. RESULTS: Out of the total 369 cases, EPT was found in 117 cases (31.7%), AALTF was positive in 91 cases (24.7%), and CS was found in 194 cases (52.3%). In comparison between EPT (+) and EPT (-) groups, CS was significantly higher (p < 0.0001) in the EPT (+) group, but there was no significant difference in age at death. In comparison between AALTF (+) and AALTF (-) groups, there was no significant difference in age at death or CS. CONCLUSION: This study showed a strong relationship between EPT and CS, and the prevalence of EPT and AALTF by age in Thailand was first reported. We believe it helps to know the pathogenesis and biomechanism of EPT and AALTF. TRIAL REGISTRATION: Not applicable.

Morphometric study and anatomical variation with its incidence of foramina transversaria on the lower cervical vertebrae / Estudio morfométrico y variación anatómica con la incidencia de forámenes transversos en las vértebras cervicales inferiores

SUMMARY: Anatomical variation of the foramina transversaria (FT) is associated with vertebral neurovascular symptoms and can cause complications after lower spine surgery, especially cervical pedicle screw (CPS) insertion. FT variation has been documented and classified in various populations, as this information can help increase cervical stability in subaxial vertebral surgery. Although the morphometry of the upper cervical spine in Thai populations has been reported, there have yet been no studies examining the features of FT. The FT of dried cervical spines (C3-C7; left and right side; n = 107, male = 53 and female = 54) were examined for morphological variation, and their anteroposterior (AP) and transverse (T) diameters were measured using a digital vernier caliper. Morphometric data and variations were compared by sex and lateral side. It was that the C3-C6 FT in both sexes were round, and the C7 FT was elliptical with an oblique right side. FT diameters did not differ significantly by sex except for the AP diameters of C6-C7 and for T diameters of C4 and C7. The left AP diameters of C3-C6 were significantly longer than the right, as were the T diameters of C4 and C7 FT. Additionally, T diameter was significantly longer than that of the AP, except that of the left C6 in male spines, which did not differ from the AP. Most FT examined were round. These findings should be considered in the provisional diagnosis of vertebral neurovascular symptoms caused by FT variation as well as that of neurovascular damage after cervical pedicle screw placement.

La variación anatómica del foramen transverso (FT) se asocia con síntomas neurovasculares vertebrales y puede causar complicaciones después de la cirugía de columna cervical inferior, especialmente la inserción de tornillos pediculares cervicales (TPC). La variación del FT se ha documentado y clasificado en varias poblaciones, ya que esta información puede ayudar a aumentar la estabilidad cervical en la cirugía vertebral subaxial. Aunque se ha informado sobre la morfometría de la columna cervical superior en poblaciones tailandesas, aún no se han realizado estudios que examinen las características de FT. Se examinó la variación morfológica del FT de vértebras cervicales secas (C3-C7; lado izquierdo y derecho; n = 107, hombres = 53 y mujeres = 54), y se midieron sus diámetros anteroposterior (AP) y transverso (T) usando un pie de metro digital. Se compararon datos morfométricos y variaciones por sexo y lado. Los FT de C3-a C6 en ambos sexos eran redondos, y el FT C7 era elíptico con el lado derecho oblicuo. Los diámetros del FT no difirieron significativamente por sexo excepto para los diámetros AP de C6- C7 y para los diámetros transversos de C4 y C7. Los diámetros AP izquierdos de C3-C6 eran significativamente más largos que los del lado derecho, al igual que los diámetros transversos de C4 y C7. Además, el diámetro transverso fue significativamente mayor que el AP, excepto el C6 izquierdo en las vértebras de hombres, que no difirió del AP. La mayoría de los FT examinados eran redondos. Estos hallazgos deben ser considerados en el diagnóstico provisional de síntomas neurovasculares vertebrales causados por la variación del FT, así como en el de daño neurovascular tras la colocación de tornillos pediculares cervicales.

Classification of sternocleidomastoid muscle variations and comparison of its incidence among populations / Clasificación de variaciones del músculo esternocleidomastoideo y comparación de su incidencia entre poblaciones

SUMMARY: This study aimed to classify and investigate anatomical variations of the sternocleidomastoid (SCM) muscle, which is commonly used as an anatomical landmark to indicate the correct position for central venous catheterization, in a Thai population. Thirty- five embalmed cadavers from the Northeast Thailand (19 females and 16 males) were systemically dissected to reveal the SCM muscles in both sides for gross human anatomy teaching. Variations in the SCM origin and insertion were observed and recorded. The prevalence of anatomical variations was approximately 11.4 % (4 of 35 cadavers) and was not different by sex. Such variations were classified into 5 types based on origin, insertion, and presence of additional heads, as follows: type I (n=31; 88.6 %), type II (n=1; 2.85 %), type III (n=1; 2.85 %), type IV (n=1; 2.85 %), and type V (n=1; 2.85 %). Clinical considerations and prevalence of variant SCM muscle have also been discussed. Since the incidence of this anatomical variations was more than 10 %, the cervical surgeons should seriously consider this issue before insertion of a central venous catheter to avoid complications.

El estudio tuvo como objetivo clasificar e investigar las variaciones anatómicas del músculo esternocleidomastoideo (MEM), que se usa comúnmente como un punto de referencia anatómico para indicar la posición correcta para el cateterismo venoso central, en una población tailandesa. Se diseccionaron sistemáticamente 35 cadáveres embalsamados del noreste de Tailandia (19 mujeres y 16 hombres) para observar los músculos MEM en ambos lados para la enseñanza de la anatomía humana macroscópica. Se observaron y registraron variaciones en el origen y la inserción de MEM. La prevalencia de la variación fue de aproximadamente 11,4 % (4 de 35 cadáveres) y no fue diferente por sexo. Dichas variaciones se clasificaron en 5 tipos según el origen, la inserción y la presencia de cabezas adicionales, de la siguiente manera: tipo I (n=31; 88,6 %), tipo II (n=1; 2,85 %), tipo III (n=1; 2,85 %), tipo IV (n=1; 2,85 %) y tipo V (n=1; 2,85 %). También se discutieron las consideraciones clínicas y la prevalencia de la variante del músculo MEM. Dado que la incidencia de esta variación fue superior al 10 %, los cirujanos de cabeza y cuello deben considerar este tema antes de la inserción de un catéter venoso central para evitar complicaciones.

Adaptor protein XB130 regulates the aggressiveness of cholangiocarcinoma.

Cholangiocarcinoma (CCA) is a group of heterogenous malignancies arising from bile duct epithelium with distinct pathological features. Adaptor proteins have implicated in cell proliferation, migration, and invasion of different cancer cells. The objective of this study was to assess whether the adaptor protein XB130 (AFAP1L2) is a critical biological determinant of CCA outcome. XB130 expression levels were investigated in four CCA cell lines compared to an immortalized cholangiocyte cell line by Western blotting. Small interfering (si) RNA-mediated XB130 gene silencing was conducted to evaluate the effects of reduced XB130 expression on cell proliferation, migration, and invasion by MTT, transwell migration and cell invasion assay. The immunohistochemical quantification of XB130 levels were performed in surgically resected formalin-fixed, paraffin-embedded specimens obtained from 151 CCA patients. The relationship between XB130 expression and the clinicopathological parameters of CCA patients were analyzed. Our results showed that XB130 was highly expressed in KKU-213A cell line. Knockdown of XB130 using siRNA significantly decreased the proliferation, migration, and invasion properties of KKU-213A cells through the inhibition of PI3K/Akt pathway, suggesting that XB130 plays an important role in CCA progression. Moreover, elevated XB130 expression levels were positive relationship with lymphovascular space invasion (LVSI), intrahepatic type of CCA, high TNM staging (stage III, IV), high T classification (T3, T4), and lymph node metastasis. We provide the first evidence that the overexpression of XB130 is associated with tumorigenic properties of CCA cells, leading to CCA progression with aggressive clinical outcomes.

Pan-Cancer Analysis of Immune Complement Signature C3/C5/C3AR1/C5AR1 in Association with Tumor Immune Evasion and Therapy Resistance.

Despite the advances in our understanding of the genetic and immunological basis of cancer, cancer remains a major public health burden with an ever-increasing incidence rate globally. Nevertheless, increasing evidence suggests that the components of the complement system could regulate the tumor microenvironment (TME) to promote cancer progression, recurrence, and metastasis. In the present study, we used an integrative multi-omics analysis of clinical data to explore the relationships between the expression levels of and genetic and epigenetic alterations in C3, C5, C3AR1, and C5AR1 and tumor immune evasion, therapy response, and patient prognosis in various cancer types. We found that the complements C3, C5, C3AR1, and C5AR1 have deregulated expression in human malignancies and are associated with activation of immune-related oncogenic processes and poor prognosis of cancer patients. Furthermore, we found that the increased expression levels of C3, C5, C3AR1, and C5AR1 were primarily predicted by copy number variation and gene methylation and were associated with dysfunctional T-cell phenotypes. Single nucleotide variation in the gene signature co-occurred with multiple oncogenic mutations and is associated with the progression of onco-immune-related diseases. Further correlation analysis revealed that C3, C5, C3AR1, and C5AR1 were associated with tumor immune evasion via dysfunctional T-cell phenotypes with a lesser contribution of T-cell exclusion. Lastly, we also demonstrated that the expression levels of C3, C5, C3AR1, and C5AR1 were associated with context-dependent chemotherapy, lymphocyte-mediated tumor killing, and immunotherapy outcomes in different cancer types. In conclusion, the complement components C3, C5, C3AR1, and C5AR1 serve as attractive targets for strategizing cancer immunotherapy and response follow-up.

Changes of tyrosine phosphorylation in liver and kidney of polycystic ovarian rats induced by letrozole / Cambios de fosforilación de tirosina en hígado y riñón de ratas ováricas poliquísticas inducidas por letrozol

Letrozole (Letro) is a drug commonly used for breast cancer treatment since it can decrease estrogen level. In experimental animal, the Letro has been used to induce the polycystic ovarian syndrome (PCOS) model. Tyrosine phosphorylation (TyrPho) is an essential process in various biological functions both normal and abnormal conditions especially reproduction. Although some side effects of Letro are reported, the alterations of TyrPho responsible for liver and kidney functions have never been demonstrated. In this study, the blood serum, liver, and kidney of control and PCOS rats induced with Letro (orally, 1 mg/ KgBW) for consecutive 21 days were used to determine the serum biochemical components and to investigate the TyrPho expression using western blot analysis. Histopathology of such tissues was observed by Masson's trichrome staining. The results showed that Letro did not affect histological structures but significantly increased the serum levels of urea nitrogen, cholesterol, triglyceride, HDL, LDL, ALT, AST, and alkaline phosphatase. Additionally, the TyrPho protein expressions of 32 and 27 kDas in liver and of 55 and 43 kDas in kidney were increased while of a kidney 26 kDa was decreased as compared to those of control. In conclusion, this recent study indicated that the changes of TyrPho proteins in liver and kidney induced with Letro associated with their functions by alteration of serum biochemical levels.

El letrozol (Letro) es un medicamento utilizado comúnmente para el tratamiento del cáncer de mama, debido a que puede disminuir el nivel de estrógeno. En animales de experimentación, el Letro se ha utilizado para inducir el modelo de síndrome de ovario poliquístico (PCOS). La fosforilación de tirosina (TyrPho) es un proceso esencial en diversas funciones biológicas, tanto en condiciones normales como anormales, especialmente en la reproducción. A pesar de informes que indican algunos efectos secundarios de Letro, no se han demostrado las alteraciones de TyrPho responsables de las funciones hepáticas y renales. En este estudio, el suero sanguíneo, el hígado y el riñón control y las ratas PCOS inducidas con Letro (por vía oral, 1 mg / KgBW) durante 21 días consecutivos se usaron para determinar los componentes bioquímicos del suero y para investigar la expresión de TyrPho usando análisis de transferencia Western. La histopatología de los tejidos se observó mediante la tinción tricrómica de Masson. Los resultados mostraron que Letro no afectó las estructuras histológicas, pero aumentó significativamente los niveles séricos de urea, colesterol, triglicéridos, HDL, LDL, ALT, AST y fosfatasa alcalina. Además, las expresiones de la proteína TyrPho de 32 y 27 kDas en el hígado y de 55 y 43 kDas en el riñón aumentaron mientras que en un riñón disminuyeron 26 kDa en comparación con el control. En conclusión, este estudio indicó que los cambios de las proteínas TyrPho en el hígado y los riñones inducidos con Letro se asociaron con sus funciones mediante la alteración de los niveles bioquímicos en suero.

Ovatodiolide, isolated from Anisomeles indica, suppresses bladder carcinogenesis through suppression of mTOR/ß-catenin/CDK6 and exosomal miR-21 derived from M2 tumor-associated macrophages.

Bladder cancer (BCa) is the fourth leading cause of cancer deaths worldwide due to its aggressiveness and resistance against therapies. Intricate interactions between cancer cells and the tumor microenvironment (TME) are essential for both disease progression and regression. Thus, interrupting molecular communications within the TME could potentially provide improved therapeutic efficacies. M2-polarized tumor-associated macrophages (M2 TAMs) were shown to contribute to BCa progression and drug resistance. We attempted to provide evidence for ovatodiolide (OV) as a potential therapeutic agent that targets both TME and BCa cells. First, tumor-suppressing functions of OV were determined by cell viability, colony, and tumor-sphere formation assays using a coculture system composed of M2 TAMs/BCa cells. Subsequently, we demonstrated that extracellular vesicles (EVs) isolated from M2 TAMs containing oncomiR-21 and mRNAs, including Akt, STAT3, mTOR, and ß-catenin, promoted cisplatin (CDDP) resistance, migration, and tumor-sphere generation in BCa cells, through increasing CDK6, mTOR, STAT3, and ß-catenin expression. OV treatment also prevented M2 polarization and reduced EV cargos from M2 TAMs. Finally, in vivo data demonstrated that OV treatment overcame CDDP resistance. OV only and the OV + CDDP combination both resulted in significant reductions in mTOR, ß-catenin, CDK6, and miR-21 expression in tumor samples and EVs isolated from serum. Collectively, we demonstrated that M2 TAMs induced malignant properties in BCa cells, in part via oncogenic EVs. OV treatment prevented M2 TAM polarization, reduced EV cargos derived from M2 TAMs, and suppressed ß-catenin/mTOR/CDK6 signaling. These findings provide preclinical evidence for OV as a single or adjuvant agent for treating drug-resistant BCa.

Evaluation of antioxidant capacity and reproductive toxicity of aqueous extract of Thai Mucuna pruriens seeds.

OBJECTIVE: In traditional medicine, the seeds of Thai Mucuna pruriens (T-MP) are used to treat male dysuria and are believed to enhance fertility. However, information pertaining to the toxicity of T-MP and its interaction with other properties is limited. This study was thus conducted to evaluate the antioxidant capacity and subacute toxicity of T-MP in the reproductive system. METHODS: Total phenolic content and antioxidant capacity of T-MP seed extract were determined using total phenolic content, 2,2-diphenyl-1-picrylhydrazyl and ferric reducing antioxidant power assays. Male and female adult rats were treated orally with T-MP at a dosage of 150 or 300 mg/kg body weight for 14 consecutive days. Sex hormones and functional parameters in the liver and kidney were evaluated. Histopathology of all tissue was conducted using Masson's trichrome staining. Sperm parameters, including concentration, morphology, acrosome reaction status and DNA damage, were also examined. Expression of tyrosine phosphorylated protein (TyrPho), androgen receptor and A-kinase-anchoring protein 4 (AKAP4) were investigated using the Western blot technique. RESULTS: T-MP seed extract contained phenolic compounds and exhibited high antioxidant capacity with no toxicity at the tested doses. It did not affect liver or kidney function parameters in the male rats, but increased estradiol, aspartate aminotransferase and alanine aminotransferase levels in the females. Additionally, it decreased serum progesterone and alkaline phosphatase levels in female rats. Serum and intratesticular testosterone levels were significantly lower in male rats that received a high dosage of T-MP. Histopathological changes were not observed in any tissue treated with T-MP. T-MP also significantly increased sperm concentration (but did not affect sperm parameters), and enhanced testicular TyrPho protein and androgen receptor and expression of AKAP4 in sperms. CONCLUSION: T-MP seed extract exhibited antioxidant capacity and was not harmful to reproductive tissues. It also had a phytoestrogenic effect on females and increased the expression of testicular and sperm markers of male fertility.

Mimosine increases the expressions of tyrosine phosphorylated protein in mouse seminal vesicles / La mimosina aumenta la expresión de la proteína tirosina fosforilada en las vesículas seminales del ratón

Acute effect of purified mimosine (MiMo) extracted from Leucaena leucocephala on testicular histopathology has been documented with seminal vesicle (SV) atrophy. Since protein phosphorylation and seminal secretions play important roles in sperm physiology, this study aimed to study the alteration of substances including tyrosine phosphorylated (TyrPho) proteins in seminal vesicle treated with MiMo. Male mice were divided into a control and experimental groups treated with purified MiMo at 3 doses of 15, 30, and 60 mg/KgBW, respectively for 35 consecutive days. The morphology and weights of SV were compared among groups. The levels of magnesium and fructosamine in SV fluid were assayed. The profiles of equally SV total proteins were compared using SDS-PAGE. The expression of seminal TyrPho proteins was detected by western blotting. Recent results showed the decreased weights of SV in MiMo treated mice compared to control. However MiMo in all doses did not affect the levels of magnesium and fructosamine in SV fluid. The SV protein expression of 130 and 55 kDas was obviously decreased in a high dose MiMo. In dose-dependent response, the expressions of 72 and 55 kDas TyrPho proteins of SV were increased. In conclusion, MiMo could affect SV morphological size and protein secretions especially TyrPho proteins.

El efecto agudo de la mimosina purificada (MiMo) extraída de Leucaena leucocephala en la histopatología testicular se ha documentado con atrofia de vesícula seminal (VS). Debido a que la fosforilación de proteínas y las secreciones seminales tienen un papel importante en la fisiología de los espermatozoides, este estudio tuvo como objetivo estudiar la alteración de sustancias como la proteína tirosina fosforilada (TyrPho) en vesículas seminales tratadas con MiMo. Los ratones se dividieron en un grupo control y un grupo experimental y se trataron con MiMo purificado en 3 dosis de 15, 30 y 60 mg / KgBW, respectivamente, durante 35 días seguidos. La morfología y los pesos de VS se compararon entre los grupos. Fueron analizados los niveles de magnesio y fructosamina en el fluido VS. Los perfiles de las proteínas totales de VS se compararon utilizando SDS-PAGE. La expresión de la proteína TyrPho en las vesículas seminales se detectó mediante transferencia de Western blot. Los resultados recientes muestran la disminución del peso de las VS en ratones tratados con MiMo, en comparación con el grupo control. Sin embargo, en ninguna de las dosis se vieron afectados por mimosina purificada los niveles de magnesio y fructosamina en el líquido de las VS. La expresión de la proteína en VS de 130 y 55 kDas disminuyó notablemente en una dosis alta de MiMo. En la respuesta dependiente de la dosis, aumentaron las expresiones de 72 y 55 kDas de las proteínas TyrPho en las VS. En conclusión, la mimosina purificada podría afectar el tamaño morfológico de las VS y la expresión de proteínas, especialmente las proteínas TyrPho.

Appropriate concentration of acetic acid for the preservation of fresh cadaveric brains to be used in surgical training: a preliminary study / Concentración adecuada de ácido acético para la preservación de cerebros de cadáveres frescos para uso en entrenamiento quirúrgico: un estudio preliminar

A small amount of acetic acid (AA), a common preservative, has been shown to increase contamination in cadaveric tissue, while larger concentrations can lead to the tissue becoming hard, especially in fresh brains. This study attempted to optimize the concentration of AA to be used in the cranial cavity in order to produce the most realistic consistency and color. Six adult cadaveric heads were preserved with descending glacial AA at concentrations of 98.5 %, 80 %, 60 %, 40 %, 20 %, and 10 %. The samples were kept at 5 °C for 14 days. The brain cortex was then dissected with a suction tube and forceps to reveal the underlying brain tissue for inspection. Color change, cortical firmness, pia mater stickiness, and participant satisfaction were evaluated. The color of the brains in all concentrations was slightly yellow. However, the temporal area of the brain preserved using 20 % AA was significantly more pink. The pia mater of the brain cortex of all samples was firm and difficult to pry apart, with the firmest consistency being in the brain tissue preserved using 98.5 % AA. The brain tissue in all samples had a liquid-like consistency. The brains preserved in AA at a concentration greater than 60 % yielded higher satisfaction scores. We conclude that acetic acid has a role in brain preservation for skull base surgery training and recommend AA concentrations higher than 60 % for maximal participants satisfaction.

Se ha demostrado que una pequeña cantidad de ácido acético (AA), un preservante común, aumenta la contaminación en el tejido del cadáver, mientras que mayores concentraciones pueden endurecer el tejido, particularmente en cerebros frescos. Este estudio intentó optimizar la concentración de AA en la cavidad craneal para producir una consistencia y coloración cerebral más cercanos a la realidad. Seis cabezas cadavéricas adultas se conservaron con AA glacial descendente en concentraciones de 98,5 %, 80 %, 60 %, 40 %, 20 % y 10 %. Las muestras se mantuvieron a 5 °C durante 14 días. Luego se diseccó la corteza cerebral con un tubo de succión y pinzas para observar e inspeccionar el tejido cerebral subyacente. Se evaluaron el color, la firmeza cortical, la viscosidad y adherencia de la piamadre y la reacción de los participantes ante esta conservación. El color de los cerebros en todas las concentraciones fue ligeramente amarillo. Sin embargo, el área temporal del cerebro, conservada con un 20 % de AA, fue significativamente más rosada. La piamadre de la corteza de todas las muestras fue de consistencia firme y difícil de separar; una mayor resistencia se observó en el tejido cerebral preservado con 98,5 % de AA. La consistencia del tejido cerebral en todas las muestras era líquida. Los cerebros conservados en AA a una concentración superior al 60 % recibieron puntuaciones de satisfacción más elevadas. Concluimos que el ácido acético desempeña un papel en la preservación del cerebro, permitiendo el entrenamiento en cirugía de base de cráneo, por lo que recomendamos concentraciones de AA superiores al 60 % para una satisfacción máxima por parte de los participantes.

Incidence of vertebral artery of aortic arch origin, its level of entry into transverse foramen, length, diameter and clinical significance.

The aim of this study was to show the incidence of vertebral artery of aortic arch origin, its level of entry into transverse foramen, including extra- and intracranial morphometry, and clinical significance. A total of 266 embalmed cadavers were studied. We found 14 left vertebral arteries (5.3%) emerging from aortic arch. Most of the left vertebral arteries of aortic arch origin (78.6%) entered the fifth cervical transverse foramina, whereas most of the vertebral arteries of subclavian origin (94.7% left and 99.2% right) entered the sixth cervical transverse foramina. Their average prevertebral length was 8.24 ± 1.09 cm ,which was about twice as long as the right vertebral artery (3.88 ± 1.14 cm). The average outer diameters of the prevertebral part and ensuing intracranial part of the left vertebral artery of aortic arch origin were 4.36 ± 0.93 and 3.62 ± 0.62 mm, respectively. The mean corresponding diameters of the vertebral artery of subclavian origin were 5.06 ± 1.04 and 3.87 ± 0.83 mm, respectively. All of the vertebral arteries decreased significantly in size after entering the cranial cavity. The reduction in caliber of the intracranial part of the vertebral artery compared with the prevertebral part of its own vessel has never been reported elsewhere. Knowledge of such anatomical variations is important in interpreting CT angiography, anterior cervical decompression and aortic arch surgery to prevent iatrogenic injury of the vertebral artery.

A Morphometric Study on Subaxial Cervical Pedicles of Thai People.

STUDY DESIGN: This study investigated the subaxial cervical pedicles from C3 to C7 to provide information for accurately transpedicular screw fixation in this region. OBJECTIVE: This study was evaluated the morphology of the subaxial cervical pedicle to determine the size and trajectory of screw fixation. SUMMARY OF BACKGROUND DATA: Cervical vertebrae are an important structure to protect the neurovascular structure. The cervical spine surgery using screw fixation is an effective method to treat the cervical spine instability. There have been many research morphological data of subaxial cervical vertebrae. However, no studies have reports on dried cervical vertebrae of Thai's people. METHODS: The measurement was conducted in 130 dried cervical vertebrae (C3-C7), including 61 males and 69 females. The measurement parameters were pedicle width (PW), pedicle length (PL), pedicle height (PH), pedicle axis length (PAL), pedicle transverse angle (PTA), and pedicle sagittal angle (PSA), which determined using ImageJ software. RESULTS: The results of morphological data of C3 to C7 was found that the mean of PW, PL, PH, PAL, PTA, and PSA that obtained from male were significantly higher than female excepted for PL (C7) and PTA (C3, C5). Except for the C6 PW, C3 PL, C4 to C5 to C7 PTA, and C4 PSA, there were no significant differences of these parameters between male and female. CONCLUSION: The appropriate pedicle screw size is 4.0 mm for C3 and C4, and 4.5 mm for C5 to C7. The results of this study are the useful information for cervical spine fixation while prevent the vascular and neurological injuries from the large screw causing pedicle breakage. LEVEL OF EVIDENCE: 3.

The alterations of microvasculature, tyrosine phosphorylation, and lipid peroxidation in kidney of rats treated with valproic acid / Alteraciones de la microvasculatura, fosforilación de tirosina y peroxidación lipídica en riñones de ratas tratadas con ácido valproico

SUMMARY: Valproic acid (VPA), an antiepileptic drug, has been demonstrated to damage histology and to change tyrosine phosphorylation patterns with increased oxidative stress in perirenal tissues. This study aimed to investigate the effect of VPA on microstructure, tyrosine phosphorylation, and lipid peroxidation of rat kidney. Adult male rats were divided into control and VPA-treated groups intraperitoneally injected with normal saline and VPA 500 mg/kgBW for 10 consecutive days, respectively (n = 7 each). The blood serum was examined for biochemical levels. The kidney tissues were routinely processed for histological observation. Total proteins from kidney were extracted to assay the malondialdehyde (MDA) levels and phosphorylation expression. The results showed that VPA significantly decreased blood glucose levels while tend to increase urea nitrogen and creatinine. MDA levels in VPA group were significantly higher that of control. Renal cortex of VPA-treated animals revealed vasodilatations. Although the ratio of a renal phosphorylated 72 kDa protein/ beta actin expression seemed to be not different in both groups, VPA significantly decreased the intensity of beta actin. In conclusion, VPA dilates renal microvasculature with increasing of MDA but suppresses the actin expression.

RESUMEN: Se ha demostrado que el ácido valproico (AVP), un fármaco antiepiléptico, daña la histología y cambia los patrones de fosforilación de la tirosina con el aumento del estrés oxidativo en los tejidos perirrenales. Este estudio tuvo como objetivo investigar el efecto del AVP en la microestructura, la fosforilación de la tirosina y la peroxidación lipídica del riñón de rata. Se dividieron ratas macho adultas en grupos control y tratados con AVP. Durante 10 días consecutivos fueron inyectadas por vía intraperitoneal con solución salina normal y 500 mg / kg de PC respectivamente (n = 7 cada uno). Se analizó el suero sanguíneo para determinar los niveles bioquímicos. Los tejidos renales se procesaron de forma rutinaria para la observación histológica. Las proteínas totales del riñón se extrajeron para analizar los niveles de malondialdehído (MDA) y la expresión de la fosforilación. Los resultados mostraron que el AVP disminuyó significativamente los niveles de glucosa en la sangre, mientras que tienden a aumentar el nitrógeno ureico y la creatinina. Los niveles de MDA en el grupo de AVP fueron significativamente más altos que los del control. La corteza renal de los animales tratados con AVP reveló vasodilataciones. Aunque la proporción de una expresión de proteína / actina de 72 kDa fosforilada renal no parece ser diferente en ambos grupos, el AVP disminuyó significativamente la intensidad de la actina beta. En conclusión, el AVP dilata la microvasculatura renal al aumentar el MDA, pero suprime la expresión de actina.

Anatomical variations of thyroid glands in northeastern-Thai embalmed cadavers / Variaciones anatómicas de la glándula tiroides en cadáveres embalsamados del noreste de Tailandia

SUMMARY: This study aimed to investigate the variation patterns of thyroid glands in embalmed cadavers donated for anatomical studying and research in the northeastern part of Thailand. The crossed-sectional descriptive study was applied to systemically observe the thyroid gland in abnormality of 45 embalmed cadavers. The study was conducted in the Anatomy Laboratory of College of Medicine and Public Health, Ubon Ratchathani University. The indications of thyroid gland abnormalities were recorded by photographs before classification of data used further in a descriptive analysis using SPSS. The results showed that 8 of the 45 cadavers (17.8 %) were observed with thyroid gland abnormality (4 males; 8.9 % and 4 females; 8.9 %). Such variations could be classified into 3 types; pyramidal lobe (8.8 %), levator glandulae thyroideae (2.2 %) and the co-existing of levator glandulae thyroideae (8.8 %), respectively. The thyroid gland abnormality observed in this study was mainly related to many previous reports. Besides the number of thyroid variations are a crucial indication of thyroid gland abnormality recurring, these gland abnormalities are susceptible to the operation of radiology physicians in thyroidectomy and tracheostomy.

RESUMEN: El objetivo de este estudio fue investigar los patrones de variación de la glándula tiroides en cadáveres embalsamados donados para estudios e investigaciones anatómicas en el noreste de Tailandia. El estudio transversal descriptivo se aplicó para observar sistémicamente la glándula tiroides en caso de anomalía en 45 cadáveres embalsamados. El estudio se realizó en el Laboratorio de Anatomía de la Facultad de Medicina y Salud Pública de la Universidad de Ubon Ratchathani. Las anomalías de la glándula tiroides se registraron mediante fotografías antes de la clasificación de los datos y se utilizaron en un análisis descriptivo con SPSS. Los resultados mostraron que en 8 de los 45 cadáveres (17,8 %) se observaron anomalías de la glándula tiroides (4 hombres; 8,9 % y 4 mujeres; 8,9 %). Tales variaciones podrían ser clasificadas en 3 tipos: lóbulo piramidal (8,8 %), músculo elevador de la glándula tiroides (2,2 %) y la coexistencia del músculo elevador de la glándula tiroides (8,8 %), respectivamente. La anomalía de la glándula tiroides observada en este estudio se relacionó principalmente con informes anteriores. Además, la cantidad de variaciones tiroideas es una indicación crucial de la anomalía de la glándula tiroides que se repite, esta anomalía de la glándula es susceptible a las intervenciones de los médicos radiólogos en la tiroidectomía y la traqueotomía.

Localization and changes of tyrosine phosphorylated proteins and ß actin in epididymis of rats treated with valproic acid / Localización y cambios de las proteínas tirosina fosforiladas y la ß actina en epidídimos de ratas tratadas con ácido valproico

Tyrosine phosphorylated proteins have been localized and identified in male reproductive tissues such as testis and capacitated/ acrosome reacted sperm except epididymis. The changes of such proteins are associated with decreased sperm quality of valproic acid treatment. This study aimed to investigate the presence and alterations of protein phosphorylation in epididymal epithelium and fluid of rats treated VPA. Sixteen adult male rats were divided into control and VPA-treated groups (n=8/ each). Treated rats were injected with VPA (500 mg/ kgBW, intraperitoneally) for 10 consecutive days. At the end of experiment, the monoclonal antiphosphotyrosine (clone 4G10) was used for immunohistochemistry to probe tyrosine phosphorylated proteins and also to examine the expression of such proteins using immuno-Western blotting in epididymal tissue and fluid. The result showed that positive reactivity of phosphorylated proteins was clearly observed in cytoplasmic principle cells, nuclei of apical & basal cells and sperm mass surrounded with epididymal fluids. The profiles of phosphorylated proteins in epididymal fluid were 182, 127, 80, 70, 57, 45, 34, and 31 kDas, respectively. Interestingly, VPA affected the changes of phosphorylated proteins and β actin in head, body, and tail epididymal fluids. We conclude that tyrosine phosphorylated proteins were detected in epididymal epithelium and fluid. The expressions of those proteins and actin were altered under VPA treating.

Las proteínas tirosina fosforiladas han sido localizadas e identificadas en tejidos reproductores masculinos tales como testículos y espermatozoides, capacitados a nivel acrosómico, excepto en el epidídimo. Los cambios de estas proteínas están asociadas con una disminución de la calidad del esperma en el tratamiento con ácido valproico (AVP). Este estudio tuvo como objetivo investigar la presencia y las alteraciones de la fosforilación de proteínas en el epitelio epididimal y en el fluido espermático de ratas tratadas con AVP. Dieciséis ratas macho adultas se dividieron en dos grupos: control y tratadas con AVP (n = 8 / cada uno). A las ratas tratadas se les inyectó AVP por vía intraperitoneal (500 mg / kg de peso corporal) durante 10 días consecutivos. Al final del experimento, se realizó inmunohistoquímica con la anti-fosfotirosina monoclonal (clon 4G10) para sondear las proteínas tirosina fosforiladas y también para examinar la expresión de tales proteínas usando inmunotransferencia Western, en tejido y fluido epididimarios. El resultado mostró reactividad positiva de proteínas fosforiladas en células citoplásmicas principales, en los núcleos de las células apicales y basales y en la masa de esperma rodeada por fluidos epididimarios. Los perfiles de proteínas fosforiladas en el fluido epididimal fueron 182, 127, 80, 70, 57, 45, 34 y 31 kDas, respectivamente. El AVP provocó cambios en las proteínas fosforiladas y en la β actina de los fluidos epididimarios de cabeza, cuerpo y cola del epidídimo. Concluimos que las proteínas tirosina fosforiladas se detectaron en el epitelio y el fluido epididimarios. Las expresiones de esas proteínas y de la β actina se alteraron bajo tratamiento con AVP.

Types and morphometric study of calcaneal articular facets on human tali of Thai population / Tipos y estudio morfométrico de las facetas articulares calcáneas en talus humano de la población tailandesa

Patterns and variant morphometries of calcaneal articular facets on talus are concerned before performing of joint ankle surgery, including used as a sex determination. Types of talar facets have been documented in many populations except in Thai race. Therefore, this study attempted to classify the types of talus facets and to measure the facet lengths on dried tali of Thais. The 372 dried tali (204 males, 168 females) from Khon Kaen University Bone Collection were observed for variant types and measured for their facet lengths. The facets were classified into 6 types: type I, tree facet are separated (1.88 %); type II (A), the anterior and middle facets are partially connected with predominant ridge (34.68 %); type II (B), the anterior and middle facets are partially connected with slight ridge (32.53 %); type III, the anterior and middle facets are fully fused to form a single facet (2.96 %); type IV, the anterior and middle facets are partially separated by a ridge and partly by a groove (27.42 %); type V, all facets are continuous fused to form a single facet (0.54 %). In addition, the morphometric lengths of AP (anterior to posterior process) and ML1&2 (medial to lateral process) in male are significantly greater than those of female. The AP, ML, and ML2 of male are 56.71±0.16, 41.63±0.18, and 37.85±0.36 mm, while of female are 51.21±0.12, 37.74±0.16, and 33.85±0.28 mm, respectively. This incidence can be used as ankle surgery consideration and an anthropological marker for sex determination of unidentified talus.

Los patrones y las variantes morfométricas de las facetas articulares calcáneas en el talus deben considerarse antes de la realización de la cirugía del tobillo a nivel articular, incluido su uso para la determinación del sexo. Se han documentado los tipos de facetas en el talus en muchas poblaciones, excepto en la raza tailandesa. Por lo tanto, este estudio clasificó los tipos de facetas del talus y se midieron las longitudes de las facetas del talus, en muestras secas de indiviuos tailandeses. Se analizaron 372 talus secos (204 de hombres, 168 de mujeres) de la colección de huesos de la Universidad Khon Kaen, se observaron distintos tipos de variantes y se midieron las longitudes de las facetas. Las facetas se clasificaron en 6 tipos: tipo I, faceta de árbol separadas (1,88 %); tipo II (A), facetas anterior y media parcialmente conectadas con la cresta predominante (34,68 %); tipo II (B), facetas anterior y media están parcialmente conectadas con una ligera cresta (32,53 %); tipo III, facetas anterior y media están completamente fusionadas para formar una sola faceta (2,96 %); tipo IV, facetas anterior y media están parcialmente separadas por una cresta y en parte por una ranura (27,42 %); tipo V, todas las facetas se fusionan continuamente para formar una sola faceta (0,54 %). Además, las longitudes morfométricas del proceso anterior o posterior (AP) y del proceso medial a lateral (ML1 y ML2) en el varón son significativamente mayores que las de la mujer. El AP, ML1 y ML2 de los hombres son 56,71 ± 0,16, 41,63 ± 0,18 y 37,85 ± 0,36 mm, mientras que las mujeres son 51,21 ± 0,12, 37,74 ± 0,16 y 33,85 ± 0,28 mm, respectivamente. Esta incidencia se puede utilizar como una consideración en la cirugía de tobillo y un marcador antropológico para determinar el sexo del talus no identificado.

Effects of Leucaena leucocephala (lamk. ) shoot tips plus young leaf extract containing mimosine on reproductive system of male rats / Efectos de los brotes de Leucaena leucocephala (lamk. ) y del extracto de hojas jóvenes que contiene mimosina en el sistema reproductivo de ratas macho

This study aimed to determine the mimosine level and examine the male reproductive toxicity effects of Leucaena leucocephala (LL) shoot tips plus young leaf extract. Mimosine level in LL extract was determined by thin layer chromatography before administration in animals. Male rats were divided into control and LL (1,500 mg/KgBW) groups (n = 6). After 60 days of experiment, serum sex hormones, sperm quality, and testicular histopathology were assayed and observed. Malondialdehyde (MDA) level and expressions of steroidogenic acute regulatory (StAR) and phosphorylated proteins in testicular lysate were examined by western blotting. Results showed that mimosine levels in LL extract was 17.35 ± 1.12 % of dry weight. LL significantly decreased FSH & LH levels, sperm qualities, and seminiferous tubule diameter compared to the control (p<0.05). Seminiferous tubular atrophies, germ cell sloughing, and degenerations were observed in LL group. In addition, testicular MDA level and StAR protein expression were significantly decreased in LL group. LL extract could increase the expression of a 50 kDa phohorylated protein in testicular lysate. In conclusion, LL extract has mimosine and reproductive toxicity effects on males.

Este trabajo tuvo como objetivo determinar el nivel de mimosina y examinar los efectos de la toxicidad reproductiva de los brotes de Leucaena leucocephala (LL), más el extracto de hojas jóvenes, en ratas macho. El nivel de mimosina en el extracto de LL se determinó mediante cromatografía en capa fina antes de la administración en animales. Las ratas se dividieron en grupos de control y LL (1,500 mg / kgBW) (n = 6). Después de 60 días, se analizaron y observaron las hormonas sexuales séricas, la calidad de los espermatozoides y la histopatología testicular. A través de Western Blot se examinaron el nivel de malondialdehído (MDA), las expresiones de reguladores agudos esteroidogénicos (StAR) y las proteínas fosforiladas en el lisado testicular. Los resultados mostraron que los niveles de mimosina en el extracto de LL fueron 17.35 ± 1.12 % del peso seco. LL disminuyó significativamente los niveles de FSH y LH, la calidad de los espermatozoides y el diámetro de los túbulos seminíferos en comparación con el control (p <0,05). Se observaron atrofias en los túbulos seminíferos, desprendimiento de células germinales y degeneraciones en el grupo LL. Además, el nivel de MDA testicular y la expresión de la proteína StAR se redujeron significativamente en el grupo LL. El extracto de LL podría aumentar la expresión de la proteína fosforilada de 50 kDa en el lisado testicular. En conclusión, el extracto de LL tiene mimosina y efectos de toxicidad reproductiva en los hombres.

Antioxidant capacity of Momordica charantia extract and its protective effect on testicular damage in valproic acid-induced rats / Capacidad antioxidante del extracto de Momordica charantia y su efecto protector sobre el daño testicular en ratas inducidas con ácido valproico

Although Momordica charantia (MC) has preventive effects on tissue injuries, antioxidant capacity and protective effect of MC pulp and peel (MCP) on valproic acid (VPA)-testicular damage have never been reported. Fresh MCPs were aqueous extracted and determined for antioxidant capacity and momordicine I level by HPLC. Male rats were divided into 5 groups (control, VPA (500 mg/kgBW), MCP20/40/ or 80 mg/kgBW+VPA). In 30 experimental days, animals were pretreated with different doses of MCPs for 20 days before VPA injection for 10 consecutive days. Sperm concentration, testosterone hormone, and testicular histology of all groups were investigated. Expressions of testicular tyrosine phosphorylated and steroidogenic acute regulatory (StAR) proteins were examined by Western blot. Results showed that MCP contains TPC (39.24±0.65 ug/mg garlic acid), antioxidant capacities (FRAP=33.08±0.21 ug/ mg ascorbic acid equivalent, IC50 of DPPH=389.8±3.20 ug/ml), and momordicine I (404.9 mg/g MCP). Sperm concentration in MCP80+VPA group was increased as compared to VPA group. Testosterone level in MCP treated groups was significantly increased. MCP protected testicular damage and could prevent the decrease of StAR and a 50-kDa phosphorylated protein expression in VPAtreated testis. In conclusion, MCP has antioxidant activities and can prevent male reproductive toxicity in VPA-induced rats.

A pesar que la Momordica charantia (MC) tiene efectos preventivos sobre las lesiones en los tejidos, capacidad antioxidante y un efecto protector de la pulpa y la cáscara de MC (CMC) sobre el ácido valproico (AVP), aún no se ha informado efectos sobre el daño testicular. Las CMC frescas fueron extraídas de forma acuosa y se determinó la capacidad antioxidante y el nivel de Momordicina I por HPLC. Las ratas machos se dividieron en 5 grupos: control, AVP (500 mg/kg de peso corporal), CMC20 / 40 / u 80 mg/kg de peso corporal + AVP . En 30 días experimentales, los animales fueron pretratados con diferentes dosis de CMC durante 20 días antes de la inyección de AVP durante 10 días consecutivos. Se investigó la concentración de espermatozoides, la hormona testosterona y la histología testicular de todos los grupos. Las expresiones de proteínas reguladoras agudas (StAR) fosforiladas con tirosina y esteroidogénicas testiculares se examinaron mediante inmunotransferencia de tipo Western. Los resultados mostraron que CMC contiene TPC (39.24 ± 0.65 ug / mg de ácido de ajo), capacidades antioxidantes (FRAP = 33.08 ± 0.21 ug / mg de ácido ascórbico equivalente, IC50 de DPPH = 389.8 ± 3.20 ug / ml) y momordicina I (404.9 mg) / g CMC). La concentración de esperma en el grupo MCP80 + AVP aumentó en comparación con el grupo AVP. El nivel de testosterona en los grupos tratados con CMC aumentó significativamente. La CMC protegió el daño testicular y pudo prevenir la disminución de StAR y una expresión de proteína fosforilada de 50 kDa en los testículos tratados con AVP. En conclusión, la CMC tiene efectos antioxidantes y puede prevenir la toxicidad reproductiva en ratas machos inducidas por VPA.

Acute effects of mimosine purified from Leucaena leucocephala on male reproductive system of adult mice / Efectos agudos de la mimosina purificada de Leucaena leucocephala en el sistema reproductor masculino de ratones adultos

This study attempted to examine the acute effect of purified minosine extracted from Leucaena leucocephala on male reproductive system. Adults male mice were divided into 4 groups (n =8); control and 3 experimental groups treated with purified mimosine at different doses of 15, 30, and 60 mg/KgBW, respectively for 7 consecutive days. The morphological features and weights of body and reproductive organs including testis, epididymis plus vas deferens, and seminal vesicle were compared among groups. In addition, epididymal sperm concentration and the changes of histopathology of testicular tissues in all groups were observed. The results showed that mimosine in all doses did not affect mice body weights. However, all doses of mimosine could significantly reduce the absolute and relative weights of testis and seminal vesicle but not of epididymis plus vas deferens. Significantly, mimosine at doses of 30, and 60 mg/KgBW could decrease sperm concentration. Moreover, the seminiferous atrophy and degeneration were obviously found in mimosine treated mice as compared to the control. In conclusion, consumption of Leucaena leucocephala edible parts containing mimosine could damage male reproductive organs which may cause acute male subfertility or infertility.

Este estudio intentó examinar el efecto agudo de la mimosina purificada extraída de Leucaena leucocephala en el sistema reproductivo masculino. Se dividieron ratones machos adultos en 4 grupos (n = 8): un grupo control y tres grupos experimentales tratados con mimosina purificada a diferentes dosis de 15, 30 y 60 mg / Kg por peso, respectivamente, durante 7 días consecutivos. Se compararon entre los grupos, las características morfológicas y el peso corporal, los órganos reproductivos, incluyendo los testículos, el epidídimo más conducto deferente y vesícula seminal. Además, se observó la concentración de espermatozoides epididimarios y los cambios de la histopatología de los tejidos testiculares en todos los grupos. Los resultados mostraron que la mimosina no afectó los pesos corporales de los ratones. Sin embargo, todas las dosis de mimosina podrían reducir significativamente los pesos absolutos y relativos de los testículos y las glándulas seminales, pero no así del epidídimo y los conductos deferentes. La mimosina en dosis de 30 y 60 mg / Kg por peso podría disminuir significativamente la concentración de esperma. Además, se observó la atrofia y degeneración seminífera en ratones tratados con mimosina en comparación con el grupo control. En conclusión, el consumo de partes comestibles de Leucaena leucocephala que contienen mimosina podría dañar los órganos reproductivos masculinos, lo que puede causar subfertilidad masculina aguda o infertilidad.

Methotrexate changes the testicular tyrosine phosphorylated protein expression and seminal vesicle epithelia of adult rats / El metotrexato cambia la expresión de la proteína testicular-tirosina fosforilada y el epitelio vesicular seminal en ratas adultas

Methotrexate (MTX) is commonly used as a chemotherapy agent and immune system suppressant but its adverse effect on male reproductive system is still limited. This study aimed to investigate the effect of MTX on structure and functional proteins of testis and seminal vesicle. Adult male rats were divided into control and MTX groups (n =12). In 30 experimental days, the treated animals were injected with MTX (tail i.v., 75 mg/KgBW) at days 8 and 15. Then, the reproductive parameters and histology of both groups were examined. Thickness of seminal seminal vesicle epithelia was analyzed. Also, the expressions of testicular tyrosine phosphorylated proteins and steroidogenic acute regulatory (StAR) protein were investigated. The results showed that MTX could significantly decrease epididymal sperm concentration. In addition, the germ cell degeneration, increased spaces of interstitial tissues, and low epididymal sperm mass density were observed in MTX group. The thickness of seminal vesicle epithelia in MTX group was significantly lower than that of control group. Moreover, the intensity of testicular phosphorylated proteins of 31, 32, 72, and 85 kDas was significantly increased while of 42 and 47 kDas in MTX group was decreased as compared to control. The expression of testicular StAR protein in MTX group was also significantly decreased as compared to the control. In conclusion, MTX affects testicular and seminal tissues and changes testicular functional proteins in adult rats.

El metotrexato (MTX) se usa comúnmente como agente de quimioterapia y supresor del sistema inmunitario, pero su efecto adverso en el sistema reproductor masculino sigue siendo limitado. Este estudio tuvo como objetivo investigar el efecto del MTX sobre la estructura y las proteínas funcionales del testículo y la vesícula seminal. Ratas macho adultas se dividieron en grupos control y grupo con MTX (n = 12). En 30 días experimentales, a los animales tratados se les inyectó MTX (cola i.v., 75 mg / KgBW) los días 8 y 15. Luego, se examinaron los parámetros reproductivos y la histología de ambos grupos. Se analizó el espesor del epitelio de la vesícula seminal. Además, se investigaron las expresiones de la proteína tirosina testicular fosforilada y de la proteína reguladora aguda esteroidogénica (StAR). Los resultados mostraron que el MTX podría disminuir significativamente la concentración de espermatozoides epididimarios. Además, se observó la degeneración de las células germinales, el aumento de los espacios de los tejidos intersticiales y la baja densidad de masa del espermatozoide epididimal en el grupo de MTX. El grosor del epitelio de la vesícula seminal en el grupo MTX fue significativamente menor que el del grupo control. Además, la intensidad de las proteínas testiculares fosforiladas de 31, 32, 72 y 85 kDas aumentó significativamente, mientras que la de 42 y 47 kDas en el grupo MTX disminuyó en comparación con el control. La expresión de la proteína StAR testicular en el grupo MTX también se redujo significativamente en comparación con el control. En conclusión, el MTX afecta los tejidos testiculares y seminales y cambia las proteínas funcionales testiculares en ratas adultas.