Anatomical analysis of ligaments surrounding calcaneocuboid joint; implications for role in foot stability.

PURPOSE: The calcaneocuboid joint is located in the lateral part of the foot and acts as a major stabilizer for the foot. Injuries to this joint often occur in association with ankle or foot injuries and are frequently overlooked, subsequently causing chronic pain or osteoarthritis. However, the relationship between ligaments surrounding the joint and joint instability remains unclear. Therefore, this study aimed to clarify the morphology and position of the ligaments surrounding the calcaneocuboid joint, and to reveal the relationship between the ligament structure. METHODS: The position and morphology of the bifurcate ligament (subdivided into calcaneonavicular and calcaneocuboid ligaments), dorsal calcaneocuboid ligament, lateral calcaneocuboid ligament, long plantar ligament, and short plantar ligament were measured (N = 11 feet in 6 Japanese cadavers). The circumference of the joint was quartered, while the ligament-uncovered area and the estimated cross-sectional area of each ligament were compared between the four sides. Furthermore, the estimated cross-sectional area of each ligament was calculated as an index for the ligament strength. RESULTS: The inferolateral side of the calcaneocuboid joint had the most uncovered area (54.63%) by the ligaments. In addition, the cross-sectional area of the ligaments on the lateral side was considerably smaller than that on the medial side. CONCLUSION: Our results suggest that ligament weakness on the inferolateral side may cause instability of the calcaneocuboid joint, especially after an inversion sprain injury, and may decrease the lateral longitudinal arch function, which results in chronic foot pain.

A novel categorization of the muscular branches of the tibial nerve within the popliteal fossa.

BACKGROUND: The muscular branches of the tibial nerve within the popliteal fossa innervate the gastrocnemius, soleus, plantaris, and popliteus muscles. Various branching patterns have been described in textbooks; however, the underlying fundamental rules explaining the patterns remain unclear. Understanding the fundamental rule explaining the branching pattern of the innervating nerves is essential for understanding the ontogeny of skeletal muscles. Therefore, this study aimed at establishing a theory to explain the branching pattern of the muscular branches of the tibial nerve within the popliteal fossa. METHODS: The branching patterns of the muscular branches of the tibial nerve within the popliteal fossa were examined macroscopically in 62 lower limbs derived from 31 adult cadavers (22 males and 9 females, aged 49-95 years). RESULTS: The branch to the medial head of the gastrocnemius muscle invariably arose from the posteromedial side of the tibial nerve. The branches to the soleus muscle and lateral head of the gastrocnemius muscle had a common trunk in all the lower limbs and invariably arose from the posterolateral side. The branches to the plantaris and popliteus muscles arose anteriorly from the tibial nerve in this order (plantaris branch first, followed by the popliteus branch). These branches invariably arose more distally than the branch to both the heads of the gastrocnemius and soleus muscles. CONCLUSIONS: Based on these fundamental branching patterns, we suggest a novel branching categorization. The branches could be categorized into a posterior group and an anterior group, which has independent branches to the plantaris and popliteus muscles. This fundamental branching pattern and novel categorization contribute to the understanding of the ontogeny of the skeletal muscles around the flexor compartment of the leg.

A bilateral third head of the gastrocnemius which is morphologically similar to the plantaris.

PURPOSE: An extra muscle was observed on both sides of the popliteal fossa in the cadaver of a 78-year-old Japanese male during dissection. The aim of this case report was to identify whether this variant is a double plantaris or a third head of the gastrocnemius according to its morphological characteristics and innervation. METHODS: The muscles were displayed by careful dissection and delineation of surrounding structures. The size of each of the muscle bellies and tendons of those extra muscles were measured manually by the vernier caliper. RESULTS: The origin of each extra muscle was lateral to the tibial nerve and superior to the plantaris, and each extra muscle which transitioned to a descending tendon parallel to the plantaris had a cone-shaped belly. However, the tendon of the extra muscles was fused into the investing fascia of the gastrocnemius with a tendon length of 4.5 cm on the left and 4.6 cm on the right. The extra muscles were innervated by the branch of the tibial nerve to the medial head of the gastrocnemius on both sides. CONCLUSION: Although they had an origin and shape similar to that of the plantaris, we identified the extra muscles in this case as a third head of the gastrocnemius, because of innervation to the plantaris arises directly from the tibial nerve. This case highlighted that the innervation is essential to understanding the myogenesis of extra muscles, especially in cases which are difficult to categorize based on the morphological features of the muscle.

In Vitro Modeling of the Bipolar Disorder and Schizophrenia Using Patient-Derived Induced Pluripotent Stem Cells with Copy Number Variations of PCDH15 and RELN.

Bipolar disorder (BP) and schizophrenia (SCZ) are major psychiatric disorders, but the molecular mechanisms underlying the complicated pathologies of these disorders remain unclear. It is difficult to establish adequate in vitro models for pathological analysis because of the heterogeneity of these disorders. In the present study, to recapitulate the pathologies of these disorders in vitro, we established in vitro models by differentiating mature neurons from human induced pluripotent stem cells (hiPSCs) derived from BP and SCZ patient with contributive copy number variations, as follows: two BP patients with PCDH15 deletion and one SCZ patient with RELN deletion. Glutamatergic neurons and GABAergic neurons were induced from hiPSCs under optimized conditions. Both types of induced neurons from both hiPSCs exhibited similar phenotypes of MAP2 (microtubule-associated protein 2)-positive dendrite shortening and decreasing synapse numbers. Additionally, we analyzed isogenic PCDH15- or RELN-deleted cells. The dendrite and synapse phenotypes of isogenic neurons were partially similar to those of patient-derived neurons. These results suggest that the observed phenotypes are general phenotypes of psychiatric disorders, and our in vitro models using hiPSC-based technology may be suitable for analysis of the pathologies of psychiatric disorders.

Castability and mechanical properties of Ti-15Mo-5Zr-3Al alloy in dental casting.

The castability, mechanical properties, and fracture characteristics of Ti-15Mo-5Zr-3Al alloy were compared with those of Ti-6Al-7Nb alloy and pure titanium (CP Ti) for application of this ß-type titanium alloy in cast dental prostheses. Cast specimens were prepared with a centrifugal casting machine. A tensile test was performed according to ISO standard 22674. The castability index for Ti-15Mo-5Zr-3Al was lower than those for Ti-6Al-7Nb and CP Ti. The tensile strength of Ti-15Mo-5Zr-3Al was 852 MPa, which was lower than that of Ti-6Al-7Nb and higher than that of CP Ti. The proof strength of Ti-15Mo-5Zr-3Al was 799 MPa, which was comparable to that of Ti-6Al-7Nb and higher than that of CP Ti. The elastic modulus of Ti-15Mo-5Zr-3Al was 81.0 GPa, which was lower than the values for Ti-6Al-7Nb and CP Ti. Elongation of Ti-15Mo-5Zr-3Al was 5.1%, which was comparable to that of Ti-6Al-7Nb and less than that of CP Ti. The shape of the fractured segment was narrower for Ti-15Mo-5Zr-3Al than for Ti-6Al-7Nb and CP Ti. The deformation characteristics of Ti-15Mo-5Zr-3Al may result in decreased stress relative to increased strain during plastic deformation in the stress-strain diagram. In conclusion, Ti-15Mo-5Zr-3Al alloy has a low elastic modulus and exhibits limited ductile plastic deformation in cast dental prostheses.

Positive association between the cross-sectional area of the rhomboid muscle, and the range of shoulder abduction after neck dissection surgery.

OBJECTIVE: To evaluate the association between the cross-sectional area of selected shoulder and scapular muscles and the range of shoulder abduction, early after neck dissection surgery. PATIENTS AND METHODS: Twenty-seven patients (contributing 34 upper limbs), who had undergone neck dissection surgery for head and neck malignancy, were enrolled into the study. Loss of strength of the trapezius muscle at 1-month post-surgery was quantified by the change in active range of shoulder abduction (%A-ROM), measured by hand-held goniometry in a standing position, from baseline, before surgery. The cross-sectional area of the following muscles were measured on unenhanced computed tomography images after surgery: trapezius, rhomboid, serratus anterior, pectoralis major, deltoid, and biceps brachii. RESULTS: There was a significant positive correlation between the %A-ROM and the cross-sectional area of the rhomboid muscle. CONCLUSION: Greater active shoulder abduction early after surgery is associated with a greater cross-sectional area of the rhomboid muscle. This muscle should be included in intensive programs for rehabilitation of upper limb movement after neck dissection surgery.

Changes in fatigue and physical function with age for patients with gastrointestinal cancer in the perioperative period: a comparison between older and young patients.

[Purpose] The purpose of this study was to examine changes in fatigue and physical function with age for groups of patients with gastrointestinal cancer in the perioperative period. [Subjects and Methods] The study involved 52 patients with gastrointestinal cancer (28 males and 24 females, aged 62.4 ± 12.0 years). The subjects were divided into two groups: those 65 or over (the so-called elderly group,) and those 64 or under (the so-called young group). The six minute walk distance (6MWD), Cancer Fatigue Scale (CFS), and serum albumin (ALB) were evaluated on three occasions: before surgery, after surgery and after discharge. This study considered change in physical function and fatigue, differences between the two groups and correlations between age and each evaluation on the three occasions. [Results] The 6MWD was the main difference between the elderly and young groups, with the former having significantly reduced 6MWD values as compared to the latter after surgery. Age was positively correlated with 6MWD and ALB after surgery and after discharge. Moreover, age was negatively correlated with CFS after surgery and after discharge. [Conclusion] It is suggested that elderly patients are more likely to experience a decline in exercise tolerance and an increase in fatigue.

Impact of the difference in surgical site on the physique in gastrointestinal tract cancer patients.

[Purpose] The purpose of the present study was to observe physical function, physique (only BMI), and nutrition status (evaluated by serum albumin levels) from before surgery to after discharge among perioperative patients with gastrointestinal tract cancer and to examine the effect of difference in surgical site (i.e., stomach, colon, and rectum) in these patients. [Subjects and Methods] The study subjects were 70 patients who underwent surgical treatment for gastrointestinal tract cancer [36 males and 34 females, aged 59.3 ± 11.4 years (mean ± SD)]. The subjects were classified into three levels according to surgical site (stomach, colon, and rectum). We evaluated patients' physical function, physique, and nutrition status in the three points: before surgery, after surgery, and after discharge. The 6-minute walk distance was measured for physical function. Body mass index was measured for physique. The serum albumin level was measured for nutrition status. [Results] Significant declines in 6-minute walk distance, body mass index, and serum albumin were observed after surgery among the study subjects. In addition, a significant decline in body mass index was observed after discharge compared with before surgery. Regarding body mass index, a significant interaction between surgical site and evaluation times was observed for ANOVA. [Conclusion] These results suggest that BMI after discharge is significantly less than that before surgery and that body mass index changes from before surgery to after surgery are efficacy the difference of surgical site in patients who undergo surgical treatment for gastrointestinal tract cancer.

Effect of silane and phosphate primers on the adhesive performance of a tri-n-butylborane initiated luting agent bonded to zirconia.

The purpose of this study was to evaluate the effects of primers on the bond strength and durability of an acrylic resin luting agent bonded to zirconia. Disk specimens were fabricated from zirconia partially stabilized with yttrium oxide. The disks were primed with one of the following materials: Alloy Primer (AP), Ceramic Primer (CP), Liquid A of the Porcelain Liner M (PLM-A), Liquid B of Porcelain Liner M (PLM-B), Porcelain Liner M (PLM-A+PLM-B), Monobond Plus (MP), and mixture of AP and PLM-B. The specimens were bonded with a tri-n-butylborane (TBB)-initiated luting agent. The shear bond strengths were determined both before and after thermocycling. The results were statistically analyzed with a non-parametric procedure. The highest post-thermocycling bond strength was generated from the groups primed with MP, CP, and AP. It can be concluded that the application of three phosphate primers is recommended for bonding the zirconia with the TBB-initiated luting agent.

Adhesive performance of silver-palladium-copper-gold alloy and component metals bonded with organic sulfur-based priming agents and a tri-n-butylborane initiated luting material.

OBJECTIVE: The purpose of the current study was to evaluate the effect of thione-based metal priming agents on the adhesive behavior of a Ag-Pd-Cu-Au alloy and component metals bonded with an acrylic resin. MATERIALS AND METHODS: Disk specimens (10 mm in diameter by 3 mm thick) were prepared from a silver-palladium-copper-gold (Ag-Pd-Cu-Au) alloy (Castwell M.C.12), high-purity silver, palladium, copper and gold. Four single-liquid priming agents containing organic sulfur compound (Alloy Primer, Metaltite, M.L. Primer and V-Primer) and three acidic priming agents (All Bond II Primer B, Estenia Opaque Primer and Super-Bond Liquid) were assessed. The metal specimens were flat-ground with abrasive papers, primed with one of the agents and bonded with a tri-n-butylborane initiated resin. The shear bond strengths were determined both before and after repeated thermocycling (5°C and 55°C, 1 min each, 20,000 cycles). The results were statistically analyzed with a non-parametric procedure (p = 0.05 level). RESULTS: The post-thermocycling bond strengths in MPa (median; n = 11) associated with the Alloy Primer, Metaltite, M.L. Primer and V-Primer materials were, respectively, 20.8, 22.8, 17.8 and 18.4 for the Ag-Pd-Cu-Au alloy; 19.6, 21.9, 14.4 and 20.1 for silver; 5.4, 4.5, 12.8 and 5.3 for palladium; 17.1, 19.2, 0.7 and 6.6 for copper; and 18.5, 17.7, 22.8 and 15.4 for gold. CONCLUSIONS: It can be concluded that the use of the four priming agents, which are based on organic sulfur compounds, effectively enhanced bonding to the Ag-Pd-Cu-Au alloy and the component metals, although the bonding performance varied among the priming agents and metal elements. The priming agents appeared to have more of an effect on the alloy, silver and gold than on the palladium and copper.

Adhesive bonding of Ti-6Al-7Nb alloy and component metals with acidic primers and a tri-n-butylborane initiated resin.

PURPOSE: To evaluate the effects of acidic functional monomers on the bond strength and durability of an acrylic resin joined to Ti-6Al-7Nb alloy and component metals. MATERIALS AND METHODS: Disk specimens of two different sizes (10 and 8 mm in diameter and 2.5 mm in thickness) were prepared from uncast Ti-6Al-7Nb alloy, titanium, aluminum, and niobium. The specimens were ground with abrasive paper and divided into 8 groups: unprimed control, primed with Acryl Bond, Alloy Primer, All Bond II Primer B, Estenia Opaque Primer, M.L. Primer, MR. Bond, and Super-Bond Liquid. The disks were bonded with tri-n-butylborane (TBB)-initiated acrylic resin, and shear bond strengths were determined both before and after thermocycling. RESULTS: The Alloy Primer and Estenia Opaque Primer agents, which contain a hydrophobic phosphate monomer (MDP), and Super-Bond Liquid demonstrated a durable bond with Ti-6Al-7Nb alloy. MDP was also effective in bonding Ti, Al, and Nb. CONCLUSION: The two primers containing MDP were effective for treating Ti-6Al-7Nb alloy and Ti. Al and Nb showed bonding behavior similar to Ti-6Al-7Nb alloy and Ti when the two metals were treated with acidic primers and bonded with the TBB-initiated acrylic resin.

Evaluation of thiouracil-based adhesive systems for bonding cast silver-palladium-copper-gold alloy.

This study aimed to evaluate the effect of adhesive systems based on a thiouracil monomer on bonding to silver-palladium-copper-gold (Ag-Pd-Cu-Au) alloy (Castwell M.C.12). Disk specimens were cast from the alloy and then air-abraded with alumina. The disks were bonded using six bonding systems selected from four primers and three luting materials. Shear bond strengths were determined both before and after thermocycling. Bond strength varied from 2.7 MPa to 32.0 MPa. Three systems based on a thiouracil monomer (MTU-6) showed durable bonding to the alloy, with post-thermocycling bond strengths of 22.4 MPa for the Metaltite (MTU-6) primer and Super-Bond, a tri-n-butylborane (TBB) initiated resin, 9.0 MPa for the Multi-Bond II resin, and 8.1 MPa for the Metaltite and Bistite II system. It can be concluded that a combination of thiouracil-based primer and TBB initiated resin is effective for bonding Ag-Pd-Cu-Au alloy.

Effects of triazine dithione and hydrophobic phosphate monomers on bonding to Ag-Pd-Cu-Au alloy and titanium with a methacrylic resin-based luting agent.

PURPOSE: The purpose of the current study was to evaluate the effects of thione and phosphate functional monomers on bond strength and durability of a methacrylic resin luting agent joined to silver-palladium based alloy and titanium. MATERIALS AND METHODS: Disk specimens of two different sizes (10 mm and 8 mm in diameter by 2.5 mm thickness) were prepared from silver-palladium-copper-gold (Ag-Pd-Cu-Au) alloy and titanium. The specimens were ground with abrasive paper, and divided into four groups based on the following conditions: 1) unprimed control; 2) priming with Alloy Primer (thione and phosphate); 3) priming with Estenia Opaque Primer (phosphate); and 4) priming with VPrimer (thione). The disks were bonded with tri-n-butylborane (TBB)-initiated resin, and shear bond strengths were determined both before and after thermocycling. RESULTS: The Alloy Primer and V-Primer agents containing a triazine dithione monomer (VTD) bonded the Ag-Pd-Cu-Au alloy, whereas the Alloy Primer and Estenia Opaque Primer agents containing a hydrophobic phosphate monomer (MDP) bonded titanium. The reduction in bond strength after 20,000 thermocycles was not remarkable for the two groups (Alloy Primer and Ag-Pd-Cu-Au alloy; V-Primer and Ag-Pd-Cu-Au alloy). CONCLUSION: The thione monomer was effective in bonding the Ag-Pd-Cu-Au alloy, whereas the phosphate monomer was useful for bonding titanium. The thione did not interfere with the bonding of MDP to titanium, and MDP did not negatively affect bonding of VTD to the Ag-Pd-Cu-Au alloy. The combinations of two thione primers and the Ag-Pd-Cu- Au alloy exhibited the best adhesive performance within the limitations of the current experiment.

Effect of alumina air-abrasion on mechanical bonding between an acrylic resin and casting alloys.

This study examined the effect of alumina air-abrasion with different pressure on bonding between an acrylic resin and casting alloys. Disk specimens (8 and 10 mm in diameter) were cast from a silver-palladium-copper-gold (Ag-Pd-Cu-Au, Castwell M.C.12) alloy and a titanium-aluminum-niobium alloy (Ti-6Al-7Nb, T-Alloy Tough). The disks were air-abraded with alumina particles (50-70 microm) under different air-pressures (0 unabraded, 0.1, and 0.6 MPa). The disk pairs were bonded together with a tri-n-butylborane (TBB)-initiated acrylic resin, and shear bond strengths were determined both before and after thermocycling. Bond strength varied from a maximum of 37.1 MPa to a minimum of 3.6 MPa for the Ag-Pd-Cu-Au alloy, whereas bond strength to Ti-6Al-7Nb alloy ranged from 34.7 MPa to 0.1 MPa. Specimens abraded with 0.6 MPa pressure recorded the greatest post-thermocycling bond strength (21.7 MPa and 17.9 MPa), and unabraded specimens showed the lowest strength (3.6 MPa and 0.1 MPa) for both alloys. Post-thermocycling bond strength to the Ag-Pd-Cu-Au alloy was higher than that to the Ti-6Al-7Nb alloy under identical air-abrading conditions. It can be concluded that alumina air-abrasion with an air-pressure of 0.6 MPa is effective in enhancing retentive characteristics of the TBB-initiated resin joined to the alloys.

Bond strength to bovine dentin of a composite core build-up material combined with four different bonding agents.

Clearfil DC Bond (DC) is a new single-step, dual-cure bonding agent. In this study, the shear bond strengths of a core build-up composite to dentin used with four bonding systems [DC, Unifil Core Self-Etching Bond (UC), Clearfil SE Bond (SE) and Cleafil tri-S Bond (TS)] were measured. The bonding ability after 7 days of storage and in vitro durability following 20,000 thermocycles were also evaluated. The bond strength of DC did not differ significantly from those of other bonding systems after 24 hours of storage. Another dual-cure bonding system, UC, showed a significant reduction of bond strength after 7 days of storage. On the other hand, the bond strength of TS, a light-cured bonding system with a similar composition to DC, was reduced significantly following 20,000 thermocycles. SE, a two-step light-cure bonding system in the same series as DC, provided superior bond strength under all conditions. Although DC showed a slightly lower bond strength than SE, there was no significant difference between DC and SE under all conditions. Consequently, DC may be a useful and effective bonding system for multiple composite resin restorations.

Comparative evaluation of thione and phosphate monomers on bonding gold alloy and Ti-6Al-7Nb alloy with tri-n-butylborane initiated resin.

This study aimed to evaluate the bonding behaviors of a gold alloy and a titanium-aluminum-niobium (Ti-6Al-7Nb) alloy after priming with three metal conditioners. Cast alloy disks were ground and divided into the following four conditions: (1) unprimed control versus priming with (2) Alloy Primer, (3) Estenia Opaque Primer, or (4) V-Primer. The disks were bonded with tri-n-butylborane (TBB) initiated methacrylic resin, and shear bond strengths were determined both before and after 20,000 times of thermocycling. Alloy Primer and V-Primer--which contained a vinyl-thione monomer--were effective for bonding the Au-Pt-Pd alloy. As for the hydrophobic phosphate monomer contained in Alloy Primer and Estenia Opaque Primer, it was effective for bonding the Ti-6Al-7Nb alloy. Further, when specimens were primed with Alloy Primer that contained both functional monomers, bond strength to Ti-6Al-7Nb alloy was greater than that to Au-Pt-Pd alloy.