Software Suite Training Tool for MSK Exploration and Botulinum Toxin Infiltration Based on Ultrasound Imaging for the Spasticity Treatment.

Nowadays, one of the choice techniques for the spasticity treatment is the ultrasound-guided infiltration of Botulinum Toxin, because it is safe and effective. In order to medical professionals can carry out this technique, they need training and education. One of the safest and most time-free ways to facilitate the acquisition of practical medical skills is through simulators. In this paper we present an innovative technological environment, which includes an ultrasound simulator for training in muscle exploration and infiltration. The simulation platform will guide health professionals, with great realism and high degree of interactivity, in the autonomous training of all the tasks involved in the spasticity treatment procedure by infiltration of Botulinum Toxin, without the need for a real patient or costly phantoms.

Urban blue: A global analysis of the factors shaping people's perceptions of the marine environment and ecological engineering in harbours.

Marine harbours are the focus of a diverse range of activities and subject to multiple anthropogenically induced pressures. Support for environmental management options aimed at improving degraded harbours depends on understanding the factors which influence people's perceptions of harbour environments. We used an online survey, across 12 harbours, to assess sources of variation people's perceptions of harbour health and ecological engineering. We tested the hypotheses: 1) people living near impacted harbours would consider their environment to be more unhealthy and degraded, be more concerned about the environment and supportive of and willing to pay for ecological engineering relative to those living by less impacted harbours, and 2) people with greater connectedness to the harbour would be more concerned about and have greater perceived knowledge of the environment, and be more supportive of, knowledgeable about and willing to pay for ecological engineering, than those with less connectedness. Across twelve locations, the levels of degradation and modification by artificial structures were lower and the concern and knowledge about the environment and ecological engineering were greater in the six Australasian and American than the six European and Asian harbours surveyed. We found that people's perception of harbours as healthy or degraded, but not their concern for the environment, reflected the degree to which harbours were impacted. There was a positive relationship between the percentage of shoreline modified and the extent of support for and people's willingness to pay indirect costs for ecological engineering. At the individual level, measures of connectedness to the harbour environment were good predictors of concern for and perceived knowledge about the environment but not support for and perceived knowledge about ecological engineering. To make informed decisions, it is important that people are empowered with sufficient knowledge of the environmental issues facing their harbour and ecological engineering options.

Assessment of the effects of discontinuous sources of contamination through biomarker analyses on caged mussels.

The present study analysed potential adverse effects of discontinuous sources of contamination, namely the discharge of a combined sewer overflow (CSO) and of runoff in an urban area, the Bay of Santander (North Iberian Peninsula). Water samples and caged mussels were used to analyse concentrations of contaminants and biological responses. Mussels (Mytilus galloprovincialis) were transplanted to a marina receiving runoff from a petrol station and to a CSO discharge site. Samples were collected in synchrony with heavy rains along 62days. Lysosomal membrane stability (LMS) and acyl-CoA oxidase (AOX) activity were measured as core biomarkers and were analysed at all sampling times. Histopathology of digestive gland and gonads, transcription levels of vitellogenin gene, volume density of black silver deposits and micronuclei formation were measured at initial and final stages of the transplant. Chemical analyses of metals, polycyclic aromatic hydrocarbons (PAHs) and endocrine disruptors were performed in water samples and mussel flesh. Mussels accumulated low concentrations of contaminants, which is in accordance with results obtained from exposure biomarkers. AOX activity decreased in all transplanted mussels after the first heavy rain, but this change seems to be related to the seasonal pattern of the enzyme activity. Mussels located close to the CSO discharge site showed a reduction in LMS after the first rain event, when compared to mussels before the transplant and to mussels from the reference location. However, this was attributable to natural environmental changes rather than to pollution. Values of the rest of analysed biomarkers were below threshold values reported for the study area.

Acquisition of Competencies by Medical Students in Neurological Emergency Simulation Environments Using High Fidelity Patient Simulators.

The training of medical students demands practice of skills in scenarios as close as possible to real ones that on one hand ensure acquisition of competencies, and on the other, avoid putting patients at risk. This study shows the practicality of using high definition mannequins (SimMan 3G) in scenarios of first attention in neurological emergencies so that medical students at the Faculty of Medicine of the University of Salamanca could acquire specific and transversal competencies. The repetition of activities in simulation environments significantly facilitates the acquisition of competencies by groups of students (p < 00.5). The greatest achievements refer to skills whereas the competencies that demand greater integration of knowledge seem to need more time or new sessions. This is what happens with the competencies related to the initial diagnosis, the requesting of tests and therapeutic approaches, which demand greater theoretical knowledge.

Relationships between lines of evidence of pollution in estuarine areas: Linking contaminant levels with biomarker responses in mussels and with structure of macroinvertebrate benthic communities.

Data obtained in a pollution survey performed in estuarine areas were integrated using multivariate statistics. The sites selected for the study were areas affected by treated and untreated urban discharges, harbours or industrial activities as well as reference sites. Mussels were transplanted to each site and after different times of exposure, samples of water, sediments and mussels were collected. Biomarkers were analysed on mussels after 3 and 21 days of transplant whereas concentrations of contaminants were measured in water, sediments and mussels after 21 days of transplant. The structure of macroinvertebrate benthic communities was studied in sediment samples. Studied variables were organised into 5 datasets, each one constituting a line of evidence (LOE): contaminants in water, contaminants in sediments, contaminants accumulated by transplanted mussels, biomarkers in transplanted mussels and changes in the structure of macroinvertebrate benthic communities of each sampling site. Principal Component Analysis (PCA) identified the variables of each LOE best explaining variability among sites. In order to know how LOEs relate to each other, Pearson's correlations were performed. Contaminants in sediments were not correlated with the rest of LOEs. Contaminants in water were significantly correlated with contaminants and biomarkers in mussels and with structure of macroinvertebrate benthic communities. Similarly, significant correlations were found between contaminants and biomarkers in mussels and between biomarkers in mussels and structure of macroinvertebrate benthic communities. In conclusion, biomarker responses give relevant information on pollution in estuarine areas and provide a link between chemical and ecological statuses of water bodies in the context of the Water Framework Directive.

Measuring biological responses at different levels of organisation to assess the effects of diffuse contamination derived from harbour and industrial activities in estuarine areas.

To evaluate the effects of diffuse contamination, biological measurements were applied in a scrap cargo harbour, a marina and an industrial area. Metal accumulation and biomarkers (survival in air, digestive gland and gonad histopathology, lysosomal membrane stability, intralysosomal metal accumulation, transcription of vitellogenin and MT20, peroxisome proliferation and micronuclei formation) were measured in transplanted mussels, together with metrics of benthic invertebrates. Benthic species were classified into ecological groups and univariate indexes were calculated. The marina showed high richness (16) and percentage of opportunistic species (55.1%) and low metal accumulation. Mussels in the scrap cargo harbour showed high metal accumulation, up-regulation of MT20 transcription, reduced health status (LP<6 min) and increased micronuclei frequencies (up to 11.3‰). At the industrial area, low species richness (4) and badly organised assemblages were detected and chemical analyses indicated significant amounts of bioavailable metals. Overall, selected biological measurements showed potential for the assessment of diffuse contamination.

Computed anatomical modelling of the optic pathway and oculomotor system using magnetic resonance imaging.

This study presents a computer-based tool for three-dimensional (3D) visualization of the optic pathway and oculomotor system using 3D high-resolution magnetic resonance imaging (MRI) datasets from a healthy subject. The 3D models were built as wireframe grids co-registered with MRI sections. First, 3D anatomical models were generated of the visual pathway from the eyeball to the primary visual cortex and of the cranial oculomotor nerves from the brain stem to the extrinsic eye muscles. Second, a graphical user interface allowed individual and group visualization, translation, rotation and zooming of the 3D models in different spatial positions simultaneously with MRI orthogonal cut planes. Educational and clinical applications are also discussed.

Assessing the effects of treated and untreated urban discharges to estuarine and coastal waters applying selected biomarkers on caged mussels.

To assess effects of urban discharges, biomarkers were measured in caged mussels in northern Iberian Peninsula. Lysosomal membrane stability and histopathology of gonad and digestive gland were analysed as general effect biomarkers. Exposure to specific pollutants was evaluated by autometallographical detection of metals, peroxisomal acyl-CoA oxidase activity, micronucleus test and transcription levels of vitellogenin and MT20 genes. Health status of mussels was impaired after 3 days of caging at the untreated outfall discharge and at the waste water treatment plant effluent discharge to the estuary. The most relevant finding was the significant up-regulation of vitellogenin gene transcription in male mussels exposed to the untreated outfall discharge. Metals and xenoestrogenic endocrine disruptors were bioavailable in some discharges and disturbed the health status of mussels. Biomarkers were effective in the assessment of effects of urban discharges and could be implemented in operative controls required to assess the risks associated to effluent discharges.

Oil spill vulnerability assessment integrating physical, biological and socio-economical aspects: application to the Cantabrian coast (Bay of Biscay, Spain).

A methodology has been developed to carry out an integrated oil spill vulnerability index, V, for coastal environments. This index takes into account the main physical, biological and socio-economical characteristics by means of three intermediate indexes. Three different integration methods (worst-case, average and survey-based) along with ESI-based vulnerability scores, V(ESI), proposed for the Cantabrian coast during the Prestige oil spill, have been analyzed and compared in terms of agreement between the classifications obtained with each one for this coastal area. Results of this study indicate that the use of the worst-case index, V(R), leads to a conservative ranking, with a very poor discrimination which is not helpful in coastal oil spill risk management. Due to the homogeneity of this coastal stretch, the rest of the methods, V(I), V(M) and V(ESI), provide similar classifications. However, V(M) and V(I) give more flexibility allowing three indexes for each coastal segment and including socio-economic aspects. Finally, the V(I) procedure is proposed here as the more advisable as using this index promotes the public participation that is a key element in the implementation of Integrated Coastal Zone Management (IZCM).

Medium-term assessment of the effects of the Prestige oil spill on estuarine benthic communities in Cantabria (Northern Spain, Bay of Biscay).

A specific monitoring program was implemented in the estuaries of Cantabria (northern Spain) in order to assess the medium-term effects (2003-2005) of the Prestige oil spill (POS) on benthic macroinvertebrate communities. A control-impact design was adopted, examining four unaffected and five oil-affected estuaries. High mortalities and significant differences in overall richness and diversity between the control and impacted estuaries were not detected. Some changes in the temporal evolution of species abundance were observed for some key species, but these could not be related to the spillage event. It was not possible to ensure that low magnitude effects had not occurred, due to the high range of natural variability of benthic communities, the confounding effects of other contamination sources and the absence of previous reference conditions.

Application of the "Visible Human Project" in the field of anatomy: A review

The present review addresses the most relevant applications developed using the Visible Human Project. We describe the origins of the Project and the procedure used for the collection of anatomical images of the cadavers from a man and a woman. Thousands of sections from these cadavers have been used in different ways, ranging from the generation of anatomical atlases to the construction of three-dimensional images for simulations and virtual training in surgery. We also include a broad review of the literature and some Internet addresses where information concerning the different uses made of the project compiled by the National Library of Medicine can be sought. Currently, the Visible Human Project is the best and most used digital reference concerning human anatomy, its application being broadest within the field of education. Nevertheless, its applications and uses have surpassed all expectations and the images are now being used in a huge area of disciplines such as art, industry, surgery, etc (AU)

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Postnatal differentiation of the immunohistochemical expression of aromatase P450 in the rat pituitary gland.

At our laboratory, we have recently demonstrated the immunohistochemical expression of aromatase P450 in the pituitary glands of adult rats; this expression was seen to be sex-dependent. In order to determine whether the changes in the expression of the enzyme are related to changes in the gonadal sphere and whether the expression of the enzyme is related to the postnatal differentiation of hypophyseal cytology, in the present work we performed an immunohistochemical study in the rat pituitary gland from birth to old age. The immunohistochemical reaction to aromatase was evident and very generalized at 7 days after birth, with no large differences between the male and female animals. At 14 days the immunohistochemical reaction was decreased in the females, with no changes in the males. At 17 days, aromatase immunoreactivity in the pituitary glands of female rats was very weak whereas the males showed large numbers of reactive cells. These observations were further pronounced at 21 days and 2 months of life. At 24 months, the immunoreactivity found in the pituitary glands of the male rats had almost completely disappeared. Our results show that a postnatal differentiation in the immunohistochemical expression of aromatase occurs; this is tightly linked to sexual activity and is lost in old age. This suggests that hypophyseal aromatase would be related to the mechanisms of action of gonadal steroids on hypophyseal differentiation and secretion.

Computerized model for the integration of data associated with the human brain / Modelo computarizado para la integración de datos asociados con el cerebro humano

Our current work aims at compiling a computerized procedure that will allow different data sets to be integrated via the generation of a brain mapping system using the Linux operative system. This will provide a digitized model of the brain based on serial sections of the organ. The sections will be voxelized, thus obtaining spatial control of the images processed. The system will permit the linking of specific brain areas to associated data bases, creating true spatial thematic maps. Our development includes the use of physical and logical computer elements that will allow the collection, management, analysis, modulation, representation and output of data to brain territories (AU)

El presente trabajo pretende recopilar un procedimiento computarizado que permitirá integrar diferentes juegos de datos mediante la generación de un sistema de mapeo del cerebro usando el sistema operativo Linux. Este método proporcionará un modelo digitalizado del cerebro basado en secciones seriadas del órgano. Las secciones serán voxelizadas obteniendo así el control espacial de las imágenes procesadas. El sistema permitirá el enlace de áreas específicas del cerebro con bases de datos asociadas, creando mapas temáticos espaciales y reales. Este desarrollo incluye el uso de elementos físicos y lógicos computarizados que admitirán la colección, manejo, análisis, modulación, representación y producción de datos de los territorios cerebrales (AU)

Characterization of GFAP expression and cell proliferation in the rat median eminence following hypophysectomy.

To analyze whether the reorganization of the rat median eminence after hypophysectomy might be related to changes in glial fibrillary acidic protein (GFAP)- and cellular proliferation, the distribution of cells immunoreactive for GFAP and the proliferation rate of such cells were analyzed at 20, 40 and 60 days posthypophysectomy. For this study, four rostro-caudal regions of the median eminence were differentiated: the retrochiasmatic, preinfundibular, infundibular and postinfundibular regions. In each of these regions, three layers were studied: the ependymal, the internal and the external. At 20 and 40 days after hypophysectomy, significant increases in cellular proliferation affecting all three layers studied in the preinfundibular and infundibular regions were found. At the same time points, increases in GFAP expression were also observed. However, after 60 days, GFAP and proliferative cellular nuclear antigen (PCNA) expression decreased. Although variations of PCNA and GFAP levels were evident, no colocalisation of PCNA and GFAP was found in the cells of the median eminence in untreated or hypophysectomized rats when sections were analyzed by double immunohistochemical staining. Our results suggest that reorganization of median eminence involves alterations (or modulation) of GFAP-immunoreactive cells together with a proliferation of cells that are not GFAP-immunoreactive. This study also demonstrates that this reorganization is completed within the first two months after hypophysectomy.

Recreation in coastal waters: health risks associated with bathing in sea water.

STUDY OBJECTIVE: To find out whether bathing in sewage polluted waters implies a danger to bathers' health and to determine the best microbiological indicator to predict the relation between bathing and the appearance of some symptoms. DESIGN: Cohort study. SETTING: City of Santander (north of Spain). PARTICIPANTS: From the people going to four Santander beaches in the period from 1 July to 16 September 1998, a cohort of 2774 persons was recruited who agreed to participate in this study. Of those, 1858 successfully completed a follow up interview conducted in seven days. Respiratory, gastrointestinal, eye, and ear symptoms, and fever occurring during the seven day follow up were recorded. MAIN RESULTS: A total of 136 participants (7.5%) reported symptoms. Visitors reported experiencing symptoms with more frequency than residents. Incidence rates of gastrointestinal, cutaneous and high respiratory tract symptoms were higher in bathers, but the differences were not significant. Total symptoms were related with the amount of total coliforms, faecal coliforms, and faecal streptococci in the water. Gastrointestinal and skin symptoms kept a positive trend with the degree of water pollution by total coliforms in both crude and adjusted analyses. An increased risk was observed in 2500-9999 total coliforms per 100 ml, a figure over the proposed standard, although below the European Union mandatory limit. CONCLUSIONS: The results of this study suggest that total coliforms are the best predictors of the symptoms.

Crystalloid architecture of a sialolith in a minor salivary gland.

A sialolith from a minor salivary gland of the mucosa of the upper lip was studied morphologically and analytically. Under stereoscopic microscopic visualisation, no core or any concentric laminar structure was found in the sialolith and it had a transparent glassy appearance. Scanning electron microscopy revealed differences between the internal structure of the sialolith and its external structure. No microbes were observed but some mineralized inclusion bodies were seen. X-ray diffraction indicated the absence of inorganic crystals in the sialolith, while energy dispersive x-ray microanalysis revealed a high content of S followed by Ca, Si and Na and little and scarce P on the fracture surface, with S, Na, Ca and P being distributed throughout the external coating of the sialolith. The results suggest that the sialolith was young and consisted of a crystalloid body with an incipient coating undergoing calcification.

Cell proliferation and apoptosis of thyroid follicular cells are involved in the involution of experimental non-tumoral hyperplastic goiter.

To assess the involvement of cellular inhibition and the appearance of apoptosis in regression of the hyperplastic thyroid gland towards normality, an experimental design was used to elicit non-toxic goiter by inducing hyperplastic goiter in rats by treatment with methimazole. We performed a morphological and PCNA immunocytochemical study together with in situ end labelling with bromodeoxyuridine in thyroid glands of rats receiving methimazole in their drinking water over 21 days after which they were allowed a recovery period of 0, 12, 24, 36, 48 and 72 h and 7, 14, 21 and 44 days. Serum T3 and T4 levels were found to be very low in the methimazole-treated animals although they increased after the goitrogenic compound had been withdrawn. Inhibition of cell proliferation and the burst of apoptosis play important roles in the regression of hyperplastic goiter in rats. Cell proliferation, which was strongly stimulated during goiter, fell significantly at 24 h, thereafter decreasing gradually as the recovery period progressed. Isolated cases of thyrocyte necrosis were observed ultrastructurally. Light and transmission electron microscopy revealed the existence of thyroid apoptosis with respect to the development of the study over time. Most apoptotic thyrocytes became detached from the follicular epithelium and later underwent cellular degeneration in the follicular lumen. The remaining apoptotic cells retracted their cytoplasm, lost contact with the follicular lumen and became located at the base of the follicles. The percentage of apoptosis showed that during the first week of thyroid involution apoptosis was already present but with low percentages while maximum values were attained at 21 days of survival. Our results suggest that, in the rat, during the return of thyroid follicular cells to normality after methimazole-induced hyperplastic goiter a balance arises between proliferation and cell death and that this balance is due to the inhibition of cellular proliferation and, secondarily, to the appearance of apoptosis, which becomes particularly evident towards the end of the first week after withdrawing the goitrogenic agent.

Coexistence of NADPH-diaphorase with tyrosine hydroxylase in hypothalamic magnocellular neurons of the rat.

The presence and distribution of NADPH-diaphorase (ND) neurons as well as tyrosine hydroxylase-immunoreactive (TH) neurons in the hypothalamus are well established. Previous studies have shown the coexistence of ND with neuroactive substances such as calbindin, somatostatin, vasopressin and oxytocin in neurons of this region of the brain. As the tópographical patterns of distribution of ND and TH coincide in many cases, the aim of this study was to determine the possible coexistence of both substances in the main hypothalamic magnocellular nuclei of the albino rat. Histochemical-immunocytochemical double labelling was employed on the same sections as well as a morphometric study. NADPH-diaphorase and tyrosine hydroxylase neurons were observed in all the nuclei under study (supraoptic, paraventricular and accessory nuclei), although most neurons showing the coexistence of both substances were mainly located in the supraoptic nucleus, isolated neurons with double labelling being found in the magnocellular parts of the paraventricular nucleus and in some of the accessory nuclei. Although both substances have previously been shown to be modified in hypothalamic neurons after osmotic stimuli, the range of functions of ND in the CNS is only beginning to be understood. Further studies are needed to elucidate the functional role that ND/TH neurons play in the nervous system.

A three-dimensional virtual model of the head generated from digitalized CT or MR images for anatomical-radiological and neurosurgical evaluations.

A computer-generated virtual model has been developed that reconstructs the head in three dimensions from digitalized images obtained with magnetic resonance and computerized tomography. Through programming and the use of commercial graphic animation software, we have developed the whole process of the rotation of the head on different spatial planes. The procedure permits multidirectional anatomical sections to be made on the structure of the head, providing a true dynamic and user-friendly anatomical-radiological atlas. The system serves as a virtual model for the localization of an ideal surgical approach to any lesion thus avoiding possible neurological lesions.

Morphological findings of an interrelationship among the neurosecretory axons of the neural lobe of the hypophysis.

In order to establish whether osmotic stimuli induce variations in the contact regions among neurosecretory axons of the neural lobe of the hypophysis, adult Sprague-Dawley rats of both sexes were treated with furosemide, a diuretic drug. Contacts between adjacent membranes with no condensations of the axolemma but increase in their osmiophilia were observed. After treatment with furosemide interaxonal contacts were significantly increased (p < 0.01, in relation to control animals). Additionally, following treatment with furosemide, axo-axonic synapses among the axons of the neural lobe were found. These findings suggest the existence of interactions among activated neurosecretory axons of the neural lobe of the adult rat.