It is likely that BPPV after TBI is more difficult to treat than idiopathic BPPV, but no tendency to recur was observed in patients who developed BPPV after TBI compared with idiopathic BPPV. Further prospective clinical meta-analytic studies are needed to investigate the outcome of BPPV after TBI.

Introduction and hypothesis This study describes a technique to quantify muscle fascicle directions in the levator ani (LA) and tests the null hypothesis that the in vivo fascicle directions for each LA subdivision subtend the same parasagittal angle relative to a horizontal reference axis. Methods Visible muscle fascicle direction in the each of the three LA muscle subdivisions, the pubovisceral (PVM; synonymous with pubococcygeal), puborectal (PRM), and iliococcygeal (ICM) muscles, as well as the external anal sphincter (EAS), were measured on 3-T sagittal MRI images in a convenience sample of 14 healthy women in whom muscle fascicles were visible. Mean ± standard deviation (SD) angle values relative to the horizontal were calculated for each muscle subdivision. Repeated measures ANOVA and post-hoc paired t tests were used to compare muscle groups. Results Pubovisceral muscle fiber inclination was 41±8.0°, PRM was −19±10.1°, ICM was 33±8.8°, and EAS was −43±6.4°. These fascicle directions were statistically different (p<0.001). Pairwise comparisons among levator subdivisions showed angle differences of 60° between PVM and PRM, and 52° between ICM and PRM. An 84° difference existed between PVM and EAS. The smallest angle difference between levator divisions was between PVM and ICM 8°. The difference between PRM and EAS was 24°. All pairwise comparisons were significant (p<0.001). Conclusions The null hypothesis that muscle fascicle inclinations are similar in the three subdivisions of the levator ani and the external anal sphincter was rejected. The largest difference in levator subdivision inclination, 60°, was found between the PVM and PRM.

Aims The levator ani muscle (LA) injury associated with vaginal birth occurs in a characteristic site of injury on the inner surface of the pubic bone to the pubovisceral portion of the levator ani muscle's origin. This study investigated the gross and microscopic anatomy of the pubic origin of the LA in this region. Methods Pubic origin of the levator ani muscle was examined in situ then harvested from nine female cadavers (35 - 98 years). A combination of targeted feature sampling and sequential sampling was used where each specimen was cut sequentially in approximately 5 mm thick slices apart in the area of known LA injury. Histological sections were stained with Masson's trichrome. Results The pubovisceral origin is transparent and thin as it attaches tangentially to the pubic periosteum, with its morphology changing from medial to lateral regions. Medially, fibers of the thick muscle belly coalesce towards multiple narrow points of bony attachment for individual fascicles. In the central portion there is an aponeurosis and the distance between muscle and periosteum is wider (~ 3 mm) than in the medial region. Laterally, the LA fibers attach to the levator arch where the transition from pubovisceral muscle to the iliococcygeal muscle occurs. Conclusions The morphology of the levator ani origin varies from the medial to lateral margin. The medial origin is a rather direct attachment of the muscle, while lateral origin is made through the levator arch.

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Excited state intramolecular proton transfer (ESIPT) of 1-hydroxy-2-acetonaphthone (HAN) has been in controversy, mainly because its Stokes shift is small compared to those of typical ESIPT molecules. We have investigated excited state dynamics of HAN by time-resolved fluorescence with a resolution high enough to record the nuclear wave packet motions in the excited state. Population dynamics of both the normal and tautomer forms were recorded together with the wave packet motions of the tautomer in the excited state, which confirm the ESIPT of HAN. The population dynamics of the normal and tautomer forms imply that the ESIPT dynamics is biphasic with two time constants <25 and 80 fs. Theoretical analysis of the vibrational modes of the tautomer excited impulsively reveals that major part of the change for the ESIPT reaction is on the naphthalene ring.