We have studied the morphology of the central sulcus and the cytoarchitecture of the primary sensorimotor cortex in 20 human brains obtained at autopsy. Although the surface appearance of the central sulcus varies greatly from brain to brain (and between hemispheres of individual brains), its deep structure is remarkably consistent. The fundus of the central sulcus is divided into medial and lateral limbs by a complex junction midway between the sagittal and Sylvian fissures. Based on functional imaging studies, this junction appears to be a structural hallmark of the sensorimotor representation of the distal upper extremity. We also identified and measured area 4 (primary motor cortex) and area 3 (primary somatic sensory cortex) in Nissl-stained sections cut orthogonal to the course of the central sulcus. Although the positions of the cytoarchitectonic boundaries in the paracentral lobule showed considerable interindividual variation, the locations of the borders of areas 4 and 3 along the course of the sulcus were similar among the 40 hemispheres examined. In addition to describing more thoroughly this portion of the human cerebral cortex, these observations provide a basis for evaluating lateral symmetry of the human primary sensorimotor cortex.

Wheels turning in the movies or in other forms of stroboscopic presentation often appear to be rotating backward. Remarkably, a similar illusion is also seen in continuous light. pertinent (9, 10).A variety of additional illusions, most of which have been described previously, were also apparent with rotating wheels (11)(12)(13)(14)(15)(16). Color illusions usually referred to as the Benham wheel effect, the Cornsweet illusion (the appearance of areal differences in luminance), and the waterfall illusion (an afterimage of slower counterrotation) could all be seen. Moreover, Abbreviation: rps, revolutions per second.

Reconstruction of oral cavity defects with the SIPF results in shorter operative time and hospitalization without compromising functional outcomes. The SIPF may be a preferable option in reconstruction of oral cavity defects less than 40 cm².

Objectives: The relative length of the second‐to‐fourth digits (2D:4D) has been linked with prenatal androgen in humans. A recent study shows that the 2D:4D ratio in mice is controlled by the balance of androgen to estrogen signaling during a narrow window of digit development. Androgen receptor (AR) activity is higher in digit 4 than in digit 2, and inactivation of AR decreases growth of digit 4, which causes a higher 2D:4D ratio. At the molecular level, the effect of androgens is mediated through the activation of AR. The CAG/GGN repeat polymorphisms of the AR gene are associated with AR activity. Here, we investigate the effect of CAG/GGN repeat polymorphisms in AR on 2D:4D in Chinese. Methods: Digit lengths of the second and fourth fingers were measured from photocopies of the ventral surface of the hand and by actual finger measurements. We genotyped AR polymorphisms by ABI 3730 DNA analyzer. Results: We found that left hand 2D:4D ratio was longer than that of the right hand both in males and in females. We failed to find any relationship between CAG / GGN alleles and the left hand, right hand, right minus left‐hand or mean hand 2D:4D ratios (all, r < 0.20, P > 0.05). Conclusions: In this study, we first found that the left hand 2D:4D ratio was longer than that of the right hand in both males and females. However, we found that both CAG and GGN alleles were not associated with the left hand, right hand, right minus left‐hand or mean hand 2D:4D ratios. Am. J. Hum. Biol., 2013. © 2012 Wiley Periodicals, Inc.

Objective: To summarize the potential risk factors for postlaryngectomy pharyngocutaneous fistula.Data Sources: Observational studies in the Englishlanguage literature about postlaryngectomy pharyngocutaneous fistula from January 1, 1970, to March 31, 2003 Studies were identified through a MEDLINE search with relevant key words; additional studies were identified through references. Study Selection:We included studies about the site of primary malignancy, type of procedure, and type of closure; studies had to have been based on individuallevel data, with a comparison group for each risk factor evaluated.Data Extraction: Data required to calculate the relative risk of fistula associated with commonly reported risk factors were abstracted from the studies, and a meta-analysis using a random-effects approach was performed to estimate a summary relative risk of fistula for each risk factor. The statistical signifi-cance of heterogeneity of effects among studies was assessed. Data Synthesis:Of 65 studies identified, 26 met the inclusion criteria. Significant risk factors identified in the pooled analysis included postoperative hemoglobin level less than 12.5 g/dL, prior tracheotomy, preoperative radiotherapy, and preoperative radiotherapy and concurrent neck dissection. The degree of heterogeneity of effects among studies was significant for postoperative hemoglobin level, preoperative radiotherapy, concurrent neck dissection, and comorbid illness. The severity of fistula was greater in patients with a history of radiotherapy.Conclusions: This meta-analysis identified several significant risk factors for postlaryngectomy pharyngocutaneous fistula. The clinical implications of these findings and the potential sources of heterogeneity of effects among studies are discussed.

Background Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restriction. Methods This international, prospective, cohort study enrolled 20 006 adult (≥18 years) patients from 466 hospitals in 61 countries with 15 cancer types, who had a decision for curative surgery during the COVID-19 pandemic and were followed up until the point of surgery or cessation of follow-up (Aug 31, 2020). Average national Oxford COVID-19 Stringency Index scores were calculated to define the government response to COVID-19 for each patient for the period they awaited surgery, and classified into light restrictions (index <20), moderate lockdowns (20–60), and full lockdowns (>60). The primary outcome was the non-operation rate (defined as the proportion of patients who did not undergo planned surgery). Cox proportional-hazards regression models were used to explore the associations between lockdowns and non-operation. Intervals from diagnosis to surgery were compared across COVID-19 government response index groups. This study was registered at ClinicalTrials.gov , NCT04384926 . Findings Of eligible patients awaiting surgery, 2003 (10·0%) of 20 006 did not receive surgery after a median follow-up of 23 weeks (IQR 16–30), all of whom had a COVID-19-related reason given for non-operation. Light restrictions were associated with a 0·6% non-operation rate (26 of 4521), moderate lockdowns with a 5·5% rate (201 of 3646; adjusted hazard ratio [HR] 0·81, 95% CI 0·77–0·84; p<0·0001), and full lockdowns with a 15·0% rate (1775 of 11 827; HR 0·51, 0·50–0·53; p<0·0001). In sensitivity analyses, including adjustment for SARS-CoV-2 case notification rates, moderate lockdowns (HR 0·84, 95% CI 0·80–0·88; p<0·001), and full lockdowns (0·57, 0·54–0·60; p<0·001), remained independently associated with non-operation. Surgery beyond 12 weeks from diagnosis in patients without neoadjuvant therapy increased during lockdowns (374 [9·1%] of 4521 in light restrictions, 317 [10·4%] of 3646 in moderate lockdowns, 2001 [23·8%] of 11 827 in full lockdowns), although there were no differences in resectability rates observed with longer delays. Interpretation Cancer surgery systems worldwide were fragile to lockdowns, with one in seven patients who were in regions with full lockdowns not undergoing planned surgery and experiencing longer preoperative delays. Although short-term oncological outcomes were not compromised in those selected for surgery, delays and non-operations might lead to long-term reductions in survival. During current and future periods of societal restriction, the resilience of elective surgery systems requires strengthening, which might include...

We have evaluated the lateral symmetry of the human central sulcus, brainstem and spinal cord using quantitative histological and imaging techniques in specimens from 67 autopsy cases. Our purpose was to determine whether the preferred use of the right hand in the majority of humans is associated with grossly discernible asymmetries of the neural centers devoted to the upper extremities. In the accompanying report, we described a consistent set of morphological features in the depths of the central sulcus that localize the sensorimotor representation of the distal upper extremity. Measurements of the cortical surface in this region, and indeed throughout the entire central sulcus, showed no average lateral asymmetry. Cytoarchitectonic measurements of area 4 and area 3 confirmed this similarity between the left and right hemispheres. The medullary pyramids, which contain the corticospinal tracts, were also symmetrical, as were the cross-sectional areas of white and gray matter in the cervical and lumbar enlargements of the spinal cord. Finally, we found no lateral difference in the size and number of motor neurons in the ventral horns at these levels of the cord. Based on these several observations, we conclude that the preferred use of the right hand in humans occurs without a gross lateral asymmetry of the primary sensorimotor system.

Application of vincristine to the gastrocnemius muscle significantly inhibits regeneration of the posterior tibial nerve after crush injury. Botulinum toxin does not prolong functional recovery after nerve injury; rather, crush injury protects against the prolonged chemodenervation seen with botulinum toxin. Doxorubicin and phenol injection did not prolong functional recovery at the doses tested.