The angiosomes of the head and neck: anatomic study and clinical applications

The angiosome concept was introduced over a decade ago by Taylor and Palmer, whereby the body was considered to be composed anatomically of multiple three-dimensional composite blocks of tissue supplied by particular source arteries. Since then, detailed studies of the forearm and leg have been examined by Taylor and his coworkers. This study focuses on another region--the head and neck. Six fresh head and neck cadaver specimens were examined after infusion with a radio-opaque lead oxide mixture and correlated with over 24 previous body studies. The vascular anatomy of the skin, superficial musculoaponeurotic system (SMAS), muscles, brain, dura, and bone was examined. Each layer was painstakingly removed, photographed, labeled, and mapped to the respective arteries and veins. A radiologic subtraction technique was used to allow successive layers to be compared. This information was then scanned into a computer, analyzed, color coded, and labeled, thereby producing a three-dimensional study of the head and neck region to identify the respective angiosomes. As in previous detailed examinations of the leg and forearm, the angiosomes were found to be connected usually within tissues, such as muscle, skin, specialized organs or glands, rather than between the tissues. The muscles usually had vessels of two or more angiosomes supplying them and fell into three major groups based on the similarity of their arterial supply. In some areas, the midline anastomoses were rich, especially in the integument of the scalp, forehead, and lips. In other regions, the midline vascular connections were poor, especially in the tongue and palate. No fewer than 13 angiosomes of the head and neck, supplied by the branches of the external carotid, internal carotid, and subclavian arteries, have been defined, mapping their three-dimensional territories in the skin, the deep soft tissues, and the bones. Although most angiosomes spanned between skin and bone, three territories, those of the vertebral, lingual, and ascending pharyngeal vessels, were confined to the deep tissues without cutaneous representation. Finally, this study provides additional data for the surgeon to help plan safer incisions and better reconstructive flap procedures. It also gives information that may help explain the etiology and treatment of head and neck arteriovenous vascular malformations.     

Radiation protection of the murine intestine by misoprostol, a prostaglandin E1 analogue, given alone or with WR-2721, is stereospecific

Misoprostol, a prostaglandin (PG) E1 analogue, is one of the most effective radiation protectors of the PGs investigated to date. Misoprostol-induced protection is also additive to protection by the widely studied thiol compound, WR-2721. The mechanism of PG-induced radiation protection and its interaction with WR-2721 is unknown. One important step in the investigation of the mechanism is to determine if PG-induced protection and its interaction with WR-2721 is mediated through PG receptor sites. A direct determination of receptor sites on murine intestinal clonogenic cells could not be made; however an indirect approach was possible. Misoprostol is composed of four stereoisomers of about equal proportions of which only one is gastric antisecretory and cytoprotective. Studies reported here compared radiation protection by this active isomer with that of one of the three inactive isomers. Furthermore, the additional protection of the two isomers when administered with WR-2721 was investigated. Results showed that only the active isomer was protective from radiation injury and this isomer was the only one which afforded additional protection with WR-2721. These data show that PG-induced radiation protection is receptor site dependent and stereospecific.     

Activity cycles and the control of four digestive proteinases in the posterior midgut of Rhodnius prolixus Stål (Hemiptera: Reduviidae)

Proteinase levels in the posterior midgut of fifth-instar and adult Rhodnius prolixus follow a cyclic pattern after ingestion of the bloodmeal. In the fifth instar, cathepsin B showed two peaks: the first occurred 6 days after ingestion and the second at the time of ecdysis. Cathepsin D, cathepsin B and lysosomal carboxypeptidase B reached maximal levels 6 days after ingestion. At this time the highest levels of these proteinases were found in mated females, the lowest in males and intermediate levels in virgin females. Maximal levels of aminopeptidase occurred later than catheptic enzymes, and the decline, after maximal levels were achieved, was much more gradual.Catheptic-proteinase levels within the posterior midgut in fifth-instar larvae and adults correlated positively with the amount of protein contained in this gut region. This indicates that production of these proteinases is controlled by a secretagogue mechanism. Aminopeptidase levels were controlled in a different manner. The mated state or sex of adults altered the proteinase levels by changing the amount of protein that was passed into the digestive midgut from the crop.     

Cattle grazing in CRP grasslands during the nesting season: effects on avian reproduction

Bird populations in grasslands have experienced declines coinciding with loss and fragmentation of prairies. The United States Department of Agriculture (USDA)-administered Conservation Reserve Program (CRP) is the most extensive grassland restoration program in North America and it has especially benefitted grassland birds. Grazing by domestic cattle has been restricted in CRP during avian nesting seasons despite the potential improvements in structuring habitat for a greater diversity of grassland bird species. Potential negative consequences of grazing in CRP grasslands include trampling of nests by cattle, reductions in nest concealment from predators, and attraction of brood-parasitic brown-headed cowbirds (Molothrus ater). We designed an experiment to test for effects of cattle grazing in CRP fields during the nesting season on nest survival and brood parasitism of 5 bird species that commonly nest in CRP grasslands: mourning dove (Zenaida macroura), grasshopper sparrow (Ammodramus savannarum), dickcissel (Spiza americana), and eastern (Sturnella magna) and western (S. neglecta) meadowlarks. Grazing was implemented during summers 2017 and 2018 on 17 of 36 fields followed by a year of rest on all fields in 2019. Of the 879 nests on grazed fields, only 4 were likely trampled by cattle (vs. 54% of all nests estimated as failing because of depredation). Experimental grazing (grazed vs. ungrazed fields) had variable effects on nest survival and cowbird parasitism among the bird species analyzed. Negative effects of grazing on daily nest survival of dickcissel and meadowlarks were apparent, at least in some years. We found no direct effects of grazing on nest survival of mourning dove or grasshopper sparrow. Probability and intensity (cowbird offspring/nest) of cowbird parasitism in dickcissel nests was higher on grazed versus ungrazed sites but only in conservation practice (CP) CP2 (vs. CP25 fields). Parasitism probability of grasshopper sparrow nests by cowbirds was higher on grazed fields in the 2 years after introduction of cattle in 2017. Greater vegetative concealment around nest sites was associated with reduced cowbird parasitism of meadowlark and grasshopper sparrow nests and higher nest survival for grasshopper sparrows. Reductions in vegetative height caused by longer-term or high-intensity grazing might therefore have negative consequences for some grassland birds by increasing nest site visibility and exposure to cowbird parasitism. Our results indicate that cattle grazing in CRP fields during the nesting season might have some negative effects on reproductive success of some grassland bird species, at least in the short term; however, the potential improvements of structuring habitat to accommodate more grassland bird species and increasing landowner participation in the CRP are considerable.     

Differential DNA methylation in umbilical cord blood of infants exposed to mercury and arsenic in utero

Mercury and arsenic are known developmental toxicants. Prenatal exposures are associated with adverse childhood health outcomes that could be in part mediated by epigenetic alterations that may also contribute to altered immune profiles. In this study, we examined the association between prenatal mercury exposure on both DNA methylation and white blood cell composition of cord blood, and evaluated the interaction with prenatal arsenic exposure. A total of 138 mother-infant pairs with postpartum maternal toenail mercury, prenatal urinary arsenic concentrations, and newborn cord blood were assessed using the Illumina Infinium Methylation450 array. White blood cell composition was inferred from DNA methylation measurements. A doubling in toenail mercury concentration was associated with a 2.5% decrease (95% CI: 5.0%, 1.0%) in the estimated monocyte proportion. An increase of 3.5% (95% CI: 1.0, 7.0) in B-cell proportion was observed for females only. Among the top 100 CpGs associated with toenail mercury levels (ranked on P-value), there was a significant enrichment of loci located in North shore regions of CpG islands (P = 0.049), and the majority of these loci were hypermethylated (85%). Among the top 100 CpGs for the interaction between arsenic and mercury, there was a greater than expected proportion of loci located in CpG islands (P = 0.045) and in South shore regions (P = 0.009) and all of these loci were hypermethylated. This work supports the hypothesis that mercury may be contributing to epigenetic variability and immune cell proportion changes, and suggests that in utero exposure to mercury and arsenic, even at low levels, may interact to impact the epigenome.     

Residual-based diagnostics for structural equation models

Summary .  Classical diagnostics for structural equation models are based on aggregate forms of the data and are ill suited for checking distributional or linearity assumptions. We extend recently developed goodness-of-fit tests for correlated data based on subject-specific residuals to structural equation models with latent variables. The proposed tests lend themselves to graphical displays and are designed to detect misspecified distributional or linearity assumptions. To complement graphical displays, test statistics are defined; the null distributions of the test statistics are approximated using computationally efficient simulation techniques. The properties of the proposed tests are examined via simulation studies. We illustrate the methods using data from a study of in utero lead exposure.     

Forest refugia revisited: nSSRs and cpDNA sequences support historical isolation in a wide‐spread African tree with high colonization capacity,Milicia excelsa (Moraceae)

The impact of the Pleistocene climate oscillations on the structure of biodiversity in tropical regions remains poorly understood. In this study, the forest refuge theory is examined at the molecular level in Milicia excelsa, a dioecious tree with a continuous range throughout tropical Africa. Eight nuclear microsatellites (nSSRs) and two sequences and one microsatellite from chloroplast DNA (cpDNA) showed a deep divide between samples from Benin and those from Lower Guinea. This suggests that these populations were isolated in separate geographical regions, probably for several glacial cycles of the Pleistocene, and that the nuclear gene pools were not homogenized despite M. excelsa’s wind‐pollination syndrome. The divide could also be related to seed dispersal patterns, which should be largely determined by the migration behaviour of M. excelsa’s main seed disperser, the frugivorous bat Eidolon helvum. Within Lower Guinea, a north–south divide, observed with both marker types despite weak genetic structure (nSSRs: F_ST = 0.035, cpDNA: G_ST = 0.506), suggested the existence of separate Pleistocene refugia in Cameroon and the Gabon/Congo region. We inferred a pollen‐to‐seed dispersal distance ratio of c. 1.8, consistent with wide‐ranging gene dispersal by both wind and bats. Simulations in an Approximate Bayesian Computation framework suggested low nSSR and cpDNA mutation rates, but imprecise estimates of other demographic parameters, probably due to a substantial gene flow between the Lower Guinean gene pools. The decline of genetic diversity detected in some Gabonese populations could be a consequence of the relatively recent establishment of a closed canopy forest, which could negatively affect M. excelsa’s reproductive system.     

Transforming Growth Factor ��1 Inhibits Cystic Fibrosis Transmembrane Conductance Regulator-dependent cAMP-stimulated Alveolar Epithelial Fluid Transport via a Phosphatidylinositol 3-Kinase-dependent Mechanism

Exogenous or endogenous β₂-adrenergic receptor agonists enhance alveolar epithelial fluid transport via a cAMP-dependent mechanism that protects the lungs from alveolar flooding in acute lung injury. However, impaired alveolar fluid clearance is present in most of the patients with acute lung injury and is associated with increased mortality, although the mechanisms responsible for this inhibition of the alveolar epithelial fluid transport are not completely understood. Here, we found that transforming growth factor β1 (TGF-β1), a critical mediator of acute lung injury, inhibits β₂-adrenergic receptor agonist-stimulated vectorial fluid and Cl⁻ transport across primary rat and human alveolar epithelial type II cell monolayers. This inhibition is due to a reduction in the cystic fibrosis transmembrane conductance regulator activity and biosynthesis mediated by a phosphatidylinositol 3-kinase (PI3K)-dependent heterologous desensitization and down-regulation of the β₂-adrenergic receptors. Consistent with these in vitro results, inhibition of the PI3K pathway or pretreatment with soluble chimeric TGF-β type II receptor restored β₂-adrenergic receptor agonist-stimulated alveolar epithelial fluid transport in an in vivo model of acute lung injury induced by hemorrhagic shock in rats. The results demonstrate a novel role for TGF-β1 in impairing the β- adrenergic agonist-stimulated alveolar fluid clearance in acute lung injury, an effect that could be corrected by using PI3K inhibitors that are safe to use in humans.