identical in 5 % of the cases, while the left part of the skull was larger in 64,7 % of the cases. We draw the con- clusion that the human skull is markedly asymmetrical not only with regard to the dimensions of individual bones but in the topological sense as well. It indicated that the number of symmetrical skulls was insignificant. The skull was observed from the functional point of view as well, and three axis inside the skull base were listed: smaller wings of sphenoidbone, temporal bone pyramid and internal occipital. These axis correspond to the direction of forces which shape the skull base. It is stated that the dependence exists only between the capacity of skull and development of brain while the configuration of skull depends mostly on the position of head and body in space, and the influence of gravitation. Human skull balances on the top of vertical vertebral column, when a balance between the activity of nuchal mussels on the rear end of the skull and the influence of gravitation on skull viscera exists. Flexion of cranial base leads to descend of posteror cranial fossa, which follows the change of vertebral col- umn position and causes increase in sphenoid angle. Thus, the brain gets new space for its development. Process of cranial base flexion allows more intensive development of neurocranium and increased capacity of the skull. It became known that the process of skull-base flexion does not end in adolescence, but it continues to old age, and follows the changes in bending of the cervical part of ver- tebral column. Also, it was indicated that the capacity of skull intensively increases during the growth of skull and that it is even more intensive than the flexion of cranial base. So, the dependence of the skull capacity on the flex- ion of skull - base seems logical.
We found the cavernous foramen in 36 male and 32 female skulls. Therefore, taking these values to- gether, it was present in 68% of the skulls studied. Our data indicate that this seemingly unimportant foramen, often ignored in descriptions of the skull, is quite often present. Moreover, its characteristic feature is great variability, including a high incidence of multiple forms. Schelling  observed the pres- ence of cavernous foramina in 5% of skulls. These had diameters of up to 2.5 mm and were, according to him, varieties of diploic vein. Bochenek and Table 2. The mean area of the studied foramina of the greater wing of the human sphenoidbone in relation to sex and body side (all data in mm 2 ). The results are presented as mean values (in bold, standard deviations (in brackets) and rang-
A wide range in the degree of pneumatization of the sphenoid sinus exists, as shown by anatomic studies (7). Cope (8) found a clearly marked lateral recess in 72 (25%) of 292 sphenoid bones exam- ined, with some of the recesses extending as far as the foramen rotundum. Rarely, the extension was seen to involve the pterygoid process (9). We also reviewed plain CT studies of the paranasal sinuses in 100 age-matched control subjects from the nor- mal population. Twenty-three had extensive lateral pneumatization of the sphenoid sinus. All of these 23 patients also had outward concavity of the in- ferior portion of the lateral wall. Nevertheless, none of the 100 patients had arachnoid pits. Six of the patients had empty sella, but these patients did not have laterally pneumatized sphenoid sinuses. In our series, the presence of extensive pneumatization of the lateral wall of the sphenoid sinus was noted in 10 (91%) patients. The pneumatization of the pter- ygoid plate results in lateral extension of the sphe- noid sinus beyond the body of the sphenoidbone. This may well be the cause of the oblique orien- tation of the lateral wall of the sphenoid sinus. We speculate that the vector forces of CSF pulsations act along the anteromedial aspect of the middle cra- nial fossa, resulting in an outward concave orien- tation of the lateral wall of the sphenoid sinus. This is supported by the concave orientation of the lat- eral wall found in 10 (91%) patients in this series. It has also been hypothesized that the CSF pres- sures and the hydrostatic pulsatile forces may lead to the development of small holes or pits at the sites of arachnoid villi with herniation of dura/arachnoid or brain tissue (10 2 13). With fixation of these me- ninges in the pits, the dura mater progressively thins out, resulting in fenestration, arachnoid di- verticula formation, or CSF fistula when the arach- noid membrane ruptures. The findings of pits or irregularity along the floor of the middle cranial fossa were seen in seven (63%) patients in our se- ries. Russell (10) postulated that intermittently raised intracranial pressure from straining and coughing and possibly rupture of the arachnoid
dicular plate is variably contoured and fuses with the medial surface of the medial pterygoid plate (Fig 3). At the upper part of the perpendicular plate, pro- cesses are present that fuse with the maxillary and sphenoid bones. The orbital process extends supero- laterally to attach to the posterior margin of the orbital surface of the maxillary bone and partly to the inferior surface of the body of the sphenoidbone (Figs 3A and B, and 5B and C). The sphenoidal process extends superomedially to attach to the base of the medial pterygoid plate (Figs 3A and B, and 4B and E). At the junction of the perpendicular and horizontal plates, the pyramidal process attaches to the maxillary bone and extends posterolaterally to attach to the angled inferior margins of the pterygoid plates (Figs 2A; 4B, C, and E; and 5B and C).
DOI: 10.4236/ojrad.2018.83021 182 Open Journal of Radiology cessible para nasal sinuses    . They are described by some authors as being the most variable cavities of the human body . They are surrounded by vital structures such as the internal carotid artery, the optic nerves and the ca- vernous sinus . The variability of the anatomy of the sphenoid sinuses is well documented   . Iatrogenic internal carotid artery or optic nerves injuries are serious complications of trans-sphenoid surgery  . The sphenoid sinus- es are irregular cavities carved into the body of the sphenoidbone with pneuma- tization ranging from absence to extension to adjacent structures including an- terior and posterior clinoid processes, lesser and greater wings, and processes pterygoids and the clivus  . Depending on the extent of sinus pneumatiza- tion, bone covering the internal carotid arteries, optic nerves, maxillary nerves, and vidian nerves may be thin or absent, making these structures susceptible to iatrogenic injury  . Computed tomography (CT) is the most accurate im- aging for studying paranasal sinuses    . CT makes reconstruc- tions in the different planes of the space notably in the coronal plane. This plan shows the deep structures progressively as encountered by the surgeon during an intervention. CT also allows a study both in bone window and soft tissue win- dow. Despite the complex anatomy and surgical importance of the anatomic va- riants of the sphenoidal sinuses, very few studies have been done in Africa. Fa- sunla et al .  in Nigeria; in 2012; showed that surgical anatomic variants of the sphenoid sinuses were also common among black Africans. 38.2% of their population had a protrusion of the optic canal and 27.3% a protrusion of carotid canal. This work aimed to study the anatomic variants of sphenoidal sinuses and adjacent structures at the National and University Teaching Hospital Hubert Koutoukou Maga of Cotonou (CNHU-HKM/Cotonou).
remaining required surgical intervention. Sphenoid sinus sur- gery is indicated when the diagnosis of bacterial sinusitis has been made with no clinical response to appropriate medical treatment during a certain period of 6–8 weeks and when the diagnosis of either fungal rhinosinusitis or mucocele has been made. Cases with cranial nerve involvements may require more urgent surgical treatment in order to timely restore or optimize all neural functions.
NCCT with its multiplanar reformation ability and isotropic resolution is now the reference standard to obtain necessary information about the para-sellar region preoperatively. Authors found no gender variation in the number or attachment of sphenoid sinus septations in present study. Single intra-sphenoid septation was the most common anatomic variant in present study (79.7%) being complete in 71.7% and partial or incomplete in 8%of the examined subjects. Absent septation was seen in 5.9%. The single septa attached to the posterior wall (sellar) in 51% of the cases with left paramedian being the most common site of attachment. Banna M et al, Hamid O et al and Idowu OE et al, also reported single septation as the most common anatomic variation in their study. 7,8,12
Obesity is traditionally viewed to be beneficial to bone health because of well-established positive effect of mechanical loading conferred by body weight on bone formation, despite being a risk factor for many other chronic health disorders. Although body mass has a positive effect on bone formation, whether the mass derived from an obesity condition or excessive fat accumulation is beneficial to bone remains controversial. The underline pathophysiological relationship between obesity and bone is complex and continues to be an active research area. Recent data from epidemiological and animal studies strongly support that fat accumulation is detrimental to bone mass. To our knowledge, obesity possibly affects bone metabolism through several mechanisms. Because both adipocytes and osteoblasts are derived from a common multipotential mesenchymal stem cell, obesity may increase adipocyte differentiation and fat accumulation while decrease osteoblast differentiation and bone formation. Obesity is associated with chronic inflammation. The increased circulating and tissue proinflammatory cytokines in obesity may promote osteoclast activity and bone resorption through modifying the receptor activator of NF- B (RANK)/RANK ligand/osteoprotegerin pathway. Furthermore, the excessive secretion of leptin and/or decreased production of adiponectin by adipocytes in obesity may either directly affect bone formation or indirectly affect bone resorption through up-regulated proinflammatory cytokine production. Finally, high-fat intake may interfere with intestinal calcium absorption and therefore decrease calcium availability for bone formation. Unraveling the relationship between fat and bone metabolism at molecular level may help us to develop therapeutic agents to prevent or treat both obesity and osteoporosis.
Isolated sphenoid inflammatory lesions are relatively rare and as a result of their nonspecific clinical presentation, they are difficult to diagnose at first presentation. 1 The sphenoid sinuses are located at the skull base at the junction of the anterior and middle cerebral fossae and they begins to grow between the 3 rd and 4 th months of fetal development. Pneumatization of the sphenoidbone starts at three years old, and reaches its final shape in the mid-teens. 2,3 The anatomic position of sphenoid sinus is bounded superiorly the sella turcica, laterally the sphenoid sinus can had important prominences including the carotidcanal and the optic canal: In the cavernous sinus, the most medial structure is the internal carotid artery.
Introduction: Study on Morphometric and radiological aspect on existence of foramen of civinini. Sphenoidbone comprises of some rare ossified ligaments, may encounter difficulty in surgical procedures. Incidence of Pterygospinous bars various with different racial groups and they are genetically controlled. Complete ossification of pterygospinous ligament form foramen of civinini. Entrapments of vessels or nerves may occur due to existence of pterygospinous bar. The bar may locate medially or inferiorly to formen ovale as seen in Hawaiian and lemurs. Co–existence of bar with the wide lateral pterygoid plate exhibits development of the bar from herbivore, carnivore and old world monkeys. Comparatively absence or small spine of civinini noted in new world monkeys, rodents and platyrrhines. Pterygospinousbar represents the phylogenetic remnant of Human beings.
chronic infection), or malignancies (a primary sellar mass with parasellar extension, an extrasellar mass with bilateral extension into parasellar space, or metastasis). His hematologic profile, blood glucose, renal and liver function tests, serum angiotensin- converting enzyme levels, and CSF examination results were within normal limits. HIV serology was negative. He underwent a noncontrast CT scan of the head (figure 2), which revealed an ill-defined mildly hyperattenuating mass causing destruction of the sphenoidbone including the sella and clivus. The mass extended to the parasellar region, sphenoid sinuses, and prepontine region bilaterally. On MRI (figure 2), a large mass was seen involving the posterosuperior aspect of the nasopharynx, as well as the sphenoidbone with destruction of the sella and clivus, sparing the basilar artery. The mass encased both internal carotid arteries without any luminal compromise. It appeared isointense with central hypointensity on T1-weighted imaging and hyperintense on T2-weighted images with heterogeneous postcontrast enhancement.
Study design: This was a cross-sectional study of 45 healthy pre-pubertal children aged 5-10 years. Total headless bone mineral content (tBMC), total headless bone mineral density (tBMD), lumbar spine bone mineral content (LS- BMC), and lumbar spine bone mineral density (LS-BMD) were measured with dual energy x-ray absorptiometry (DEXA). Dietary calcium intake was assessed using a food frequency questionnaire (FFQ) and a 3-day estimated food record. Anthropometric data was collected and a previous day physical activity recall (PDPAR) was used to measure the physical activity as metabolic equivalents of task (METs) and energy expenditure (EE). The FFQ was also validated against the 3-day estimated food record.
Adulthood Even after bones stop growing, they go through cycles in which old bone is broken down and new bone is formed. As people age, more bone is broken down than is formed. This can lead to a decrease in bone mass, which causes a decrease in bone density. The strength of bones depends upon their density. As people age, their bone density may decrease. Bones that are less dense may break more easily. Many doctors recommend that adults over a certain age get regular bone density tests.
Among children with SCD-SS, the prevalence of low bone status (at or below the third percentile) was 14% for WBBMC-age (n ⫽ 13; 10 boys), 9% for WBBA-age (n ⫽ 8; 5 boys), 6% for WBBMC-ht (n ⫽ 5; 2 boys), and 6% for WBBA-ht (n ⫽ 5; 1 boy). Three girls had low WBBMC-age (7% of girls). Among boys, low bone WBBMC-age was more common, occurring in 17% of the boys with SCD-SS (see Fig 1). Boys with low WBBMC-age weighed less, were shorter (both P ⬍ .01), were older (16 ⫾ 3 vs 11 ⫾ 4; P ⬍ .01), and had more delayed bone age ( ⫺ 2.1 ⫾ 1.3 vs ⫺ 0.5 ⫾ 1.3; P ⬍ .05) but did not show signs of greater disease severity compared with boys with normal WBBMC-age. There was insufficient power to detect delayed puberty in children with low bone status because the 10 boys were distributed across 5 Tanner stages. However, the growth and skeletal age data suggest that low WBBMC-age in boys is associ- ated with delayed growth and maturation.
Background: Patients receiving androgen deprivation therapy experience secondary hypogonadism, associated bone loss, and increased fracture risk. It has been shown that tocotrienol from Bixa orellana (annatto) prevents skeletal microstructural changes in rats expe- riencing primary hypogonadism. However, its potential in preventing bone loss due to androgen deprivation therapy has not been tested. This study aimed to evaluate the skeletal protective effects of annatto tocotrienol using a buserelin-induced osteoporotic rat model.
In our previous study on chronic inflammatory bone loss in a mouse IBD model , we found that the increase in whole body BMD, and bone microstructural parameters induced by Scl-AbI treatment, was asso- ciated with a reduction of inflammation-increased TRAPC5b and a restoration of inflammation-depressed osteocalcin serum levels, which corresponds to increasing bone formation and decreasing bone resorption. It seems likely that similar mechanisms operated to maintain/ restore whole body BMD in arthritic animals treated with Scl-AbI. However, in the arthritis model, these mechan- isms were not effective at modulating focal erosion in the periarticular bone of the joints affected by the disease. This was clearly demonstrated using two independent structural parameters for assessing bone focal erosion, namely BS/BV (which depends on changes in the bone volume) and BSsmooth/BS (independent of changes in bone volume). These parameters revealed that the block- ade of sclerostin mainly stimulated bone mass accrual on the endosteal surface but not on the periosteal surface of the arthritic periarticular bone (Figure 3, Figure 4 and Figure 7). It is not clear why Scl-AbI is unable to prevent focal bone loss but it is possible that the intensity or
Background: Animal studies have shown that nutritional exposures during pregnancy can modify epigenetic marks regulating fetal development and susceptibility to later disease, providing a plausible mechanism to explain the developmental origins of health and disease. Human observational studies have shown that maternal peri-conceptional diet predicts DNA methylation in offspring. However, a causal pathway from maternal diet, through changes in DNA methylation, to later health outcomes has yet to be established. The EMPHASIS study (Epigenetic Mechanisms linking Pre-conceptional nutrition and Health Assessed in India and Sub-Saharan Africa, ISRCTN14266771) will investigate epigenetically mediated links between peri-conceptional nutrition and health-related outcomes in children whose mothers participated in two randomized controlled trials of micronutrient supplementation before and during pregnancy. Methods: The original trials were the Mumbai Maternal Nutrition Project (MMNP, ISRCTN62811278) in which Indian women were offered a daily snack made from micronutrient-rich foods or low-micronutrient foods (controls), and the Peri-conceptional Multiple Micronutrient Supplementation Trial (PMMST, ISRCTN13687662) in rural Gambia, in which women were offered a daily multiple micronutrient (UNIMMAP) tablet or placebo. In the EMPHASIS study, DNA methylation will be analysed in the children of these women (~1100 children aged 5 – 7 y in MMNP and 298 children aged 7 – 9 y in PMMST). Cohort-specific and cross-cohort effects will be explored. Differences in DNA methylation between allocation groups will be identified using the Illumina Infinium MethylationEPIC array, and by pyrosequencing top hits and selected candidate loci. Associations will be analysed between DNA methylation and health-related phenotypic outcomes, including size at birth, and children ’ s post-natal growth, body composition, skeletal development, cardio-metabolic risk markers (blood pressure, serum lipids, plasma glucose and insulin) and cognitive function. Pathways analysis will be used to test for enrichment of nutrition-sensitive loci in biological pathways. Causal mechanisms for nutrition-methylation-phenotype associations will be explored using Mendelian Randomization. Associations between methylation unrelated to supplementation and phenotypes will also be analysed.