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PubMed2002

[Evaluation of the usefulness of vascularized bone grafts for surgical reconstruction of the face].

The process of healing of vascularised bone grafts was examined clinically and the use of vascularised bone grafts in face reconstruction surgery was assessed basing on author's experience with the surgical technique, availability of graft recipient and donor sites and final outcome. Patients enrolled in this study were treated at the Department of Maxillofacial Surgery, Pomeranian Academy of Medicine in Szczecin, for cancer, injuries, developmental anomalies and atrophic changes. In each case it was necessary to restore facial bone structures of functional and aesthetic importance, including: floor of the orbital cavity, alveolar process of maxilla, palate, malar bone and mandible (Tab. 2). Reconstruction was done mostly with parietal bone grafts pedicled on temporal fascia and muscle, coronoid process of the mandible pedicled on temporal muscle, and lower part of the diaphysis of mandible pedicled on masseter and pterygoid muscles. In some cases, reconstruction material consisted of a rib on greater pectoral muscle, clavicle on sternocleidomastoid muscle and scapular bone crest pedicled on trapezius muscle. Free microvascular flaps with some elements of fibula and radius were used in two patients for the reconstruction of mandible and soft tissues. In total, 41 vascularised grafts were performed in 40 patients. Graft healing was examined clinically and usefulness of this technique for face reconstruction surgery was assessed basing on author's experience with the preparation technique, intraoperative complications and extent of trauma to donor sites. The results of healing of specific grafts are enclosed in Table 1. The surgical technique for graft preparation and its transfer into the recipient site varied from case to case. The most difficult and effortful approach was with free bone grafts transferred from remote sites by means of a microsurgical technique (group V). Despite the complexity of the reconstruction method, no intraoperative complications occurred in the course of preparation of the radial and fibular bone grafts. In group IV, the most difficult grafts included those taken from ribs, clavicle and scapular bone. Parietal bone grafts were much less troublesome (subgroups Ia and Ib) although associated with the largest number of intraoperative complications. The easiest preparation method applied to the grafting of coronoid process and lower part of the body of mandible (group II and III). Clinical evaluation of vascularised bone grafts confirmed without reservations the value of this approach in face reconstruction surgery. However, the extent to which individual graft types proved to be usable varied. The most valuable ones included parietal bone grafts pedicled on temporal muscle and fascia used for restoring upper and central facial structures and the coronoid process of mandible pedicled on temporal muscle used for reconstructing the floor of the orbital cavity and alveolar process of the maxilla. Rib grafts pedicled on pectoral muscle were of limited use. The same applies to grafts from the lower part of the body of mandible pedicled on masseter and pterygoid muscles occasionally used for restoring the mental part of mandible. Grafts from remote sites (fibula, radius) should be used only when other reconstruction methods are unavailable.

Bone Transplantation↗
PubMed1985

[Craniometry of cranial vault bones in newborn infants].

10 craniometric measurements of the skull bones' fornix have been performed on 89 dried infant skulls. The authors have shown that the craniometric variability of the skull bone's fornix is connected with the skull length rather than with its height. The skull length is determined mostly by the squama of the temporal bone and occipital squama. The shape of the skull vault is determined mainly by parietal bone and squama of the frontal bone. Parietal bones shut unpaired fontanelle, but the remaining bones, under investigation, contribute to the closure of anterolateral and postero-lateral fontanelle.

Cephalometry↗
PubMed2005

Bone morphology and vascularization of untreated and guided bone augmentation-treated rabbit calvaria: evaluation of an augmentation model.

OBJECTIVES: Cranial vault is widely used in experimental models on membranous bone healing in general, guided bone augmentation (GBA) studies being one example. To our knowledge, however, few studies on the characteristics of the untreated calvaria regarding bone density, vessel topography, and their intra/interindividual variations and associations are available. The aims of this investigation were to (1) map the large vessel topography of the skull vault, (2) describe the parietal bones of the adult rabbit histologically and morphometrically, and (3) histologically compare untreated parietal bone with parietal bone that had been treated with a GBA device. MATERIAL AND METHODS: Ten adult untreated rabbits were microangiographed. General anesthesia was induced and the mediastinum was opened. Heparin and lidocaine were injected in the aorta followed by perfusion with India ink. After death, en bloc biopsies of the skull vault including the overlying soft tissues and dura mater were taken. The specimens were cleared with the Spalteholtz technique, microscopically examined, and digitally imaged. Thereafter, circular biopsies were harvested to obtain decalcified sections. In addition, sections from 14 GBA-treated rabbit skulls (of the same race, sex and age as the untreated animals) served as reference specimens for comparison. Histomorphometric examinations were carried out. RESULTS: In the cleared specimens, all parietal bones were found to be supplied by one major branch of the meningeal artery. From each of these, separate branches supplied the dura wherein a fine vessel network covered the bone. No major vessels were found in the supracalvarial soft tissue. Numerous fine vessels were found within the periosteum and dura entering the cortical plates. The decalcified sections of the parietal bones revealed an outer and inner cortical plate enveloping a diploic space containing bone trabeculae, marrow tissue and larger sinusoids. Hollow connections were frequently found in both the outer and inner cortical plates in both the untreated and the GBA-treated specimens. These connections contained marrow tissue that extended to the periosteum and the dura. The morphometric measurements revealed similar proportions of cortical, trabecular, and marrow areas in the right and left untreated bones. The area of the outer cortical plate was significantly larger than the area of the inner cortical plate. Bone density was similar in the right and left untreated and GBA-treated specimens, as was the frequency and width of hollow connections through the cortical bone plates. CONCLUSIONS: The symmetry between the left and right parietal bones concerning the large vessel topography and the histomorphometric parameters assessed was high. Hollow connections in the cortical plates were frequently found. The bilateral use of the parietal bones is suggested to be reliable in experimental GBA models regarding the blood supply and bone quality.

Animals↗
PubMed1989

Keyhole craniectomy for correction of sagittal synostosis.

A modification of the technique combining sagittal strip, circular occipital and biparietal wedge craniectomies (Albright's procedure) for the treatment of sagittal synostosis, with prominent occipital bossing, is described. "Keyhole," as opposed to wedge, parietal craniectomies allow improvement in the shape of the skull, beginning intraoperatively, while eliminating the outbending of the parietal bone that occurs at the apex of a wedge craniectomy.

Cranial Sutures↗
PubMed1996

The auriculomastoid fasciocutaneous island flap: a new flap for orofacial reconstruction.

PURPOSE: Various designs for previously reported postauricular skin flaps have the disadvantages of being two-stage procedures, providing a limited pedicle, or requiring microvascular anastomoses. To overcome such problems, a new auriculomastoid fasciocutaneous (AMFC) island flap for orofacial reconstruction has been developed. This article presents the technique and reports the clinical results. PATIENTS AND METHODS: A long ipsilateral AMFC island flap pedicled by the parietotemporal fascia and based on the parietal branches of the superficial temporal artery, the occipital artery, and the postauricular artery was designed. Twenty-five of these island flaps were used to reconstruct intraoral or external facial defects. RESULTS: The fasciocutaneous flap could be extended to reach any orofacial defect as a single or compound design in a one-stage subcutaneous procedure. Compound types of AMFC island flaps, including scalp, parietal bone, or the parietotemporal fascia were performed successfully based on single vessels. The flap has the characteristics of providing thin and pliable skin, a good color match to the face, and restored sensitivity. The donor defect is designed to be closed directly and concealed behind the ear without ear deformity. CONCLUSIONS: This flap is very useful in orofacial reconstruction because the skin quality equals that of the radial forearm flap, without the need for microvascular anastomoses, with many additional advantages and various modifications of design.

Adult↗
PubMed2005

Neurocranial morphology and growth in Williams syndrome.

Williams syndrome (WS) is a rare congenital neurodevelopmental disorder with distinctive facial features, cardiovascular abnormalities, short stature, mental retardation, and behaviour and cognitive characteristics. The aim of this study was to describe the neurocranial morphology and growth in a group of 62 individuals with WS. The neurocranium was analysed on lateral cephalograms and comparisons were made with neurocranial standards from longitudinal data derived from the Oslo University Craniofacial Growth Archive. The size and morphology of the neurocranium in WS subjects differed from controls. Females as a group showed greater differences than males. The posterior cranial base length was shorter in both WS males and females, and the anterior cranial base length was shorter in WS females whereas it was close to normal in the WS male group. The cranial base angle was, however, not different from the control groups. A flattening was seen in the superior aspect of the parietal bone in both WS males and females. In the posterior part of the neurocranium, the prominence of the occipital bone was larger than in the control groups, which was also reflected in a larger total length of the neurocranium. The thickness of the frontal and occipital bones was considerably greater than in the control group. The deviant size and morphology of the neurocranium in WS subjects was already established in the youngest age group and maintained throughout the observation period. The growth pattern of the neurocranium in WS subjects seemed to be similar to that of the control groups, except in a few individuals.

Adolescent↗
PubMed2004

Imaging features of calvarial tuberculosis: a study of 42 cases.

BACKGROUND AND PURPOSE: Tuberculosis of the calvaria is a rare entity, and only anecdotal reports describing its imaging features have been previously published in the literature. We report the role of conventional radiography and CT findings on in the evaluation of calvarial tuberculosis in 42 cases. METHODS: Forty-two cases of pathologically verified calvarial tuberculosis were analyzed retrospectively by using conventional radiography and CT imaging. The patients included 28 male and 14 female subjects ranging in age from 5 to 48 years (mean age, 16 years). Surgery was performed in 28 patients, and the remaining 14 patients underwent fine needle aspiration cytology. The histologic findings were consistent with the diagnosis of tuberculosis. At follow-up after 2 years, all patients had completely recovered. RESULTS: The male-to-female ratio was 2:1 (28 male and 14 female). The maximum number of patients affected by calvarial tuberculosis ranged in age from 11 to 20 years (61.2%). The average duration of symptoms was 2.5 months. Thirty-nine (92.8%) patients had subgaleal soft tissue swelling, whereas 31(73.8%) patients had a well-defined lytic lesion in the calvaria. The parietal bone was most commonly affected site of the calvaria (ie, in 22 patients [52.4%]). These lesions were detected at conventional radiography in 34 (80.95%) patients. CT depicted bone destruction in 36 patients (85.7%) cases. Extradural lesions and intraparenchymal pathologies were detected in 22 (52.3%) patients and 5 (11.9%) patients, respectively. CONCLUSION: In calvarial tuberculosis, conventional radiographs of the skull show focal bone destruction often with accompanying soft tissue opacity. CT helps in assessing the extent of bone destruction, scalp swelling, and degree of intracranial involvement. Surgery involving bone debridement is resorted to only in cases where bone destruction is extensive.

Adolescent↗
PubMed1998

Occipital remolding for correction of scaphocephaly in the young infant. Technical note.

BACKGROUND: Several surgical techniques have been described for correction of scaphocephaly. Recent advances in the field of craniofacial surgery have allowed more extensive operative procedures for the treatment of cranial vault anomalies. In general the aim of surgical treatment is to prevent early refusion of the parietal bones after the sagittal craniectomy associated with the widening of the biparietal diameter. In children older than 6 months these procedures may result unsatisfactory providing only a partial correction of the malformation. Therefore operative techniques of total cranial vault reshaping are reported in the literature. METHODS: We performed a surgical procedure of biparietal widening and occipital remolding in eight 3 month old infants with a marked deformation of the occipital prominence from sagittal synostosis. RESULTS: This technique has provided excellent cosmetic results with an immediate correction of the parieto-occipital malformation. There have not been intraoperative complications and the postoperative course was uneventful. CONCLUSIONS: The occipital remolding is useful in young infants with a marked skull deformity; this technique will produce immediate restoration of an esthetically pleasing cranial shape and a more satisfactory cosmetic result compared to less extensive procedures.

Cranial Sutures↗
PubMed1988

Differences in the kinetics of the mineralization process in endochondral and intramembranous osteogenesis in human fetal development.

About 300 samples of bone tissue from femoral diaphyses and from parietal bones of calvaria were collected from human fetuses aged from 6-8 to 40-41 weeks in order to compare the kinetics of the mineralization process in endochondral and intramembranous bone formation. The crystallinity of bone mineral was evaluated by the method based on electron spin resonance (ESR) spectrometry, and mineral content was measured after ashing of the samples. Highly significant differences in the kinetics of deposition of mineral (ash content) and maturation of deposited mineral (crystallinity coefficient) were found between parietal bones and femoral diaphyses in the course of fetal development. In the early stages of development (6-8 to 10-12 weeks), the content of mineral and its crystallinity in parietal bones were significantly lower than in femoral diaphyses. In the parietal bones a gradual increase in both values was observed until they reached a plateau at the age of 30 weeks. On the other hand, in femoral diaphyses of 6-8-week-old fetuses mineral content was high and deposited mineral showed a high degree of crystallinity. Both these values did not change significantly until birth. The differences in kinetics of the mineralization process between the weight-bearing bones and bones that are not exposed to the influence of strong external forces are most probably genetically conditioned. The collected data supply embryological information and might be used in the future for evaluation of pathologic changes in skeletal development.

Embryonic and Fetal Development↗
PubMed2006

Hereditary cranium bifidum persisting as enlarged parietal foramina (Catlin marks) on cephalometric radiographs.

Cranium bifidum occultum is a rare skull ossification disorder referred to as the Catlin mark characterized by ossification defects in the parietal bones. Evidence suggests that this condition has a strong genetic heterogenicity. It is believed that, as calvarial growth continues, ossification in parietal bones fills these defects, and they can remain as parietal foramina on either side of the sagittal suture. During the conversion phase of cranium bifidum to the persistent parietal foramen, there will be periods when the brain is unprotected because of the delay in the ossification of the parietal bones. This report describes cranium bifidum occultum diagnosed as an incidental finding in a 14-year-old boy who initially had large bilateral unossified parietal bones and many congenital abnormalities. The patient underwent various surgical procedures over 6 years for the correction of cleft lip and palate. With craniofacial corrections and orthodontic treatment, the patient now has stable dentition and a firm palate with most of the parietal bones ossified. Cranioplasty was not recommended by his family physician after consultation with a neurosurgeon. Orthodontists should be familiar with this genetic abnormality because it causes delay in parietal bone ossification, and they should be able to distinguish between anatomic parietal foramina and enlarged parietal foramina (persistent unossified areas of cranium bifidum occultum), especially when craniofacial abnormalities are noticed.

Adolescent↗
PubMed1999

Mineralization density and apparent density of bone in cranial and postcranial sites in the aging human.

This study addressed the question whether bone density of the mandible reflects bone density at other sites. Samples of cranial bone (mandible and parietal bone) and postcranial bone (fourth lumbar vertebral body, iliac crest and femoral neck) from 14 individuals aged 69-96 years were compared. One slice from each bone was used for apparent density determination by weighing it and dividing by a volume calculated as the product of section thickness and the mean area of the two sides of the section. Another slice was embedded in poly(methylmethacrylate) and micromilled to study the mineralization density by quantitative backscattered electron (QBSE) analysis in a scanning electron microscope, rescaling image histograms to the signal range from a monobrominated (0) to a monoiodinated (255) dimethacrylate resin standard. Mandibular QBSE values (e.g., at the mental foramen region 178.0) were much higher (p < 0.0001, paired t-test) than at other sites (parietal, 170.1; fourth lumbar vertebra (L4), 155.4; iliac crest (IC), 155.2; femoral neck (FN), 160.7 units), and correlated only with parietal bone (r = 0.70). Mean QBSE values for the postcranial sites were correlated (L4 with IC, r = 0.63; L4 with FN, r = 0.88; IC with FN, r = 0.59) as were the apparent density values (L4 with IC, r = 0.87; L4 with FN, r = 0.75; IC with FN, r = 0.80). Neither the apparent density nor the mineralization density of the mandible showed a correlation with values for the postcranial sites. The condition of bone in the elderly mandible should not be used to infer status at postcranial sites.

Aged↗
PubMed1995

Guided bone regeneration in calvarial bone defects using polytetrafluoroethylene membranes.

Guided bone regeneration is defined as controlled stimulation of new bone formation in a bony defect, either by osteogenesis, osteoinduction, or osteoconduction, re-establishing both structural and functional characteristics. Bony defects may be found as a result of congenital anomalies, trauma, neoplasms, or infectious conditions. Such conditions are often associated with severe functional and esthetic problems. Corrective treatment is often complicated by limitations in tissue adaptations. The aim of the investigation was to compare histologically the amount of bone formed in an experimentally created parietal bone defect protected with one or two polytetrafluoroethylene membranes with a contralateral control defect. A bony defect was created bilaterally in the parietal bone lateral to the sagittal suture in 29 6-month-old male Wistar rats. The animals were divided into two groups: (1) In the double membrane group (n = 9), the left experimental bone defect was protected by an outer polytetrafluoroethylene membrane under the periosteum and parietal muscles and an inner membrane between the dura mater and the parietal bone. (2) In the single membrane group (n = 20), only the outer membrane was placed. The right defect was not covered with any membrane and served as control. The animals were killed after 30 days. None of the control defects demonstrated complete or partial bone regeneration. In the single membrane group, the experimental site did not regenerate in 15 animals, partially in four, and completely in one. In the double membrane group, six of the experimental defects had complete closure with bone, two had partial closure, and one no closure.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed2002

Haemodynamic effects of lead(II) acetate, ethanol, and their combination in rats.

OBJECTIVE: The aim of the study was to analyse the haemodynamic background of the hypertension-inducing effect of lead and the role of alcohol effect in hypertension caused by lead. METHODS: Daily lead acetate doses of 0 or 500 mg/kg were administered to Sprague-Dawley male rats. One half of each group received water containing 5% w/v sugar (without ethanol), while the other half of each group received water containing 5% w/v sugar and 10% v/v ethanol, respectively, to drink. At the end of the 12th week ECG and haemodynamic tests were performed with the method of McDevitt and Nies (1976). The tests were repeated after the administration of 5 microg noradrenaline (NA) by i.v. infusion for 3 min. RESULTS: Lead acetate administration increased the arterial blood pressure and total peripheral resistance (TPR), the organ fractions of the cardiac output and blood flow of the parietal bone, and the vascular resistance of the liver and kidneys, and decreased the cardiac output, the blood flow of the liver and kidneys, and the vascular resistance of the parietal bone. Ethanol administration decreased the blood flow of the intestines and increased the vascular resistance of the intestines. Following the simultaneous administration of lead acetate and ethanol, lead acetate reversed (inhibited) the decreasing effect of ethanol on gastrointestinal organ fraction and blood flow. Lead acetate pre-treatment decreased the blood-pressure-increasing effect of NA; it augmented the increasing effect on vascular resistance of the stomach and the reducing effect on parietal bone organ fraction and blood flow. CONCLUSIONS: Lead acetate causes hypertension in male rats, in which the decreased blood flow to the kidneys may play a role; ethanol, ingested in a low dose, does not cause hypertension, and though it can decrease the enhanced vascular tone caused by lead, it is not able to prevent "lead-hypertension"; the considerably increased blood flow in the bones (parietal bone) caused by the lead salt may contribute to the increase and maintenance of the blood lead level. The anticipated mechanism may explain the increased cardiovascular risk proportional to the increased lead concentration in the bones.

Animals↗
PubMed2003

Osteopontin expression in osteoblasts and osteocytes during bone formation under mechanical stress in the calvarial suture in vivo.

UNLABELLED: To clarify the role of OPN in bone formation under mechanical stress, we examined the expression and the function of OPN in bone using an expansion force-induced osteogenesis model. Our results indicated that OPN expression was enhanced during the bone formation and that OPN would be one of the positive factors for the bone formation under mechanical stress. INTRODUCTION: Bone formation is known to be stimulated by mechanical stress; however, molecules involved in stress-dependent regulation of bone formation have not yet been fully characterized. Extracellular matrix proteins such as osteopontin (OPN) could play a role in mediation of the mechanical stress signal to osteoblasts. However, the function of OPN in bone formation under mechanical force is not known. Therefore, we examined the expression and the role of OPN in bone formation in vivo under tensile mechanical stress. MATERIALS AND METHODS: Sagittal sutures of mice were subjected to expansion mechanical stress by setting orthodontic spring wires, and OPN expression during bone formation within the suture gap was examined. RESULTS: Expansion of the sutures resulted in bone formation at the edges of the parietal bones within the sagittal suture. Immunohistochemical analysis revealed abundant accumulation of OPN protein in the matrix of newly formed bone on the inner edge of the parietal bone within the mechanically expanded sutures. Osteoblasts forming bone within the suture subjected to tensile stress also exhibited high levels of OPN protein expression. Reverse transcriptase-polymerase chain reaction (RT-PCR) analysis indicated that OPN mRNA expression was enhanced in wild-type calvariae subjected to expansion force compared with the control calvariae where dead spring wires were set without expansion stress. In addition, type I collagen mRNA was also expressed in the calvariae under the mechanical stimuli. To understand the function of OPN, sagittal sutures in OPN-deficient mice were subjected the expansion stress, and bone formation within the suture to fill the expanded gap was compared with that observed in wild-type mice. OPN deficiency reduced bone formation at the edge of the parietal bone in contact with the expanded suture gap. CONCLUSIONS: These observations revealed that OPN plays a pivotal role in bone formation under tensile mechanical stress.

Animals↗
PubMed1986

Structural differences between bone formed intramuscularly following the transplantation of isolated calvarial bone cells or chondrocytes.

Bone formed in intramuscular transplants of isolated syngeneic calvarial bone cells in mice, was compared with endochondral bone induced by cartilage produced by analogous transplants of isolated epiphyseal chondrocytes, as well as with parietal bones forming the bulk of the calvaria. Transplanted calvarial cells produced islands of bone, some of which contained intraosseous cavities. Osteoclasts inside these cavities were observed only in 14-day-old transplants and bone marrow cells in 28-day and older transplants. On the contrary, bone marrow appeared soon after formation of bone trabeculae in endochondral bone. The percentage area occupied by bone marrow in these specimens was about twentyfold larger than in the bone formed by transplanted bone cells. On the other hand, the bone marrow area in the latter type of bone was somewhat smaller but of similar order as in parietal bones. Moreover, both in parietal bones and in bone formed by isolated bone cells, the bone marrow was devoid of fat cells which were numerous in bone arising by endochondral ossification. It appears, therefore, that the ratio of bone marrow to the bone tissue area in parietal bones depends more on the intrinsic properties of osteoblasts than on the local factors in the environment of the developing bone. In the case of bone induced by cartilage, the bone marrow/bone tissue area could be determined both by the extent of cartilage resorption by vascularized tissue and by the properties of osteoblasts.

Animals↗
PubMed1989

In vivo stimulation of bone formation by transforming growth factor-beta.

The effect of transforming growth factor-beta (TGF beta) on bone in vivo was examined. Twelve daily injections of 1 microgram TGF beta directly onto the periostea of parietal bones of neonatal rats stimulated the formation of periosteal woven bone. The thickness of the treated parietal bones increased at least 2-fold in a dose-dependent manner. This TGF beta effect was localized at the sites of injection, and no change was observed in contralateral parietal bones and tibiae. The body weight in these growing rats was not affected by TGF beta 1. TGF beta 2 had effects similar to those of TGF beta 1 on the parietal bones in vivo. These results reveal for the first time that TGF beta stimulates bone formation in vivo and indicate its anabolic role in local bone metabolism.

Animals↗
PubMed1985

Migration of craniofacial periosteum in growing guinea-pigs.

The use of a carbon particle tattoo provided stable periosteal markers and a means of recording periosteal movement both anteroposteriorly and transversely during growth in guinea-pigs. In general, the periosteum migrated toward the cranial sutures. The radial pattern, demonstrated on the frontal bones and indicated on the nasal and parietal bones, showed that a periosteal envelope is identifiable with each bone. The area of origin of this centrifugal pattern of migration coincided with the ossification centre of that bone. Trabeculae and vascular canals tended to point in the direction of periosteal migration. The anteroposterior periosteal migration was proportional to but less than the anteroposterior growth of the craniofacial bones studied. The absolute medial periosteal marker migration, similar on the frontal and parietal bones, was directed in the opposite direction from the slight transverse bone growth. This may indicate a biophysical response to tension on the fibrous periosteum from the principally anteroposterior craniofacial growth. The amount of growth at the frontonasal, coronal and midline sutures diminished from anterior to posterior. The observed histological and morphological sutural characteristics concurred with these growth changes which correlate with the decreased cranial and increased facial growth during the age period studied. Although the fibrous periosteum is continuous over the separate membranous bones its behaviour appears to be intimately related to the growth of the craniofacial bones which it covers. The blending of the fibrous periosteum within the transverse sutures may prevent significant migration across craniofacial bones. It seems that the observed migratory patterns result from a close association of the fibrous periosteum with each growing craniofacial bone. The relationship of the fibrous periosteum to the growth of the craniofacial bones is a question requiring further investigation.

Animals↗