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Non-union of fractures of the atlas.

Eighteen patients who had a fracture of the atlas were evaluated clinically and by computed axial tomography an average of forty-six months (range, two to 164 months) after injury. The purpose of the evaluation was to determine the effect of the pattern of the fracture, the quality of osseous healing, and the method of primary immobilization on the long-term outcome. Three (17 per cent) of the patients had a non-union, and two of them had a poor clinical result. These two patients had had a unilateral comminuted fracture--that is, one fracture that was anterior and one that was posterior to the lateral mass, with an associated osteoperiosteal avulsion of the transverse ligament on the same side of the ring of the atlas. Six (33 per cent) of the eighteen patients had an osteoperiosteal avulsion of the transverse ligament. The avulsions usually progressed to osseous union. Rupture of the mid-substance of the transverse ligament was uncommon. No patient had a neurological deficit or late neurological sequelae that were directly attributable to the fracture of the atlas.

Adolescent↗

[Aplasia of the posterior arch of the atlas--report on two cases].

Two cases of aplasia of the posterior arch of the atlas incidentally found are reported. Case 1: A 37-year-old man hit the forehead and the right mandible against the front glass at a head-on collision of his car and was brought to the emergency room. He was alert and neurologically normal except for multiple incision wounds with glass fragments in the face. CT, and cervical X-rays revealed total absence of the posterior arch of the atlas. Case 2: A 73-year-old woman, who sustained whip lash injury at an automobile accident, was admitted several hours after injury, complaining of neck and occipital pain. No neurological deficit was seen. CT demonstrated hemi-aplasia of the posterior arch of the atlas and isolated rudimentary posterior tubercle. Review of the literature and discussions were made on the incidence and genesis of this anomaly.

Adult↗

[Atlas arch aplasia].

A bilateral aplasia of the dorsal arches of the atlas with persisting tuberculum posterius has been observed by the authors. Since the patient had suffered a severe cranio-cerebral trauma, it became necessary to exclude a possible fracture by differential diagnosis. This was possible by means of CT and conventional x-ray diagnosis. According to the classification of dorsal atlas arch aplasia by von Torklus and Gehle (1975) into 6 types, the diagnosis was, in the case under report, Keller's type of aplasia of the arch of the atlas.

Adult↗

Bipartite atlas and hypertrophy of its anterior arch. A case report.

On the lateral cervical spine radiographs of a 60-year-old woman complaining of neck pain, diffuse hyperostosis or calcification was present anterior to the anterior arch of the atlas. CT of atlas revealed it to be bipartite and the hyperostosis to be due to hypertrophy of its anterior arch. We report this as a new sign associated with a bipartite atlas.

Calcinosis↗

Hyoid bone and atlas vertebra in established mouth breathers: a cephalometric study.

The position of hyoid bone and atlas vertebra in 29 established mouth breathers (17 boys and 12 girls) in the age group of 10-14 years were cephalometrically evaluated and compared with 23 nose breathers (11 boys and 12 girls). The children of both the groups were selected on the basis of history and clinical examination. The comparisons were made using univariate analysis for male and female groups separately as well as combined. It was observed that mouth breathers do maintain an extended head posture, which was evident from a decrease in distance between the occiput and dorsal arch of atlas vertebra. However the results of the present study did not reveal any distinct characteristics of hyoid bone and atlas vertebra that can be used to predict or associate the craniofacial pattern of mouth breathers.

Adolescent↗

[Partial bilateral agenesis of the posterior arch of the atlas].

INTRODUCTION: Congenital abnormalities of the posterior arch of the atlas (C-1) are very uncommon and not widely known. Isolated partial agenesis of the posterior arch of the atlas was initially considered a benign variation without any clinical or pathological significance. There is, however, increasing evidence that neurological symptoms may occur after minor cervical trauma in patients with an isolated partial agenesis of the posterior arch of the atlas, specially the types 'C' and 'D' malformations described by Currarino et al. CLINICAL CASE: A 63 year old woman with cervicalgia and 'seasickness', was study with a plain cervical spine radiographs and CT with three-dimensional reconstruction, who showed a bilateral partial absence of the posterior arch of C-1 with persistent posterior tubercle, corresponded to type 'D' in the classification descrites by Currarino et al. CONCLUSIONS: The fact of this pathology can unchain an important neurological symptoms after minor cervical trauma, oblige to the physician (radiologist, neurologist, neurosurgeon, traumatologist, rehabilitation specialist) know this pathology, for to include this patients in a group of the risk, and indicate to them who should avoid contact sports and other strenuous athletic endeavors, and furthermore value the surgical treatment.

Anti-Inflammatory Agents, Non-Steroidal↗

[Radiologic description of the growth plates of the atlas and axis in foals].

Fractures of the first two cervical vertebrae, atlas and axis, may occur in foals for different reasons, e.g. in cases of a fall, going head over heels or when being hit by a hoof. The tentative clinical diagnosis can be confirmed by x-raying the standing animal, with aid of computed tomography in the anaesthetized foal respectively. The growth plates however, and their time of closure have to be considered when interpreting radiographs. In the atlas there are two ventrolateral plates and one dorsomedian cartilagineous plate. Only the dorsal plate, however, can be found in the dorsoventral projection up to an age of about 12 months. The ventrolateral growth plates which have closed at about six months of age cannot be seen in either ther dorsoventral or laterolateral projection. In transversely oriented CT-scans all of the three centres of ossification can easily be made visible in the atlas. In the axis the cartilagineous gaps between the dens axis and the cranial epiphysis as well as the cranial and caudal epiphyseal growth plate can be shown in normal x-radiographs in both planes of projection. Besides this there are growth plates between the corpus vertebrae and the arcus vertebrae in the axis which cannot be seen in either radiographic projection. They become clearly visible in transversal CT-scans and are ossified at the age of three to four months. At the end of the first year the growth plates between the dens axis and the cranial epiphysis have closed. The cranial and caudal epiphyseal plate are gone at an age of about four to five years.

Animals↗

Automated Talairach atlas labels for functional brain mapping.

An automated coordinate-based system to retrieve brain labels from the 1988 Talairach Atlas, called the Talairach Daemon (TD), was previously introduced [Lancaster et al., 1997]. In the present study, the TD system and its 3-D database of labels for the 1988 Talairach atlas were tested for labeling of functional activation foci. TD system labels were compared with author-designated labels of activation coordinates from over 250 published functional brain-mapping studies and with manual atlas-derived labels from an expert group using a subset of these activation coordinates. Automated labeling by the TD system compared well with authors' labels, with a 70% or greater label match averaged over all locations. Author-label matching improved to greater than 90% within a search range of +/-5 mm for most sites. An adaptive grey matter (GM) range-search utility was evaluated using individual activations from the M1 mouth region (30 subjects, 52 sites). It provided an 87% label match to Brodmann area labels (BA 4 & BA 6) within a search range of +/-5 mm. Using the adaptive GM range search, the TD system's overall match with authors' labels (90%) was better than that of the expert group (80%). When used in concert with authors' deeper knowledge of an experiment, the TD system provides consistent and comprehensive labels for brain activation foci. Additional suggested applications of the TD system include interactive labeling, anatomical grouping of activation foci, lesion-deficit analysis, and neuroanatomy education.

Anatomy, Artistic↗

Bony ponticles of the atlas (C1) over the groove for the vertebral artery in humans and primates: polymorphism and evolutionary trends.

The aim of this study was to ascertain the distribution in primates of the three possible bony ponticles over the groove for the vertebral artery (ventral, lateral, and dorsal ponticles), in order to attempt to understand the variants observed in humans and to ascertain possible evolutionary trends in primates. The material consisted of 393 atlases of extant nonhuman primates representative of 41 genera, and of 500 human atlases (dried bones of adults). For each atlas, we studied the existence and morphology of the ponticles, and the type of association of these three ponticles on a given side, which are theoretically of eight in number (types A-H). The occurrence of these ponticles varied from complete absence to constant presence, according to the genera and taxa of primates. The presence of each of these ponticles in primates can be interpreted as a primitive or plesiomorphic character, and their absence as a derived or apomorphic character. The strepsirhines-platyrrhines-cercopithecines group, presenting a predominant primitive pattern (type A), appeared to be separated from the colobines-hominoids group, presenting predominant derived patterns (type C in colobines, Pongo pygmaeus, and Pan troglodytes, and the more derived type D in Hylobates, Gorilla gorilla, and Homo sapiens). The last derived stage, corresponding to the disappearance of the three atlantal ponticles (type H), was only observed in some individuals in hominoids. A marked intraspecific polymorphism characterized the hominoids. The presence of lateral and dorsal ponticles in humans appeared to correspond to their persistence within the progressive disappearance of the atlantal ponticles, constituting an evolutionary tendency characteristic of primates and particularly of hominoid evolution.

Animals↗

Anatomy online: presentation of a detailed WWW atlas of human gross anatomy--reference for medical education.

We present an online anatomy atlas based on the Visible Human Project (VHP) of the US National Library of Medicine. The objective is to provide original unlabeled as well as labeled sections of the human body of high quality and resolution on the Internet, for use in basic and continuing medical education. For a representative overview of the body, 370 axial sections were selected from the male and female data base of the VHP with special regard to regions of clinical interest. Each section is accompanied by its corresponding computer tomography (CT) image and, if available, magnetic resonance images (MRI) for quick and easy comparison of morphologic and radiologic structures. The sections can be studied unlabeled or labeled according to the current Terminologia Anatomica. A linked vocabulary with more than 850 terms explains the labeling. Animations of the sections as well as of CT and MR images allow for further visualization of the topographic relationships of anatomical structures. The responses to the project indicate that students and physicians regard the Internet Atlas of Human Gross Anatomy as a most useful aid for learning and reviewing anatomical details. The atlas is accessible on: http://www.uni-mainz.de/FB/Medizin/Anatomie/workshop/vishuman/Eready.html.

Anatomy, Artistic↗

How the Pernkopf controversy facilitated a historical and ethical analysis of the anatomical sciences in Austria and Germany: a recommendation for the continued use of the Pernkopf atlas.

Eduard Pernkopf's Topographical Anatomy of Man has been a widely used standard work of anatomy for over sixty years. International inquiries about the National Socialist (NS) political background of Eduard Pernkopf and the use of bodies of NS victims for the atlas were first directed at the University of Vienna in 1996. A public discussion about the further use of the book followed and led to the creation of the Senatorial Project of the University of Vienna in 1997. This historical research project confirmed the strong NS affiliation of Pernkopf and revealed the delivery of at least 1,377 bodies of executed persons to the Anatomical Institute of Vienna during the NS time. The possible use of these bodies as models cannot be excluded for up to half of the approximately 800 plates in the atlas. In addition tissue specimens from NS victims were found and removed from the collections of the Viennese Medical School and received a burial in a grave of honor. The Pernkopf controversy facilitated the historical and ethical analysis of the anatomical sciences in Austria and Germany during the NS regime. The continued use of the Pernkopf atlas is not only justifiable but desirable as a tool in the teaching of anatomy, history, and ethics.

Anatomy↗

Three-dimensional antennal lobe atlas of the male moth, Agrotis ipsilon: a tool to study structure-function correlation.

The glomerular structure of the primary olfactory neuropil has long been thought to play an important role in odour coding. In insects, the number of glomeruli in the antennal lobe is limited in most species to fewer than 100 compared with more than 1,000 in vertebrates, making it possible to identify individual glomeruli. A complete three-dimensional atlas of the glomeruli within the antennal lobe of the male noctuid moth Agrotis ipsilon was constructed. All 66 glomeruli were singly identifiable in both antennal lobes of the three brains investigated. Further, six antennal lobes containing intracellularly stained projection neurones were reconstructed. By using the atlas, the respective target glomerulus of each projection neurone could be identified. The importance of the glomerular atlas as a tool to study central olfactory processing and its plasticity is discussed.

Action Potentials↗

Comprehensive expression atlas of fibroblast growth factors and their receptors generated by a novel robotic in situ hybridization platform.

A recently developed robotic platform termed "Genepaint" can carry out large-scale nonradioactive in situ hybridization (ISH) on tissue sections. We report a series of experiments that validate this novel platform. Signal-to-noise ratio and mRNA detection limits were comparable to traditional ISH procedures, and hybridization was transcript-specific, even in cases in which probes could have hybridized to several transcripts of a multigene family. We established an atlas of expression patterns of fibroblast growth factors (Fgfs) and their receptors (Fgfrs) for the embryonic day 14.5 mouse embryo. This atlas provides a comprehensive overview of previously known as well as novel sites of expression for this important family of signaling molecules. The Fgf/Fgfr atlas was integrated into the transcriptome database (www.genepaint.org), where individual Fgf and Fgfr expression patterns can be interactively viewed at cellular resolution and where sites of expressions can be retrieved using an anatomy-based search.

Animals↗

Stereotaxic atlas of the brain of Octodon degus.

We present a stereotaxic atlas of the brain of the trumpet-tailed rat or degu (Octodon degus), an hystricomorph rodent native to Chile and one which has become increasingly popular as a research animal, among other things because of its use as a model for diabetic cataracts and its tendency to become hyperglycemic. The atlas contains 38 transverse and two sagittal sections of the brain covering pros-, mes-, and rhombencephalon, as well as diagrams of the brain's surface anatomy. It was constructed from brains of young adult male degus but can be used readily in studies of adult females, since there is no apparent sexual dimorphism in the brain size of this rodent. Ninety percent of 40 experimental lesions used to check the accuracy of the atlas were correctly placed. The fore- and midbrain of the degu are generally more compact than corresponding regions of the brain in the laboratory rat (suborder Myomorpha) and the guinea pig (another hystricomorph). The amygdaloid complex extends further forward in the telencephalon. Major mesencephalic nuclei and fiber tracts are more rostral in position. However, superior and inferior colliculi are much longer in degus than rats. The basic organization of the rhombencephalon is similar in degus and rats, although there are clearcut differences in the length or size of some hindbrain nuclei.

Anatomy, Artistic↗

The digital anatomist information system and its use in the generation and delivery of Web-based anatomy atlases.

Advances in network and imaging technology, coupled with the availability of 3-D datasets such as the Visible Human, provide a unique opportunity for developing information systems in anatomy that can deliver relevant knowledge directly to the clinician, researcher or educator. A software framework is described for developing such a system within a distributed architecture that includes spatial and symbolic anatomy information resources, Web and custom servers, and authoring and end-user client programs. The authoring tools have been used to create 3-D atlases of the brain, knee and thorax that are used both locally and throughout the world. For the one and a half year period from June 1995-January 1997, the on-line atlases were accessed by over 33,000 sites from 94 countries, with an average of over 4000 "hits" per day, and 25,000 hits per day during peak exam periods. The atlases have been linked to by over 500 sites, and have received at least six unsolicited awards by outside rating institutions. The flexibility of the software framework has allowed the information system to evolve with advances in technology and representation methods. Possible new features include knowledge-based image retrieval and tutoring, dynamic generation of 3-D scenes, and eventually, real-time virtual reality navigation through the body. Such features, when coupled with other on-line biomedical information resources, should lead to interesting new ways for managing and accessing structural information in medicine.

Anatomy↗

The Atlas of Health and Working Conditions by Occupation. 1. Occupational ranking lists and occupational profiles from periodical occupational health survey data.

In this article, we describe methods which have been applied in the compilation of the Atlas of Health and Working conditions by Occupation. First, we discuss the need for information systems to identify problems concerning working conditions and health. Such information systems have an exploratory purpose, being deployed to identify work risks in companies, groups of occupations and sectors of industry, and can also be a starting point for the generation of hypotheses on the causes of adverse health effects. In the Netherlands, occupational health services gather questionnaire data about work and health as part of periodical occupational health surveys. In the atlas, aggregated questionnaire data for 129 occupations with male employees and 19 occupations with female employees are presented. In this article, we explain the methodology used to compare occupations with regard to each item in the questionnaire. We then discuss applications of these occupational ranking lists. The cross-sectional nature of the data collection, various forms of selection and the limited size of some occupational populations have to be taken into account when interpreting the results. Occupational ranking lists can be applied in the allocation of resources and in the design of scientific research. The overviews for each occupation, presented in the second half of the atlas, provide an occupational profile of existing problems with respect to work and health. These profiles are used as basic information to develop a practical policy on working conditions and health.

Adult↗

Matching of digitised brain atlas to magnetic resonance images.

A method has been developed to match a standard digitised brain atlas onto MR images for identification of cerebral structures in anatomical images. This method uses, first, a three-dimensional crude registration based on the proportional system of Talairach. Then, a two-dimensional refined registration is performed using a deformation function based on a set of homologous landmarks on both images (MR and atlas). Displacements vectors are computed between each corresponding landmark. These vectors are interpolated by thin-plate splines, generating an unwarping function defined on the whole image. This function can then be applied on any structure of the atlas. An evaluation of the matching procedure has been performed. First, the influence of the choice of the landmarks has been evaluated for the fine registration method. The latter has been then compared to the crude registration method considered as a classical reference method. These results show the advantages of the fine registration approach.

Algorithms↗

Is the Greulich and Pyle atlas still valid for Dutch Caucasian children today?

BACKGROUND: In our Paediatric Radiology Department, the Greulich and Pyle technique is used to assess skeletal age. Several authors have raised questions with regard to the applicability of this technique in a contemporary paediatric and adolescent population. OBJECTIVE: To compare skeletal age and calendar age in a healthy Dutch Caucasian population in order to test the applicability in this specific population. MATERIALS AND METHODS: For this study we enrolled 278 Dutch Caucasian boys (age range 5.0-19.5 years, mean 12.6 years) and 294 Dutch Caucasian girls (age range 5.2-19.9 years, mean 12.2 years). Radiographs of the left hand were scored according to the Greulich and Pyle atlas by two investigators. RESULTS: Intra-observer coefficient of variation of duplicate assessment of skeletal age for investigator 1 (resident) was 2.4 % and for investigator 2 (radiologist) was 1.5 %. We found no significant systematic differences between the two observers regarding variability and levels of measurement, and the agreement was good. There was a strongly significant correlation between skeletal and calendar age rgirls = 0.974 and rboys = 0.979 (P < 0.001). On average, calendar age preceded skeletal age by a small amount (1.7 months in girls and 3.3 months in boys, both P < 0.001). CONCLUSIONS: The reliability of the Greulich and Pyle atlas in our study corresponds well with previously reported studies. Based on our data, we conclude that the Greulich and Pyle atlas is still applicable in Dutch Caucasian children and adolescents.

Adolescent↗