Maurizio Ripani

The evolution of the meningeal vascular system in the human genus: From brain shape to thermoregulation

The imprints of the middle meningeal vessels make it possible to analyze vascularization in fossil specimens. The association between changes in the cortical anatomy and vascular organization raises questions about the actual physiological meaning of these features, most of all when dealing with the origin of the modern human brain. Metabolism and thermoregulation may be relevant factors in influencing morphological adaptations between brain and vessels. This study is aimed at investigating the relationships between endocranial morphology and endocranial vessels in modern humans and to analyze the pattern of heat dissipation through the endocranial surface in fossil specimens.

A Passive Exoskeleton Can Push Your Life Up: Application on Multiple Sclerosis Patients

In the present study, we report the benefits of a passive and fully articulated exoskeleton on multiple sclerosis patients by means of behavioral and electrophysiological measures, paying particular attention to the prefrontal cortex activity. Multiple sclerosis is a neurological condition characterized by lesions of the myelin sheaths that encapsulate the neurons of the brain, spine and optic nerve, and it causes transient or progressive symptoms and impairments in gait and posture. Up to 50% of multiple sclerosis patients require walking aids and 10% are wheelchair-bound 15 years following the initial diagnosis. We tested the ability of a new orthosis, the “Human Body Posturizer”, designed to improve the structural and functional symmetry of the body through proprioception, in multiple sclerosis patients. We observed that a single Human Body Posturizer application improved mobility, ambulation and response accuracy, in all of the tested patients. Most importantly, we associated these clinical observations and behavioral effects to changes in brain activity, particularly in the prefrontal cortex.

Retinal microcirculation as revealed by SEM corrosion casts in the rat.

The morphology of the retinal microcirculation has been extensively studied by different techniques. Nevertheless, some problems concerning the capillary bed lamination and pre- and postcapillary patterns have not yet been clarified. In the present study the SEM corrosion cast technique was employed to study the three-dimensional relationships of rat retinal vessels and to follow the smallest vascular branches. Rat retina is considered a useful experimental model for a number of pathologies which affect the microvascular bed deeply. Two precapillary patterns have been observed. Precapillary arterioles gave rise to capillaries both as terminal branches or as collaterals. The former pattern of ramification allows only a regulation of flow in a whole group of capillaries downstream, the latter pattern could provide a finer regulation of blood flow. SEM corrosion casts have shown very well the lamination of the capillary bed: one can easily realize this by seeing the overlapped meshes of the two different planes, vessels in between the two capillary laminae can always be followed from one meshwork to the other. This three-dimensional organization is an interesting model for retinal circulation because it shows many features in common with the retina of humans and primates

Calcific tendinopathy of the rotator cuff. Conservative management with 434 Mhz local microwave diathermy (hyperthermia): A case study

Purpose. To report the effects of local microwave diathermy (hyperthermia) at 434 Mhz on calcific tendinopathy of the shoulder in two middle aged patients. Methods. Two middle-aged women with calcific tendinopathy of the shoulder were treated with local microwave diathermy (hyperthermia) at 434 Mhz three times a week for four weeks. Plain radiographs and ultrasonography demonstrated calcific deposits in the area of infraspinatus or supraspinatus. Shoulder Pain and Disability Index (SPADI) and passive Range of Motion (ROM) were used to assess the response to treatment. Results. At the end of the treatment period, the improvement as measured by the SPADI score was respectively 30% for the first patient and 40% for the second patient with an improvement of the shoulder passive ROM for both patients. The calcific deposits seen on the initial radiographs and ultrasonography were no longer visible. At 1 year follow-up, both patients continued to be symptom free. Conclusions. Hyperthermia is a safe option in the management of calcific tendinopathy of the shoulder. Prospective randomized controlled studies with long term assessment are needed to further document its therapeutic efficacy.

evaluation of the Human body Posturizer in postural diseases and its impact on of the fall risk in the elderly

Introduction: Orthosis are external aids designed for different postural problems and represent the most commonly used conservative treatment (Noonan K et al., 1996). In this analysis, a modular exoskeleton named Human Body Posturizer (HBP) has been tested to evaluate the morphological variations due to it’s prolonged use and its effects on the fall risk in the elderly. Methods: a sample of 20 normal male subjects (age: 23.4±4.3) have worn the HBP 3 days for week for 6 months. Subject were examined by baropodometry, Surfacer system and SF-36 questionary. Furthermore, 150 subjects with mild fall risk met inclusion criteria (64.85±2.75) were enrolled. A test battery of physiological parameters related to balance and falls (Tinetti Gait and Balance test, Short Physical Performance Battery, Numeric Pain Rating Scale) has been used in order to determine fall risk in elderly people (Shimada H et al., 2011). Results: in normal subjects, a general increasing of the bilateral symmetry associated to a structural reorganization of the dorsal and lumbar regions. In elderly subjects, a significant improvements in Short Physical Performance Battery, Tinetti Scale and Pain Numeric Rating Scale (p < 0.05) have been showed after treatment with HBP. A significant reduction in fall risk was shown in HBP treated subjects. Discussions: the results of this study suggested a general improvement of the postural assessment due to the increasing of the structural symmetry of the back. The use of Human Body Posturizer seems to be a new significant device for prevention of fall in elder patients. The use of the HBP could represent an integrative therapy for different postural diseases. Further studies will be performed in order to demonstrate the efficacy of this device on elder patients.

A Synovial Ganglion of the Knee: Two Cases in Athletes

The objective of the study is to describe two cases of proximal tibiofibular ganglion cysts in high level athletes. In May 2003 and March 2005 two athletes (one tennis player in the top eighty of the Italian national ranking and a gymnast belonging to the Italian rhythmic gymnastics national team) were referred to our institution complaining of postero-lateral knee discomfort and the presence of localized swelling over the fibular head and the antero-lateral aspect of the leg, with a clinically suspected diagnosis of ganglion cyst of the proximal tibiofibular joint. Ultrasonography clearly detected the fluid-filled structures while magnetic resonance imaging confirmed the diagnosis, also showing precisely the anatomic relationship between the ganglions and the surrounding structures. Both athletes underwent surgical excision and the histological examination was compatible with a proximal tibiofibular joint ganglion cyst; as yet they have had no recurrence.

Microcirculation of the extra-ocular muscles of rats. A scanning electron-microscopic corrosion cast study

Specific researches, employing corrosion casts, were performed on different skeletal muscles, but not on extra-ocular muscles (EOMs). The microvascular bed of EOMs was studied by the corrosion cast technique in the rat. Two histologically and physiologically different layers were present in the EOMs. On the whole, the capillary pattern of EOMs was less dense than in the other skeletal muscles. The EOM orbital layer turned out to have a higher number of transverse anastomoses and tuning-fork divisions than the global layer had. These different microcirculatory patterns can be related with the physiological function and the anatomical situation of the EOMs.

Effects of an innovative esoskeleton (Human Body Posturizer) on static balance in patients with Parkinson’s Disease

Parkinson disease (PD) is a progressive neurodegenerative disease, affecting 0.3% of the general population; cardinal symptoms include tremor, rigidity, bradykinesia, and postural instability. Individuals with PD commonly experience gait and postural stability impairments, which may lead to falls, mobility loss, and reduced independence (de Lau et al, 2006). Human Body Posturizer (HBP) is a fully articulated orthosis, light and able to adapt to the physical characteristics of each individual (Di Russo et al, 2013). Our aim has been to preliminary evaluate the role of HBP as an innovative tool for the conservative treatment of gait and postural stability impairments in patients affected by PD. This study analyzed 10 subjects (5 male and 5 female) affected by PD. A bipodal platform (Prokin, Tecnobody) was used to evaluate static balance. All patients were firstly evaluated without HBP and wearing normal clothes; then, patients were asked to wear HBP and, after 40 mins, a second acquisition with HBP was performed. For the static evaluation, the patients performed a stabilometric test, 30 sec with eyes open and then 30 sec with eyes closed; perimeter sway, area of the center of pressure (CoP), anterior-posterior velocity (VA-P), and medial-lateral velocity (VM-L) have been evaluated. Our results showed a significant reduction in VA-P (p<0.05) when patients wear HBP in both open and closen eyes condition. Moreover, a significant reduction (p<0.05) of the CoP area was observed in closen eyes evaluation. Area of the ellipse contained 95% of CoP data points, computed by considering the main axes of the ellipse, estimated using principal component analysis. This variable reflects the ability of balance system to achieve body stability. Our data suggest a stabilizing effect of HBP on anterior-posterior balance, in patients with PD.

Effects of a new system of postural realignment (HBP): evaluation through the sensorizer

Orthosis are external aids designed for different postural problems and represent the most commonly used conservative treatment (Noonan K et al., 1996). In this analysis, a modular exoskeleton named Human Body Posturizer (HBP) has been tested to evaluate parameters related to the gait cycle and thus any positive effects on balance A sample of 20 normal subjects, 10 male and 10 female (age: 24.8±1.83) who had no previous or current diseases of the bones, joints and muscles have been considered. They wore the HBP for thirty days, three times a week for 30 minutes and then performed a motor task final. The Sensorizer C1-S has been used to analyse their motor task before and after the use of HBP. Regularity of the step, the step symmetry and regularity of the double step were the parameters analyzed in this study. In normal subjects, all three parameters analyzed statistically with the t-test showed a significant change after wearing the HBP resulting in a positive effect on the balance. The results of this study suggested a general improvement of the balance during walking. Symmetry and regularity of the step parameters are fundamental and predictive of the risk of falls (Tura et al. 2010). An improvement of these parameters is associated with a better balance, since low values may be associated with postural imbalances and asymmetries in the way. Further studies will be performed in order to demonstrate the efficacy of this device on elder patients.

Human Body Posturizer (H.B.P.): new orthosis for improving postural dynamics

Introduction . Posture is the result of many complex processes involving the entire body in relationship with different environmental changes (Penha P.J.,2005). Interaction between the different anatomical districts occurs at different levels and it is influenced by different initial conditions. Alterations in imbalances and associated diseases produce a structural and physiologic reorganization of the anatomical structures to improve postural dynamics (Kasim et al., 2010). Generally, these modifications can be divided into para-mophisms and dis-morphisms of the spine. Currently postural diseases are treated by passive (brace and orthosis) and active (gymnastic) methods according with the severity of imbalance (LeBauer et al., 2008; Ugwonali et al., 2004). Purpose of this study is to validate a new type of orthosis named Human Body Posturizer (H.B.P). It is a modular flexible structure composed of different modules which act on the cervical, thoracic and lumbar traits of the back, and an inferior module which acts on the inferior limbs. Materials and methods . The present study considers a sample of 20 male subjects with age spanning from 19 to 35 years (mean age 23,4 ± 4,3). Subjects underwent 4 weeks of H.B.P. treatment consisting of 30 minutes, two times for week. The sample was analyzed by using the Surfacer System (Diagnostic Support), which permits to capture the external geometry of the back. Each subject was sampled before and after the treatment and differences between pre and post treatment were analyzed trough geometric morphometric approach (Slice 2000). Results . The results of this study showed a reorganization of the bilateral structures of the back after treatment. In particular an increased degree of symmetry was observed both in trunk and lumbar regions of the back. Conclusions . The preliminary results of the present study suggest that the HBP, acts on the spatial organization of the back, rectifying the position of the anatomical components associated to the early postural diseases. Nevertheless these results should be considered as preliminary and need of further researches.