Epiphysis Sixth sense

Pineal Gland Activation Course

World renowned expert on the pineal gland, Shaktipat Seer has helped thousands around the planet activate their pineal gland safely. Through pineal gland activation you can have a thorough cleansing of your aura, bringing into full effect the latent kundalini powers of your body. Over the years he has perfected his ability to give direct transmission of Spiritual Energy to the Third Eye Chakra, setting alight the glowing powers of the Philosophers Stone of the Neo Cortex region. Discover A Simple System That Anyone Can Do, Regardless Of Age Or Ability And From The Comfort Of Their Own Home. Through Pineal Gland Activation You Can Have A Cleansing Of Your Aura, Bringing Into Full Effect The Latent Kundalini Powers Of The Body Leading To. Shaktipat Seer is not trying to give you some cooky pseudo-science that many snake oil salesman push that has no real transcendental benefit. Instead he is merely presenting the natural way that this process has been effected (through transmission of Shakti to the Third Eye) in the East (India,Tibet,China etc.) for thousands and thousands of years.

Pineal Gland Activation Course Summary


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Author: Shaktipat Seer
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Slipped Capital Femoral Epiphysis

Slipped capital femoral epiphysis (SCFE) is the posterior slippage of the proximal femoral epiphysis relative to the femoral neck. The clinical presentation of SCFE is of pain in the hip that is often worse with ambulation. The classic physical exam finding is loss of internal rotation of the affected hip. Clinical classification of SCFE is based on the duration of symptoms. SCFE is considered acute if symptoms have been present less than 3 weeks, and chronic if the symptoms have progressed beyond 3 weeks. Acute on chronic SFCE describes a preexisting chronic displacement with a superimposed acute slip. Radiographically, slipped capital femoral epiphysis is classified according to the percentage the epiphysis has displaced on the neck of the femur.

Separation of Proximal Tibial Epiphysis

The separation of the proximal tibial epiphysis is a rare phenomenon because the tibia is well protected. The mechanism of injury is usually indirect forces of abduction or hyperextension against a fixed knee. Occasionally this injury is due to a direct force such as encountered in an automobile-pedestrian accident. Again, the classification is the Salter-Harris method. The symptoms and signs are similar to those of all other knee injuries, with pain, swelling, effusion, and a limited range of motion, especially extension-flexion. As with all epiphyseal injuries, there is circumferential tenderness over the injured growth plate. Stress examination reveals instability to the various maneuvers. Standard radiographs to evaluate the knee are recommended, with stress films required if no injury is seen, but one is suspected. Careful evaluation looking for an occult fracture line is important. The treatment for nondisplaced fractures is a long-leg cast with the knee flexed approximately 30...

Cyclic Model Of Perception

Where the retinal images from both eyes are combined. Historically, the French philosopher Rene Descartes (1596-1650) asserted, erroneously, that such an entity resides in the pineal gland (because that structure is located in the center of the head) the German physiologist physicist Hermann L. F. von Helmholtz (1821-1894) named the hypothetical structure the Cyclopean eye after the Greek mythological figure of the Cyclops, a member of a family of giants, who had a single round eye in the middle of its forehead and, most recently, the Canadian-born American neurophysiologist David H. Hubel (1926-) and the Swedish neurobiologist Torsten N. Wiesel (1924- ) located a region in the brain, containing the binocular cells neurons of the visual cortex (approximately half the neurons in the primary visual cortex are binocular), where such retinal images combine to give one the sensation or experience of a single stereoscopic three-dimensional depth perception. See also HOROPTER THEORY PANUM...

Circadian Clocks and Event Timers Are Localized to Different Areas of the Nervous System

SCN neurons in hypothalamic slices are observed to fire rhythmically at around 8 to 10 Hz during the day and 2 to 4 Hz at night (Hastings, 1997 Wagner et al., 1997). Isolated SCN neurons show a spontaneous rate of firing at near the same rates as in slices (Hastings, 1997). They also show a higher-order rhythm in frequency over the circadian day. The SCN reaches most of its targets via thalamus- and hypothalamus- (e.g., the pineal gland) mediated hormonal control (Hastings, 1997).

Monteggia Fractures

Monteggia originally described this injury as a fracture of the proximal third of ulna with associated anterior dislocation of the radial epiphysis. Bado (31) expanded the term Monteggia lesion to include any fracture of the proximal third of the ulna with associated radioulnar pathology.

Ossification Center Appearance and Epiphyseal Union

Epiphyses are most useful in skeletal age estimation procedures when they are approximately fully formed and in the process of uniting with the associated diaphysis. The epiphyses of the lower extremity that are most useful in age estimation are those of the proximal femur, greater trochanter of the femur, distal femur, proximal tibia, distal tibia, proximal fibula, distal fibula, and the metatarsals and foot phalanges. Radiographically, ununited epiphyses can be recognized by a clear line of non-union between the epiphysis and the adjacent aspect of the bone. As the epiphyses unite, these lines diminish or disappear altogether. With bones devoid of soft tissue, evidence of non-articulation consists of an uneven and fracture-free articular surface (on the articular surfaces of both the epiph-ysis and the diaphysis or associated bone). It is important to remember that a considerable length of time can elapse between the beginning and end of epiphyseal closure for each epiphysis (115)....

Learning Style Theory

Both from sensory experience and from thinking reasoning. However, for Aristotle (unlike Plato), the laws and forms in the universe did not have an existence independent of their empirical aspects but are simply observed relationships in nature. Thus, Aristotle's position was that of an empiricist (where knowledge is based on sensory experience), and he formulated his laws of association (such as the laws of similarity, contrast, and contiguity) within this empiricist context. According to Aristotle, sensory experience gives rise to ideas, and the ideas stimulate other ideas in accordance with the principles of association. Later, in philosophy, the attempt to explain the relationship between ideas using the laws of association came to be known as associa-tionism. Aristotle's ideas regarding associa-tionism were so significant that they operate even today in all the major contemporary learning theories. Next, the French philosopher Rene Descartes (1596-1650) inferred from his famous...

The Caudal Diencephalon

Ventrobasal Schema

Anterior of the pretectum lies the dorsal thalamus and epithalamus complex (alar p2). Its dorsal midline includes the epiphysis (pineal gland), the habenular commissure, and choroid plexus rostrally. The epitha-lamus (ET or habenula) is the most dorsal nuclear complex these neurons relate to the longitudinal stria medullaris tract (sm), which crosses the dorsal midline in the habenular commissure (hc in Fig. 3). The habenular nuclei produce the retroflex tract (habenu-lointerpeduncular tract). This compact transverse fascicle is a landmark that remains just anterior to the p1 p2 boundary throughout its dorsoventral extent near the diencephalic floor it bends caudally (retroflects), continuing longitudinally across p1 and

Physiology Of Musculoskeletal System In Children

Physis Zone

TYPE I PHYSEAL FRACTURE In type I physeal fracture (representing 6 percent of physeal injuries), the epiphysis separates from the metaphysis. The cleavage is through the hypertrophic cell zone of the physis. The reproductive cells of the physis remain with the epiphysis. There are no associated fragments of bones, since the thick periosteal attachments surrounding the physis remain intact. However, the epiphysis may be somewhat displaced from the metaphysis. Bone growth is not usually disturbed (Fig 132-2). to the epiphysis (Fig 132-2). Growth is preserved, since the reproduction layers of the physis maintain their position with the epiphysis and the epiphyseal circulation. Diagnosis is made radiographically by noting the triangular fragment of metaphysis (Holland sign) unassociated with discernible injury to the epiphysis. TYPE III PHYSEAL FRACTURE The hallmark of this injury is an intraarticular fracture of the epiphysis extending to the hypertrophic cell zone of the physis, with...

Axial Loading Fractures

In the rare cases in which relatively pure axial loading is applied quickly to a lower extremity (as when an unrestrained passenger is involved in a frontal crash and the flexed knee strikes the dashboard), the result can be an impacted fracture, especially in the young (Fig. 12) and the very old. Note that bending fractures are still common (Fig. 13), and with high force levels there can be significant comminution, even in healthy bone. At lower levels of force or in particularly robust bone, acetabular and patellar fractures may occur without concomitant femur fractures, because the long bones are approx 50 stronger during compression (axial loading) vs bending (58). However, if an impacted fracture is seen, there can be little doubt that the mechanism of injury involved significant axial loading of the bone. In these cases, the compact bone of the diaphysis is driven into the epiphysis. Presumably the less dense spongy bone is simply compacted within the epiphysis.

Rationale for Dcemri of EFT

MRI is the preferred modality for therapy planning in Ewing's family tumors, for many of the same reasons it is preferred for osteosarcoma therapy planning. Over 50 of EFT occur in the extremities, and limb-salvage surgery is preferred over amputation when possible. MRI shows excellent accuracy in depicting the extension of osseous osteosarcoma and Ewing's tumors to the physis and epiphysis (San Julian et al. 1999).

Twentyfourhour Rhythms In Plant Melatonin

The rise in melatonin in this organism begins with the onset of darkness, peaks near the middle of the dark phase of the light dark cycle and then diminishes as morning approaches this is highly reminiscent of the melatonin synthesis cycle in the pineal gland of mammals, including humans (15). A melatonin rhythm similar of that described in G. polyedra has also been measured in Chenopoduim rubrum (8). In this case, 15-day-old plants were maintained under a light dark cycle of 12 12 (in hours). Melatonin concentrations were measured in the above-ground parts of the plant sampled at 2-hr intervals over a 24-hr period during the dark period, the samples were collected with the aid of a dim green light. During the day, melatonin levels were uniformly low and in some cases undetectable. In contrast, during darkness, indoleamine concentrations began to increase to reach a peak at 4 to 6 hr after darkness onset during the latter half of the dark period, melatonin levels diminished to day...

Legg CalvePerthes Disease

Avascular necrosis of the skeletally immature femoral head, or Legg-Calve-Perthes disease, is characterized by os-teonecrosis of the ossific nucleus of the femoral head secondary to occlusion of the arterial or venous blood supply. After infarction, healing occurs by a process of creeping substitution and resorption of the dead bone, with deposition of new bone. The deformity of the femoral head and acetabu-lum may be extensive and can exceed the remodeling and healing capacity of the developing epiphysis. In general, younger children with small areas of involvement have a better prognosis.

TABLE 2591 Mechanisms Associated with Particular Orthopedic Injuries

Some musculoskeletal injuries or conditions may not necessarily be associated with a history of trauma. Occult fracture of the hip in an osteoporotic individual, occult stress fracture of a metatarsal in someone who has recently done an unusual amount of walking, and slipped capital femoral epiphysis in a preteenager or young adolescent, are all examples of injuries whose symptoms may be gradual and insidious in onset, unrelated to an isolated traumatic event. Tenderness to palpation or pain on weight-bearing or range-of-motion suggests the possibility of an occult or easily missed fracture. Depending on the index of suspicion, further studies, such as bone scan or magnetic resonance imaging (MRI), may be indicated to rule out significant pathologic conditions before the patient is allowed to resume weight-bearing.

Hip Injuries in Children

FRACTURES AND DISLOCATIONS Fractures of the proximal end of the femur are extremely rare in children and are usually due to severe trauma. Trauma may produce a displaced epiphysis or a fracture of the neck, trochanteric, or subtrochanteric region. Traumatic epiphyseal separation is probably less common than the previously mentioned fractures, but is more common than dislocation. The treatment of displaced fractures is anatomic reduction, followed by internal fixation surgically. Nondisplaced fractures of the intertrochanteric and subtrochanteric regions may be treated with skin or skeletal traction followed by abduction spica casting.35 There is a significant complication rate, especially avascular necrosis with transepiphyseal and transcervical (femoral neck) fractures.

A A Biological Clock in Hypothalamus

Elucidating the connections of the SCN has been an important component of understanding how this group of hypothalamic neurons imposes its temporal message on the physiology and behavior of the parent organism. One of the most well-characterized systems in this regard is the circuitry through which the SCN exerts regulatory control over the secretion of the hormone melatonin. Melatonin is secreted by the pineal gland in a circadian manner but is also responsive to light such that light stimulation during the dark phase of the photoperiod inhibits the normally high levels of melatonin secretion. This dynamic regulatory capacity renders the temporal profile of melatonin secretion a precise measure of day length. A large literature has established that the SCN controls both the circadian and photoperiodic aspects of melatonin secretion through multisynaptic pathways that sequentially involve the paraventricular hypothalamic nucleus, the intermediolateral cell column of the spinal cord,...

Storage Sites Plasma Proteins

Effect Food Irradiation

The blood-brain barrier, placental barrier, and blood-to-testis barrier are physiological barriers to toxicants. Capillary borders exist between the plasma and brain cells. This boundary is much less permeable than the boundary between plasma and other tissues to water-soluble compounds. The boundary is a single row of brain capillary endothelial cells that are joined by continuous, tight intercellular junctions. Thus, water-soluble compounds must pass through cells rather than between them, which can only occur if the compounds exhibit high lipid-water partition coefficients, enabling them to penetrate the cell membrane. Some areas of the brain are more permeable to toxicants than others. This may be a function of increased blood supply to those areas or a more permeable barrier to substances, or perhaps both. Cortex, lateral nuclei of the hypothalamus, the pineal body, and the posterior lobe of the hypophysis are more permeable than other areas of the brain. The toxicant enters into...

Categories of Contrast Agents

There are four main categories of normal micro-vasculature, based on endothelial structure continuous (e.g., skeletal muscle), discontinuous (e.g., liver sinusoids), fenestrated (e.g., kidney glomerular microvasculature), and tight junctional (blood-brain barrier, BBB). The molecular size, shape, and charge of an agent determine whether it will be diffusible in a specific microvascular environment. As mentioned above, the most restrictive environment is the brain due to the presence of the BBB. Certain vascular mid-line brain regions, collectively known as circumven-tricular organs, are exceptions, however, and are void of a BBB. These include the posterior pituitary (neu-rohypophysis), median eminence, area postrema, pineal gland, subcommissural organ, and subfornical organ. Due to the vascular nature of these areas they often enhance with routine contrast applications (especially the larger brain regions such as posterior pituitary and pineal gland). Other microvascular barriers...

Computed Tomography Emergency Department Applications

Mri Subcommissural Organ

CT scanning has replaced most other modalities of imaging in the acute evaluation of neurologic injury or disease. No longer are we taught to look for pineal gland calcification on skull film as a way of detecting midline shift, nor do we order plain skull films to identify skull fractures, when what we are really concerned about is underlying brain injury. (Although there may still be a role for skull films in selected cases.)

Identification Of Melatonin In Plants

Melatonin was first detected and quantified in the dino-flagellate, Gonyaulax polyedra (4,5). In this species, melatonin was found to be at concentrations similar to those measured in the pineal gland of vertebrates. In addition to its obvious presence in this autotrophic organism, melatonin also exhibited a rhythm in these unicells like that observed in the pineal gland. Thus, melatonin levels measured either by high performance liquid chromatography or gas chromatography-mass spectrometry were higher at night than during the day. This finding stimulated research directed at identifying melatonin in higher plants, and in recent years, this indoleamine has been found in a remarkably large number of taxa (Table 1). Among angio-sperms, melatonin has been identified in more than 30 species belonging to 19 different families, in both mono- and dicotyledons. Although melatonin has been reported in a rather small number of species, their diversity and the fact that almost all plants...

Sensory Cranial Nerves Derived from the Neural Tube

The epiphysis forms from the roof plate of the diencephalon and comprises a variety of structures in various vertebrates, including a frontal organ and pineal gland in frogs, a parietal eye and pineal gland in lizards, and a pineal gland in mammals. The pineal gland does not receive light directly, as do the neural retina and the parietal eye, but it is influenced by light via a pathway from the suprachiasmatic nucleus of the hypothalamus to the sympathetic intermediolateral column of the spinal cord and then via postganglionic sympathetic fibers that arise from the superior cervical ganglion and travel on branches of the internal carotid artery to reach the pineal gland, where the sympathetic input inhibits the conversion of serotonin to melato-nin. In mammals, the pineal gland contains neurons that project to the medial habenular nucleus and part of the pretectum. Pineal projections to other brain sites are minor in humans, but recognition of an epiphyseal cranial nerve is justified...

Insights gained from animal models of ocular autoimmunity

Vitreous Body Imune

The questions outlined above are being studied in animal models of ocular autoimmunity (Table 1). The best studied is experimental autoimmune uveo-retinitis (EAU), which serves as a model for human posterior uveitic disease that is most likely to result in impairment of vision. EAU can be induced in various species of rodents and in primates by any of several defined retinal antigens injected in emulsion with complete Ereund's adjuvant (CFA). A number of uveitogenic proteins derived from the photoreceptor cell layer have been identified (Table 2). EAU is characterized by destruction of the photoreceptor cells of the retina, where the eliciting antigen(s) are located (Figure 1), and is usually accompanied by autoimmune inflammation of the pineal gland ('third eye'), which shares ocular-specific antigens with the retina. today that this view is no longer tenable. Recent work has shown that by using the sensitive PCR technique, messenger RNA for ocular antigens is detectable in the...

Clinical Evaluation and Management

Imaging with cranial CT or MRI can be useful in metabolic coma to differentiate between an ischemic infarct, an intracerebral hemorrhage, and a mass lesion involving the cortex or the brain stem. However, these imaging studies are often unremarkable during metabolic coma. Patients in coma who present with cranial nerve deficits and posturing likely suffer from a mass lesion involving the cortex or the brain stem. However, patients in coma with unilateral masses may not initially suffer from transtentorial herniation. In this group, CT and MRI demonstrate horizontal displacement at the level of the pineal body.

TABLE 2312 Symptoms and Signs of Hypocalcemia

X-rays Radiologically, rickets is characterized by craniotabes, frontal skull bossing, rachitic rosary ribs, widened rib cage (Harrison groove), bowed legs, and, often, fractures. Other radiographic changes include cupping and splaying of the metaphyseal ends of long bones, widening between the metaphyses and epiphysis, bone demineralization, and thinning of cortical bone.

Special Considerations

In a child, identifying a fracture with plain radiographs may be difficult owing to an open epiphysis. It is often necessary to obtain radiographs of the uninvolved hand for comparison. If a surgical procedure is indicated and the child is unable to tolerate the procedure after a digital nerve block alone, conscious sedation may be required. Medications commonly used for conscious sedation include the sedatives anxiolytics, such as benzodiazepines and barbiturates pain relief is achieved using opioids such as fentanyl and morphine. In children, a commonly used agent is ketamine, a nonopiate phencyclidine derivative that produces both analgesia and sedation. Before performing conscious sedation, specific attention should be paid to allergies (including those to latex), current medications, and last oral intake of solids and liquids.

Nervous System

The Prosencephalon is made up of the telencephalon and diencephalon. The telencephalon is known as the fore-brain and contains the paired olfactory lobes. The fore-brain is predominantly involved with reception and conduction of smell impulses. The size of the lobes indicates the importance the role of smell has in the fish species. Elasmobranchs (sharks) and bony fishes have quite pronounced olfactory lobes. The forebrain also appears to play a role in fish behavior. The diencephalon is sometimes known as the between brain. It lies in between the olfactory lobes of the telencephalon and contains the pineal organ. There are two possible functions of the pineal organ. It has been suggested that the pineal body is either a pho-tosensory structure or plays a secretory role. The pineal gland may react to the chemical composition of the cerebrospinal fluid or brain tissue by external or internal (endocrine) secretion. Another important component of the diencephalon is the hypothalamus,...


Melatonin is produced from serotonin in two enzymatic steps. Serotonin is first converted to N-acetylserotonin by arylalkamine N-acetyltransferase (AANAT), which, in turn, is converted to melatonin by hydroxyindole-O-methyltransferase (HIOMT). This conversion takes place in the pineal gland and is regulated by b-adrenergic receptor-mediated regulation of AANAT activity. The pineal gland is located in the epithalamus adjacent to the habenular nuclei. Pineal melatonin synthesis is driven by the SCN via a rather elaborate neural pathway. SCN efferents project to cells in the paraventricular nucleus, which in turn send projections to the intermediolateral cell column (IML) of the spinal cord. The IML projects to the superior cervical ganglia cells, which in turn send noradrenergic sympathetic projections to the pineal gland.

Physeal Injuries

The weakest zone, or layer, of the physis is its third layer of cells and matrix (hypertrophic cell zone). It is particularly susceptible to shearing, bending, and tension stresses. It represents the layer of the physis that is most consistently fractured. Consequently, the reserve and proliferative cartilage cells in the first two zones of the injured physis usually remain with the epiphysis. This is relevant in that the predominant circulatory support of the cells in these two reproductive zones of the physis arises through the epiphyseal vasculature and thus is more likely to be spared in the event of physeal injury ( Fig 132-1).


Subluxation of the left femoral epiphysis due to intracapsular blood or effusion. This child had massive trauma elsewhere and was probably swung by this extremity. Compare with the right hip to see the widened joint. Reprinted from Brogdon BG, Vogel H, McDowell JD, eds. A radiologic atlas of abuse, torture, terrorism, and inflicted trauma (2003) with permission from CRC Press. Fig. 47. Subluxation of the left femoral epiphysis due to intracapsular blood or effusion. This child had massive trauma elsewhere and was probably swung by this extremity. Compare with the right hip to see the widened joint. Reprinted from Brogdon BG, Vogel H, McDowell JD, eds. A radiologic atlas of abuse, torture, terrorism, and inflicted trauma (2003) with permission from CRC Press.

Age Determination

Age Determination Radiology

The radiologic determination of maturity or prematurity at birth is based on the ossification of secondary centers at the knee. The distal femoral epiphysis will be partially ossified in 90 or more of full-term fetuses. The proximal tibial epiphysis will be similarly visible in 80 or more of mature neonates (Fig. 10). Thereafter, chronological age is estimated according to skeletal maturation, as indicated by the appearance, growth, and ultimate fusion of epiphyses and apophyses (non-articulating secondary ossification centers). Detailed tables and schematic representations of skeletal maturation are amply provided in the literature (20-25). Some examples that are particularly useful in the lower extremity are included here (Table 1, Figs. 11, 12).


The simplest indole alkaloids are derived from tryptamine itself. These include indole-3-acetic acid, a potent plant-growth stimulator serotonin (5-hydroxytryp-tamine), a vital mammalian product that inhibits or stimulates smooth muscles and nerves AT-acetyl-5-methoxy-tryptamine (melotonin), a constituent of the pineal gland with melanophase-stimulating properties 5-methoxy-Ar,AT-dimethyltryptamine, a constituent of the hallucinogenic Virola snuffs psilocybine, a hallucinogenic found in the mushroom Psilocybe mexicana Heim.


Production of a pure tension-type fracture in the shaft of a normal lower-extremity long bone is difficult to imagine in the real world. Perhaps a grossly negligent traction setup could somehow apply sufficient tensile force to fracture a bone. A more likely scenario might involve a foot being caught in a type of machinery and then violently distracted. It is difficult to know where the injury would occur in this situation, because the force would be spread to virtually all the joints in the lower limb. This might result in dislocations and ligament damage before any fractures would be seen. However, this is speculation, as no reports of distraction-type injury mechanisms have been presented to date. If tension were applied to the long axis of a single bone, it is presumed the bone would fail with a transverse fracture based on materials property testing of bone samples. One cannot help but wonder, however, whether the fracture would occur at a metaphysis, given that it is a...

Bone Growth

Postnatal growth in length of long bones of the appendicular skeleton precedes growth in diameter. Growth in length involves both cartilage and bone cells. Chondroblasts continue to proliferate at the growth plate adjacent to the epiphysis to maintain this cartilage plate throughout the growth period. Chondro-blasts produce cartilage matrix materials but gradually differentiate into chondrocytes, which produce and maintain mature matrix. As more chondroblasts arise, and accompanying newly synthesized matrix accumulates, mature matrix and chondrocytes begin to abut the diaphysis. Chondrocytes eventually die as a result of their initiation of the ossification process, which prevents diffusion of nutrients to cartilage cells. Ossification of cartilage results in invasion of capillaries, osteoblasts, and, ultimately, osteocytes to further bone formation adjacent to the diaphysis, thus extending its length. 3,4 While a growth plate is present at both the proximal and the distal ends of...

Growth Plate

Chondrocytes within the growth plate are organized in a precise pattern reflecting cell functionality. Randomly distributed stem cell chondrocytes lie adjacent to the epiphysis in a region termed the resting zone. Resting zone cells induced to divide produce columns of clo-nally expanding cells, forming the proliferative zone. The proliferative zone chondrocytes then mature in their metabolic activities, secrete additional matrix, and hypertrophy. This expansive proliferation and hypertrophy occurring in both growth plates essentially pushes the ends of the bone apart, resulting in overall elongation. The retention of cartilaginous growth plates permits elongation of bone by an internal mechanism, enabling structural support and maintenance of the physical configuration of the bone necessary for tendon and ligament insertion sites. In contrast to the endochondral growth process, intra-membranous bone enlarges by appositional deposition of osteoid matrix.


Other potentially teratogenic drugs include andro-gens, which result in masculinization of the embryo and stimulate growth and differentiation of sex steroid receptor-containing tissues. Angiotensin-converting enzyme inhibitors are antihypertensive agents that have detrimental effects during the second and third trimesters, including fetal death, oligohydramnios, pulmonary hypoplasia, neonatal anuria, intrauterine growth retardation, and skull hypoplasia. The pregnant woman who uses cocaine risks preterm delivery, fetal loss, intrauterine growth retardation, microcephaly, neurobehavioral abnormalities, vascular disruptive phenomena, cerebral infarctions, and certain types of visceral and urinary tract malformations. Coumadin, a vitamin K analog, is an anticoagulant and in the first trimester can produce malformations, including nasal hypoplasia, stippling of secondary epiphysis, intrauterine growth retardation, and anomalies of the eyes, hands, neck, and central nervous system....

Ankle Injuries

Similar to injuries to the knee joints, ankle injuries form patterns (Fig. 20) determined by the direction of the external force and dislocation of joint structures (26-28). Thus, injuries occur when the distal tibial epiphysis lies beyond the range of physiological flexion (dorsal or plantar) and when excessive pronation or supination of the shins towards the fixed foot is observed (Table 2). Contrary to typical ankle sprains caused by improper positioning of the foot during running, jumping, or skidding, victims of traffic accidents often lack the rotational component and their injuries are caused by forces acting in one direction only. Injuries that occur during the first phase of trauma are usually caused by tearing forces, while those occurring during later phases of trauma are usually caused by crushing forces (the limb must be loaded by body mass). The site of compression may be indicated by bone bruises on the section of the trochlea tali whose edges press the lateral...

Parenchymal Vessels

Brain capillaries differ from those of other organs by their complete or almost complete impermeability (blood-brain barrier) and lack of fenest-rations. The neighboring endothelial cells are bound together by tight junctions or zonulae occludentes, which prevent the passage of tracer substances. This barrier function is absent in vessels of the choroid plexus, pineal body, pituitary gland, area postrema, tuber cinereum, and median eminence.

Vitamin D

A vitamin D deficiency impairs normal Ca absorption and bone mineralization in young animals, resulting in an enlarged epiphysis. 5 As body weight increases, the bending of legs (i.e., rickets) and beaded ribs occur. In older animals, bone demineralization (i.e., osteomalacia) weakens bones, often resulting in posterior paralysis. These deficiencies are the consequences of impaired absorption of Ca, due to inadequate production of the Ca-binding protein in the intestinal mucosa and the low supply of Ca and P to the growing skeletal matrix. In the adult, the bones are demineralized because of high demands for Ca, thus mobilizing skeletal Ca reserves. 10

Cosmetic Problems

Orthopedic problems Flat feet and knock knee, perhaps related to the excess weight and need to internally rotate the knees to accommodate fat thighs when bringing the legs together, are common and can lead to ungainly gait. Slipped upper femoral epiphysis is a more serious problem, which is particularly common in overweight young adolescents and may also be associated with hormonal abnormalities such as hypothyroidism.


SE is found in the tissues of vertebrates, invertebrates, plants, and fruits. In vertebrates, it is found in many organ systems (e.g., gastrointestinal tract, lungs, and skin) and the peripheral and central nervous systems. It is the precursor for the melatonin produced in the pineal gland.


Activities of the thalamus and hypothalamus. The subthalamus is a very small region inferior to the thalamus that contains the subthalamic nucleus and zona incerta these areas have connections to the basal ganglia and cerebral cortex, but their functions are largely unknown. The epithalamus is found superior and caudal to the thalamus and contains the pineal gland and the habenular nuclei. The pineal gland is an unpaired structure that was once thought to harbor the seat of the soul today, it is known to secrete a hormone called melatonin, hypothesized to have a role in sleep and gonadal function.


Recently, a PepT1 gene product has been identified in the rat pineal gland (pg-PepT1), which encodes 150-amino acid protein encompassing the three C-terminal membrane-spanning domains of intestinal PepT1 and three additional N-terminal residues.91 PgPepTl forms a functional PepTl-like transporter through oligomeriza-tion. Interestingly, pgPepTl mRNA and protein (approximately 16 kDa) levels were found to be 100-fold higher at night, suggestive of a diurnal regulatory mechanism. The neural pathway that controls pineal melatonin production has been suggested to play an important role in regulating the expression of pgPepTl. Thus, a peptide transporter in the pineal gland could play an important role in circadian pineal physiology and contribute to clearance of active or degraded neuropeptides.91