Axillary Fossa Variations

Knowledge of muscular, vascular, and neural variations in the axilla is of great clinical importance, especially in mastectomies, breast reconstruction, and axillary bypass operations. The aim of our study is to emphasize on multiple variability of the axillary structures and its clinical importance. In this paper we report some varieties of the axilla, found in two cadavers, including: the axillary arch muscle of Langer; atypical inflow of cephalic vein into external jugular vein; variations in branching of brachial plexus. In one of the axillae we discover an availability of muscular fibers bridging between pectoralis major and latissimus dorsi muscles. The second finding though more rare than the first one is of particular importance for cardiac implant techniques still treating the cephalic vein as a target for venesection. The branching varieties of the nerves in the axilla are presented by musculocutaneus nerve starting from median nerve. Identification of the axillary arch and its variations may help avoid accidental injury to axillary vessels and the brachial plexus during surgical procedures. Some device implanters still prefer to cut down the cephalic vein as the initial approach to venous access for transvenous placement of pacemaker or defibrillator leads out of concern for the risk of pneumothorax, subclavian crush, and other possible complications. Anesthesiologists administering local anesthetic blocks and surgeons operating in the axilla should be aware of nerve varieties to avoid iatrogenic injury. We conclude that more wide concern of the pattern of the axillary fossa structures is necessary to escape inadvertent accidents

Sex Estimation from the Upper End of Bulgarian Femur Using 3D Hand-Held Laser Scanner

The present study aimed to establish standards for determining sex from the upper end of the femur in a modern Bulgarian population focused on an innovative approach to the numerical assessment of gluteal tuberosity through 3D visualization and its use as a sex predictor. The sample is composed of 156 femora. Seven measurements were taken: vertical head diameter, transverse head diameter, maximum head diameter, head circumference, sagittal subtrochanteric diameter, transverse subtrochanteric diameter and supero-inferior neck diameter. The surface of gluteal tuberosity was captured in a 3D image, using a hand-held laser scanner. A 3D shape comprising two tetrahedrons with a common base was constructed. The volume of the rough area of muscle insertion was approximately equal to the sum of the area of volumes of these two tetrahedrons (volume). Several points were placed on the surface of the area of roughness on the 3D image. Based on these points a two-dimensional shape was created which was a function of the three-dimensional one. Thus, volume, area of the newly-formed shape, its greatest elevation and the three angles between the constructed planes were used as sex predictors. The mean values of all metric and 3D measurements showed significant differences between genders p<0.001, volume p=0.02. According to stepwise discriminant analysis the combination of head circumference, sagittal subtrochanteric diameter, transverse subtrochanteric diameter and supero-inferior neck diameter provided 88.5% accuracy. Using the same analysis the combination of volume, elevation and angle b1 provided the best result with 93.0% accuracy

Comparative dermatoglyphic study of fingerprint patterns in patients with schizophrenia and healthy controls

Purpose : The aim of this study was to compare the fingerprint patterns in patients with schizophrenia and healthy controls.Material and methods : The study included 136 patients with schizophrenia (72 males, 64 females) and 113 mentally healthy subjects (52 males, 61 females) of Bulgarian origin. Fingerprints were obtained using an ink method and were read with light (6D) magnification in accordance with the methods given by Cummins, Midlo. The data were analyzed with SPSS 17.0.Results : Our results showed a higher mean score of whorls and lower mean score of loops and arches for both hands in schizophrenia males compared with their same-sex controls. Schizophrenia females had a higher mean score of arches and whorls, but lower mean score of loops for both hands, compared with the healthy females. The differences were statistically significant for the loops and whorls of the left hands in males, and for the loops of the left hands and those of both hands in females. Conclusion : Within the context of neurodevelopmental hypothesis of mental disorders dermatoglyphic traits may become reliable biological markers of the timing of prenatal damage and the pathogenetic mechanisms behind it