48 research outputs found
The normal growth of the pulmonary trunk in human foetuses
The rate of growth of the pulmonary trunk during gestation has not been sufficiently determined. The present study was performed on 128 spontaneously
aborted human foetuses aged 15-34 weeks in order to compile normative data for pulmonary trunk dimensions at various gestational ages. With the use of anatomical dissection, digital-image analysis (the Leica QWin Pro 16 system) and statistical analysis (ANOVA, regression analysis) a range of measurements (length, diameter and volume) was analysed for the pulmonary trunk during gestation. No significant gender differences were found (p > 0.05). Growth curves were generated of the best fit for the plot for each morphometric feature against gestational age. The results obtained show a statistically significant correlation
(p < 0.001) between the parameters examined and gestational age. Both the
length and diameter of the pulmonary trunk were found to increase in a linear
fashion throughout gestation. The length ranged from 3.17 ± 0.36 mm to 13.54 ± 1.39 mm, according to the linear function y = -5.6035 + 0.5705 x ± 0.9171 (r = 0.96). The diameter ranged from 1.51 ± 0.24 mm to 5.30 ± 1.53 mm, according to the linear model y = -1.4813 + 0.2154 x ± 0.7452 (r = 0.86). The pulmonary trunk volume ranged from 5.94 ± 2.21 mm3 to 312.37 ± 154.34 mm3, according to the quadratic function y = 143.2 - 20.961 x + 0.791 x2 ± 63.306 (R2 = 0.74). The growth curves generated from my data may
be useful as a reference for foetal echocardiographers in the detection of congenital cardiovascular abnormalities
An angiographic study of the anterior tibial artery in patients with aortoiliac occlusive disease
The anterior tibial artery is of great clinical relevance to vascular infrapopliteal
surgery. The sources (origins), length and luminal diameter of the anterior tibial
artery in 46 men and 30 women with Lerich syndrome were studied by means
of radiological and digital methods. The results obtained were described by twoway
analysis of variance (Multi-group ANOVA) for unpaired data — the means
for six subtypes with regard to sex and side of the body, using the STATISTICA
5.5 program. The anterior tibial artery occurred most frequently (92.11%) as
a terminal branch of the popliteal artery in its normal (IA: 87.5 %, IB: 2.63%)
and high (IIA 1: 1.32%, IIA 2: 0.66%) division. In the remainder (7.89%), the
anterior tibial artery arose from both the anterior tibioperoneal trunks (IC: 1.97%,
IIB: 5.92%). The statistical analysis of the sources of the anterior tibial artery did
not show gender differences. Symmetry of the left and right popliteal patterns was
observed in the two most frequent subtypes: IA (r1 = 0.80) and IIB (r2 = 0.83).
The anterior tibial artery was the longest (p = 0.02 for men, p = 0.04 for
women) in subtype IIA 2. The greatest diameter of the anterior tibial artery was
characteristic for a trifurcation (IB) and the smallest for subtype IIA 2 (p = 0.04).
Both the length (p = 0.03) and luminal diameter (p = 0.04) of the anterior tibial
artery in men were significantly greater than in women in all the popliteal subtypes
observed. Morphometric parameters of the right and left anterior tibial
artery showed no statistically significant differences. The anterior tibial artery
was the predominant vessel in a trifurcation (IB) and in the two subtypes with an
anterior tibioperoneal trunk (IC, IIB). These results have implications in vascular
grafting below the knee
The normal growth of the thoracic aorta in human foetuses
The present study was performed on 128 spontaneously aborted human foetuses
aged 15-34 weeks in order to establish normal values for thoracic aorta
dimensions at various gestational ages. Using anatomical dissection, digital-image analysis (the Leica QWin Pro 16 system) and statistical analysis (ANOVA, regression analysis) the growth of the length, the original and terminal external diameters and the volume of the thoracic aorta during gestation was examined. No significant gender differences were found (p > 0.05). The growth curves were generated of the best fit for the plot for each morphometric feature against gestational age. Both the length and external diameters of the thoracic aorta increased in proportion to the advance in foetal age. The length ranged from 12.49 ± 1.85 mm to 48.82 ± 6.31 mm according to the linear function
y = –19.654 + 2.0512 x ± 3.5168. The original external diameter ranged from
1.25 ± 0.28 mm to 5.65 ± 0.48 mm according to the linear fashion y = -2.3834 + 0.2367 x ± 0.3850. The terminal external diameter ranged from 1.15 ± 0.26 mm to 5.18 ± 0.45 mm, in agreement with the linear model y = -2.1438 + 0.2156 x ± 0.3555 (r = 0.96, p < 0.001 for each feature). The volume of the thoracic aorta ranged from 15.75 ± 8.06 mm3 to 1158.01 ± 301.85 mm3 according to the quadratic function y = 1376.2 - 154.42 x + 4.419 x2 ± 125.6 (R2 = 0.90). The growth curves generated from my data may be useful as a reference for foetal echocardiographers, who must distinguish abnormal from normal foetal development
Compensating crural anastomoses in chronic critical limb ischaemia
Compensating crural anastomoses develop in patients with multi-level occlusion of
the calf arteries in the course of atherosclerosis, arteriitis, diabetes, and in vascular
malformations of the limbs. The peroneal artery is frequently the only patent calf
vessel, especially in diabetic patients who have advanced tibial occlusive disease.
The purpose of this study was to identify different types of compensating crural
anastomoses in chronic critical limb ischaemia. Using combined anatomical-radiographic
and statistical methods, 86 compensating crural anastomoses were studied
in 59 specimens of lower limbs (amputated at the thigh) in the course of chronic
critical ischaemia. Three types of compensating crural anastomosis and their
components were identified. The most common type (55.8%) was the posterior
tibioperoneal anastomosis. Less common (23.3%) was the intertibial anastomosis
and least common (20.9%) the anterior tibioperoneal anastomosis. The posterior
tibioperoneal anastomosis was concurrent with anterior tibioperoneal anastomosis
in 26.3% of cases and with the intertibial anastomosis in 15.3% of cases. The great
importance of the peroneal artery in the formation of natural crural collateral circulation
should encourage vascular surgeons to consider peroneal bypasses
Length growth of the various aortic segments in human foetuses
This study defines normal growth for the various aortic segments in
128 spontaneously aborted human foetuses aged 15-34 weeks. With the
use of anatomical dissection, digital-image analysis (using the Leica Q Win Pro 16 system) and statistical analysis (ANOVA, regression equation),
a range of length measurements for the ascending aorta, aortic arch and
thoracic aorta was examined. No significant gender differences were found
(p ≥ 0.05). The length of the ascending aorta ranged from 2.63 ± 0.42 to 10.80 ± 1.49 mm, according to the linear function y = -4.678 + 0.4647 x ± 0.8447. The aortic arch length increased from 3.93 ± 0.57 to 15.25 ± 1.98 mm, in accordance with the linear model y = -6.079 + 0.6370 x ± 1.1133. The length of the thoracic aorta ranged from 12.49 ± 1.85 to 48.82 ± 6.31 mm, according to the linear pattern y = -19.654 + 2.0512 x ± 3.5168. The sum of the lengths of these aortic segments generated the linear function y = -30.410 + 3.153 x ± 5.4332. The relationships between the lengths of the various aortic segments generated the linear regressions: y = -0.2256 + 0.7276 x ± 0.3093 (for the ascending aorta vs. the aortic arch), y = 0.0252 + 0.3105 x ± 0.2189 (for the aortic arch vs. the thoracic aorta), and y = -0.2408 + 0.22709 x ± 0.2026 (for the
ascending aorta vs. the thoracic aorta). The ascending aorta, aortic arch
and thoracic aorta also increased proportionally (5:7:22) during gestation
External diameters of the pulmonary arteries in human foetuses: an anatomical, digital and statistical study
This study defines the growth patterns for the external diameters of the pulmonary
arteries in human foetuses, including relationships with sex, side of body
(right-left) and foetal age. Using anatomical dissection, digital-image analysis
(system of Leica Q Win Pro 16) and statistical analysis (ANOVA, regression analysis),
a range of external diameters for the right and left pulmonary arteries in
128 spontaneously aborted human foetuses aged 15-34 weeks was examined.
No significant gender differences were found (p > 0.05). In the examined age range
the values of the external diameter of the right pulmonary artery ranged from
0.97 ± 0.24 to 2.95 ± 0.89 mm, according to the linear function y = -0.7753 + 0.1148 x ± 0.4580 (r = 0.83; p < 0.001). The values of the external diameter
of the left pulmonary artery ranged from 0.88 ± 0.25 to 2.63 ± 0.80 mm, in
accordance with the linear relationship y = -0.6228 + 0.1007 x ± 0.4280
(r = 0.81; p < 0.001). The external diameters of the right pulmonary artery were
greater than those of the left pulmonary artery (p < 0.001). Parallel to the increase
in the values of the external diameters of both the pulmonary arteries, the
pulmonary artery-to-ascending aorta diameter ratio (the relative diameter of the
pulmonary artery) decreased with advanced foetal age from 0.46 ± 0.10 to
0.43 ± 0.13 for the right pulmonary artery, and from 0.43 ± 0.10 to 0.39 ± 0.12 for the left one. The growth curves generated may be useful as reference
data for foetal diagnosis
External diameters of the crural arteries in patients with chronic critical limb ischaemia
Knowledge of the diameters of the crural arteries forms the basis for reconstructive
vascular surgery and percutaneous angioplasty. The external diameters of
the crural arteries were examined in 152 specimens of lower limbs by anatomical,
digital and statistical methods. The diameters of all the crural arteries were
significantly greater (p ≤ 0.01) in the male subjects. The differences between
the right and left arterial diameters were statistically significant (p ≤ 0.01) only
in relation to the posterior tibial artery. In subtypes IC and IIB the anterior tibial
artery was the strongest, the peroneal artery was of intermediate diameter and
the posterior tibial artery was the weakest. In subtype IB the anterior tibial artery
presented as the predominant vessel but in subtypes IIA-1 and IIA-2 it was the
posterior tibial artery that did so. In subtype IA 24 examples of the coexistence
of angiometric variants of the crural arteries were distinguished. It was demonstrated
that the strongest vessel was the anterior tibial artery (32.24%), rarely
the posterior tibial artery (14.47%) or the peroneal artery (9.87%). In most cases
(21.71%) three of the crural arteries had intermediate diameters. In 13.16% of
cases there were two arteries of intermediate diameter, the posterior tibial and
the peroneal, which accompanied a strong anterior tibial artery and, the least
common variant (6.58%), two intermediate tibial arteries with a weak peroneal
artery. A hyperplastic peroneal artery (6.59%) compensated for either the anterior
tibial artery (1.98%) or the posterior tibial artery (4.61%)
A new variant of aberrant left brachiocephalic trunk in mam: case report and literature review
Importance is placed on aberrant arteries in the radiological and surgical literature.
A normal left brachiocephalic trunk is characteristic for the right aortic arch.
However, an aberrant left brachiocephalic trunk arising as the last branch of the
aortic arch on the left side has not yet been described in the literature. Described
here is a new variant of the retro-oesophageal aberrant left brachiocephalic trunk,
occasionally observed in a patient during diagnostic investigation or surgical treatment
for steno-obstructive involvement of the carotid district. The triple anomaly
of the left aortic arch consisted of: 1. the presence of a hypoplastic left brachiocephalic
trunk behind the oesophagus, 2. the absence of a brachiocephalic trunk
on the right side and 3. separate origins of the arteries on the right side, with the
right common artery preceding the right subclavian artery. In front of the trachea
an 8-mm prosthetic PTFE was implanted from the proximal segment of the right
subclavian artery to the junction of the left common carotid and left subclavian
arteries. The author demonstrates the inadequacy of auxiliary investigations to
detect aberrant arteries, which may only be identified precisely intra-operatively
Skeletopic analysis of the gonadal veins in human foetuses
During ontogenesis an imbalance is observable in the development of the skeletal
and vascular systems. By means of anatomical and radiological methods the
gonadal veins were studied in relation to the vertebral column in 60 human
foetuses of both sexes aged from 4 to 6 months of prenatal life. In male foetuses
aged 4–5 months the origin of the gonadal veins projected onto the sacral
apex (r1 = 0.95, r3 = 0.85), and in 6th month they extended below the vertebral
column (r1’ = 0.80, r3’ = 0.90). In female foetuses the origin of the gonadal
veins in the 4th month projected symmetrically onto S1 (r5 = 0.70, r7 = 0.70). In
the 5th month of intrauterine life the origin of the left ovarian vein was found at
S2 (r7’ = 0.80) and the origin of the right one at S1–S2 (r5’ = 0.80). In the
6th month the origin of the left ovarian vein was located at S3 (r7’ = 0.80) and
the right one at S2–S3 (r5’’ = 0.90). The skeletopic analysis of the origin of the
gonadal veins demonstrated gender (the origin was higher in females) and syntopic
(the origin was higher on the right side) differences (p ≤ 0.05). In foetuses
of both sexes aged 4 months of prenatal life the termination of the left gonadal
veins projected onto Th12–L1 (r4 = 0.85, r8 = 0.80) and in foetuses aged
5–6 months it projected onto L1–L2 (r4’ = 0.90, r8’ = 0.95). In both sexes the
termination of the gonadal veins on the right side projected constantly onto L2
(r2 = 0.90, r6 = 0.95) from the 4th to the 6th month of intrauterine life. The skeletopic
analysis of the termination of the gonadal veins showed syntopic dimorphism
(p ≤ 0.05) without gender differences (p > 0.05). On the right side the
termination of the gonadal (testicular and ovarian) veins projected constantly
onto L2. On the left side the termination of the left gonadal (testicular and
ovarian) veins apparently descended by one vertebra (pseudodescensus)
Digital-image analysis of the left common carotid artery in human foetuses
The rate of growth of the left common carotid artery during gestation has not
been sufficiently evaluated. The present study was performed on 128 spontaneously
aborted human foetuses aged 15–34 weeks to compile normative data
for the dimensions of the left common carotid artery at varying gestational
ages. Using anatomical dissection, digital image analysis (system of Leica Q
Win Pro 16) and statistical analysis (ANOVA, regression analysis), a range of
measurements (length, original external diameter and volume) for the left common
carotid artery during gestation was examined. No significant gender differences
were found (p > 0.05). The growth curves of the best fit for the plot
of each morphometric parameter against gestational age were generated. The
lengths ranged from 14.82 ± 2.22 to 42.84 ± 4.32 mm, according to the
linear model y = -9.6918 + 1.5963 x ± 3.1706 (r = 0.95; p < 0.001). The
original external diameter increased from 0.72 ± 0.18 to 3.28 ± 0.40 mm,
according to the linear function y = –1.5228 + 0.1428 x ± 0.2749 (r = 0.95;
p < 0.001). The left common carotid artery-to-aortic root diameter ratio
increased from 0.356 ± 0.062 to 0.480 ± 0.101. The left common carotid
artery-to-aortic arch diameter ratio increased from 0.447 ± 0.079 to 0.535 ±
± 0.113. The volume ranged from 6.73 ± 4.06 to 369.30 ± 107.42 mm3 in
accordance with the quadratic function y = 344.8 – 41.001 x + 1.254 x2 ±
± 46.955 (R2 = 0.87). The parameters examined have clinical application in
the early recognition of arterial abnormalities, especially aortic coarctation