Cost effectiveness of bio-ethanol to reduce carbon dioxide emissions in Greece

The purpose of this study is to evaluate ethanol cost- effectiveness with regards to carbon dioxide emissions. Actually, bio-fuel production is only viable thanks to the tax credit policy resulting in economic ‘deadweight’ loss. The environmental performance is assessed under the Life Cycle Assessment (LCA) framework. Economic burden to society to support the activity divided by avoided CO2 equivalent emissions indicates the bio-ethanol cost effectiveness. Agricultural feedstock supply that comprises of sugarbeets, grains and industrial processing sub-models are articulated in a regional sector model. The maximization of total welfare determines optimal crop mix for farmers and the best configurations for industry. This is illustrated for bio-ethanol produced by the ex-sugar industry in Thessaly, Greece. Life cycle activity analysis showed that, at the optimum, CO2 emission is reduced between 1 and 1.5 t of carbon dioxide equivalent per ton of ethanol. The unitary cost falls in the range of 100 to 250 euro per ton of CO2 and it is remarkably dependent on the agricultural policy scenario.Cost effectiveness, ethanol, mathematical programming, life cycle assessment, greenhouse gases

Anatomic variability in the relation between the retromandibular vein and the facial nerve: a case report, literature review and classification

Knowledge of anatomic variations concerning head and neck veins is important to surgeons performing interventions in these regions, as well as to radiologists. The retromandibular vein is used as a guide to expose the facial nerve branches inside the parotid gland, during parotid surgery and open reduction of mandibular condyle fractures. It is also used as a landmark for localisation of the nerve and compartmentalisation of parotid gland lesions preoperatively, during computed tomography, magnetic resonance imaging and sonography. In this paper, the anomalous retromandibular vein’s course on the left side of a male cadaver is described. The vein was formed around the nerve, while the maxillary vein travelled medial to the facial nerve branches and superficial to the superficial temporal vein. Interestingly, the facial nerve temporofacial division crossed again the superficial temporal vein upwards, forming a “nerve fork”. The incidence of the reported variability of the relationship between the retromandibular vein and the facial nerve are discussed with a detailed literature review. Accordingly, the typical deep position of the retromandibular vein in relation to the facial nerve is estimated to 88.17% to all sides. Furthermore, an updated classification system is proposed, including 4 types and subtypes

A prefix brachial plexus with two trunks and one anterior cord

The brachial plexus presents a great variability in formation, division and branching pattern. Its variants are of immense importance during axillary and arm surgery and nerve blockade. The current case highlights a unilateral atypical formation of brachial plexus, the so called prefix, in which the C4 root contributed a large branch to the superior trunk and further anastomosis with the inferior trunk. Thus, the prefix or high brachial plexus consisted of a superior and inferior trunk and one anterior cord. Coexisting neural and arterial variations are also discussed in relation to the data literature

Retro-oesophageal right subclavian artery in association with thyroid ima artery: a case report, clinical impact and review of the literature

A 37-year-old female Caucasian cadaver with an aberrant right subclavian artery extending from the left side of the aortic arch and following a retro-oesophageal course is presented. A non-recurrent right laryngeal nerve and a thyroid ima artery arising from the lower part of the middle third of the right common carotid artery coexisted. The brachiocephalic trunk was absent, while both common carotid arteries and left subclavian artery followed their normal course. The aim of the current study is to highlight the clinical impact of the above abnormalities providing useful and practically applicable knowledge to interventional clinicians, thoracic and neck surgeons, since the vast majority of documented cases with an arteria lusoria are clinically silent and in most cases discovered incidentally. Clinical manifestations such as dysphagia, chronic cough, and acute ischaemia to the right upper limb may occur, leading to misinterpretation in radiographic examination and complications during neck and thoracic surgery. Review of the literature was also performed and the embryological background of the aberration is highlighted

A rare cadaveric finding of ectopic origin of a bronchial artery: surgical and imaging consequences

Bronchial arteries arise normally directly from the descending thoracic aorta, at the level between the fourth and sixth thoracic vertebra. However the anatomical variations are very frequent regarding the origin or the number of branches. We present a rare cadaveric finding of an ectopic right bronchial artery originating from the right subclavian artery through common stem with the right internal thoracic artery and we discuss the clinical significance of this finding. A 72-year-old formalin-embalmed male cadaver was dissected during a routine anatomical course. The right bronchial artery originated from the right subclavian artery with a common stem with the right internal thoracic artery. Although ectopic origin of the right bronchial artery from the right internal thoracic artery is rare, recognition of this anatomical variation is important in bronchial embolization due to hemoptysis, in coronary bypass grafting and in lung transplantation

A coexisting anatomic variation of median and ulnar nerves in a cadaver palm

During a routine dissection we observed an anatomical variation of the median nerve and an atypical anastomosis in the palm region of a male cadaver. There were four distinct recurrent motor branches of the left median nerve and the palmar cutaneous branch of the ulnar nerve communicated directly with the third common palmar digital nerve. The presence of such anatomical variant in the hand should keep surgeons alert in the management of hand pathology especially in carpal tunnel syndrome which is a routine operation for many medical centers

Anastomotic loop between common hepatic artery and gastroduodenal artery in coexistence with an aberrant right hepatic artery

Anatomical variations of the hepatic arteries are not uncommon. The anomalous hepatic arterial supply is of paramount importance in hepatobiliary, pancreatic or liver transplantation and in laparoscopic surgery. We describe an unusual case of a 66-year-old Greek male cadaver, where a rare anastomosis (in the form of an enlarged arterial loop, 4.84 mm in diameter) between the common hepatic artery (6.42 mm) and the gastroduodenal artery (GDA) (4.82 mm) coexisted with an aberrant right hepatic artery (ARHA) (6.38 mm) originating from the superior mesenteric artery. The proper hepatic artery was absent. The ARHA followed a route posterior to the portal vein and the common hepatic duct, entering the liver and supplying the right hepatic segment. A hypoplastic right gastric artery emanated from the GDA. Our case report highlights the combined variations of hepatic arteries and possible anastomoses emphasizing that a thorough knowledge of the classic and variable hepatic arterial anatomy are mandatory for surgeons and radiologists performing hepatic surgery and arteriography to avoid potential iatrogenic injuries in hepatobiliary and pancreas area and further medico-legal implications

An atypical biceps brachii and coracobrachialis muscles associated with multiple neurovascular aberrations: a case report with clinical significance

Neural and vascular variations in the axilla and upper limb area are usually paired, but coexistence of muscular aberration on top of this is uncommon. The current case report emphasizes on the unilateral coexistence of a three-headed (tricipital) biceps brachii muscle, a two-headed coracobrachialis with an accessory muscle bundle joining the superficial and deep heads of coracobrachialis muscle. On the ipsilateral side of the 72-year-old male cadaver, a connecting branch originated from the musculocutaneous nerve and joined the median nerve after surpassing the accessory muscle bundle. A large diameter subscapular trunk originated from the 2nd part of the axillary artery and after giving off the 1st lateral thoracic artery trifurcated into a common stem which gave off the 2nd and 3rd lateral thoracic arteries, the circumflex scapular artery and a common branch that gave off the 4th and 5th lateral thoracic arteries and the thoracodorsal artery, as the ultimate branch. All lateral thoracic arteries were accompanied by multiple intercostobra- chial nerves. Documentation of such muscular and neurovascular variants and their embryologic origin increases awareness of their potential impact on diagnosis and treatment of upper limb pathology. To the best of our knowledge, the currently reported cadaveric observations seem to constitute a unique finding.

Accessory muscles of the anterior thoracic wall and axilla. Cadaveric, surgical and radiological incidence and clinical significance during breast and axillary surgery

Background: The present study aims to summarise the accessory muscles of the anterior thoracic wall and axilla that can be encountered during breast and axillary surgery and record their incidence and clinical significance. Moreover, the laterality of the atypical muscles is highlighted and possible gender dimorphism is referred. Accessory anterior thoracic wall muscles include: Langer’s axillary arch, sternalis muscle, chondrocoracoideus, chondroepitrochlearis, chondrofascialis, pectoralis minimus, pectoralis quartus and pectoralis intermedius. Materials and methods: The anatomical, surgical and radiological literaturę has been reviewed and an anatomical study on 48 Greek adult cadavers was performed. Results: Literature review revealed the existence of accessory muscles of the anterior thoracic wall and axilla that have a significant incidence that can be considered high and may, therefore, have clinical significance. For the most common of these muscles, which are axillary arch (Langer’s) and sternalis muscle, the cadaveric incidence is 10.30% and 7.67%, respectively. In the current cadaveric study, accessory thoracic wall muscles were identified in two cadavers; namely a bilateral sternalis muscle (incidence 2.08%) extending both to the anterior and posterior surface of the sternum and a left-sided chondrocoracoideus muscle (of Wood) (incidence 2.08%). Conclusions: Despite the fact that accessory anterior thoracic wall and axillary muscles are considered to be rare, it is evident that the incidence of at least some of them is high enough to encounter them in clinical practice. Thus, clinicians’ awareness of these anatomical structures is advisable

The size of the foramen ovale regarding to the presence and absence of the emissary sphenoidal foramen: is there any relationship between them?

Background: The study investigates the size of the foramen ovale (FO) in relation to the presence and absence of the emissary sphenoidal foramen (ESF). Any possible alteration of the FO size in relation to the ESF (unilateral or bilateral) presence and absence was also examined. Materials and methods: One-hundred and ninety-five (117 male and 78 female) Greek adult dry skulls were investigated. Results: The ESF was present in 40% of the skulls (21.5% bilaterally and 18.5% unilaterally). No statistical significant difference was detected between ESF presence or absence and its unilateral or bilateral occurrence. The ESF existence had no relation to the FO size. Conclusions: The ESF absence or presence has no effect on FO size. The emissary sphenoidal vein is an additional venous pathway connecting cavernous sinus with the pterygoid venous plexus. These findings enhance that the venous plexus of the FO is a constant trait. The meticulous knowledge of the middle cranial fossa anatomy is of paramount importance during transovale procedures, as the outcome of cannulation may be affected by the existence of ESF, the confluence FO-ESF, the existence of osseous spurs and bridging into the FO. (Folia Morphol 2018; 77, 1: 90–98)