The valve of the superior vena cava - the supernumerary structure of the precaval segment of the crista terminalis

The primitive right sinuatrial valve persists in humans as the crista terminalis, the valve of the inferior vena cava and the valve of the coronary sinus, while according to the known data the primitive left sinuatrial valve is supposed to have no derivatives. Ten human right atria were opened with intercaval incisions and the precaval segment of each crista terminalis was studied macroscopically. Three specimens did not present any peculiarities at this level, but the other 7 had sagittal muscle bundles and supernumerary valves in individual arrangements. Supernumerary valves were present in 2 specimens, one complete and the second fenestrated; these valves were located immediately below the superior vena cava orifice and covered the medial end of the crista terminalis. The supernumerary valves at the superior vena cava orifice may be termed, mirroring that of the inferior vena cava, "valves of the superior vena cava". Their exact frequency of occurrence and their embryonic precursors must be further established. The presence of such valves in the right atrium may interfere with the flow to the right side of the heart, may represent conditions for thrombotic changes and may disturb a central venous catheter placement. If present, the valve of the superior vena cava will also interfere with the catheter ablation procedures used for supraventricular tachycardia

Microanatomy of the neural scaffold of the pterygopalatine fossa in humans: trigeminovascular projections and trigeminal-autonomic plexuses

The pterygopalatine fossa (PPF) is an anatomically-hidden deep extracranial space. The neural scaffold of the PPF remains anatomically understudied in humans. Moreover, there are no anatomical data in humans pointing out the extracranial trigeminovascular distributions, in contrast to the trigeminal supratentorial ones. By anatomical microdissections, the neural scaffold of the PPF and the presence of trigeminovascular projections were evaluated. The anterior and superior approaches of the pterygopalatine fossae in nine dissected blocks of human middle skull base and the frontal cuts of two different specimens, led to several results: (1) the neurovascular contents of the PPF, embedded in the pterygopalatine adipose body, have a layered disposition; (2) the posterior neural layer is represented by a pterygopalatine cross, centred by the pterygopalatine ganglion (PPG) that sends off ascending, descending, and medial branches and has a lateral connection with the maxillary nerve - 4 quadrants could have been defined as referring to this cross; (3) at the level of the upper lateral quadrant there are two superposed layers (i) a superficial plexus contributed by the maxillary nerve, the maxillary artery plexus and the PPG and its orbital branches (OBs) and (ii) a deep layer, consisting of the OBs proper of the PPG; (4) within the PPF and on the posterior wall of the maxillary sinus distinctive trigeminovascular projections were evidenced. The anastomoses involving autonomic and trigeminal fibres, located in the PPF passage to the orbital apex, support the complicate and polymorphous neural input to the orbit, while the evidence of a pterygopalatine trigeminovascular scaffold offers a substrate for a better understanding of various facial algias. (Folia Morphol 2010; 69, 2: 84-91

Bilateral alar thoracic artery

During a routine dissection a superficial artery was observed coursing subcutaneously at the anterior border of the axillary base towards the thoracic wall and bilaterally at the lower border of the pectoralis major muscle. On the right side it originated from the 3rd part of the axillary artery but on the opposite side the origin was from the first centimetre of a left radial artery originating directly from the axillary artery together with the left brachial artery. Apart from the bilateral absence of the deep brachial artery, no other anomalies were identified at this level. This variant corresponds to the alar thoracic artery, an unusual and rarely reported artery. The literature on the subject contains no reference either to the bilateral evidence for the alar thoracic artery or to the possibility of an origin from a high radial artery. The presence of such an alar thoracic artery may interfere with surgical access within the axillary fossa and should be taken into consideration

Transverse subisthmic course of the innominate artery in an adult: detailed anatomy and additional variation

A rare morphology of an aberrant innominate artery (IA) is reported here, together with additional arterial variation encountered in the respective specimen. The IA originated in the aortic arch on the left side of the trachea, coursed on that side of the trachea to reach the left thyroid lobe, turned in at a right angle to pass anterior to the trachea and immediately inferior and parallel to the thyroid isthmus, and finally it divided inferior to the right thyroid lobe into the right subclavian and common carotid arteries. The right common carotid artery immediately turned at a right angle to ascend in the neck. Thus the terminal branches of the IA had origins in a higher position than is usually expected. This aberrant course of the IA determined a step-like morphology in the sagittal plane of the left common carotid artery. Additional variations were also encountered: (a) a lateralised right external carotid artery with the superior thyroid artery initially coursing over the internal carotid artery; (b) the right vertebral artery coursing over the inferior thyroid artery and entering the transverse process of the fifth cervical vertebra; (c) the left subclavian and vertebral arteries were tortuous. Knowledge of the presence of this IA variant, with a transverse subisthmic segment, appears to be important in various surgical approaches, such as tracheostomies, thyroidectomies, and mediastinoscopies; in addition, the variations of the IA and the vertebral arteries are relevant for lower cervical spine approaches. Nevertheless, the lateralised external carotid artery may lead, if unidentified, to hemorrhagic complications during carotid space approaches. It is important for surgeons to be aware that if an aberrant IA is identified it may not be the only variation in that patient. (Folia Morphol 2010; 69, 4: 261-266

The anatomy of a horizontally impacted maxillary wisdom tooth

A completely horizontally impacted upper third molar was revealed after routine dissection of a 62-year-old human cadaver of a Caucasian male. The molar was penetrating into the maxillary sinus and there was antral dehiscence of its bony alveolus. The bony alveolus was immediately in front of the greater palatine canal contents, and the bottom of the alveolus was dehiscent towards the greater palatine foramen. Within the greater palatine canal and foramen the greater palatine artery was duplicated and the nerve was found. Such antral relations of an impacted upper third molar predispose to oroantral communications if extraction is performed, while the close neurovascular relations represent a risk factor for postextractional haemorrhage and neurosensory disturbances and must be borne in mind when deciding on or performing the extraction. (Folia Morphol 2008: 67: 154–156

Search for the standard model Higgs boson decaying to a bbˉb\bar{b} pair in events with no charged leptons and large missing transverse energy using the full CDF data set

We report on a search for the standard model Higgs boson produced in association with a vector boson in the full data set of proton-antiproton collisions at $\sqrt{s} = 1.96$ TeV recorded by the CDF II detector at the Tevatron, corresponding to an integrated luminosity of 9.45 fb$^{-1}$. We consider events having no identified charged lepton, a transverse energy imbalance, and two or three jets, of which at least one is consistent with originating from the decay of a $b$ quark. We place 95% credibility level upper limits on the production cross section times standard model branching fraction for several mass hypotheses between 90 and $150 \mathrm{GeV}/c^2$. For a Higgs boson mass of $125 \mathrm{GeV}/c^2$, the observed (expected) limit is 6.7 (3.6) times the standard model prediction.Comment: Accepted by Phys. Rev. Let

Search for the standard model Higgs boson decaying to a bb pair in events with one charged lepton and large missing transverse energy using the full CDF data set

We present a search for the standard model Higgs boson produced in association with a W boson in sqrt(s) = 1.96 TeV p-pbar collision data collected with the CDF II detector at the Tevatron corresponding to an integrated luminosity of 9.45 fb-1. In events consistent with the decay of the Higgs boson to a bottom-quark pair and the W boson to an electron or muon and a neutrino, we set 95% credibility level upper limits on the WH production cross section times the H->bb branching ratio as a function of Higgs boson mass. At a Higgs boson mass of 125 GeV/c2 we observe (expect) a limit of 4.9 (2.8) times the standard model value.Comment: Submitted to Phys. Rev. Lett (v2 contains clarifications suggested by PRL

Search for the standard model Higgs boson decaying to a bb pair in events with two oppositely-charged leptons using the full CDF data set

We present a search for the standard model Higgs boson produced in association with a Z boson in data collected with the CDF II detector at the Tevatron, corresponding to an integrated luminosity of 9.45/fb. In events consistent with the decay of the Higgs boson to a bottom-quark pair and the Z boson to electron or muon pairs, we set 95% credibility level upper limits on the ZH production cross section times the H -> bb branching ratio as a function of Higgs boson mass. At a Higgs boson mass of 125 GeV/c^2 we observe (expect) a limit of 7.1 (3.9) times the standard model value.Comment: To be submitted to Phys. Rev. Let

Burden and risk factors for Pseudomonas aeruginosa community-acquired pneumonia:a Multinational Point Prevalence Study of Hospitalised Patients

Pseudornonas aeruginosa is a challenging bacterium to treat due to its intrinsic resistance to the antibiotics used most frequently in patients with community-acquired pneumonia (CAP). Data about the global burden and risk factors associated with P. aeruginosa-CAP are limited. We assessed the multinational burden and specific risk factors associated with P. aeruginosa-CAP. We enrolled 3193 patients in 54 countries with confirmed diagnosis of CAP who underwent microbiological testing at admission. Prevalence was calculated according to the identification of P. aeruginosa. Logistic regression analysis was used to identify risk factors for antibiotic-susceptible and antibiotic-resistant P. aeruginosa-CAP. The prevalence of P. aeruginosa and antibiotic-resistant P. aeruginosa-CAP was 4.2% and 2.0%, respectively. The rate of P. aeruginosa CAP in patients with prior infection/colonisation due to P. aeruginosa and at least one of the three independently associated chronic lung diseases (i.e. tracheostomy, bronchiectasis and/or very severe chronic obstructive pulmonary disease) was 67%. In contrast, the rate of P. aeruginosa-CAP was 2% in patients without prior P. aeruginosa infection/colonisation and none of the selected chronic lung diseases. The multinational prevalence of P. aeruginosa-CAP is low. The risk factors identified in this study may guide healthcare professionals in deciding empirical antibiotic coverage for CAP patients

Measurement of the difference of CP-violating asymmetries in D0 -> K+K- and D0 ->pi+pi- decays at CDF

We report a measurement of the difference (Delta Acp) between time-integrated CP--violating asymmetries in D0-> K+ K- and D0-> pi+pi- decays reconstructed in the full data set of proton-antiproton collisions collected by the Collider Detector at Fermilab, corresponding to 9.7 fb-1 of integrated luminosity. The strong decay D*+->D0 pi+ is used to identify the charm meson at production as D0 or anti-D0. We measure Delta Acp = [-0.62 +- 0.21 (stat) +- 0.10 (syst)] %, which differs from zero by 2.7 Gaussian standard deviations.This result supports similar evidence for CP violation in charm-quark decays obtained in proton-proton collisions.Comment: Phys. Rev. Lett. 109, 111801 (2012