Anatomy of the supraventricular crest in human hearts

The supraventricular crest is a fleshy trabecula of the right ventricle that has an important function in guiding the blood flow. However, controversy persists regarding its anatomical constitution. In this study, we aimed to investigate its frequency, formation, termination, morphometry, and relationships with the septomarginal trabecula, septal papillary muscle, right atrioventricular ring, and left posterior semilunar valve of the pulmonary trunk valve. Our material consisted of 50 hearts from adult individuals of both sexes that had been preserved in 10% formalin. They were opened along the arterial cone by means of an incision starting at the pulmonary trunk and ending at the right margin. The supraventricular crest was always present. The marginal (right) extremity was formed by two to six muscle bundles that joined together (88%). On the septal (left) side, the single muscle bundle penetrated the interventricular septum directly (88%) or by means of two or three divisions (12%). It could form a septal band (52%) and could pass over the septal papillary muscle (43.5%) or just below it (34.8%). There was a relationship of muscle fibres between these two structures in 64% of cases. Dissection of the septal band demonstrated continuity with the septomarginal trabecula (46%). In 80% of cases, the crest was connected to the right atrioventricular ring and it participated in its outline directly (64%) or by means of muscle expansions (16%). Its muscle fibres bordered the left semilunar valve of the pulmonary valve in 50% of cases. Regarding morphometry, we observed that the length varied little with increasing weight of the heart (22.6%), but the height and width increased markedly with increasing weight of the heart. Folia Morphol 2010; 69, 1: 42-4

The subscapular artery and the thoracodorsal branch: an anatomical study

The motive for this research was the use of the muscles of the scapular region in transposition, transplantation and reparative surgery and the need for more detailed knowledge of the blood supply to these muscles. In addition, the subscapular arterial tree may be used as a source of microvascular grafts to replace damaged or diseased portions of arteries, particularly in the hand and forearm. The research was conducted on 60 sides of corpses of adults of both sexes. It was noticed that the subscapular artery was present in 96.7% of cases and originated laterally to the pectoralis minor muscle in 76.7% of cases. The average calibre was 5.0 mm, and in 73.2% of cases it measured between 4.0 and 5.9 mm. The average length was 18.0 mm, ranging from 10.0 to 29.9 mm (76.7%). It presented in its course important relations with the axillary nerve (69%) and with the radial nerve (82.8%). Its branches were collateral (subscapular muscle - 61.3%) and terminal (except for the circumflex scapular artery), leading to the following muscles: serratus anterior (43.9%), latissimus dorsi (27.6%), and subscapular (23.3%). The thoracodorsal artery, one of the terminal branches, most frequently showed a calibre of between 2.0 and 3.9 mm (70.3%), collateral branches in 85.0%, was mainly distributed to the subscapular muscle (36.7%) and to the serratus anterior muscle (29.0%) and had terminal branches to the following muscles: latissimus dorsi (44.1%), serratus anterior (40.5%) and the subscapular (12.5%). The serratus anterior muscle received one branch in 39.5% and two branches in 41.9%, while the latissimus dorsi muscle received one branch in 66.7% and two branches in 23.1%. (Folia Morphol 2008; 67: 58-62

The anatomy of the human thyroid veins and its surgical application

The present study was motivated by the importance of the thyroid veins in surgery in the anterolateral cervical region, particularly in tracheostomies, the need for information on modern diagnostic imaging techniques and the lack of specific publications on the subject. The research was performed on 30 adult human specimens by means of dissection and measurement. The superior thyroid vein was constant, single on both sides (83.3%), with its termination (87.1%) at the internal jugular vein (97.2%), either isolated (29.4%) or with other veins, mostly the lingual vein (52.1%), and was located between 1.0 and 2.5 cm below a plane that passes the upper margin of the hyoid bone. The medial thyroid vein, when present, was not constant (43.3%), was single (96.1%), terminated in the internal jugular vein and was located between 2.0 and 4.0 cm from the mid-sagittal line (84.6%). The inferior thyroid vein was constant (96.7%) and varied in number, with one (62.1%), two (27.6%) or even five occurring, and was formed by the confluence of two primary branches (78.6%) as a result of the abundance of anastomoses coming from the lower and medial parts of the gland. The number of terminations corresponded to the number of veins, at the level of the 5th to 8th rings in 36.9%, of the 9th to 10th rings in 34.8% and of the 11th to 14th rings in 28.3%, and occurred in the right brachiocephalic vein (26.1%), in the left brachiocephalic vein (60.9%) or in both veins (13.0%)

Assessment of normal tricuspid valve anatomy in adults by real-time three-dimensional echocardiography

Background: The tricuspid valve (TV) is a complex structure. Unlike the aortic and mitral valve it is not possible to visualize all TV leaflets simultaneously in one cross-sectional view by standard two-dimensional echocardiography (2DE) either transthoracic or transesophageal due to the position of TV in the far field. Aim: Quantitative and qualitative assessment of the normal TV using real-time 3-dimensional echocardiography (RT3DE). Methods: RT3DE was performed for 100 normal adults (mean age 30 ± 9 years, 65% males). RT3DE visualization was evaluated by 4-point score (1: not visualized, 2: inadequate, 3: sufficient, and 4: excellent). Measurements included TV annulus diameters (TAD), TV area (TVA), and commissural width. Results: In 90% of patients with good 2DE image quality, it was possible to analyse TV anatomy by RT3DE. A detailed anatomical structure including unique description and measurement of tricuspid annulus shape and size, TV leaflets shape, and mobility, and TV commissural width were obtained in majority of patients. Identification of each TV leaflet as seen in the routine 2DE views was obtained. Conclusion: RT3DE of the TVis feasible in a large number of patients. RT3DE may add to functional 2DE data in description of TV anatomy and providing highly reproducible and actual reality (anatomical and functional) measurements

BDNF Methylation and Maternal Brain Activity in a Violence-Related Sample

It is known that increased circulating glucocorticoids in the wake of excessive, chronic, repetitive stress increases anxiety and impairs Brain-Derived Neurotrophic Factor (BDNF) signaling. Recent studies of BDNF gene methylation in relation to maternal care have linked high BDNF methylation levels in the blood of adults to lower quality of received maternal care measured via self-report. Yet the specific mechanisms by which these phenomena occur remain to be established. The present study examines the link between methylation of the BDNF gene promoter region and patterns of neural activity that are associated with maternal response to stressful versus non-stressful child stimuli within a sample that includes mothers with interpersonal violence-related PTSD (IPV-PTSD). 46 mothers underwent fMRI. The contrast of neural activity when watching children-including their own-was then correlated to BDNF methylation. Consistent with the existing literature, the present study found that maternal BDNF methylation was associated with higher levels of maternal anxiety and greater childhood exposure to domestic violence. fMRI results showed a positive correlation of BDNF methylation with maternal brain activity in the anterior cingulate (ACC), and ventromedial prefrontal cortex (vmPFC), regions generally credited with a regulatory function toward brain areas that are generating emotions. Furthermore we found a negative correlation of BDNF methylation with the activity of the right hippocampus. Since our stimuli focus on stressful parenting conditions, these data suggest that the correlation between vmPFC/ACC activity and BDNF methylation may be linked to mothers who are at a disadvantage with respect to emotion regulation when facing stressful parenting situations. Overall, this study provides evidence that epigenetic signatures of stress-related genes can be linked to functional brain regions regulating parenting stress, thus advancing our understanding of mothers at risk for stress-related psychopathology

Fibroblastic rheumatism: Scientific Letter

Fibroblastic Rheumatism (FR) is a rare rheumatologic entity of unknown etiology. The pathophysiological mechanism involving fibroblast proliferation is characterized by symmetrical polyarthritis associated with sudden onset of cutaneous nodules, flexion contractures. Bone erosion can occur as the disease progresses and destructive arthropathy is inconstant. The diagnosis of fibroblastic rheumatism is based on histological study of the nodules. Fibroblastic rheumatism treatment is di cult and relies on corticosteroids or immunosuppressive treatment. Given its rarity, we considered necessary to present the diagnostic and therapeutic approach to this disease still imperfectly known. Keywords: Fibroblastic rheumatism, Sclerodactyly, Nodules, Corticosteroid

ANATOMICAL STUDY of the HUMAN TRICUSPID-VALVE

ESCOLA PAULISTA MED SCH,DEPT MORPHOL,RUA BOTUCATU 740,VILA CLEMENTINO,BR-04023 São Paulo,SP,BRAZILESCOLA PAULISTA MED SCH,DEPT MORPHOL,RUA BOTUCATU 740,VILA CLEMENTINO,BR-04023 São Paulo,SP,BRAZILWeb of Scienc