Nedostatak dugog dlanskog mišića kod jedne od jednojajčanih blizankinja: prikaz slučaja

Palmaris longus is a very variable muscle in the human body, but it is often used as an applicable tendon graft. We report on differences between one pair of identical twins regarding the existence of the palmaris longus, which were detected accidentally during examination of the presence/absence of this muscle in Caucasian population. In one of the twins, the palmaris longus was present at both forearms, while the other twin was lacking this muscle at both forearms. On search of the available literature, we found no articles about distinctions in the presence or absence of the palmaris longus in twins.Dugi dlanski mišić je jedan od najvarijabilnijih mišića u tijelu, a često se koristi kao tetivni graft. Opisali smo razlike između jednog para jednojajčanih blizankinja u postojanju dugog dlanskog mišića, koje su slučajno identificirane tijekom ispitivanja prisustva/odsustva ovoga mišića u općoj populaciji. Kod jedne blizankinje dugi dlanski mišić je bio prisutan na obje podlaktice, dok je druga blizankinja bila bez ovoga mišića na objema podlakticama. Pretraživanjem dostupne literature nismo pronašli nijedan objavljen rad o razlikama u prisustvu ili odsustvu dugog dlanskog mišića kod blizanaca

Insights into a Mummy: A Paleoradiological Analysis

The aim of the study was to analyze possible human skeletal remains within the wrappings of a mummy from the Archaeological Museum, Zagreb, Croatia through the use of the multidetector CT (MDCT) technology. Plain X-ray films and MDCT images of the mummy were taken in both frontal and lateral views. In a single volumetric acquisition of the whole body by MDCT, 0.75 mm axial slices were obtained and combined with sagittal and coronal reformatting and three-dimensional (3D) reconstruction. Sex and age was assessed visually using standard anthropological methods. The results suggest that the mummy was of an adult female, most likely over 40 years of age at death. Pathologies observed included degenerative changes on the vertebral column and healed fractures of the lower right arm. Damage of the ethmoid bone at the roof of the nasal cavity was most likely caused by mortuary brain removal practice. Remnants of a resin and an unusual object were found inside the cranial cavity. An elongated metal object and additional three metal »belts« can be seen on the lower portion of the body. All internal organs were removed and thoracic and abdominal cavities were filled with various substances, most likely mud and pieces of linen cloth. Our results show that the MDCT is a very useful technique for assessing the human remains in archeological samples, especially in comparison to the use of plain film (X-ray), where important details are obscured and 3D imaging impossible

Initial experiences of hemodialysis HeRO graft in University Hospital Dubrava – A report of two cases and review of literature

U Kliničkoj bolnici Dubrava u Zagrebu prvi je put u Hrvatskoj ugrađen novi sustav za krvožilni pristup kod bolesnika koji se liječi kroničnom hemodijalizom. Radi se o kombinaciji centralnoga venskog katetera i grafta engleskog naziva Hemodialysis Reliable Outflow (HeRO) device, skraćenog naziva HeRO-graft. Glavna je indikacija za primjenu ovoga krvožilnog pristupa okluzija ili značajna stenoza centralnih vena. Iz literature se doznaje da ovaj krvožilni pristup ima značajne prednosti u odnosu na tunelirani centralni venski kateter koji bi trebao biti zadnja opcija kod bolesnika koji zahtijevaju trajno nadomještanje izgubljene bubrežne funkcije. Za razliku od tuneliranih katetera ovaj je sustav u potpunosti smješten potkožno, što ga čini otpornijim na infekcije. Do sada su u Kliničkoj bolnici Dubrava ugrađena dva HeRO-grafta za hemodijalizu i prema prvim iskustvima potrebna je detaljna obrada kandidata za ovu proceduru. Potrebno je dobro poznavati indikacije i kontraindikacije te je nužna suradnja više timova: nefrološkog, anesteziološkog, radiološkog i kirurškog. Osobito je potrebno obratiti pažnju na stanje arterijske cirkulacije okrajine koja se koristi za ovaj krvožilni pristup kako bi se izbjegle moguće ishemijske komplikacije. Kod obaju naših bolesnika postupak ugradnje protekao je uredno te smo započeli s korištenjem HeRO-grafta za potrebe hemodijalize.A new vascular access system in patients undergoing chronic hemodialysis was implanted for the first time in Dubrava University Hospital in Zagreb. It is a combination of a central venous catheter and a graft known as Hemodialysis Reliable Outflow device (HeRO graft). The main indication for this vascular access is the occlusion or a significant stenosis of the central veins. Literature supports the significance of this type of vascular access over tunneled central venous catheters which should be the last option for patients requiring permanent renal replacement therapy. Unlike tunneled catheters, this system is completely located subcutaneously which makes it more resistant to infections. So far, two HeRO grafts for hemodialysis have been implanted in Dubrava University Hospital, and according to the first experiences, detailed workup on candidates is required before this procedure. It is necessary to be well aware of the indications and contraindications, and the cooperation of several specialties is required: nephrology, anesthesiology, radiology and surgery. It is especially important to pay attention to the condition of the arterial circulation of the arm used for this vascular access in order to avoid possible ischemic complications. In both of our patients, the implantation procedure had no immediate complications and we started using the HeRO graft

Insights into a mummy: a paleoradiological analysis [Uvid u mumiju: paleoradiološka analiza]

The aim of the study was to analyze possible human skeletal remains within the wrappings of a mummy from the Archaeological Museum, Zagreb, Croatia through the use of the multidetector CT (MDCT) technology. Plain X-ray films and MDCT images of the mummy were taken in both frontal and lateral views. In a single volumetric acquisition of the whole body by MDCT 0.75 mm axial slices were obtained and combined with sagittal and coronal reformatting and three-dimensional (3D) reconstruction. Sex and age was assessed visually using standard anthropological methods. The results suggest that the mummy was of an adult female, most likely over 40 years of age at death. Pathologies observed included degenerative changes on the vertebral column and healed fractures of the lower right arm. Damage of the ethmoid bone at the roof of the nasal cavity was most likely caused by mortuary brain removal practice. Remnants of a resin and an unusual object were found inside the cranial cavity. An elongated metal object and additional three metal "belts" can be seen on the lower portion of the body. All internal organs were removed and thoracic and abdominal cavities were filled with various substances, most likely mud and pieces of linen cloth. Our results show that the MDCT is a very useful technique for assessing the human remains in archeological samples, especially in comparison to the use of plain film (X-ray), where important details are obscured and 3D imaging impossible

Palmaris Longus Absent in One Identical Twin: a Case Report

Palmaris longus is a very variable muscle in the human body, but it is often used as an applicable tendon graft. We report on differences between one pair of identical twins regarding the existence of the palmaris longus, which were detected accidentally during examination of the presence/absence of this muscle in Caucasian population. In one of the twins, the palmaris longus was present at both forearms, while the other twin was lacking this muscle at both forearms. On search of the available literature, we found no articles about distinctions in the presence or absence of the palmaris longus in twins