Two types of vascularisation of intramural uterine leiomyomata revealed by corrosion casting and immunohistochemical study

The blood supply of myomatous uteri collected upon autopsy was examined. The uterine vascular beds were perfused via afferent vessels with fixative followed by Mercox resin and corroded after polymerisation of the resin. The vascular casts thus obtained were examined using scanning electron microscopy. The vascular system of the uterine fibroids was also examined using immunohistochemical analysis (FVIII, factor VIII-related antigen)

Correct human cardiac nomenclature

Proper heart’s nomenclature is very important in daily clinical practice and research studies, andwhen it is consistent, it can facilitate better communication between different medical specialists. Thegeneral rule of the anatomy is to describe organs and their structures in attitudinally correct position.However, the use of the old-fashioned Valentine position (where the heart is described as if it werestanding on its apex) is still in use to describe important cardiac structures. Upon closer analysis, all main chambers of the heart and their associated subcomponents have mislabeled structures that should be renamed. In this article we aimed to emphasize the limitations of Valentinian nomenclature, presentproper anatomical names of the most important heart’s structures and advocate to change certain mis-labeled anatomical structures. Attitudinally correct designations presented in this study will benefit allmedical specialties, and they will reinforce the importance of consistent orientational naming. Correctnaming of heart’s structures will also help improve communication between different medical specialists

Application of a mixture of glycol polyethylenes for the preparation of microcorrosion casts - an observation

Preparation of microcorrosion casts that can be used for observation in SEM is a laborious, time-consuming procedure. The authors paid particular attention to the process of dissection of the microcorrosion casts. This prompted the authors to reconstruct the plastic mass, produced by the firm Gurr (Great Britain) in the 1970s, which was used by them in previous research to immerse the cast in order to minimise the damage. By using easily obtainable polyethylene glycols, characterised by different physical and chemical features, in order to obtain smooth surface of the section, a low-toxic mixture was composed, which protected the microcorrosion casts sufficiently and did not interfere with the physical and chemical properties of the cast

Application of acrylic emulsion Liquitex R (Binney and Smith) for the preparation of injection specimens and immunohistochemical studies - an observation

Application of acrylic emulsion Liquitex R for injection studies of the vascular system of human myomatous uteri was analysed. It was found that this injection mass does not penetrate the capillary bed of human organs, but it is useful in studies carried out on the blood supply of the human organs removed from cadavers. The results were compared with the studies performed with the help of immunohistochemical tests for von Willebrandt's factor

Validation of the Polish language version of the SF-36 Health Survey in patients suffering from lumbar spinal stenosis

[b]introduction and objective[/b]. Patient-reported outcome (PRO) questionnaires have become the standard measure for treatment effectiveness after spinal surgery. One of the most widely used generic PROs is the SF-36 Health Survey. The aim of this study was to specifically focus on validating the SF-36 Health Survey to confirm that the tool is an acceptable and psychometrically robust measure to collect HRQoL data in Polish patients with spinal stenosis. [b]materials and methods[/b]. Patients were eligible if they were above 18 years of age and had been qualified for spine surgery of the lumbar region due to either discopathy or non-traumatic spinal stenosis. All patients filled-in the Polish version of the SF-36 and a demographic questionnaire. Standard validity and reliability analyses were performed. [b]results.[/b] 192 patients (83 women – 43.2%) agreed to take part in the study (mean age: 57.5±11.4 years). In 47 patients (24.5%), using MRI, ossification of the ligamenta flava were found. Cronbach’s alpha coefficients showed positive internal consistency (0.70–0.92). Interclass correlations for the SF-36 ranged from 0.72 – 0.86 and proved appropriate test-retest reliability. Satisfactory convergent and discriminant validity in multi-trait scaling analyses was seen. [b]conclusions.[/b] The Polish version of the SF-36 is a reliable and valid tool for measuring HRQoL in patients with spinal stenosis. It can be recommended for use in clinical and epidemiological settings in the Polish population. However, caution is warranted when interpreting the results of the ‘role limitations due to physical health problems’ and the ‘role limitations due to emotional problems’ scales because of floor and ceiling effects

Variations and morphometric analysis of the proximal segment of the superior cerebellar artery

Introduction The superior cerebral artery is a clinically significant vessel, but little is known about its radiological anatomy. The aim of this study was to describe the anatomical variations of the proximal segment of the superior cerebellar artery using Computed Tomography Angiography. Materials and methods The study group consisted of 200 subjects (54.5% female, mean age±SD 56.2±17.2 years) that had undergone head Computed Tomography Angiography. Subjects with any intracranial pathologies were excluded. Images in Maximum Intensity Projections were used to study the anatomical anomalies of the superior cerebellar artery. Results In 200 subject 388 superior cerebellar arteries were found. Twelve (3.09%) SCAs were duplicated in 11 patients and all originated from the basilar artery. In 8 (4.00%) patients the superior cerebellar artery was absent. The origin of the SCA was most often bilateral, mainly from the basilar artery (76.29%). The superior cerebellar artery diameter, measured at the site of the origin, was statistically significantly different depending on the place of the origin: wider when originating from the basilar artery as a single vessel (1.48±0.42mm vs. 1.34±0.52mm; p=0.03) and narrower when originating as duplicated one (1.38±0.48mm vs. 1.46±0.44mm; p=0.55). Conclusion Superior cerebellar artery usually originates bilaterally from the basilar artery as a single trunk. Its diameter is significantly wider in that type in comparison to other anatomical variations

Reappraisal of the variational anatomy of the vermiform appendix and their possible clinical applicability: a cadaveric analysis

Background: The anatomical variations in the position, length, arterial supply and extension of mesoappendix of the vermiform appendix (VA) are pivotal to establishing a standard pattern in the study population of known ethnicity and their clinical applicability. Materials and methods: The present study was conducted on 47 adult human cadavers, thirty-five males and twelve female subjects of North Indian ethnicity. Results: Retrocaecal appendix was found in 23 cases (48.9%) followed by pelvic in 13 (27.7%), three cases each of pre-ileal, post-ileal, and promontoric (6.4%), one case (2.1%) each of paracaecal and subcaecal reported. The length of VA varied from three to ten centimetres, averaging about 7.37±1.67 cm, both the shortest (2.9 cm) (female) and longest (10 cm) (male) were of retrocaecal type. The main appendicular artery (MAA) showed a widely varied branching pattern within the mesoappendix, ranging from three to seven. Fourteen cases (29.78%) showed the accessory appendicular artery (AAA) or dual arterial supply, arising from the ileocolic artery in ten (21%) and in four from the post-caecal (9%). In the specimens with dual arterial supply, the estimated portions of the VA supplied by the MAA also vary with distal ¾th being supplied in 57.14%. In ten cases (21%), the mesoappendix failed to reach the tip of the VF. Conclusions: Knowledge of anatomical diversities in position, length, course, arterial supply, branching pattern, and mesoappendix is potentially crucial in avoiding surgical catastrophes. Atypical positions of the organ can cause diagnostic confusion and result in delayed treatment. VF supplied by an end artery is one of the causes of the occurrence of appendicitis and mesoappendix not reaching the tip making the organ more vulnerable to necrosis. Vascular variations and anomalies involving the main or accessory appendicular artery are critical to prevent haemorrhage or faulty ligatures

Superior mesenteric artery clinical classification and morphometrical analysis

Background: The superior mesenteric artery is one of the most important arteries in the abdominal cavity, which is of great clinical importance, especially in surgical procedures and fatal ischemic complications. The aim of this study was to develop a clinical classification of the superior mesenteric artery. Materials and methods: Postmortem contrast-enhanced computed tomography of 104 (29.8% female, age 50.7±18.7) human bodies were analyzed. Based on anatomic predisposition to ischemic and iatrogenic complications, a three-tiered clinical classification of the superior mesenteric artery was developed. Type 0 was defined as standard risk for ischemic and iatrogenic complications. Type 1 was defined as increased thromboembolic risk with decreased risk of iatrogenic bleeding, and type 2 was defined as decreased ischemic risk with increased risk of iatrogenic bleeding. The supply area of the superior mesenteric artery was divided into 4 regions: pancreas, caecum, ascending colon, and transverse colon. Results: Type 0 (standard risk) was found in 62.5% of cases. Type 1 was most frequently observed in the ascending colon region (15.4%). Type 2 was most frequently observed in the pancreatic region (17.3%). Regarding type, most abnormalities were found in the region of the ascending colon (18.3%), pancreas region (17.3%), and transverse colon (16.3%). Conclusions: The proposed clinical classification of SMA links anatomic variations in morphology with their clinical significance. A simple, three-level classification can be easily applied in daily practice and serve as a great support for preoperative evaluation and recognition of patients at risk of iatrogenic or thromboembolic complications

A three-headed piriformis muscle: an anatomical case study and narrative review of literature

Introduction: The piriformis muscle (PM) is found in the gluteal region, exiting the pelvis through the greater sciatic foramen and dividing it into the suprapiriform and infrapiriform foramina. The piriformis works as part of the hip external rotator muscle group, and is responsible for rotation of the femur upon hip extension and abduction of the femur during flexion of the hip joint. The aim of the present report is to describe a very rare case of the primary three-headed piriformis muscle. To the best knowledge of the authors, the said variant has not yet been described in the existing literature. Case report: The 71-year-old male formalin-fixed cadaver was subjected to routine dissection. After careful removal of the connecting tissue, three separate, primary heads of the PM were identified. The lower head of the PM arose from the middle part of the sacral bone; 87.56 mm long and 9.73 mm wide. The medial head was attached to the internal part of the posterior inferior iliac spine; 121.6 mm long and 20.97 mm wide. The upper head was attached to the external part of the posterior inferior iliac spine; 78.89 mm long and 23.94 mm wide. All heads converged into a common tendon which inserted onto the greater trochanter. Conclusions: The clinical importance of this work comes down to the fact that the aberrant PM may be the reason behind the piriformis syndrome and its associated symptoms. Moreover, knowledge regarding the variant anatomy of the PM is of immense importance to, e.g., anesthesiologists performing CT- or ultrasound-guided SN injection for local anesthesia, radiologists interpreting imaging studies, and surgeons, especially during posterior approaches to the hip and pelvis

Prevalence of the Onodi cell in the Polish adult population: an anatomical computed tomography study

Background: Onodi cell is a posterior ethmoid air cell with the optic canal bulging into it; the common position of the bulge is into the sphenoid sinus, usually immediately posterior to the posterior ethmoid air cells. Variable pneumatization patterns lead to various structures of lamellae and sinuses occasionally exposing important nerves and vessels, such as the optic and vidian nerves, internal carotid artery and cavernous sinus. In clinical practice, special imaging techniques are used to navigate through the paranasal sinuses and hence avoid injury to these structures. This study is aimed to determine the prevalence of the Onodi cell in the Polish population and compare it with other reported occurrences. Materials and methods: A retrospective analysis of 296 computed tomography (CT) scans of patients treated in Cracow, Poland, using a Siemens Somatom Sensation 16 spiral CT scanner. No contrast medium was administered. Results: The Onodi cell was found in 31 out of the 296 patients, or approximately 10.5%, consistent with the majority of research reporting on Onodi variants. Additionally, there was one presentation of a bilateral Onodi cell in a male patient. No statistically significant difference was found between the male and female populations with a positive identification of the variant (p = 0.095, Chi2 test). Conclusions: This study helped approximate the Onodi variant prevalence of 10.47%, falling within a commonly reported range 8-14%. This gives clinicians and surgeons a better understanding of this variant's structure and significance, and therefore an opportunity to improve treatment outcomes and research