Computer-assisted measurements of the histological structure of the tibial nerve and its terminal branches

Background: The aim of this study was to analyse the histological structure (cross-sectional area [CSA] and number of nerve bundles) of the distal part of the tibial nerve and its terminal branches (medial plantar nerve, lateral plantar nerve) using computer-assisted image analysis. Materials and methods: The tibial nerve and its distal branches (medial and lateral plantar nerves) were dissected from the fresh cadavers. Each nerve was harvested 5 mm proximally and respectively 5 mm distally from the tibial nerve bifurcation, marked, dehydrated, embedded in paraffin, sectioned at 2 μm slices and stained with haematoxylin and eosin. Then photographed and analysed using Olympus cellSens software. Results: The studied group comprised 28 female and 32 male feet (mean age 68.1 ± 15.2 years). The mean CSA and the number of nerve bundles were respectively 17.86 ± 4.57 mm2, 33.88 ± 6.31 for the tibial nerve, 9.58 ± 1.95 mm2, 23.41 ± 7.37 for the medial plantar nerve and 7.17 ± 2.36 mm2, 15.06 ± 5.81 for the lateral plantar nerve in males and 12.27 ± 2.45 mm2, 26.32 ± 8.87 for the tibial nerve, 7.81 ± 1.41 mm2, 17.71 ± 5.28 for the medial plantar nerve and 5.83 ± 1.25 mm2, 11.50 ± 3.72 for the lateral plantar nerve in females. Both CSA and number of nerve bundles of the tibial, medial plantar and lateral plantar nerves revealed no statistical differences when comparing foot side of the individual. The statistical difference was related to the gender, showing significantly bigger CSA and number of nerve bundles in males (CSA: p = 0.000, p = 0.000, p = 0.016; number of nerve bundles: p = 0.01, p = 0.003, p = 0.004, respectively). A positive correlation was found between the donor age and the tibial nerve CSA (r = 0.44, p = 0.000). A significant statistical difference was found between the medial and lateral plantar nerves both in CSA and number of nerve bundles (p < 0.001, p < 0.001, respectively). Conclusions: The CSA and the number of nerve bundles in the distal part of the tibial nerve and its branches are significantly larger in males with no differences between right and left foot of the individual. The tibial nerve shows increasing CSA with advanced age. The medial plantar nerve has larger CSA and more nerve bundles than the lateral plantar nerve

The dimensions of the sphenoid sinuses: evaluation before the functional endoscopic sinus surgery

Background: The following study aimed to evaluate the dimensions (anteroposterior, transverse and vertical) of the sphenoid sinuses in the adult population. Materials and methods: The study was conducted as a retrospective analysis of the computed tomography (CT) scans of the paranasal sinuses of 296 patients (147 females and 149 males), who did not present any pathology in the sphenoid sinuses. The CT scans of the paranasal sinuses were done with the spiral CT scanner, without using any contrast medium. After obtaining transverse planes, frontal and sagittal planes were created using secondary reconstruction tool. Results: The anteroposterior dimension was found to be 2.65 cm on average, in the range of 0.5–4.3 cm. The transverse dimension was on average 1.98 cm, ranging from 0.5 cm to 4.9 cm. The average vertical dimension was found to be 2.1 cm, in the range of 0.7–3.7 cm. Conclusions: Due to the high incidence of the anatomical variants of the paranasal sinuses, a CT scan is recommended in all patients before a planned surgery in order to avoid the potential iatrogenic complications. Dimensions of the sphenoid sinuses might point towards more at risk variants, but there is still a substantial amount of research that needs to be done in that aspect

An aberrant right subclavian artery in a 63-year-old male cadaver

An aberrant right subclavian artery (ARSA), also called “Arteria lusoria”, is described as a right subclavian artery with a retro-esophageal course that most frequently originates as the most distal branch of the aortic arch. The aim of the following study was to present and thoroughly describe a case of an ARSA, its course, branches, and relation to the surrounding anatomical structures and discuss the clinical significance and embryology of this variant. During routine dissection, a 63-year-old male cadaver with an abnormal variant of the right subclavian artery was found. The right subclavian artery branched off from the aortic arch as the most distal branch. Subsequently, it coursed posteriorly to the trachea and esophagus at the level of T2 and T3. Abnormalities in the branching pattern of the right subclavian artery were also discovered, such as the right vertebral artery originating from the right common carotid artery as its first branch. The present study presents a case of an ARSA, which is a rare anatomical variant of the branches of the aortic arch. The course and branching pattern of an aberrant subclavian artery is quite variable, and each variant can be associated with different possible complications. Furthermore, the ARSA is associated with other cardiovascular anomalies, such as the Kommerells diverticulum. Therefore, knowledge about the possible variations of this anomaly may be of great importance for physicians who encounter this variant in their practice

The divided zygoma: a meta-analysis of its prevalence with a review of the literature

Background: Divided zygoma (DZ) is an important structure in the midfacial region. The anatomy of DZ is poorly researched, but knowledge about this entity could be useful during posttraumatic facial reconstructions. The aim of this study was to estimate the prevalence and anatomy of DZ in different regions around the world. Therefore, the authors performed a meta-analysis, including all studies that report extractable data on the DZ. Materials and methods: The main online medical databases such as PubMed, EBSCO, ScienceDirect, Web of Science, SciELO, BIOSIS, Current Content Connect, Korean Journal Database and Russian Citation Index, were utilized to gather all studies on anatomical characteristics, prevalence, symmetry, and a number of divisions of zygomatic bone. Results: A total of 20 studies were included in this meta-analysis. Data were grouped and analyzed in 5 categories: (1) prevalence of DZ bone, (2) prevalence of DZ skulls, (3) gender prevalence of DZ with sides, (4) divisions of zygomatic bone, (5) symmetry of DZ. Conclusion: In conclusion, the authors of the present study believe that this is this study can be considered and up-to-date meta-analysis regarding the prevalence, divisions, and symmetricity of the DZ. The data provided by the present study may be useful information for physicians in recognizing the DZ of the fracture and may be important information during zygomatic bone osteotomy. Detailed anatomical knowledge of the midfacial region can prevent surgical complications when operating in this area

Prewalencja wieloogniskowych zarazen grzybami u chorych z przeszczepami nerek poddawanych stalej immunosupresji

Prevalence of multifocal fungal infections in patients undergoing permanent immunosuppresion alter renal transplantation. The aim of the study was to estimate the prevalence of fungi in monofocal and multifocal infections in renal transplant recipients. 32 renal transplant recipients were examined for presence of fungi in genital organs, oral cavity and rectum. Fungal strains were recovered in 66 out of 96 samples (68.2% of all renal transplant recipients) in oral cavity (65.6%), rectum (37.5%) and genital organs (25.0%). Monofocal mycosis was found only in 21.9% of the patients. Multifocal infections occurred in 68.2% and contained ontocenoses of oral cavity and rectum (34.4%) the most frequently. Trifocal infection (genital organs - oral cavity - rectum) occurred in 12.5% of all examined renal transplant recipients. The following fungi were found: Candida albicans (31 strains), C. glabrata (5), C. guilliermondii (2), C. krusei (20, Saccharomyces cerevisiae (1)

Prewalencja wieloogniskowych zarazeń grzybami u chorych z przeszczepami nerek poddawanych stałej immunosupresji

Prevalence of multifocal fungal infections in patients undergoing permanent immunosuppresion alter renal transplantation. The aim of the study was to estimate the prevalence of fungi in monofocal and multifocal infections in renal transplant recipients. 32 renal transplant recipients were examined for presence of fungi in genital organs, oral cavity and rectum. Fungal strains were recovered in 66 out of 96 samples (68.2% of all renal transplant recipients) in oral cavity (65.6%), rectum (37.5%) and genital organs (25.0%). Monofocal mycosis was found only in 21.9% of the patients. Multifocal infections occurred in 68.2% and contained ontocenoses of oral cavity and rectum (34.4%) the most frequently. Trifocal infection (genital organs - oral cavity - rectum) occurred in 12.5% of all examined renal transplant recipients. The following fungi were found: Candida albicans (31 strains), C. glabrata (5), C. guilliermondii (2), C. krusei (20, Saccharomyces cerevisiae (1)