Folia morphologica最新文献

The existence of the anterolateral ligament (ALL) has been questioned. It has recently attracted attention because of increased internal rotation after anterior cruciate ligament reconstruction, which could relate to simultaneous anterolateral ligament rupture. The current literature reports a highly variable anatomy of this ligament, and the first classification system for it was published recently. One goal of this review is to compare the abilities of magnetic resonance imaging and ultrasonography to detect the exact course of the anterolateral ligament, its proximal and distal attachments being depicted differently by different researchers. The main goal is to establish if all morphological types of the ALL can be identified and distinguished using noninvasive methods.

Background: The pes anserinus (PA) is a tendinous complex located on the anteromedial surface of the proximal tibia, formed by the conjoined insertions of the sartorius, gracilis, and semitendinosus muscles. It contributes to internal rotation and flexion of the tibia, providing stability to the medial knee compartment.

Case report: During the routine dissection of a 75-year-old female cadaver, an unusual PA variant was found. On the right limb, four accessory tendons were identified: one accessory sartorius tendon (aSART), one accessory gracilis tendon (aGRT), and two accessory semitendinosus tendons (aSTT1 and aSTT2). Distally, the aSTT1 fused with the aGRT and subsequently joined the aSART, forming a single fascial band that inserted slightly inferior to the typical PA footprint. No corresponding variations were present on the contralateral side. The coexistence of accessory slips from all three PA muscles appears exceedingly rare.

Conclusions: This case report presents a unique variant of PA, emphasizing the extent of its anatomic variability. Awareness and recognizing such variants of PA is crucial for surgeons, as this knowledge may help prevent the misidentification of tendons during medial knee procedures and tendon graft harvesting.

Background: The ceremonial inauguration of the Medical Faculty at Lviv University on September 9, 1894, by Emperor Franz Joseph, signified the culmination of a decades-long endeavor to reestablish medical education in Lviv. The institution was initially established in 1784 under the auspices of Emperor Joseph II. However, it was subsequently dissolved in 1805 and subsequently reinstated in 1817, albeit without a medical faculty. This study provides an analysis of the faculty's complete restoration as a result of international and interdisciplinary collaboration within the political, academic, and architectural spheres in the 19th century within the Habsburg Empire.

Materials and methods: Utilizing archival collections from Ukraine, Austria, and Poland, along with university repositories and current publications, this study performs a contextual and actor-focused analysis. Stakeholders are categorized into three sectors: governmental, academic, and technical. These categories are used to examine their respective roles and interactions.

Results: The reestablishment of the university was driven by the sustained advocacy of Lviv's academic community, with support from the Galician Governorship, and it was officially authorized by the Viennese Ministry of Education through an Imperial Decree in 1891. Academic contributions from prominent scholars in Lviv, including Henryk Kadyi, and in Cracow, such as Ludwik Teichmann and Napoleon Cybulski, exerted a significant influence on the curriculum and spatial organization of the faculty. The supervision of the construction process was overseen by architect Josef Braunseis and builder Ivan Levynsky, who engaged in close consultation with academic experts. International suppliers furnished essential materials and equipment. The medical faculty was officially established in 1894, with the inaugural academic year commencing in 1894/95.

Conclusions: The restoration of the Medical Faculty in Lviv serves as a prime example of a trans-regional, interdisciplinary Habsburg endeavor, integrating political vision, scientific leadership, and architectural innovation.

Background: The authors report phrenic nerve branch and communication variations at the cervicothoracic junction and upper mediastinum through adult cadaveric dissection, analyze their local morphological characteristics, and discuss their anatomical significance in conjunction with previous literature.

Materials and methods: During adult cadaveric dissection, two cases of phrenic nerve anatomical variations were discovered.

Results: Case 1 showed the left phrenic nerve composed of upper and lower branches that straddled the transverse cervical artery at the C4 level before reuniting and entering the thoracic cavity, with subsequent mediastinal course and terminal distribution consistent with standard anatomical descriptions. Case 2 showed early branching of the left phrenic nerve within the upper mediastinum, with its superior and inferior branches connected by communicating branches before joining the vagus nerve, while the main phrenic nerve trunk continued along its typical path to terminate at the diaphragm. Both variations were primarily limited to proximal branches or communicating structures, without significantly altering the main trunk course of the phrenic nerve within the mediastinum.

Conclusions: This study reports two types of branch and communication variations of the phrenic nerve at the cervicothoracic junction and upper mediastinum. However, the main trunk course within the mediastinum and terminal distribution at the diaphragm remained relatively constant overall. Understanding these variations helps enrich phrenic nerve anatomical data and provides anatomical basis for identification and protection of the phrenic nerve during related cervical, mediastinal, and minimally invasive surgeries.

Background: Femoroacetabular impingement (FAI) morphology is defined by anatomical variants that may predispose to mechanical conflict between the bony structures of the acetabulum and proximal femur with underlying bony incongruence leading to damage of adjacent tissues. Repetitive abnormal contact in this region can contribute to the formation of herniation pits (HPs) in the anterosuperior femoral head-neck junction, which may exacerbate symptoms and complicate surgical management of FAI.

Case report: This case report describes a 55-year-old male who underwent arthroscopic osteochondroplasty for mixed-type FAI morphology, combined with resection of a large HP and subsequent cavity filling using allogenic bone graft. Importantly, even though he did not have classic acetabular overcoverage, focal acetabular retroversion resulted in mechanical impingement when combined with anatomical variation of the femoral head-neck junction and patient's activity patterns. The postoperative course was uneventful, and graft incorporation was confirmed during the three-year follow-up.

Conclusions: This case highlights the anatomical and surgical interplay between osseous morphology, soft-tissue integrity, and joint biomechanics in the setting of FAI. Importantly, the various FAI morphologies should be considered anatomical variants that, when combined with specific movement patterns or loading conditions, may predispose to impingement and subsequent clinical symptoms. Additionally, this case demonstrates that allogenic bone grafts used to fill the herniation pit cavity can successfully incorporate into the surrounding bone, even in the anterosuperior femoral neck - a region known for relatively limited vascular supply.

Background: Recent studies have challenged the traditional two-layer description of the masseter, suggesting a distinct innermost layer. Clarifying the identity of this structure requires integration of macroscopic, histological, and functional perspectives.

Materials and methods: We examined 22 Korean cadavers using lateral and medial dissection routes. We prepared transverse histological sections (H&E and Masson's trichrome) and performed ultrasonography at standardized anatomical landmarks. Morphometric variables were recorded, and associations with sex and age were analyzed.

Results: The innermost layer originated from the medial surface of the zygomatic arch and inserted onto the mandibular notch and posterior coronoid process. Well-defined fascial planes separated this layer from the temporalis and from the traditional deep portion of the masseter, designated here as the middle part. Comparative anatomy linked this layer to the maxillomandibularis in nonhuman primates. Quantitative analyses showed pronounced sexual dimorphism and progressive age-related atrophy.

Conclusions: We propose redefining the masseter as a three-layer muscle - superficial, middle (formerly deep), and deep (the newly characterized layer). This framework increases anatomical precision and evolutionary continuity and may provide a more reliable basis for future functional studies and clinical applications.

Background: Arterial hypertension is a primary risk factor for kidney disease. Recent advances have implied a potential link between the apelin system and renal homeostasis.

Materials and methods: The authors used 6- and 12-month-old spontaneously hypertensive rats and age-matched normotensive controls to assess changes in the renal expression of the apelin receptor by the immunohistochemical method. The study also evaluated correlations between the renal apelin receptor's expression and renal injury indicators.

Results: Histological analysis showed elevated glomerular sclerosis and tubulointerstitial damage indices in both groups of hypertensive rats compared to age-matched controls. Older rats within each group exhibited higher scores than younger ones. Immunohistochemical analysis revealed varying apelin receptor expression patterns, with tubular expression intensifying with both hypertension severity and age. Glomerular expression was notably higher in older hypertensive rats compared to normotensive controls. The authors found significant positive correlations between glomerular apelin receptor expression and glomerular sclerosis index in older hypertensive animals. Similarly, a positive correlation between tubular apelin receptor expression and tubulointerstitial damage index was discovered in hypertensive rats, suggesting hypertension-related changes in apelin receptor expression and renal damage.

Conclusions: This study found kidney changes and varying apelin receptor correlations in hypertensive rat kidneys, suggesting complex roles requiring further research.

Background: The aim of this study was to evaluate the anatomical characteristics of the abdominal aorta in adult Vietnamese individuals using 128-slice computed tomography (CT).

Materials and methods: This descriptive, retrospective study analysed 128-slice contrast-enhanced CT images from 193 Vietnamese adults acquired at Tam Anh General Hospital, Hanoi, between December 2023 and December 2024. Measurements included the termination level of the abdominal aorta, aortic diameter at three standardised levels (origin, above renal arteries, and bifurcation), total aortic length, and the bifurcation angle between the common iliac arteries. Data was processed using MIP and VR reconstruction techniques and analysed using SPSS v20.0 software.

Results: The most frequent termination level was the L4-L5 intervertebral disc (27.5%), followed by the L4 vertebral body (26.4%). The mean aortic diameters were 19.84 ± 2.76 mm at the origin, 17.45 ± 2.44 mm above the renal arteries, and 14.55 ± 2.10 mm at the bifurcation. Males had significantly larger diameters than females at all levels (p < 0.001). The mean aortic length was 138.98 ± 12.15 mm, with males showing significantly longer aortas than females (143.88 ± 11.57 mm vs 134.03 ± 10.66 mm, p < 0.001). The average bifurcation angle was 43.2° ± 9.52°, with no significant difference between sexes (p = 0.45).

Conclusions: This study has provided detailed morphometric data of the abdominal aorta in a Vietnamese population, revealing significant sex-based differences in diameter and length, with implications for clinical decision-making, particularly in endovascular procedures.

Background: This study reports a rare case of a nonbifurcating carotid artery with bilateral internal carotid artery anastomoses. Special anatomical features related to nonbifurcating carotid arteries are comprehensively summarized. The embryological causes and potential clinical significance of this variation are discussed.

Materials and methods: An anatomical variant of the left common carotid artery was discovered in a middle-aged elderly Chinese female cadaver during standard dissection in an anatomy course.

Results: The left common carotid artery was unbranched; instead, it continued intracranially as the internal carotid artery and gave rise to branches of the external carotid artery. In the sella turcica region, bilateral internal carotid arteries developed aberrant anastomoses, which is even rarer. Furthermore, both posterior communicating arteries arose from the left posterior cerebral artery and were accompanied by multiple large intracranial aneurysms. According to a thorough literature review, this is the first documented instance of this complex combination of variants.

Conclusions: This study demonstrates that abnormal vascular embryogenesis can lead to complex vascular variants. Clinicians should remain vigilant for potential hemodynamic irregularities and take prompt action to prevent larger aneurysms from forming and enlarging. Precise identification and thorough preoperative evaluation are crucial for reducing surgical risks and avoiding serious complications, such as infarction. Detailed knowledge of these variations is critical for imaging, interventional procedures, and surgery involving the cervical and cerebral vessels.

Background: Conventional embalming relies on arterial cannulation, which may be difficult when vessels are diseased, inaccessible, or damaged. Intraosseous (IO) vascular access, widely used in emergency medicine, provides a rapid and reliable route into the medullary venous system. This technical note describes a simple IO embalming protocol and assesses its feasibility and performance in human cadavers.

Materials and methods: IO access was established in cadavers using bone-marrow needles inserted into the proximal tibia, distal femur, sternum and iliac crest. Standard formaldehyde-based embalming solution was infused using a low-pressure pump. Outcomes were assessed qualitatively by evaluating perfusion patterns, fixation quality, tissue handling, and presence of leakage.

Results: IO access was quick and dependable, requiring no arterial dissection. The proximal tibia provided the easiest insertion, while the iliac crest allowed the broadest diffusion, particularly toward thoraco-abdominal regions. All specimens demonstrated adequate firmness, coloration, and structural preservation suitable for anatomical education.

Conclusions: IO injection is a practical and minimally invasive alternative to arterial cannulation for cadaver embalming. It reduces procedural complexity, limits exposure to biological fluids, and provides adequate fixation for teaching and research.