Folia morphologica最新文献

Anatomical variations of the gastrointestinal tract, particularly those associated with atypical vascular supply, are of significant surgical concern. This case report presents a rare combination of anomalies observed in a 65-year-old male cadaver. These included the complete absence of the ascending colon, a subhepatic cecum with an appendix, a duodeno-ileal band, an unusual branching pattern of the superior mesenteric artery, and the presence of a vascular watershed area due to discontinuity of the marginal artery anastomosis between the right colic and middle colic arteries. Additionally, the arterial supply to the cecum was altered, as the anterior and posterior cecal arteries originated from the middle colic artery, further highlighting the uniqueness of this case. Embryological explanations and comparisons with previously reported cases are discussed to underscore the novelty and potential surgical implications of these findings.

Background: The right ventricular outflow tract (RVOT) exhibits complex morphology and spatial orientation, posing challenges for accurate anatomical assessment. Detailed characterization of this region has become increasingly important in interventional cardiology, where the success of lead placement and catheter ablation depends on precise knowledge of RVOT geometry.

Materials and methods: In this study, a total of 60 adult human hearts were examined and subsequently stratified into three age groups: young adults (18-40 years), middle-aged (41-60 years), and older adults (61-85 years). Silicone RVOT casts were prepared and digitized through photogrammetry to generate three-dimensional models. Secondary cross-sections were derived, and the centroids were determined. The resulting coordinates and their distances from the central RVOT axis were analyzed using a custom MATLAB algorithm. Intergroup comparisons were conducted employing appropriate statistical tests.

Results: Centroids positions varied across all age groups. Significant differences in x-coordinate values were identified only in older adults hearts (p < 0.001), reflecting greater displacements in the mid-RVOT segment. The most pronounced shifts occurred in cross-section no. 3, corresponding to the central portion of the RVOT. Deviations from the central axis demonstrated that the mid-RVOT consistently deflects away from this axis across all age groups, suggesting a rotational configuration.

Conclusions: Age-related displacement of RVOT centroids, particularly in older individuals, may have direct implications for procedural planning in catheter ablation and device implantation. Three-dimensional modeling with spatial analysis enables high-fidelity reconstruction of RVOT anatomy, supporting individualized therapeutic strategies and potentially improving procedural outcomes.

Background: According to several descriptions the hyoid apparatus consists of styloid process (SP), stylohyoid ligament and lesser horn of the hyoid. However, it is elongation of styloid process plays the most important role in creation of clinically important symptoms, called Eagle syndrome. There are several theories clarifying the styloid process elongation have been proposed. Some researchers described a congenital etiology of such finding, but others postulated that ossification of the stylohyoid ligament may results such elongation. Never-the-less the origin, the elongated styloid processes can provoke symptoms from pressing nearby structures, such as the internal carotid artery, internal jugular vein, and cranial nerves V, IX. In this manuscript we present a case of a patient with symtoms of dizziness and neck pain firstly associated with recent trauma but finally with Eagle syndrome.

Conclusions: Eagle syndrome, although rare, may be encountered in practice as an unclear medical situation with diverse otolaryngologic or/and neurologic manifestations and may present a clinical challenge. The awareness of its existence and implications can help to shorten the time to make a final diagnosis and introduce the right treatment.

Background: This study reported a rare case of coeliac trunk pentafurcation variation and reviewed the relevant literature to summarize the classification of coeliac trunk variations and their potential clinical significance.

Materials and methods: This study provided a detailed anatomical description of a coeliac trunk pentafurcation variation found in the cadaver of an elderly Chinese woman, measuring and recording the diameter and positional relationships of each branch. Through a literature review, we summarised the classification, frequency, and clinical significance of coeliac trunk variations.

Results: Anatomical findings revealed that the coeliac trunk in this case gave rise to five branches: the left inferior phrenic artery, left gastric artery, splenic artery, right inferior phrenic artery, and common hepatic artery. A literature review indicated that the typical coeliac trunk three-branch pattern occurs with a frequency of 89.42%. Atypical branch patterns include two branches (7.66%), four branches (1.74%), and five or more branches (0.18%). Among the cases of pentafurcation variation, those involving bilateral inferior phrenic arteries are extremely rare, with only sporadic reports in the literature. This variation may impact surgical planning and patient treatment strategies, making it essential to recognise in clinical practice.

Conclusions: Understanding the normal anatomical structure of the coeliac trunk and the variations in its branching pattern has significant reference value in surgery, oncology and radiological interventional procedures. Clinicians should remain vigilant in clinical practice and be prepared to address potential anatomical variations they may encounter. Furthermore, rare anatomical variations should be thoroughly documented and reported to enrich medical literature and provide valuable resources for anatomical teaching.

Background: The suprascapular notch (SSN) varies anatomically and may affect nerve entrapment risk. This study examines SSN variations in scapulae of Slovak origin using Rengachary's and Polguj's classifications.

Materials and methods: We examined 111 dried scapulae, measured key SSN dimensions and classified SSN using Rengachary's and Polguj's systems, followed by statistical analysis.

Results: According to Rengachary's classification, Type II (32.43%), Type III (29.73%), and Type IV (22.52%) represent most common SSN shapes. Suprascapular foramen was present in 5.41% and a rare occurrence of double suprascapular foramen was also observed. According to Polguj's classification, Type III was most frequent (72%), followed by Type I (13%); Type IV accounted for 5%. Statistically significant differences in morphometric parameters were demonstrated among most common Rengachary SSN types.

Conclusions: Using Rengachary's and Polguj's classifications together allows for a detailed assessment of SSN variations in samples of Slovak origin. Certain SSN variations are associated with specific clinical relevance.

Background: The supranavicular bone or os supranaviculare (OS) is a rare accessory ossicle of the foot located dorsally at the proximal navicular margin. This study aimed to estimate the pooled prevalence of the OS through a systematic review and meta-analysis and to discuss its anatomical and orthopaedic significance.

Materials: AND METHODS: : A systematic review and meta-analysis were conducted according to the PRISMA 2020 and Evidence-Based Anatomy Workgroup guidelines.

Results: Twenty radiological studies comprising 23,816 lower limbs were included. The pooled prevalence of the OS was 0.79%, with significant heterogeneity across studies. CT-based studies reported a higher prevalence (2.88%) compared to radiographs (0.65%) (p < 0.0001). The ossicle was more frequently unilateral (1.01%) than bilateral (0.21%) (p = 0.0061), with no significant sex or side predilection.

Conclusions: The OS is a rare anatomical variant with potential clinical and surgical relevance, particularly in the context of navicular pathology. Its presence should be considered in radiological assessment and preoperative planning, especially in athletes and patients with midfoot pain or stress injuries. Future anatomical and biomechanical investigations are needed to further elucidate its pathophysiological role.

Background: The Achilles tendon (AT) is crucial for locomotion but is vulnerable to diabetes mellitus (DM) associated pathologies. Comprehensive human histological comparisons between diabetic and non-diabetic ATs are scarce. This study provides this detailed histological comparison, addressing a significant knowledge gap.

Materials and methods: Achilles tendons from four diabetic individuals (undergoing amputations for diabetic foot syndrome) and four non-diabetic donors were analysed. Samples from three anatomical levels (Level 1: calcaneal insertion; Level 2: mid-portion; Level 3: myotendinous junction) underwent histological processing, including Hematoxylin & Eosin and Sirius Red staining. Key features were semi-quantitatively scored.

Results: Diabetic ATs exhibited a tendency for increased adipose tissue at Level 1 and a higher frequency of blood vessels across all levels. Control (non-diabetic) ATs exhibited a higher prevalence of cells located in lacunae (Levels 1 and 2). At Level 1, non-diabetic cases also presented more developed cartilage compared to its traces in diabetics, and exclusively showed ossification.

Conclusions: Diabetes mellitus is associated with distinct histological alterations in the human Achilles tendon, affecting adipose tissue, vascularity, cellular components, and entheseal features, such as cartilage development and ossification. This study presents novel human histological evidence of DM's impact on AT structure, suggesting impaired adaptive and regenerative capacity in individuals with diabetes.

Background: Airways are lined by the stratified squamous or ciliated columnar epithelia.

Materials and methods: Using D2-40 immunohistochemistry of airway specimens from 20 donated cadavers, we aimed to find an epithelia-dependent morphology of lymph vessels (LVs).

Results: LVs tended to run along and around the hair follicle in the vestibular skin, while they tended to run along the anteroposterior axis in the other nasal walls. They tended to run circularly in the bronchus and both circularly and longitudinally in the upper pharynx. LVs density (mm² per 1 mm length of the epithelium) was highest in the upper pharynx (0.087 ± 0.043 mm²) and lowest in the mucocutaneous junction of nose (0.022 ± 0.006 mm²) although both were covered by squamous epithelia. In the nose, the ciliated epithelia accompanied significantly dense network of LVs relative to the squamous epithelial parts (p < 0.01). The nasal ciliated epithelia (0.052 ± 0.014 mm²) often showed higher density than the bronchial ciliated epithelia (0.032 ± 0.014 mm²), but we found no statistical significance. Therefore, a site-dependent specificity of the pharynx was so evident that it seemed to mask an epithelial type-dependent difference. Histological observations of 10 human fetuses exhibited distinct site-dependent features in airway subepithelial vessels: 1) a well-developed venous plexus occupied the nasal wall and palate and it might interfere with development of LVs; 2) subepithelial LVs appeared abundantly beneath the tracheal and laryngeal epithelia before the epithelial differentiation.

Conclusions: Site-dependent differences in subepithelial LVs appeared in fetuses and, after birth, they seemed to drastically change depending on the functional demand. Accordingly, epithelia-dependent differences tended to became unclear.

Background: The femoral nerve typically arises as a single trunk from L2-L4 posterior divisions of ventral rami. Variations are rare but clinically significant.

Materials and methods: During routine dissection of a 80 years old female cadaver, the femoral nerve was found to originate as two distinct trunks - with one passing beneath the psoas major and the other coursing through it. The trunks unified distal to the inguinal ligament. No anomalous muscular slips were present.

Results: This configuration appears to be previously unreported.

Conclusions: Surgeons and clinicians performing femoral nerve blocks or interpreting lumbar plexus imaging (e.g., MRI, CT, or ultrasound) should be aware of this variant, as it may influence both diagnostic interpretation and procedural outcomes.

Modern achievements in surgical techniques concerning lobectomy, segmentectomy and liver transplantation, but also transcatheter chemoembolization of the arteries require a thorough knowledge of the arterial vascularisation of the liver. Knowledge of the ways of arising and the topography of replaced or accessory hepatic arteries is particularly important here. In the presented paper, we report a case with early bifurcation of the common hepatic artery (EBCHA), which is a rare anatomical variant (1%). It is often overlooked, which can lead to accidental ligation during surgery replaced right hepatic artery and potential very serious complications. However, this case is considered a normal pattern in the classic classifications of hepatic arteries, like some other rare cases that remain unclassified. We present the new CRL and ex-common, right, left(CRL) classifications available in the literature and propose our modification called adv-CRL, considering not only the way of arising, but also the topography of replaced or accessory hepatic arteries.