Folia morphologica最新文献

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.

Background: This study aimed to determine normative pancreatic volume (PV) values in healthy Western Asian adults using computed tomography and 3D Slicer software, and to evaluate the relationship between PV and demographic parameters including age, sex, and body mass index (BMI).

Materials and methods: A retrospective analysis was conducted on 905 adults (403 females, 502 males; mean age: 43.88 ± 17.11 years) who underwent abdominal CT between January and December 2023. Individuals with diabetes mellitus, pancreatic or peripancreatic pathology, prior malignancy, or inadequate imaging were excluded. Pancreas segmentation was manually performed on axial slices using 3D Slicer v.4.11.2, excluding ducts and vascular structures. Statistical analyses included t-tests, Pearson's correlation, and multivariate linear regression.

Results: The mean PV was 84.33 ± 5.74 cm³. Males had significantly higher PV than females (85.68 ± 6.05 cm³ vs 82.65 ± 4.83 cm³, p < 0.001). PV peaked in the fourth decade in males and the fifth decade in females, followed by a decline. A significant negative correlation between age and PV was observed in males (r = -0.321, p < 0.001), but not in females. PV positively correlated with BMI in both sexes. Age, BMI, and male sex were identified as independent predictors of PV (R² = 0.326, p < 0.001).

Conclusions: Pancreatic volume varies with age, sex, and BMI in healthy Western Asian adults. These normative values may assist in future clinical and radiological evaluations of pancreatic morphology.

Background: The quadriceps femoris is the main extensor of the knee joint, traditionally described as having four heads. Since the 19th century, reports have suggested an additional head between the vastus lateralis and vastus intermedius. In 2016, Grob et al. described this structure in detail, naming it the tensor vastus intermedius (TVI) and proposing a morphological classification. This study aimed to assess the prevalence, morphology, and dimensions of the TVI in cadaveric specimens and compare the results with the literature.

Materials and methods: Ten lower limbs from five preserved cadavers (four male, one female) were dissected using a standardized protocol. The presence, Grob type, and dimensions of the TVI were recorded with an electronic caliper. A literature review included only cadaveric studies consistent with Grob's classification and containing quantitative data.

Results: The TVI was present in all specimens (100%). The most common type was VL (50%), followed by VI (30%) and bicipital (20%). VI and bicipital types occurred only in males; females showed only the VL type. Identical bilateral types were found in 20% of cases (females). The mean belly length was 105.99 mm, and width was 19.15 mm. Literature reports prevalence ranging from 34% to 100% with variable type distribution.

Conclusions: The TVI was a consistent anatomical feature in this sample, with type VL predominating and notable sex-related differences. Findings confirm considerable morphological variability, highlighting potential relevance in imaging interpretation, surgical planning, and rehabilitation. Further imaging-based studies on larger populations are needed to clarify its biomechanical and clinical roles.

Background: The kidney is covered with a renal fascia consisting of a fibrous capsule and a fatty capsule and is located extraperitoneally. The properties of this organ allow for mechanical protection, protecting against injury.

Materials and methods: We describe an anatomical variation observed during the dissection of the body of an 85-year-old man.

Results: The right kidney was located intraperitoneally, freely among the loops of the small intestine, and had normal vascularization. In addition, it measured 12.5 cm in length and 5.7 cm in width. The left kidney was significantly smaller, with no abnormalities.

Conclusions: According to the databases, this is the third case of intraperitoneal kidney described in the world. Such a localization variant should be considered because of the complications it brings to diagnostic imaging and surgical management.

Background: The recurrent branch of the median nerve (RBMN) is a critical structure in carpal tunnel surgeries, where inadvertent injury can lead to significant functional impairment. While soft tissue landmarks are commonly used for RBMN localization, they often vary between individuals and are susceptible to intraoperative shifts. This study aims to establish fixed bony landmarks for the reliable localization of the RBMN, potentially reducing the risk of iatrogenic nerve injury.

Materials and methods: This clinical-surgical study included 58 patients (59 hands) undergoing open carpal tunnel release between January 2020 and September 2022. Intraoperative measurements were taken from the origin of the RBMN to three fixed bony landmarks: the apex of the first metacarpal head, the apex of the third metacarpal head, and the tip of the radial styloid process. Distances were recorded using a sterile, millimeter-calibrated ruler by two independent observers. Statistical analysis included inter- and intra-observer reliability assessments.

Results: The mean distance from the RBMN origin to the first metacarpal head was 39.7 ± 5.2 mm, to the third metacarpal head 50.2 ± 4.7 mm, and to the radial styloid process 59.4 ± 4.9 mm. There were no statistically significant differences in these measurements between male and female patients (p > 0.05). The majority of RBMN branches (67%) were extraligamentous, followed by subligamentous (25%) and transligamentous (8%), as classified by the Lanz classification. Postoperative clinical evaluations using the Boston Carpal Tunnel Questionnaire (BCTQ) showed significant improvements in both symptom severity and functional status (p < 0.001).

Conclusions: Fixed bony landmarks provide a reliable and reproducible method for localizing the RBMN during carpal tunnel release, potentially reducing the risk of nerve injury. These findings support the use of bony reference points as consistent intraoperative guides for safer surgical outcomes.