Folia morphologica最新文献

Background: The renal nutcracker phenomenon is a left renal vein entrapment that may cause hematuria, orthostatic proteinuria, left flank pain, and other, extrarenal symptoms resulting from venous congestion. Most commonly renal vein is compressed between the anterior wall of the abdominal aorta and the superior mesenteric artery or between the posterior wall of the aorta and the vertebral column. Much less data concerns uncommon entrapment mechanisms, which can lead to the same clinical presentation.

Case report: The following case report presents a 78 y.o. male with incidentally found microhematuria caused by atypical nutcracker phenomenon with two consecutive left renal vein stenoses: first between the left crus of the diaphragm and a portal vein, and second between the ureteropelvic junction and the splenic artery. A second kidney vasculature anomaly, an accessory left renal artery, was observed.

Conclusions: To the best knowledge of the authors, this case report is the first to present left renal vein entrapment between the right crus of diaphragm and the portal vein. Understanding various, uncommon mechanisms of the nutcracker phenomenon may be essential for diagnosing nutcracker syndrome without entrapment in typical localisations.

Background: The aim of this study was to provide a detailed analysis of the topographical anatomy of the inferior epigastric artery (IEA), including its origin pattern, morphometric parameters, spatial relationships to anatomical landmarks and perforating branches.

Materials and methods: Data from 75 patients who underwent computed tomographic angiography of the abdomen and pelvis were analyzed. A total of 142 sides that met the eligibility criteria were evaluated.

Results: The IEA was found to originate from the external iliac artery in 110 cases (77.5%), in 22 cases (15.5%) it had a common trunk with the obturator artery, in 9 cases (6.3%) it originates from the femoral artery, and in one case (0.7%) from the deep femoral artery. The median diameter of the IEA at its origin was 3.12 mm, while its cross-sectional area was 5.97 mm². The median distance between the origin of the source artery to the origin of the IEA was 8.46 mm. The number of perforators varies per patient side from 2 to 7, with the most common direction of their origin being the medial direction.

Conclusions: The most common origin was the external iliac artery (77.5%), although a common trunk with the obturator artery was also observed relatively often (15.5%). The IEA originated most commonly in the medial direction (93.0%). A key focus was on the perforators, with a median of 2 per side and up to 7 observed. The first perforator that could be used in the deep inferior artery perforator (DIEP) flap had a mean diameter of 1.71 mm and was located approximately 64.6 mm from the IEA origin and 95.3 mm from the umbilicus. The obtained results may find clinical application during pedicle preparation during DIEP flap elevation and in penile revascularization procedures.

Background: To our knowledge, few studies have investigated anatomy of the Trigeminal cave (TC) with neuroimaging modalities. We aimed to evaluate it using thin-sliced magnetic resonance (MR) imaging examination in children.

Materials and methods: The acquired MR imaging examinations between October 2023 and January 2025 of boys and girls aged ≤ 18 years were performed. Total of 557 patients included in the study. According to age ranges, the study population were divided into five groups: Infancy, early childhood, late childhood, prepubescent and postpubescent group. On the sagittal and coronal T2-weighted images, the maximal height, length, diameter of the entrance of the TC the maximal major and minor axes of the TC values were measured on both sides. The morphology of the TC were categorized as bulbous, oval and flat types based on the height to diameter at the entrance ratio of the TC.

Results: The main height and length values of the pre- and postpubescent groups were higher than the infancy group (p = 0.047 and p = 0.041, respectively). There was no statistical difference in the main diameter of the entrance and major and minor axes of the TC values between other groups. The oval type was the most common morphological type of the TC (p = 0.038). The flat type was also found to be the least common type of the TC (p = 0.045).

Conclusions: We have demonstrated the morphometric and morphological features of the TC using thin-sliced MR imaging series in large pediatric population. It is very useful for exploring the anatomy of the TC.

Background: Anterior inferior cerebellar artery (AICA) is one of the three major cerebellar arteries. Nevertheless, AICA may exhibit a wide range of variations in its origin site, degree of development, number, and its reciprocal relationship with neighboring vessels. These morphological variations have important anatomical and clinical implications. The aim of this study was to investigate the anatomical variations of the AICA based on computed tomography angiography, a modality frequently used in clinical practice.

Materials and methods: The study retrospectively analyzed the computed tomography angiography examinations of the head and neck performed consecutively on a cohort of 153 hemifaces that met the established inclusion criteria.

Results: Based on the results of the present study, a new classification system dividing AICA into six distinct types has been developed. Among these types, Type 1 (single AICA originates from the proximal part of the basilar artery) was the most prevalent, accounting for 57.5% of all cases. Type 2 (single AICA originates from the middle part of the basilar artery) was the next most common at 22.9%. The median diameter of the AICA at its origin was 2.10 mm, ranging from 1.14 mm to 2.88 mm, while its cross-sectional area ranged widely from 0.81 mm² to 4.59 mm², with a median of 2.52 mm². The diameter of the basilar artery at the AICA origin was notably larger, with a median of 4.41 mm and a maximum of 12.00 mm. Correlation analysis between measured parameters and patient age indicated generally weak and statistically non-significant correlations.

Conclusions: This study underscores the anatomical complexity and variability of the AICA, emphasizing the importance of precise morphological knowledge for both diagnostic and surgical procedures involving the posterior fossa. The findings reveal notable diversity in AICA origin, course, and diameter, with implications for imaging interpretation and clinical management, particularly in cases of vascular pathology such as infarction or aneurysm.

Background: The incus is one of the three auditory ossicles involved in the conductive process of audition. The incus is often a target in oculoplastic procedures, which have high revision and failure rates. Foundational knowledge of the incus' morphological parameters is generally limited to linear dimensions due to its small size and complex articulations. Our aim is to utilize a landmark-based approach to capture and quantify the bone's shape.

Materials and methods: Incus bones were harvested from 53 anatomical body donors and scanned in a Bruker 1276 Skyscan micro-CT with 100 µm resolution. 3DSlicer was used for geometric morphometric landmarking and analyses. Warps corresponding to the major axes of variation determined by the PCA were created to visualize shape changes. Wilcoxon rank-sum tests were used to compare PC scores between sexes and sides (α = 0.05). Centroid size was calculated and correlated with shape scores.

Results: The PCA revealed 53 PCs with the first ten PCs accounting for 83.5% of the variation in the sample. The first PC (18.0%) corresponded with inverse crural lengths, while PC2 accounted for 16.9% of the variation and was associated with angulation of the incudomallear joint. There were no significant differences in shape between sexes or left and right sides. Centroid size had a significant relationship with PC1 scores (R2 = 0.1638, p = 0.0026).

Conclusions: Crural form - specifically lengthening and anterior-curving long crura - may represent morphological adaptations associated with an increase in size. Incudomallear joint angle variation was notable, which should be considered in predisposition to pathological processes.

Background: Anatomical variations of the external jugular vein (EJV) are significant due to their notable implications in flap design and diagnostic evaluations (EJV cannulation).

Case report: The present case report details a unique venous anomaly observed during the dissection of right posterior cervical triangle in an adult male donated human body. Notably, the EJV atypically terminated by forming a venous loop with the transverse cervical vein. This loop comprised three segments: the proximal segment formed by the EJV, distal by the transverse cervical vein, and an intervening midsegment. From the convexity of the loop, two veins originated, running parallel for approximately 2.5 cm before piercing the investing layer of the deep cervical fascia to drain into the subclavian vein (SCV) separately.

Results: The first vein (V1) entered the SCV 1.77 cm distal to the clavicular head of the sternocleidomastoid muscle (SCM), while the second (V2) did so at 2.57 cm distal to the same landmark. Additionally, posterior external jugular vein (PEJV), an infrequent finding, was observed running along the anterior border of the trapezius muscle, draining into the transverse cervical vein instead of the EJV. The suprascapular vein, instead of opening into the EJV, drained directly into the SCV.

Conclusions: These findings underscore the significance of acknowledging such rare venous variations to avoid potential complications during surgical procedures involving the neck region.

Background: Cerebral ischemia-reperfusion (I/R) injury is a leading cause of long-term neurological disability and mortality, primarily due to oxidative stress, neuroinflammation, blood-brain barrier disruption, and neuronal apoptosis. Despite numerous therapeutic attempts, clinical translation of neuroprotective agents remains limited. This study investigates the neuroprotective potential of cimifugin, a flavonoid with antioxidant and anti-inflammatory properties, in a rat model of middle cerebral artery occlusion (MCAO).

Materials and methods: Rats were subjected to MCAO and treated with cimifugin (10, 20, and 30 mg/kg). Behavioral assessment was performed using the neurological deficit score and Morris Water Maze test. Brain infarct volume was evaluated using TTC staining. Histological and biochemical analyses were conducted to assess cerebral edema, oxidative stress markers (MDA, SOD, GSH), inflammatory cytokines (TNF-α, IL-1β, IL-6), apoptotic cell death (TUNEL assay), and expression of iNOS, and COX-2.

Results: Cimifugin significantly improved neurological outcomes in a dose-dependent manner, as indicated by reduced neurological deficit scores and enhanced cognitive performance in the Morris Water Maze test. TTC staining revealed a marked reduction in infarct volume, particularly at 30 mg/kg. Cimifugin attenuated cerebral edema and significantly decreased neuronal apoptosis. It reduced MDA levels while enhancing SOD and GSH activity, indicating robust antioxidative effects. Inflammatory cytokines (TNF-α, IL-1β, IL-6), as well as iNOS and COX-2 expression, were significantly downregulated.

Conclusions: Cimifugin confers neuroprotection in cerebral I/R injury through multi-targeted mechanisms involving antioxidant, anti-inflammatory, and anti-apoptotic actions. These findings suggest its potential as a low-toxicity, plant-derived candidate for managing ischemic stroke and related cerebrovascular diseases.

Background: Cardiovascular disease is among the most common causes of death worldwide. Interventions, such as percutaneous coronary intervention, used to recanalise coronary stents, require precise anatomical knowledge, particularly regarding vascular variations, to avoid complications.

Materials and methods: In our study, we describe a rare anatomical variation of the superficial brachioulnar artery (SBUA).

Results: We present an SBUA originating from the brachial artery in its upper third further running superficially in a straight course to the hand, where it comprises the full function of the ulnar artery. At the same time, the regular ulnar artery terminates as a hypoplastic vessel which exclusively supplies the local musculature. This combination expands the existing literature and highlights the clinical relevance of vascular variations.

Conclusions: Our case report underscores the importance of precise preoperative imaging to identify vascular anomalies early on and at the same time minimise patient safety-related complications. Additionally, this new variation of the SBUA emphasises the need to integrate anatomical variations more thoroughly into medical education and research. The latter would ensure the systematical capture of their prevalence and implications to improve clinical practice in the long run.

Background: Body height is an important measurement in the forensic individual identification of the body. It was aimed to estimate height from head circumference measurement values ​​representing the population according to age and to create a model for age estimation in infants from birth to 12 months.

Materials and methods: In the present study, head circumference measurements of 500 healthy infants, 250 girls and 250 boys, whose ages and heights are known, were evaluated. To estimate height by looking at head circumference separately for both genders and also in 8 different measurement periods, linear regression model, quadratic and cubic models and nonparametric, nonlinear MARS model were used. In addition, various growth curves were examined in age estimation by looking at head circumference and the most successful exponential growth curve results were given.

Results: It was found that the relationship between head circumference and height is linear, especially starting from the 6th month, according to gender and measurement periods. When the relationships between head circumference measurements and ages in girls and boys were examined with the exponential growth curve, a significant relationship was observed. Exponential growth curve model parameters were developed to be used in estimating age.

Conclusions: The results of the present study showed that height can be estimated with head circumference measurement representing the population according to age and age can be estimated using the developed model.

Background: 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 analyzed 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 standardized levels (origin, above renal arteries, and bifurcation), total aortic length, and the bifurcation angle between the common iliac arteries. Data were processed using MIP and VR reconstruction techniques and analyzed with SPSS v20.0.

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 provides 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.