Purpose. The current case series describes three cases of fusion between the 2nd cervical vertebra, the axis (C2), and the 3rd cervical vertebra (C3), creating a C2-C3 osseous complex and ...highlighting its morphological type of fusion (partial or complete) and morphometric details. The developmental background of this complex is emphasized, pointing out the possible clinical significance. Materials and Methods. The osseous complexes were derived from disarticulated skeletons of body donors and were collected from the osseous collection of the Anatomy Department of the Medical School of the National and Kapodistrian University of Athens. Results. Three blocked vertebral complexes (2 partial and 1 complete C2-C3 osseous masses) were identified. In two cases, the vertebral bodies were partially fused and in one case were completely fused. In the 1st case, the C2-C3 complex had fused spinous processes and distinct transverse processes. Facets were completely fused on the left and partially fused on the right side. In the 2nd case, the C2-C3 complex had partially fused vertebral bodies and distinguishable spinous processes. In the 3rd case, the C2-C3 complex had completely fused vertebral bodies, facets, laminae, and transverse and spinous processes. Conclusions. Among the three (C2-C3) fused osseous complexes, the two were partially and the one was completely ossified. The fused vertebrae were characterized by osteophytic formations (at the dens and C3 area) and osteoporotic lesions. Taking into consideration the C2-C3 fusion, and possible coexisted variants, particular caution should be made in the upper cervical area, to interpret possible neurological manifestations and to reach a safe surgical plan.
The human knee is a complex joint that comprises several ligaments, including the medial collateral ligament (MCL). The MCL provides stability to the knee and helps prevent its excessive inward ...movement. The MCL also has a thin layer of connective tissue known as the epiligament (EL), which adheres to the ligament. This unique feature has drawn attention in the field of ligament healing research, as it may have implications for the recovery process of MCL injuries. According to the EL theory, ligament regeneration relies heavily on the provision of cells, blood vessels, and molecules. The present study sought to compare the expression of vascular endothelial growth factor (VEGF), CD34, and α-smooth muscle actin (α-SMA) in healthy knees' proximal and distal MCL segments to better understand how these proteins affect ligament healing. By improving the EL theory, the current results could lead to more effective treatments for ligament injury. To conduct the present analysis, monoclonal antibodies were used against CD34, α-SMA, and VEGF to examine samples from 12 fresh knee joints' midsubstance MCLs. We identified a higher cell density in the EL than in the ligament connective tissue, with higher cell counts in the distal than in the proximal EL part. CD34 immunostaining was weak or absent in blood vessels and the EL, while α-SMA immunostaining was strongest in smooth muscle cells and the EL superficial layer. VEGF expression was mainly in the blood vessels' tunica media. The distal part showed more SMA-positive microscopy fields and higher cell density than the proximal part (4735 vs. 2680 cells/mm
). Our study identified CD34, α-SMA, and VEGF expression in the MCL EL, highlighting their critical role in ligament healing. Differences in α-SMA expression and cell numbers between the ligament's proximal and distal parts may explain different healing capacities, supporting the validity of the EL theory in ligament recovery.
The internet and web technologies have radically changed the way that users interact with museum exhibits. The websites and their related services play an important role in accessibility and ...interaction with the multimedia content of museums. The aim of the current research is to present a heuristic evaluation of forty-seven medical and anatomy museum websites from usability experts, for the determination of the principal/key characteristics and issues towards the effective design of a museum website. For homogeneity and comparison purposes, the websites of museums with no support of English language were not included in the evaluation process. In the present paper, the methodology was structured with the assessment of the technologies and services of anatomy museum websites in mind. The results of the current statistical examination are subsequently analyzed and discussed.
Background:
Detailed knowledge of the popliteal artery division and possible anatomical variants is of paramount importance for vascular surgery.
Aim:
The aim of the current study was to highlight a ...rare unilateral case of posterior tibial artery hypoplasia.
Materials and methods:
A dissection was performed at the posterior surface of the tibia in a 78-year-old Caucasian male cadaver of Greek origin.
Results:
The findings were consistent with unilateral posterior tibial artery hypoplasia and fibular artery enlargement. The variant fibular artery supplied the posterior surface of the distal leg and foot. Clinical implications of the fibular artery dominance are discussed.
Conclusions:
Rare anatomical variants of the tibial artery are of clinical significance to maximize safety and minimize intraoperative complications.
Purpose
The goal of the study is to analyze the morphometric diversity of the pyramidalis muscle (PM) and to evaluate how it is affected by gender and side of occurrence.
Materials and methods
...Ninety-six (50 male and 46 female) formalin-embalmed Greek cadavers were dissected.
Results
The PM was present in 93.8 %, usually bilaterally (79.2 %) than unilaterally (14.6 %) (
p
= 0.003) and more frequently in females (91.3 %) than in males (68 %) (
p
= 0.0001). Side symmetry was detected. The mean length of PM in males and females was 8.37 ± 2.80 and 6.18 ± 1.64 cm on the right and 7.50 ± 2.66 and 6.56 ± 1.68 cm on the left side. Male predominance existed on the right and left-sided PM lengths (
p
= 0.0001 and
p
= 0.054). The mean width of the right-sided PMs in males and females was 1.61 ± 0.55 and 1.50 ± 0.44 cm and the left-sided 1.56 ± 0.53 and 1.55 ± 0.38 cm without gender dimorphism. The positive correlation between the PM length and width indicates a symmetrical muscle augmentation on the two dimensions.
Conclusions
The study demonstrates that the PM is almost constant in Greeks. Among populations the muscle morphometric variability, its clinical significance and its variable uses will help surgeons when intervening in the lower abdominal wall.
The study determines the variability of the length of the styloid process in a Greek population and investigates how it is affected by gender and age; it also evaluates the side asymmetry, ...highlighting clinical implications. One hundred and forty-nine dry adult modern skulls (94 male and 55 female) were divided into subgroups according to their age: 20–39, 40–59 and older than 60 years. The lengths of 262 styloid processes (127 right and 135 left-sided) were measured. The lengths of right-sided styloid processes ranged from 6.4 to 70.2 mm and left-sided styloid processes from 5.2 to 69.0 mm. The processes were classified according to their lengths as short <18 mm, normal 18–33 mm and elongated >33 mm. The majority of the processes were normal (45.8 %), 27.5 % were short and 26.7 % elongated. No statistical significant correlation was established among the lengths of the styloid processes, gender and age. Side asymmetry was found only in the group with elongated styloid processes (right processes were longer, 28.3 %, than the left ones 25.2 %;
p
= 0.016). Our study contributes to the literature, adding important information about the length of the styloid process and its diversity in the Greek population. It also confirms the existence of an osseous landmark as a starting point for the measurement of the length of the styloid process and proposes a method of measurement for the evaluation of the actual length of the styloid process.
This current case is the first report of severe unilateral (left-sided) post-traumatic trigeminal neuropathic pain involving all branches of the trigeminal nerve after custom-made total ...temporomandibular joint replacement (TMJR). After a bilateral TMJR procedure a, 43-year old female patient complained of left-sided lingual and mental nerve hypoesthesia. In the following months, the patient developed unsustainable neuropathic pain at the area of cutaneous distribution of the mental (V3) and infraorbital (V2) nerves combined with hypoesthesia in all trigeminal divisions. Neurosensory deficits in V1-3 were confirmed by quantitative sensory testing and electrophysiological studies. Treatments consisted of anti-depressants, anti-epileptics, opioids and eventually radiofrequent ablation of the peripheral branches without notable improvement in pain complaints or sensory deficits. The current case warrants temporomandibular joint surgeons for the possible risk of post-traumatic trigeminal neuropathic pain.
•Trigeminal neuropathic pain may follow temporomandibular joint replacement.•Symptoms may spread far beyond the affected dermatome on the basis of an inflammatory and/or excitotoxic response.•Quality of life deteriorates with persistent neuropathic pain.•Conservative treatment is disappointing.•A multidisciplinary approach with thorough investigation is advised.
Laryngocele (LC) is an uncommon clinical entity, occasionally associated with fatal complications. If its neck becomes obstructed, mucous accumulates and then a laryngeal mucocele (LMC) is formed. ...Reports of LMCs are rare in the literature. A fluid-filled combined LMC in a 48 year-old Greek construction worker with presenting symptoms of cervical swelling and dysphonia is described. The male patient was surgically treated via an external approach. A LC rarely becomes symptomatic and infection unusually occurs. Magnetic resonance imaging depicts in detail the size, extension and structure of the neck mass and remains the diagnostic gold standard, providing superior soft-tissue discrimination, in cases of a concurrent laryngeal tumor. Histopathological examination confirms diagnosis, since there is always a high index of suspicion for malignancy. Established guidelines regarding surgical treatment of a LC do not exist. Although during the last two decades micro laryngoscopy with CO2 laser has gained popularity for the treatment of an internal LC, the external approach still remains the method of choice in cases of a combined LMC.
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