Purpose
Fenestrations of posterior cerebral artery are exceedingly rare and, therefore, deserve being reported.
Methods
During an educational dissection, a peculiar anatomical variant of the ...posterior cerebral artery (PCA) was found.
Results
During an educational dissection targeting the right cerebellopontine angle, a peculiar variant of the right PCA was found. The respective posterior communicating artery inserted posteriorly into the junction of the P1 and P2 segments of the PCA. The P1 segment was thinner than the P2 segment. That junction was superior to the oculomotor nerve and was fenestrated, with a thin postero-medial arm facing the cerebral peduncle, and a larger antero-lateral arm formed by the distal end of the P1 segment and the proximal end of the P2 segment.
Conclusions
To the authors’ knowledge, fenestrated P1–P2 junctions of PCA were not found previously by dissection. The evidence presented here recommends such variations not to be ignored.
Telocytes and Lymphatics of the Human Colon Zurzu, Mihai; Nicolescu, Mihnea Ioan; Mogoantă, Laurențiu ...
Life (Basel, Switzerland),
09/2021, Letnik:
11, Številka:
10
Journal Article
Recenzirano
Odprti dostop
Background: Telocytes (TCs) are a peculiar morphological type of stromal cells. They project long and moniliform telopodes, visible on various bidimensional sections. Originally regarded as ...“interstitial Cajal-like cells”, gastrointestinal TCs were CD34+. Further double-labelling studies found that colon TCs are negative for the expressions of the PDGFR-α and α-SMA. However, the TCs in colon were not distinguished specifically from endothelial cells (ECs), vascular or lymphatic. A combinational approach is important for accurate TC identification. Hence, we designed an immunohistochemical study of human colon to check whether ECs and CD34+ TCs express different markers. Methods: Immunohistochemistry was performed on archived paraffin-embedded samples of human colon (nine cases) for the following markers: CD31, CD34, CD117/c-kit and D2-40 (podoplanin). Results: A distinctive population of CD34+ TCs was found coating the myenteric ganglia. However, also perivascular cells and vascular ECs were CD34+. c-kit expression was equally found in interstitial Cajal cells (ICCs) and perivascular cells. The CD34 TCs did not express c-kit. As they were equally CD31- and D2-40- they were assessed as different from ECs. Conclusions: Testing specific markers of ECs, vascular and lymphatic, in the same tissues in which CD34+ TCs are found, is much more relevant than to identify TCs by transmission electron microscopy alone.
(1) Background. The vertebral level of origin (VLO) of the celiac trunk (CT) and superior mesenteric artery (SMA) has been scarcely investigated. (2) Method. This study used 107 computed tomography ...angiograms and an eleven type grading system to classify the VLO of the CT and SMA. Each of the T12–L2 vertebra were divided in three horizontal levels. The intervertebral discs were considered distinct levels. (3) Results. The VLO of the CT ranged from the upper third of the T12 vertebra to the lower third of the L1 vertebra. The VLO of the SMA ranged from the lower third of the T12 vertebra to the upper third of the L2 vertebra. There was a highly significant association between the VLO of the CT and SMA (Chi2 = 201, p < 0.001), usually respecting a “plus two” rule. The mean CT–SMA distance was 1.82 +/− 0.66 cm in males and 1.55 +/− 0.411 cm in females, the difference being statistically significant. The mean CT–SMA distance tended to decrease with increasing CT–SMA types, the differences being statistically significant. (4) Conclusions. These characteristics of CT and SMA origins and their relations should be known by surgeons, as they could impact operative management and should be evaluated on a case-by-case basis.
Purpose
Anatomic variations at the junction of primitive internal carotid and basilar arteries are exceedingly rare. We aimed at reporting such rare variants involving the posterior communicating ...artery (PComA) and the P1 segment of posterior cerebral artery (PCA).
Methods
The circle of Willis was dissected in an adult cadaver after removal of the cranial vault and cerebral hemispheres.
Results
The basilar end was rotated axially to the right. The P1 segment of the right PCA was fenestrated and occupied the interpeduncular fossa. The right PComA passed over the oculomotor nerve to join the anterior arm of the P1 fenestration. On the opposite side, the PComA coursed supero-medially to the oculomotor nerve and it had a partly duplicated posterior end, with two arms, medial, larger, and lateral, thinner, inserting successively into the left PCA.
Conclusion
Extremely rare anatomic variations of the circle of Willis should not be ignored when endovascular or microneurosurgical specific approaches are intended.
Probably, the most variable anatomic pattern relates to the iliac arteries system. There are reported here multiple rare anatomic variants found in a single case, at CT evaluation: (a) the ...unilaterally present common trunk of origin of the obturator, inferior epigastric, and medial circumflex femoral arteries and (b) the medial insertion of the deep femoral artery (DFA) onto the femoral artery, which placed the DFA initially on the medial side of the femoral vein. Such rare, but possible, anatomic variations should recommend surgeons to plan the procedures on a case-by-case basis.
The Axial Spin of the Carotid Bifurcation Manta, Mihaela Daniela; Rusu, Mugurel Constantin; Hostiuc, Sorin ...
Diagnostics (Basel),
10/2023, Letnik:
13, Številka:
19
Journal Article
Recenzirano
Odprti dostop
(1) Background: Twisted carotid bifurcations (CBs) lead to lateralized external carotid arteries (ECAs). Such variants are usually reported on a case-by-case basis. We aimed to study the anatomical ...possibilities of the axial spin of CB. (2) Methods: Determinations were made bilaterally on a retrospectively assessed sample of 150 cases, 88 males and 62 females. The following types of the axial spin of the CB were determined: type CK1–CB in the coronal plane, with ICA lateral of ECA; type CK3–CB in the coronal plane, with ECA lateral of ICA; the oblique type OK1, with the ECA antero-medial of ICA; the oblique type OK3a, with the ICA antero-medially; the oblique type OK3b, with the ICA postero-laterally; the sagittal type SK2a, with ECA anterior of ICA. (3) Results: In the overall group of 300 CBs, type OK1 was found in 40%, type OK3a in 1%, type OK3b in 2%, type CK1 in 9%, type CK3 in 5.67%, and type SK2a in 42.33% of the bilateral BC group. The types SK2a (46.67%) and OK1 (33.33%) prevailed on the right side. The types OK1 (46.67%) and SK2a (38%) prevailed on the left side. There was no statistically significant association between gender and left or right subtypes. A very strong symmetry existed between the left and right sides (Pearson Chi2 = 53.93 p < 0.001) for types OK1 and SK2a. Asymmetrical types were found in different bilateral combinations. (4) Conclusions: The spin of the CB is relatively symmetrical bilaterally, especially for the variants with the ECA antero-medial or anterior to ICA.
A leptomeningeal mass was encountered during microdissection of a 63-year-old male cadaver, located dorsal to the left side of the medulla oblongata. The structure was compressing the posterior ...inferior cerebellar artery (PICA) and was composed of cerebellar-like tissue. Immunohistochemistry for S100 protein, glial fibrillary acidic protein and neurofilaments (NF, the triplet proteins and the 200 kD antibody) on paraffin-embedded samples confirmed the cerebellar heterotopion. Abundant Lewy-like degenerative bodies were also identified within the heterotopion; they were positive for the NF triplet and negative for the 200 kD neurofilaments. Purkinje cells were rare. This is the first evidence of a leptomeningeal cerebellar heterotopia in contact with PICA in adult. Such subtentorial heterotopias, even if rare, should be searched for during clinical, paraclinical and surgical explorations of the posterior fossa.
Fenestrations of the vertebral arteries (VAs) are usually identified angiographically. A left fenestrated vertebral artery (fVA) is reported here, identified in an adult specimen by microdissection. ...The distal segment of this VA was fenestrated and it consisted of two arms, the caudal one being larger than the cranial one. The caudal end of the rostral arm and the left posterior inferior cerebellar artery (PICA) were inserted at the same point. The anterior spinal artery was leaving the caudal arm of the fVA. On that side the anterior inferior cerebellar artery (AICA) was rudimentary, its cerebellar hemispheric territory being supplied by the PICA. The rostral arm of the fVA and the AICA were united by an anastomosis coursing on the ventral side of the olive. The AICA-to-fVA anastomosis, as well as the PICA, were supplying perforator arteries of the retro-olivary sulcus. Anatomical details of various arterial morphologies are important during specific surgical and interventional procedures.
The rare anatomic variants of the celiac trunk and superior mesenteric artery include the hepatosplenic, hepatosplenomesenteric (HSMT), celiacomesenteric, hepatomesenteric and gastrosplenic trunks. ...We report a 72-year-old female patient whose computed tomography angiograms indicated a rare anatomic feature whereby the right inferior phrenic artery was inserted in the origin of an HSMT, thus modifying it into a hepatosplenomesentericophrenic trunk (HSMPT). Above the HSMPT, the insertion of the left inferior phrenic artery in the origin of the left gastric artery determined a left gastrophrenic trunk (GPT). Proper identification of this type of rare anatomic variant is of utmost importance prior to different surgical procedures. For example, an HSMT origin of the right inferior phrenic artery is surgically relevant if this artery is an extrinsic pedicle of a hepatocellular carcinoma and is used for embolization of the tumor.
Body dysmorphic disorder (BDD) is an obsessive-compulsive disease, associated with increased addressability to plastic surgeons; however, as patients perceive body defects due to decreased insight, ...they are often unsatisfied with their appearance after cosmetic surgery. The purpose of this study is to evaluate the ethical reasoning that should be performed before accepting these patients as cosmetic surgery candidates. We will focus our analysis on three main areas of interest: autonomy, which in these patients is significantly decreased, beneficence as satisfaction, which in these particular patients does not justify performing the intervention, and loyalty, which should render cosmetic procedures immoral in patients with body dysmorphic disorder.
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