Wyniki wyszukiwania - Biblioteka Nauki

1

An unusual muscle of the wrist with potential compression of the ulnar nerve

100%

Hill M. L. , Shoja M. M. , Salter E. G. , Tubbs R. S.

Folia Morphologica

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2006

|

tom 65

|

nr 2

178-180

EN

During routine cadaveric dissection of the upper extremity an unusual muscle was discovered arising from the tendon of the flexor carpi ulnaris and inserting into the muscle belly of the flexor digiti minimi. The muscle’s course was superficial to the ulnar nerve and artery in Guyon’s canal. We review the literature regarding such muscle variations and discuss the potential for compression of the ulnar nerve by such muscles.

2

A rare variation of the posterior cranial fossa: duplicated falx cerebelli, occipital venous sinus, and internal occipital crest

100%

Shoja M. M. , Tubbs R. S. , Khaki A. A. , Shokouhi G.

Folia Morphologica

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2006

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tom 65

|

nr 2

171-174

EN

Folds of the meningeal layer of the dura mater, the falx cerebri and tentorium cerebelli, traverse the vertebrate intracranial cavity and thus compartmentalise the brain. The falx cerebelli, another dural fold, is found in the posterior cranial fossa and attaches to the inferior aspect of the tentorium cerebelli and to the internal occipital crest. We present a case of a duplicated falx cerebelli, occipital venous sinus and internal occipital crest that was detected upon routine dissection of a male cadaver. Since haemorrhage of a dural venous sinus can be a fatal complication of posterior cranial fossa surgery, knowledge of venous sinus variations in this region may prevent unpredictable complications during intracranial procedures.

3

The most common anatomical sites of arterial injury in the extremities: a review of 75 angiographically-proven cases

100%

Shakeri A. B. , Tubbs R. S. , Shoja M. M.

Folia Morphologica

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2006

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tom 65

|

nr 2

116-120

EN

The incidence of vascular injury has increased worldwide. In an attempt to quantitate the specific arteries most commonly involved in the extremities, we reviewed 75 patients with extremity trauma who were evaluated with angiography (DSA, digital subtraction angiography). The majority of these injuries were related to motor vehicle accidents (93.3%). The mean age of these patients was 28.16 ± 11.14 years, 94.7% of these patients being male. The ratio of upper to lower extremity arterial trauma was 12 to 86. A total of 99 arterial injuries were detected angiographically. Simultaneous injuries to two and three extremity arteries were identified in 13.3% and 9.3% of patients respectively. The most common arteries injured were the anterior tibial, femoral, peroneal, and popliteal arteries. Associated fractures were present in 86.7% of patients. These data may prove useful to the clinician who evaluates post-traumatic injuries of the extremities.

4

Type I split cord malformation with an unusual bony morphology

100%

Shokouhi G. , Tubbs R. S. , Shoja M. M.

Folia Morphologica

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2007

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tom 66

|

nr 1

EN

Variations in the configuration of the bony septum found in patients with split cord malformations are rare. We report the seemingly rare occurrence of a midline bony septum that ended posteriorly as a fully formed bony spinous process. We speculate that this variation is due to misplaced mesodermal cells associated with the primitive endomesenchymal tract during approximately the third week of foetal life. The clinician that manages these patients may wish to consider this rare morphology and avoid excessive manipulation of such a process, which could potentially injure an underlying hemicord.

5

Accessory venous sinus of Hyrtl

100%

Tubbs R. S. , Loukas M. , Shoja M. M. , Oakes W. J.

Folia Morphologica

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2007

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tom 66

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nr 3

EN

Variations of the intracranial venous sinuses are important to the surgeon during intraoperative procedures and to the clinician during imaging interpretation. We report a male cadaver found to have a rare venous sinus variation. In all likelihood, this sinus corresponded to the rarely reported accessory venous sinus of Hyrtl. The sinus was approximately 5 mm in width and traveled from the sphenoparietal sinus anteriorly to the veins, draining into the foramen spinosum (i.e. the middle meningeal veins) posteriorly. No other variations or obvious pathology were identified intracranially or extracranially. Knowledge of such a venous variation may be of use to the clinician.

6

An interrupted inferior vena cava in a situs inversus: a case report and review of the literature

88%

Loukas M. , Strike D. R. G. , Tubbs R. S. , Tarneja N. , Shoja M. M.

Folia Morphologica

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2009

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tom 68

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nr 3

EN

Situs inversus with interrupted inferior vena cava is an uncommon anatomic variant found in the abdominal and thoracic viscera. In this report, we present a 59-year-old woman with this variation, found during gross anatomical dissection. While this type of variation has been variable, in the present case the hepatic veins drained directly into a very short (2.2 cm) inferior vena cava. The infrarenal component of the inferior vena cava was present and drained into the azygos and hemiazygos veins. Clinical considerations of this variant anatomy are of interest, as they may present in patients as pathology on cross sectional imaging. (Folia Morphol 2009; 68, 3: 184–187)

7

A rare variation of the inferior alveolar artery with potential clinical consequences

88%

Khaki A. A. , Tubbs R. S. , Shoja M. M. , Shokouhi G. , Farahani R. M.

Folia Morphologica

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2005

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tom 64

|

nr 4

345-346

EN

Variations of the inferior alveolar artery are seemingly quite rare, especially with regard to its origin from the maxillary artery. We present an unusual case of an inferior alveolar artery that originated from the external carotid artery. To the best of our knowledge, our case is one of only two reports of the inferior alveolar artery arising from the external carotid artery. The clinician who deals with the mandibular region should be aware of such a variation in the arterial architecture.

8

Retroscalenic course of the transverse cervical artery with the suprascapular artery travelling through the suprascapular notch

88%

Tubbs R. S. , Shoja M. M. , Shokouhi G. , Loukas M. , Oakes W. J.

Folia Morphologica

|

2007

|

tom 66

|

nr 1

EN

Variations involving the cervical portion of the vagus nerve are seemingly very rare. We report an adult male found to harbour a right cervical vagus nerve that crossed anterior to the right common carotid artery to terminate in the lateral aspect of the thyroid gland. A very small continuation of this nerve was found to continue distally into the thorax. Histologically, this part of the vagus nerve did not contain ganglion or other cell bodies. There were no heterologous inclusions (thyroid, parathyroid, thymus, salivary gland or branchial cleft remnants) present. Although grossly there was a connection into the thyroid gland, this was not observed histologically. No signs of trauma were found to the ipsilateral neck region. We hypothesise that this variation is due to entanglement between the thyroid gland and cervical vagus nerve during development. This rare variation might be considered by the clinician who operates in the cervical region or interprets imaging of the neck. To our knowledge, a vagus nerve with the above described morphology has not been described.

9

A complex dural-venous variation in the posterior cranial fossa: a triplicate falx cerebelli and an aberrant venous sinus

88%

Shoja M. M. , Tubbs R. S. , Loukas M. , Shokouhi G. , Oakes W. J.

Folia Morphologica

|

2007

|

tom 66

|

nr 2

EN

Variations of the dural folds and the dural venous sinuses are seldom reported in the extant medical literature. Such variations in the posterior cranial fossa may be problematic in various diagnostic and operative procedures of this region. We report our observation of an extremely rare variation of the falx cerebelli and posterior cranial fossa venous sinuses encountered upon dissection of a young male cadaver. In this specimen the falx cerebelli was duplicated with dimensions of 45.3 × 5.1 mm and 49.8 × 5.3 mm for the right and left falces respectively. The distance between the two falces was 3.2, 4.5 and 7.8 mm at their proximal, middle and distal thirds. An accessory small falx (31.8 × 2 mm) was also found approximately 3.4 mm lateral to the right falx cerebelli and blended with the lateral surface of the right falx cerebelli. There was only one occipital venous sinus (diameter, 2.5 mm) and no marginal sinus was detected. At the right floor of the posterior cranial fossa (posterolateral to the foramen magnum) an additional dural venous sinus was found, which connected the terminal portion of the right sigmoid sinus to the occipital and right transverse sinuses via one medial and two lateral branches respectively. We believe that such a complex dural-venous variation in the posterior cranial fossa has not previously been reported. Neurosurgeons and neuroradiologists should be aware of such variations, as these could be potential sources of haemorrhage during suboccipital approaches or may lead to erroneous interpretations of imaging of the posterior cranial fossa.

10

Enamel matrix derivative Emdogain as an adjuvant for a laterally-positioned flap in the treatment of gingival recession: an electron microscopic appraisal

88%

Lafzi A. , Farahani R. M. , Tubbs R. S. , Roushangar L. , Shoja M. M.

Folia Morphologica

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2007

|

tom 66

|

nr 2

EN

Enamel matrix derivative (EMD), such as Emdogain®, has been suggested for the improvement of wound healing in periodontal surgical therapy. The present qualitative study seeks to illustrate the ultrastructural changes associated with a human gingival wound at 10 days after the application of EMD as an adjunct to a laterally-positioned flap in a patient with gingival recession. An otherwise healthy patient, who had been suffering from bilateral gingival recession defects on teeth #23 and #26, was studied. One defect was treated with a laterally-positioned flap, while the other was treated with a combination of EMD and a laterally-positioned flap. Ten days after the operation gingival biopsy specimens were obtained from the dentogingival region and examined using a transmission electron microscope. A considerable difference was found in both the cellular and extracellular phases of EMD and non-EMD sites. The fibroblasts of EMD site were more rounded with plump cytoplasms and euchromatic nuclei. A well-developed rough endoplasmic reticulum and numerous mitochondria could be detected. In contrast, the fibroblasts of non-EMD site were of flattened spindle-like morphology. While the signs of apoptosis could rarely be detected at EMD site, apoptotic bodies and ultra-structural evidence of apoptosis (crescent-like heterochromatic nuclei and dilated nuclear envelopes) were consistent features at non-EMD site. The extracellular matrix at EMD site mainly consisted of well-organised collagen fibres, while non-EMD site contained sparse and incompletely-formed collagen fibres. Coccoid bacteria were noted within the extracellular matrix and neutrophils at non-EMD site. It seems that EMD may enhance certain features of gingival wound healing, which may be attributable to its anti-apoptotic, anti-bacterial or anti-inflammatory properties.

11

Aortic bifurcation angle as an independent risk factor for aortoiliac occlusive disease

88%

Shakeri A. B. , Tubbs R. S. , Shoja M. M. , Nosratinia H. , Oakes W. J.

Folia Morphologica

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2007

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tom 66

|

nr 3

EN

Recently, there has been interest in potential geometric risk factors that might result in or exaggerate atherosclerosis. The aortic bifurcation is a complex anatomical area dividing the high pressure blood of the descending abdominal aorta into the lower limbs and pelvis. The distribution of the bifurcation angle and any asymmetry, its relation with age and its possible contribution to the risk of aortoiliac atherosclerosis are presented here. Statistical analysis was performed by SPSS version 11.0 using, Fisher’s exact test, the Pearson and Spearman correlation tests and logistic regression analysis. The p value was set at 0.05. No correlations were found between age, bifurcation angle and angle asymmetry in the Pearson test (p > 0.05). Logistic regression analysis revealed that the bifurcation angle, but not its asymmetry, gender or age, was a significant and independent risk factor for aortoiliac atherosclerosis (model r² = 0.662, p = 0.027). With additional study these results may have implications regarding risk factors for aortoiliac atherosclerosis. To our knowledge, this study is the first of its kind to indicate the potential of such an important geometric risk factor for atherosclerosis at the aortic bifurcation.

12

Bilateral accessory middle cerebral arteries associated with an aneurysm of the anterior circulation

75%

Daghigi M. H. , Tubbs R. S. , Shoja M. M. , Shakeri A. B. , Pourisa M. , Salter E. G. , Oakes W. J.

Folia Morphologica

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2006

|

tom 65

|

nr 2

161-163

EN

An accessory middle cerebral artery is one variation of the intracranial vasculature that may be a source of misinterpretation by clinicians dealing with cerebrovascular diseases. We report a case of an elderly female found to have bilateral accessory middle cerebral arteries, who presented with the rupture of an aneurysm of the anterior part of the circle of Willis. Accessory middle cerebral arteries are rare anatomical findings and the bilateral occurrence is exceedingly rare. We believe this to be the first report of bilateral accessory middle cerebral arteries associated with an aneurysm of the anterior cerebral-anterior communicating arteries. The anatomical and clinical relevance of this variation is described.

13

A review of the tragal pointer: anatomy and its importance as a landmark in surgical procedures

75%

Muhleman M. A. , Wartmann C. T. , Hage R. , Matusz P. , Shoja M. M. , Tubbs R. S. , Loukas M.

Folia Morphologica

|

2012

|

tom 71

|

nr 2

EN

The tragal pointer has long been used as a surgical landmark for the identification of the facial nerve trunk and the maxillary artery in such procedures as parotidectomy, internal fixation of subcondylar and condylar fractures, mandibular osteotomy, temporomandibular joint arthroplasty, and percutaneous blocks of branches of the trigeminal nerve and pterygopalatine ganglion. Aside from its use as an external landmark, it has also been implicated as a contributor to crease formation in the presence of peripheral arterial disease. This article will review the available literature on the tragal pointer’s use as an external landmark. (Folia Morphol 2012; 71, 2: 59–64)

14

Malignant fibrous histiocytoma of the spermatic cord: a case report and review of the literature

75%

Shoja M. M. , Tubbs R. S. , Asvadi I. , Farahani R. M. , Seyednejad F. , Oakes W. J.

Folia Morphologica

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2006

|

tom 65

|

nr 4

390-395

EN

Malignant fibrous histiocytoma (MFH) is a morphologically ill-defined tumour of the soft tissues and may involve nearly every organ of the body. MFH of the spermatic cord represents an extremely rare entity and reports of it in the literature are limited. We report a 69-year-old man found to have a left spermatic cord MFH and retroperitoneal and mediastinal lymphadenopathy, who was treated with radical orchiectomy and adjuvant chemotherapy. The morphological findings of the spermatic tumour are presented and the literature is reviewed to clarify the potential diagnostic/therapeutic approaches and the prognosis related to spermatic cord MFH.

15

A rare variation of the vertebral artery

75%

Shoja M. M. , Tubbs R. S. , Khaki A. A. , Shokouhi G. , Farahani R. M. , Moein A.

Folia Morphologica

|

2006

|

tom 65

|

nr 2

167-170

EN

Variations of the vertebrobasilar arterial complex are important with regard to their potential clinical impact. We present an unusual case of the vertebral artery, in which the left vertebral artery in its ascent in the neck through the transverse foramina passed posteriorly between the transverse processes of C3 and C4 and supplied the posterior muscles of the neck without continuing intracranially. Albeit speculatively, we hypothesise that the variation of the vertebral artery reported here was caused by degeneration of the proximal portion of the left postcostal longitudinal anastomosis (i.e. C1 and C2 intersegmental arteries) in the context of a persistent third cervical intersegmental artery. Our case is unique in that the left vertebral artery terminated extracranially. Knowledge of the variations of the vertebrobasilar arterial complex is important for surgeons operating at the skull base, craniocervical junction, and cervical region, and for clinicians interpreting the imaging of this region.

16

An unusual muscular variation of the infratemporal fossa

75%

Tubbs R. S. , Stetler W. , Shoja M. M. , Loukas M. , Salter E. G. , Oakes W. J.

Folia Morphologica

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2007

|

tom 66

|

nr 3

EN

The infratemporal fossa is often the site of pathology or surgical intervention. We describe an unusual muscle found during the routine dissection of the right infratemporal fossa. The literature germane to this variable muscle, best described as a variant of the pterygoideus proprius, is reviewed. The clinician may contemplate the wide array of muscular anomalies within the infratemporal fossa when considering unexplained neurological symptoms attributed to branches of V3 and pursue appropriate diagnostic testing.

17

Does a third head of the rectus femoris muscle exist?

63%

Tubbs R. S. , Stetler W. J. , Savage A. J. , Shoja M. M. , Shakeri A. B. , Loukas M. , Salter E. G. , Oakes W. J.

Folia Morphologica

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2006

|

tom 65

|

nr 4

377-380

EN

Current anatomical texts describe only two tendinous origins of the rectus femoris muscle. The authors identified one older reference in which a third head of the rectus femoris muscle was briefly described. In order to confirm the existence of this head, 48 adult cadavers (96 sides) underwent detailed dissection of the proximal attachments of the rectus femoris muscle. Of these sides 83% were found to harbour a recognised third head of the rectus femoris muscle. This additional head was found to attach deeply to the iliofemoral ligament and superficially with the tendon of the gluteus minimus muscle as it attached into the femur. This tendon attached to the anterior aspect of the greater trochanter in an inferolateral direction compared to the straight head. The mean length and width of the third head was 2 cm and 4 cm, respectively. The mean thickness was found to be 3 mm. Most commonly this third head was bilaterally absent or bilaterally present. However, 4.2% were found only on left sides and 5.2% were found only on right sides. The angle created between the reflected and third heads was approximately 60 degrees. Two sides (both left sides with one female and one male specimen) were found to have third heads that were bilaminar. These bilaminar third heads had a distinct layer attaching to the underlying iliofemoral ligament and a superficial layer blending with the gluteus minimus tendon to insert onto the greater trochanter. Although the function of such an attachment is speculative, the clinician may wish to consider this structure in the interpretation of imaging or in surgical procedures in this region, as in our study it was present on the majority of sides.

18

The effects of an electromagnetic field on the boundary tissue of the seminiferous tubules of the rat: a light and transmission electron microscope study

63%

Khaki A. A. , Tubbs R. S. , Shoja M. M. , Rad J. S. , Khaki A. , Farahani R. M. , Zarrintan S. , Nag T. C.

Folia Morphologica

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2006

|

tom 65

|

nr 3

188-194

EN

Human beings are unavoidably exposed to ambient electromagnetic fields (EMF) generated from various electrical devices and from power transmission lines. Controversy exists about the effects of EMF on various organs. One of the critical issues is that EMF may adversely affect the reproductive system. In order to examine this 30 rat pups were exposed to 50 Hz EMF (non-ionising radiation) during in utero development (approximately 3 weeks) and postnatal life (5 weeks). Groups of exposed rats were subsequently left in an environment free of EMF in order to observe recovery, if any, from the changes induced by EMF on the boundary tissue of the seminiferous tubules. The materials were processed and observed under a light and a transmission electron microscope. In the experimental rats boundary tissue was found disrupted at various layers. This tissue showed infoldings, which were perhaps due to the loss of collagen and reticular fibrils from the inner and outer non-cellular layers. The outer non-cellular layer, which was thinner than that of the control, was stripped away from the myoid cell layer in multiple regions, giving a “blister-like” appearance. The myoid cells showed fewer polyribosomes, pinocytotic vesicles and glycogen granules. Most mitochondria were found to lack cristae. The connections between individual myoid cells were apparently lost. There were signs of recovery in the boundary tissue following withdrawal from EMF exposure. These results suggest that EMF exposure may cause profound changes in the boundary tissue of the seminiferous tubules. Therefore exposure to EMF may result in pathological changes that lead to subfertility and infertility.

19

The morphology and function of the quadrate ligament

63%

Tubbs R. S. , Shoja M. M. , Khaki A. A. , Lyerly M. , Loukas M. , O'Neil J. T. , Salter E. G. , Oakes W. J.

Folia Morphologica

|

2006

|

tom 65

|

nr 3

225-227

EN

There is a paucity of information in the literature regarding the quadrate ligament and the information that does exist is extremely conflicting. We dissected 30 cadavers (60 sides) to determine the morphology and function of this enigmatic ligament. A quadrate ligament (thickening of the elbow joint capsule) was found in all specimens. In all specimens this band was distinct from the circumferential fibres of the annular ligament. The length, width, and thickness of the quadrate ligament were found to be 11 mm, 8 mm, and 1 mm respectively. This ligament not only aided in securing the neck of the radius to the ulna but also resisted excessive supination and, to a lesser degree, pronation of the forearm. Following transection of the quadrate ligament, the head of the radius was secured to the ulna considerably less firmly and supination and pronation increased by 10 to 20 degrees and 5 to 8 degrees respectively. The quadrate ligament contributes to proximal radioulnar stability, limits the “spin” of this joint, and should be considered in manipulation, surgery, or imaging of the proximal forearm.

20

An unreported variation of the cervical vagus nerve: anatomical and histological observations

63%

Tubbs R. S. , Loukas M. , Shoja M. M. , Blevins D. , Humphrey R. , Chua G. D. , Kelly D. R. , Oakes W. J.

Folia Morphologica

|

2007

|

tom 66

|

nr 2

EN

Variations involving the cervical portion of the vagus nerve are seemingly very rare. We report an adult male found to harbour a right cervical vagus nerve that crossed anterior to the right common carotid artery to terminate in the lateral aspect of the thyroid gland. A very small continuation of this nerve was found to continue distally into the thorax. Histologically, this part of the vagus nerve did not contain ganglion or other cell bodies. There were no heterologous inclusions (thyroid, parathyroid, thymus, salivary gland or branchial cleft remnants) present. Although grossly there was a connection into the thyroid gland, this was not observed histologically. No signs of trauma were found to the ipsilateral neck region. We hypothesise that this variation is due to entanglement between the thyroid gland and cervical vagus nerve during development. This rare variation might be considered by the clinician who operates in the cervical region or interprets imaging of the neck. To our knowledge, a vagus nerve with the above described morphology has not been described.