Partial duplication of tentorium cerebelli and complete duplication of falx cerebelli / 대한해부학회지

Variations of the dural folds and the dural venous sinuses are infrequently reported in the existing medical literature. Such variations in the posterior cranial fossa may pose difficulties in various analytical and surgical procedures of this region. We present a rare concurrent variation of the falx cerebelli and tentorium cerebelli that was detected during routine dissection of an adult male cadaver. While removing the brain, a partial duplication of tentorium cerebelli was observed below the left half of the tentorium cerebelli and above the left cerebellar hemisphere. This fold did not have any dural venous sinus in it. Further, a complete duplication of falx cerebelli with a single occipital venous sinus within its attached border was also observed. We present the review of literature and discuss the comparative anatomy of this case.

Solitary osteochondroma in the body of the pubic bone: a cadaveric case report / 대한해부학회지

Osteochondromas develop as cartilaginous nodules in the periosteum of bones. They are the commonest benign tumors of the skeleton, generally observed in the long bones. Rarely, they are also found in the axial skeleton, flat bones of skull and facial bones. During a regular dissection, we came across a solitary osteochondroma in posterior surface of the body of the right pubic bone. Histopathology of the bony projection confirmed the typical features of the osteochondroma. The symptomatic osteochondromas are usually evaluated during radiographic examination. Though, the observed osteochondroma is relatively smaller its unusual location is remarkable and knowledge of occurrence of such nodules is clinically important during the diagnosis and planning of treatment.

Surgical and radiological importance of a rare cysto-duodeno-colic peritoneal fold / 대한해부학회지

It is quite common to see abnormal peritoneal folds in the abdominal cavity. Some of them might compress or strangulate the viscera and others might determine the direction of the flow of peritoneal fluid, pus or blood. Many unusual clinically important peritoneal folds such as Ladd's band, cysto-gastro-colic fold, omento-cystic fold, and cysto-colic fold have been reported earlier. Knowledge of these folds is important for radiologists, gastroenterologists, and surgeons. We report an unusual cysto-duodeno-colic fold observed during our dissection classes. The fold was seen to compress the duodenum and colon. The fold extended from the descending part of the duodenum and the transverse colon to the gallbladder. It enclosed the entire gallbladder. A case similar to this has not been reported yet. It is important for the gastroenterologists and laparoscopic surgeons to be aware of this fold to avoid misdiagnosis and iatrogenic injuries.

A study on the number and arrangement of the structures passing through the porta hepatis in South Indian population / Estudio sobre el número y disposición de las estructuras que pasan por la fisura porta hepática en individuos del sur de la India

The porta hepatis of the liver is a very important area surgically. The knowledge of the variations in the structures passing through the porta hepatis might be of great help in reducing the risks of surgery in this area. In the current study 59 livers from South Indian cadavers were observed for the number and arrangement of the structures passing through the porta hepatis. In all the livers the portal vein was posteriormost and the hepatic duct was the anteriormost structure. The hepatic artery and its branches were in between the duct and the vein. The mean weight of the liver was 1.025 kg. The mean length of porta hepatis was 4.825 cm and the mean breadth was 2.433 cm. The number varied from one to three for the duct and vein but for the artery it was between one and four. In 51% of livers, only one vein and in 80% of cases only one duct passed through the porta hepatis. In 56% of cases two arteries passed through the porta hepatis.

La fisura porta hepática del hígado es un área quirúrgica muy importante. El conocimiento de las variaciones en las estructuras que pasan a través de la fisura porta hepática puede ser de gran ayuda para reducir los riesgos de la cirugía de esta región. En el presente estudio se observaron 59 hígados procedentes de cadáveres del Sur de la India, en relación al número y disposición de las estructuras que pasan a través de la fisura porta hepática. En todos los hígados, la vena porta hepática fue el elemento más posterior y el conducto hepático común el más anterior. La arteria hepática y sus ramas se ubicaban entre el conducto hepático común y la vena porta hepática. El peso medio de los hígados fue 1,025 kg. La longitud media de la fisura porta hepática fue 4,825 cm y el ancho medio de 2,433 cm. El número varió de uno a tres para el conducto y la vena. El número de arterias varió entre una y cuatro. En 51% de los hígados, sólo una vena pasaba a través de la fisura porta hepática y en el 80% de los casos sólo pasaba un conducto. En el 56% de los casos, dos arterias pasaban a través de la fisura porta hepática.

Eight prehilar branches of the right renal artery / 대한해부학회지

Imaging technology with its advancement in the field of urology is the boon for the patients who require minimally invasive approaches for various kidney disorders. These approaches require a precise knowledge of the normal and variant anatomy of vessels at the hilum of the kidney. During routine dissections, a variation in the branching pattern of the right renal artery was noted in an adult male cadaver. The right renal artery divided into upper and lower divisions 6cm away from the hilum of the kidney. The upper division gave 4 branches, and the lower division gave two branches. These two branches further bifurcated and gave 2 branches each. Thus, there were 8 prehilar branches of renal artery. The multiple prehilar branches led to a congested atmosphere at the hilum of the kidney. This arterial congestion might result in hindering the blood flow at the renal hilum. Apart from this, it might cause difficulties in diagnostic and therapeutic invasive procedures. Knowledge of this variation is of importance to radiologists and urologists in particular.

Unusual branches of femoral artery in the femoral triangle: a case report / Ramas inusuales de la arteria femoral en el triángulo femoral: reporte de caso

Femoral artery is the major artery of the lower limb. It shows some variations in its branching pattern. One of the rare but clinically important variations is the origin of deep circumflex iliac and inferior epigastric arteries from it instead of from external iliac artery. We report here the origin of inferior epigastric and deep circumflex iliac arteries from the femoral artery bilaterally. Both the arteries passed up deep to the inguinal ligament and had a normal course and distribution after crossing the inguinal ligament. Knowledge of these variations is of importance in plastic surgery, anterior approach to the hip joint, draining psoas abscess or reducing a femoral hernia.

La arteria femoral es la principal arteria del miembro inferior. Se observan algunas variaciones en su patrón de ramificación. Una variante rara, pero clínicamente importante es el origen común de las arterias circunfleja iliaca profunda y epigástrica inferior no desde la arteria ilíaca externa. Presentamos el origen bilateral de las arterias epigástricas inferiores y circunfleja ilíaca profunda desde la arteria femoral. Ambas arterias pasaron profundas al ligamento inguinal y tuvieron un curso y distribución normal después de cruzar el ligamento inguinal. El conocimiento de estas variaciones son de importancia en la cirugía plástica, en el acceso anterior a la articulación de la cadera, el drenaje absceso del músculo psoas mayor o para reducir una hernia femoral.

Hypoplastic anterior tibial artery associated with continuation of fibular (peroneal) artery as dorsalis pedis artery: a case report / Arteria tibial anterior hipoplásica asociada con la continuación de la arteria fibular como arteria dorsal del pié: un reporte de caso

Arterial variations of distal parts of lower limb are well documented. However, continuation of fibular artery as dorsalis pedis artery is a rare finding. Unusual course and distribution of the anterior tibial artery and fibular artery were observed during routine anatomical dissection of the right lower limb of an approximately 40-year-old male cadaver. The arteries of the crural region arose from the popliteal artery, as usual. However the anterior tibial artery was hypoplastic. The fibular artery was larger than usual and crossed the lowest portion of the interosseous membrane and continued as dorsalis pedis artery. Posterior tibial artery had a normal course and distally divided into medial and lateral plantar arteries. The awareness of these variations is important to vascular surgeons while performing arterial reconstructions in femorodistal bypass graft procedures, and also to orthopaedic surgeons during surgical clubfoot release.

Las variaciones arteriales de las partes distales de los miembros inferiores están bien documentados. Sin embargo, la continuación de la arteria fibular como arteria dorsal del pie es un hallazgo raro. El curso y distribución inusual de la arteria tibial anterior y la arteria fibular se observaron durante la disección anatómica de rutina en el miembro inferior derecho del cadáver de un hombre de aproximadamente 40 años de edad. Las arterias de la región crural se originaron desde la arteria poplítea como es usual. Sin embargo, la arteria tibial anterior era hipoplásica. La arteria fibular era más grande de lo habitual, cruzó la porción más baja de la membrana interósea y se mantuvo como la arteria dorsal del pie. La arteria tibial posterior tuvo un curso normal; distalmente se dividió en las arterias plantares medial y lateral. El conocimiento de estas variaciones es importante para los cirujanos vasculares al realizar reconstrucciones arteriales en procedimientos de injerto de bypass femorodistal, y también para los cirujanos ortopédicos durante la liberación quirúrgica del pie zambo.

A peculiar liver with surgically and radiologically important variations: a case report / 대한해부학회지

A peculiar liver was found in an adult male cadaver during a dissection class for undergraduate medical students. The quadrate lobe and fissure for the ligamentum teres were totally absent. Thus, the cystic notch on the inferior border was very broad and deep, and the fundus and body of the gall bladder popped out through this notch. The cystic duct terminated into the right hepatic duct at the porta hepatis instead of terminating into the common hepatic duct. Awareness of variations of the lobes and fissures may minimize a misdiagnosis of liver problems. The aim of the current study was to alert radiologists and surgeons about possible variations in the external appearance and anomalies of the lobes and fissures of the liver.

The foramen meningo-orbital in Indian dry skulls.

Background & objective: Foramen meningo-orbital is present in greater wing of sphenoid bone close to superior orbital fissure. It provide route for an anastomosis between the orbital branch of the middle meningeal artery and recurrent meningeal branch of ophthalmic artery. Basic textbooks of anatomy stated that it was a rare occurrence but some recent studies indicate a more frequent incidence of this which shows side and gender variation. These discrepancies were verified in our research work. Methods: We studied 150 dried human skulls (100 male and 50 female) of known sex. Only patent foramina were included in the observation. Results: Incidence of foramen as whole was 44.33% (male- 37.5% and female- 58%). In 4%, it was present bilaterally. Average distance between lateral end of superior orbital fissure and foramen was 6.22 mm. Conclusion: Our study indicates that a foramen meningo-orbital is present as often as, mostly unilaterally and multiple foramina may exist and also it shows side and genders variation. Knowledge of it may be of surgical significance to ophthalmologist and neurosurgeons and for radiologist because it masquerading as an intraocular foreign body. Further detail study on this topic in other populations from different areas is required.

Looped external iliac artery: a case report / Arteria ilíaca externa en bucle ­ reporte de caso

Variations of the external iliac artery are very rare. We found a rare variation in the left external iliac artery. The artery was long and formed a characteristic loop. The loop was found in the lesser pelvis in close relation to the obturator nerve. This loop may compress obturator nerve and vessels. The knowledge of this loop might be important for gynaecologists, orthopaedic surgeons and urologists since it may be involved in surgeries of hip, ovary and prostate...

Las variaciones de la arteria ilíaca externa son raras. Se encontró una variación poco frecuente en la arteria ilíaca externa izquierda. La arteria era larga y formaba un bucle característico. El bucle se encontró en la pelvis menor en estrecha relación con el nervio obturador. Este circuito puede comprimir el nervio obturador y los vasos circundantes. El conocimiento de este circuito podría ser importante para los ginecólogos, cirujanos ortopédicos y urólogos, ya que pueden estar involucrados en las cirugías de cadera, ovario y próstata...

Association of CYP3A5*3 polymorphism with development of acute leukemia.

BACKGROUND: CYP3A5 was observed to be an important genetic contributor to inter individual differences in CYP3A-dependent drug metabolism in acute leukemic patients. Loss of CYP3A5 expression was mainly conferred by a single nucleotide polymorphism at 6986A>G (CYP3A5*3). We investigated the association between CYP3A5*3 polymorphism and acute leukemia. MATERIALS AND METHODS: Two hundred and eighty nine acute leukemia cases comprising of 145 acute lymphocytic leukemia (ALL), 144 acute myeloid leukemia and 241 control samples were analyzed for CYP3A5*3 polymorphism using PCR-RFLP method. Statistical analysis was performed with SPSS version (15.0) to detect the association between CYP3A5*3 polymorphism and acute leukemia. RESULTS: The CYP3A5*3 polymorphism 3/3 genotype was significantly associated with acute leukemia development (χ2- 133.53; df-2, P 0.000). When the data was analyzed with respect to clinical variables, mean WBC, blast % and LDH levels were increased in both ALL and AML cases with 3/3 genotype. The epidemiological variables did not contribute to the genotype risk to develop either AML or ALL. CONCLUSION: The results suggest that the CYP3A5*3 polymorphism might confer the risk to develop ALL or AML emphasizing the significance of effective phase I detoxification in carcinogenesis. Association of the polymorphism with clinical variables indicate that the 3/3 genotype might also contribute to poorer survival of the patients.

Costodorsalis ­ an Additional Slip of Pectoralis Major Muscle: a Case Report / Costodorsal ­ un Fascículo Adicional del Músculo Pectoral Mayor: Reporte de un Caso

Occurrence of variant muscular slips from pectoralis major muscle is rare. In this report, we present a rare case of aberrant muscular slip associated with the pectoralis major muscle which we call costodorsalis. This muscular slip originated from the 6th rib near the costochondral junction and ran along the lower border of pectoralis major muscle. It crossed the axilla from medial to lateral side and merged with the latissimus dorsi muscle. This type of origin and insertion is unique and has not been reported earlier. The knowledge of this muscle variation may be of special importance to the anesthesiologists, physiotherapists and plastic surgeons.

Es poco frecuente la aparición de variaciones de un fascículo muscular desde el músculo pectoral mayor . En este trabajo, presentamos el caso de un fascículo muscular aberrante asociado con el músculo pectoral mayor que denominamos costodorsal. Este fascículo muscular se originó en la 6 costilla cerca de la unión costocondral y corrió a lo largo del margen inferior del músculo pectoral mayor. Cruzó la axila de medial a lateral y se fusionó con el músculo latísimo del dorso. Este tipo de origen y la inserción es único y no se ha informado anteriormente. El conocimiento de esta variación muscular puede ser de especial importancia para los anestesistas, fisioterapeutas y cirujanos plásticos.

A Study on the Variations in the Formation of the Trunks of Brachial Plexus / Estudio sobre las Variaciones en la Formación de los Troncos del Plexo Braquial

Brachial plexus shows several variations in its formation and branching pattern. Variations in the formation of the trunks are very rare. We studied 44 dissected specimens specifically for variations in the formation of the trunks of the brachial plexus. 5 cadavers (11.3 percent) showed variations in the formation of the trunks. All the variations were unilateral. In one cadaver (2.27 percent), the middle trunk was formed by union of C7 and C8 roots and lower trunk was formed by T1 root. Upper and middle trunks were fused with each other in one specimen (2.27 percent). In 3 specimen (6.81 percent), the C5 root pierced scalenus anterior before joining C6 to form the upper trunk. Knowledge of its variations is of importance to orthopedic surgeons, neurologists and anesthesiologists.

EL plexo braquial muestra algunas variaciones en su formación y patrón de ramificación. Las variaciones en la formación de los troncos son muy raras. Se disecaron 44 especímenes para observar las eventuales variaciones en la formación de los troncos del plexo braquial. Cinco cadáveres (11,3 por ciento) mostraron variaciones en la formación de los troncos. Todas las variaciones fueron unilaterales. En un cadáver (2,27 por ciento), el tronco medio se formó por la unión de las raíces C7 y C8 y, parte inferior del tronco, estaba formado por la raíz de T1. En un caso (2,27 por ciento) los troncos superior y medio se fusionaron entre sí. En 3 muestras (6,81 por ciento), la raíz de C5 cruzó el músculo escaleno anterior antes de unirse a C6 para formar la parte superior del tronco. El conocimiento de estas variaciones es importante para los cirujanos ortopédicos, los neurólogos y anestesiólogos.

Association of CYP1A1*2 polymorphisms with breast cancer risk: a case control study.

BACKGROUND: The Cytochrome P-4501A1 (CYP1A1) gene, located on chromosome 15q, is involved in the metabolism of carcinogens mainly polycyclic aromatic hydrocarbons as well as estrogen. It is considered as candidate gene for low-penetrance breast cancer susceptibility. Hence the present study aims to discuss the role of CYP1A1 polymorphisms in breast cancer. MATERIALS AND METHODS: A total of 250 breast cancer patients and the same number of healthy age-matched controls were analyzed for the polymorphism of CYP1A1*2 by polymerase chain reaction-restriction fragment length polymorphism. RESULTS: In the present study, association of CYP1A1*2 (Ile 462Val) polymorphism with breast cancer was studied. Only one breast cancer patient was observed to be homozygous for Val allele but none among controls. The frequency of heterozygous Ile/Val genotype was found to be increased significantly in breast cancer patients (68.1%) as compared to controls (51.0%). Higher frequency of heterozygotes for Val allele was observed among premenopausal breast cancer patients and patients with high BMI, positive for HER2/neu status and advanced stage of the disease in comparison to the corresponding groups. No significant association of CYP1A1*2 polymorphism was observed with occupation, estrogen receptor and progesterone receptor status of breast cancer patients. CONCLUSIONS: In conclusion, our results suggest a significant correlation between CYP1A1*2 expression and the occurrence of breast cancer.

PvuII polymorphism of estrogen receptor-α gene in breast cancer.

BACKGROUND: Estrogen receptor (ER) is a ligand-inducible transcription factor that mediates estrogen action in target tissue. Several common polymorphisms of the ERα gene have been reported to be associated with alterations in receptor expression in breast cancer. MATERIALS AND METHODS: A case-control study was designed to compare 250 breast cancer patients with 250 age-matched healthy controls. The frequency distribution of PvuII polymorphism in the ERα gene was assessed by PCR-RFLP method. RESULTS: The frequency of the PP genotype (35.3%) was increased significantly in breast cancer patients when compared to controls (19.8%), with a corresponding increase in P allele frequency (χ2= 16.4; P = 0.0003). The OR for genotypes PP vs. Pp was 1.989 (95% CI: 1.2708 to 3.113). Premenopausal women with breast cancer had an elevated frequency of the PP genotype (22.8%) as compared to postmenopausal women (16.8%). The frequency of the PP genotype was increased in patients positive for ER and HER-2/neu as compared to those with receptor-negative status. The pp and p allele frequencies were increased in progesterone-receptor-negative status. When stage of the disease was considered, both Pp and pp genotype frequencies were elevated in patients with advanced stage breast cancer. The frequency of the P allele and PP genotype frequencies tended to increase with increase in body mass index, whereas the Pp genotype frequency was elevated only in obese patients. The reverse was observed in the case of pp genotype frequency. CONCLUSION: The study thus highlighted the influence of ERα PvuII polymorphism on the development and progression of breast cancer.