Anatomical variations of the uncinate process of the nose of egyptian population and its impact on different techniques of infundibulotomy

The uncinate process is a very important landmark in functional endoscopic sinus surgery, as its removal is the first step in anterior ethmoidectomy. An understanding of the anatomic variations of the uncinate process in any patient undergoing functional endoscopic sinus surgery [FESS] is critical to safely performing the infundibulotomy. The traditional method of performing infundibulotomy has the risk of penetration of the lamina papyracea with orbital fat exposure. Our aim of this Study was :1- To study the anatomical variations of the uncinate process in cadavers and CT scans of Egyptian population.2-To compare the traditional surgical technique of infundibulotomy and another technique of infundibulotomy [Retrograde infundibulotomy] .The incidence of orbital penetration, the ease of identification of the natural maxillary ostium and lacrimal apparatus injury by each technique were reported. The work was carried out on 30 cadaveric specimens, 100 radiological films and 100 patients of FESS. We the anatomical variations of the uncinate process in cadavers and C.T scans of Egyptian population were documented. The incidence of orbital penetration and - ostium non-identification was significantly less with the retrograde technique. No naso-lacrimal duct injury occurred with either technique of infundibulotomies. The techniques were described and the complications discussed .The retrograde technique of infundibulotomy is recommended technique as it is easy to learn, allows easy identification of the natural ostium of the maxillary sinus and is associated with significantly decreased incidence of orbital penetration

human interossous membranes anatomical and histological study

This study was performed to describe anatomical details and histological picture of interosseous membrane [IOM] of forearm as well as crural interosseous membrane [IOM]. The results showed that IOM of forearm was a complex structure joining radius and ulna and was formed mainly of collagen fibers with some elastic fibers. A proximal well- defined band was also found in about half of the specimens. Two major openings and two to three secondary openings were observed. As regards crural interosseous membrane, it was found to be whitish glistening membrane stretched between both crural bones and was formed mainly of collagen fibers, while elastic fibers could not be detected. Two major openings were observed as well as two to three secondary openings along the length of membrane were found

distal fascicle of the anterior inferior tibio-fibular ligament in correlation with talar impingement

Up till now, the anterior inferior tibiofibular ligament [AITFL] is described in the anatomic tradition as one entity. The present investigation confirmed the presence of what was recently termed [a distal fascicle] of the ligament, which appeared as a separate band found in all [thirteen] the examined cadavers. It took the shape of a parallelogram that lied below and parallel to the rest of the AITFL. A pad of fat separated this fascicle from the rest of the ligament that masked its easy differentiation for a long time. In extreme dorsiflexion of the ankle, the lower border of the fascicle became tight and touched the dome of talus. Also, the clinical study showed audible popping and friction between the thickened fascicle and the opposite hyaline cartilage on talus. This indicated a ligamentous talar impingement with chronic pain on the anterolateral aspect of the ankle in 5 out of 9 patients with soft tissue talar impingement syndrome related to the anterolateral compartment of the ankle. Arthroscopic resection of the distal fascicle gave excellent results with complete relief of pain in all 5 patients suffering of this lesion. Arthroscopic removal of this fascicle along with treatment of other offending pathological lesions gave excellent results in 8 out of 9 patients after an average follow up of 13 months. It was concluded that the anatomy of this distal fascicle has to be included in literature. Furthermore, its pathologic role in talar impingement should be appreciated, yet not overemphasized by clinicians and those dealing with sport injuries, especially when exostoses are absent in radiographs

effects of aging and vincamine administration on the structure of the rat pineal gland

The pineal tissue was studied in four groups of male albino rats: a group of adult rats, a second group of senile rats, the third and fourth groups consisted of senile rats which were injected with the vehicle of vincamine drug and the drug itself respectively in their old adult stage of life. The investigations showed that the adult pineal gland was characterized by high cellularity, and two types of cells were observed; the pinealocytes and the glial cells. The pinealocytes constituted the majority of cells and were of two types; light and dark, while the glial cells were fewer, smaller with ramifying thin processes. Using electron microscopy, the cytoplasm of light pinealocytes was noted to be rich in secretory organelles, containing euchromatic nuclei and with prominent nucleoli. On the other hand, the dark pinealocytes appeared more electron dense with less amount of organelles and heterochromatic nuclei in their cytoplasm. Glial cells appeared as small cells of high electron density with thin ramifying processes full of filaments and large dark heterochromatic nuclei. Senile pineal glands of both the second and third groups showed marked decrease in the cellularity, irregularity and in folding of the nuclei were a prominent feature. By electron microscopy, the light pinealocytes showed marked decrease in the amount of secretory organelles together with the appearance of lipid droplets, lysosmes, and dense bodies. In addition, the nuclei of this type showed deep indentations. The cytoplasm of dark pinealocytes showed abundant multivesicular bodies and deeply indented heterochromatic nuclei. The glial cells had to same structure as in the adult glands. The study of the pineal tissue in senile animals which were previously treated with vincamine showed marked increase in the cellularity, and the majority of cells were of the light variety. By electron microscopy, the cells had the picture of highly active cells. The light pinealocytes were rich in mitochondria and secretory organelles such as dilated cisterns of endoplasmic reticulum, and Golgi apparatus. On the other hand, lysosomes, lipid droplets and dense bodies were hardly observed. The nuclei of these cells were either oval or irregular and of the euchromatic appearance. The dark pinealocytes showed secretory organelles in their cytoplasm but less abundant than those observed in the cytoplasm of the light cells. The nuclei, although of high electron density, yet they were of the euchromatic appearance. According to the present investigation, it could be concluded that the currently discussed drop in melatonin synthesis in old age is due to regressive changes in the morphology of the gland. Moreover, the use of vincamine may prevent or delay the appearance of such degenerative changes. This may preserve the melatonin synthesis in the body and consequently delays the aging process