Large intradiploic arachnoid cyst of the skull in child-a case report and new terminology proposition.

We present a rare finding of the arachnoid matter invaginating into the base of middle cranial fossa and creating an abnormal space. Presented entity was incidentally found in head CT scan of 12-year-old male. Based on the radiological characteristics in CT scans and MR images, the diagnosis of intradiploic arachnoid cyst (AC) was suggested. After surgical intervention and histopathological analysis of the specimen, the diagnosis was confirmed. We assume this is the first description of large intrasphenoid AC without any traumatic or iatrogenic cause. The literature provides many different terms for the phenomenon. We are proposing the term intradiploic arachnoid diverticulum as the more accurate for capturing the essence of the phenomenon. It provides clear differentiation of the entities from classical arachnoid cysts since they are of different anatomical localization (intradural vs. extradural) and etiopathogenesis. Management with arachnoid diverticulum is not yet established, but observation with serial imaging studies should be recommended as primary management in case of asymptomatic cyst. When cyst is symptomatic, surgical treatment may be required.

Basilar tip fenestration giving rise to Percheron's and mesencephalic arteries.

The basilar bifurcation region is a common site for intracranial aneurysms, as well as it gives rise to a group of perforating arteries that supply the mesencephalon and the thalamus. Complex vascular microanatomy poses a diagnostic and therapeutic challenge for neurosurgeons, neuroradiologists and neurologists. In this paper, we present a previously unreported case of basilar tip fenestration that gave rise to five perforating arteries: the artery of Percheron and four mesencephalic arteries. Due to invaluable clinical significance, the possibility of such a variant must be considered during performing various neurovascular procedures, since e.g., embolization of the fenestration misdiagnosed as an aneurysm would inevitably lead to severe neurological complications (consciousness disturbances, quadriplegia, and sensory loss). Comprehensive knowledge of the neuroanatomy and neuroembryology is crucial to safe execution of intracranial interventions.

Anatomy of the pontine arteries and perforators of the basilar artery in humans.

Cerebral blood flow constitutes a critical area of interest for neurologists, neurosurgeons, and interventional radiologists as a social burden related to ischemic stroke, hemorrhagic stroke, and vascular dementia is expected to intensify. There is a great need to develop new and effective therapies, therefore deepening understanding of cerebrovascular anatomy, physiology, and pathology is crucial. The main aim of the study was to develop a comprehensive classification of the pontine arteries considering their typology, relations to the cranial nerves, branching schemes, and superficial pontine blood supply areas. We prepared 100 anatomical specimens of the human brainstem with the basilar artery, the pontine arteries, and the terminal perforating arteries. With the use of microsurgical microscope, we analyzed morphometry of the basilar artery, origins, courses, and branching patterns of the pontine arteries as well as distribution of the terminal perforators in relation to pontine superficial vascular areas and the cranial nerves. Additionally, we studied presence of pontine branches of the superior cerebellar artery (SCA) and anterior inferior cerebellar artery (AICA). Repetitive branching patterns, origins, and courses led us to distinguish five types of the pontine arteries: type 1-the paramedian branches, type 2-the short circumflex branches, type 3-composition of the paramedian and the short circumflex branches, type 4-long circumflex branches, and type 5-median branches penetrating the pons along the basilar sulcus. Types 1, 2, and 4 were described in the literature previously, but the classification did not include the median branches (the most prevalent branches) and frequently occurring combinations of the types 1 and 2. There were seven pontine arteries on both sides on average that presented the following general pattern: the first pontine artery below the SCA is a type 4 vessel called the posterolateral pontine artery and it is followed by a type 2 vessel-the superolateral pontine artery; the next three arteries represent the types 1, 2, and 3 and supply most of the ventral pontine surface; the sixth artery-the anterolateral pontine artery-is a short circumflex branch and the seventh artery, originating below the AICA, represents long circumflex arteries. Occlusion of each of the abovementioned vessels relates to a specific pontine vascular syndrome. As explained by the phylogenesis and ontogenesis of the central nervous system, the pontine arteries are subject to variability. The SCA and the AICA took part in the pontine blood supply in 2.5% and 12.5% of cases, respectively, therefore neurovascular interventions involving the SCA, or the AICA may lead to pontine ischemia. Contact of the pontine arteries with the cranial nerves depends on the vessel type and origin location.

Factors Contributing to Risk of Persistence of Positive and Negative Symptoms in Schizophrenia during Hospitalization.

The aim of the study was to evaluate factors that may contribute to the persistence of positive, negative and other psychopathological symptoms of schizophrenia. All patients were treated in general psychiatric wards between January 2006 and December 2017. The initial study sample comprised of the medical reports of 600 patients. The main, specified inclusion criterion for the study was schizophrenia as a discharge diagnosis. Medical reports of 262 patients were excluded from the study due to no neuroimaging scans being available. The symptoms were categorised into three groups: positive, negative, and other psychopathological symptoms. The statistical analysis comprised modalities such as demographic data, clinical symptoms, as well as neuroimaging scans linking them to a potential impact of sustaining the mentioned groups of symptoms during the period of hospitalization. The analysis revealed that statistically significant risk factors of persistence of the three groups of symptoms are the elderly age, the increasing toll of hospitalizations, suicidal attempts in medical history, a family history of alcohol abuse, the presence of positive, negative and other psychopathological symptoms on admission to the hospital, as well as the absence of cavum septi pellucidi (CSP). The study showed that addiction to psychotropic drugs and a family history of schizophrenia were more frequent in patients with persistent CSP.

Meningovertebral ligaments could be a barrier for migration of a herniated intervertebral disc: An anatomical study.

Purpose: Intervertebral disc degeneration can manifest as sequestration. In most cases, the material could be found ipsilateral to the annular tear; however, a contralateral migration is also possible. We present an anatomical description of anterior meningovertebral ligaments (MVLs) as a possible barrier for disc migration. Methods: Anatomical dissection of 20 fresh human cadavers was carried out. Complete lumbar laminectomies with facetectomies were performed. All lumbar segments were exposed. Morphologic and morphometric descriptions of anterior MVLs were presented, with special attention to possible routes of herniated disc migration. Results: Anterior MVLs were present in all cases. They were divided in three separate groups: medial, lateral, and attached to the nerve roots. The medial group was the thickest, its mean length was 26.2 ± 1.2 mm, and it had no attachment to the disc in 51% of cases. The lateral group was less firm than the medial group, its mean length was 26.9 ± 1.0 mm, and it had no relation with the disc in 47% of cases. Ligaments related to the nerve root were the most delicate and always attached to the intervertebral disc. Their mean length was 14.9 ± 1.8 mm. Conclusions: The medial group of anterior MVLs are strong connective tissue bands dividing the anterior epidural space. The lateral group is more delicate, and in most cases, lateral MVLs lack annular attachment. MVLs could be an anatomical barrier for disc migration in particular cases.

Mechanism of Spontaneous Intracerebral Hemorrhage Formation: An Anatomical Specimens-Based Study.

BACKGROUND: Despite advances in understanding various risk and prognostic factors, spontaneous intracerebral hemorrhage is connected to very high morbidity and mortality, while the therapy is mainly supportive. Understanding of the pathophysiology of initial hematoma expansion is limited due to insufficient clinical data and lack of a suitable animal model. METHODS: We injected 40 anatomic specimens of the basal ganglia with contrast medium, scanned them with a micro-computed tomography scanner and analyzed the results of radiological studies, direct and histological examinations. RESULTS: In 9 cases, micro-computed tomography and histological examinations revealed contrast medium extravasations mimicking intracerebral hematomas. The artificial hematomas spread both proximally and distally along the ruptured perforator and its branches in the perivascular spaces and detached the branches from the adjacent neural tissue leading to destruction of the tissue and secondary extravasations. Moreover, some contrast extravasations skipped to the perivascular spaces of unruptured perforators, created further extravasation sites and aggravated the expansion of the artificial hematoma. There was no subarachnoid extension of any artificial hematoma. CONCLUSIONS: We postulate that a forming basal ganglia intracerebral hematoma spreads initially in the perivascular space, detaches the branches from the neural tissue and causes secondary bleeding. It can also skip to the perivascular space of a nearby perforator. The proposed mechanism of hematoma initiation and formation explains extent of damage to the neural tissue, variability of growth in time and space, creation of secondary bleeding sites, and limited usefulness of surgical interventions. The model is reproducible, the extent of the artificial hematoma can be easily controlled, the rupture sites of the perforating arteries can be determined, and preparation of the model does not require specialized, expensive equipment apart from the micro-computed tomography scanner.

Magnetic resonance imaging of the brachial plexus. Part 2: Traumatic injuries.

The most common indications for magnetic resonance imaging (MRI) of the brachial plexus (BP) are traumatic injuries. The role of MRI of the BP has increased because of recent trends favoring earlier surgery. Determining preganglionic vs. postganglionic injury is essential, as different treatment strategies are required. Thus, MRI of the BP should be supplemented with cervical spine MRI to assess the intradural part of the spinal nerves, including highly T2-weighted techniques. Acute preganglionic injuries usually manifest as various combinations of post-traumatic pseudomeningocele, the absence of roots, deformity of nerve root sleeves, displacement of the spinal cord, hemorrhage in the spinal canal, presence of scars in the spinal canal, denervation of the back muscles, and syrinx. Spinal nerve root absence is more specific than pseudomeningocele on MRI. Acute postganglionic injuries can present as lesions in continuity or tears. The following signs indicate injury to the BP: side-to-side difference, swelling, partial, or total BP rupture. Injury patterns and localization are associated with the mechanism of trauma, which implies a significant role for MRI in the work-up of patients. The identification and description of traumatic lesions involving the brachial plexus need to be systematic and detailed. Using an appropriate MRI protocol, obtaining details about the injury, applying a systematic anatomical approach, and correlating imaging findings to relevant clinical data to make a correct diagnosis. Information about the presence or suspicion of root avulsion should always be provided.

Magnetic resonance imaging of the brachial plexus. Part 1: Anatomical considerations, magnetic resonance techniques, and non-traumatic lesions.

For magnetic resonance imaging (MRI) of non-traumatic brachial plexus (BP) lesions, sequences with contrast injection should be considered in the differentiation between tumors, infection, postoperative conditions, and post-radiation changes. The most common non-traumatic inflammatory BP neuropathy is radiation neuropathy. T2-weighted images may help to distinguish neoplastic infiltration showing a high signal from radiation-induced neuropathy with fibrosis presenting a low signal. MRI findings in inflammatory BP neuropathy are usually absent or discrete. Diffuse edema of the BP localized mainly in the supraclavicular part of BP, with side-to-side differences, and shoulder muscle denervation may be found on MRI. BP infection is caused by direct infiltration from septic arthritis of the shoulder joint, spondylodiscitis, or lung empyema. MRI may help to narrow down the list of differential diagnoses of tumors. The most common tumor of BP is metastasis. The most common primary tumor of BP is neurofibroma, which is visible as fusiform thickening of a nerve. In its solitary state, it may be challenging to differentiate from a schwannoma. The most common MRI finding is a neurogenic variant of thoracic outlet syndrome with an asymmetry of signal and thickness of the BP with edema. In abduction, a loss of fat directly related to the BP may be seen. Diffusion tensor imaging is a promising novel MRI sequences; however, the small diameter of the nerves contributing to the BP and susceptibility to artifacts may be challenging in obtaining sufficiently high-quality images.

Anatomical variants of the medioplantar oblique ligament and inferoplantar longitudinal ligament: an MRI study.

PURPOSE: The spring ligament complex (SL) is the chief static stabilizer of the medial longitudinal foot arch. The occurrence of normal anatomical variants may influence radiological diagnostics and surgical treatment. The aim of this study was to evaluate anatomical variants of the part of SL located inferior to the talar head (i-SL), medioplantar oblique ligament (MPO) and inferoplantar longitudinal ligament (IPL). METHODS: We included 220 MRI examinations of the ankle performed on a 3.0 T engine. Only patients with a normal SL were included. Two musculoskeletal radiologists assessed the examinations and Cohen's kappa was used to assess agreement. Differences between groups were assessed using the chi-squared test; p < 0.05 was considered as significant. The final decision was made by consensus. RESULTS: Most commonly, i-SL was composed of the two ligaments IPL and MPO n = 167 (75.9%); in this group, bifid ligaments occurred in 19.2%, most commonly in the MPO. A branch to the os cuboideum was seen in n = 17 (10.2%). Three ligaments were seen in n = 52 (23.6%). In this group, bifid ligaments occurred in 13.5%; most commonly, the IPL was bifid and a branch to the os cuboideum was noted in n = 6 (11.5%). In one case, n = 1 (0.04%), we identified MPO, IPL and two accessory ligaments. No significant relationship was noted between the number of ligaments, the presence of bifid ligaments and side or gender (p > 0.05). CONCLUSION: More than two aligaments were seen in 24.1% of examined cases, the most common variant was the presence of MPO, IPL and one accessory ligament.

Morphological Analysis of Cerebral Artery Fenestrations and Their Correlation with Intracranial Aneurysms.

BACKGROUND: Fenestrations of cerebral arteries are congenital variants that develop when primitive vessels fuse incompletely. An association between the incidence of aneurysm and a fenestrated artery has been noted in the radiological literature. However, technical limitations of radiological studies may hamper visualization of small fenestrations and aneurysms. We sought to analyze a large, postmortem collection of human brains to assess the association between aneurysm formation and the presence of fenestrations. METHODS: This study included 333 formalin-fixed brains. The arachnoid was dissected under a microscope, the cerebral arteries were completely exposed, and fenestrations and aneurysms were identified and measured. For each specimen, age, sex, and all vascular abnormalities and variations were recorded for analysis. RESULTS: Fenestrations were present in 41% of the specimens, and 37% of these were multiple. Fenestrations were 3.1 ± 2.5 mm long and most commonly occurred in the anterior communicating artery (63%). Aneurysms were present in 8% of the specimens, usually in the anterior communicating artery or the middle cerebral artery. An aneurysm correlated with a fenestration was detected in 2% of all specimens (n = 4) and was not statistically significant (P = 0.18). CONCLUSIONS: Fenestrations of the intracranial arteries are a common anatomical finding. They are present most often in the anterior communicating artery. Most aneurysms were detected in the anterior communicating artery and middle cerebral artery. We conclude that the existence of an aneurysm in a fenestrated artery is an incidental, rather than causal, relationship.

Method of creating 3D models of small caliber cerebral arteries basing on anatomical specimens.

The cerebral circulation is a common site of vascular lesions and concurrent hemodynamic accidents, which often lead to serious neurological disabilities. Recent advances in understanding pathogenesis, improving diagnostics and developing new treatment methods for these conditions result from an interdisciplinary approach to the problem - linking clinical sciences, basic medical sciences and hemodynamical analyses. Most common techniques used in such studies include computational fluid dynamics, which allows for development of 3D models of cerebral vasculature, basing on radiological studies. However, these methods remain flawed, mainly because of their spatial resolution, which is not high enough to visualize the smallest arterial branches (perforating branches) in the models. That leaves the perforators (<1.0 mm) out of most of the contemporary studies, whilst their clinical importance is widely recognized in clinical practice. Obstruction of these vessels by atherosclerotic plaques, thrombi or implantation of flow diverting stents may result in neurological complications such as paralysis or coma. Our research team has recently developed a new method of creating 3D models of the cerebral arterial system based on anatomical specimens and micro computed tomography (micro-CT). We have infused fresh brainstem vasculature specimens with contrast medium, subsequently scanned them using an industrial-grade micro-CT system and finally, created spatial models, which included branches of diameter less than 0.1 mm. None of the current methods have been able to produce models of detail as high as this, which allows us to presume, that our procedure may open up new opportunities for hemodynamical studies within cerebral circulation and beyond.

A Comprehensive miRNome Analysis of Macrophages Isolated from db/db Mice and Selected miRNAs Involved in Metabolic Syndrome-Associated Cardiac Remodeling.

Cardiac macrophages are known from various activities, therefore we presume that microRNAs (miRNAs) produced or released by macrophages in cardiac tissue have impact on myocardial remodeling in individuals with metabolic syndrome (MetS). We aim to assess the cardiac macrophage miRNA profile by selecting those miRNA molecules that potentially exhibit regulatory functions in MetS-related cardiac remodeling. Cardiac tissue macrophages from control and db/db mice (an animal model of MetS) were counted and sorted with flow cytometry, which yielded two populations: CD45+CD11b+CD64+Ly6Chi and CD45+CD11b+CD64+Ly6Clow. Total RNA was then isolated, and miRNA expression profiles were evaluated with Next Generation Sequencing. We successfully sequenced 1400 miRNAs in both macrophage populations: CD45+CD11b+CD64+Ly6Chi and CD45+CD11b+CD64+Ly6Clow. Among the 1400 miRNAs, about 150 showed different expression levels in control and db/db mice and between these two subpopulations. At least 15 miRNAs are possibly associated with MetS pathology in cardiac tissue due to direct or indirect regulation of the expression of miRNAs for proteins involved in angiogenesis, fibrosis, or inflammation. In this paper, for the first time we describe the miRNA transcription profile in two distinct macrophage populations in MetS-affected cardiac tissue. Although the results are preliminary, the presented data provide a foundation for further studies on intercellular cross-talk/molecular mechanism(s) involved in the regulation of MetS-related cardiac remodeling.

The twisted structure of the fetal calcaneal tendon is already visible in the second trimester.

INTRODUCTION: The progress in morphological science results from the greater possibilities of intra-pubic diagnosis and treatment of congenital disabilities, including the motor system. However, the structure and macroscopic development of the calcaneal tendon have not been investigated in detail. Studies on the adult calcaneal tendon showed that the calcaneal tendon is composed of twisted subtendons. This study aimed to investigate the internal structure of the fetal calcaneal tendon in the second trimester. MATERIALS AND METHODS: Thirty-six fetuses fixed in 10% formaldehyde were dissected using the layer-by-layer method and a surgical microscope. RESULTS: The twisted structure of the calcaneal tendon was revealed in all specimens. The posterior layer of the calcaneal tendon is formed by the subtendon from the medial head of the gastrocnemius muscle. In contrast, the anterior layer is formed by the subtendon from the lateral head of the gastrocnemius muscle. The subtendon from the soleus muscle constitutes the anteromedial outline of the calcaneal tendon. The lateral outline of the calcaneal tendon is formed by the subtendon originating from the medial head of the gastrocnemius muscle. In contrast, the medial outline is formed by the subtendon from the soleus muscle. In most of the examined limbs, the plantaris tendon attached to the tuber calcanei was not directly connected to the calcaneal tendon. CONCLUSIONS: The twisted structure of the subtendons of the fetal calcaneal tendon is already visible in the second trimester and is similar to that seen in adults.

Assessing functional status of cardiac lymphatics: From macroscopic imaging to molecular profiling.

Here we describe various techniques for visualization of the lymphatic vasculature, particularly in the heart. Addressing macro-, microscopic, and molecular levels of lymphatic organization, we give examples of how to explore the roles of specific antigens/markers expressed in lymphatic vessels and their extracellular matrix as structural and functional elements involved in various biological functions of lymphatics. Some obstacles and technical challenges related to lymphatic visualization are also discussed.

The Kager's fat pad radiological anatomy revised.

PURPOSE: The aim of the study was to map connections within the Kager's fat pad between the structures which limit it. METHODS: A retrospective re-review of 200 ankle magnetic resonance imaging (MRI) examination was conducted. Connections within the Kager's fat pad between the superior peroneal retinaculum, the fibulotalocalcaneal ligament, the posterior talocalcaneal ligament, the flexor hallucis longus, the paratenon of the Achilles tendon, the flexor retinaculum and bones were studied and a model of the connections was constructed. RESULTS: The superior peroneal retinaculum was directly connected with the fibulotalocalcaneal ligament in 85.5% of cases, the lateral part of the paratenon in 82.5%, the processus posterior tali in 78.5%, the posterior talofibular ligament in 32%, the flexor retinaculum in 29.5% and the anterior talofibular ligament in 9%. The fibulotalocalcaneal ligament was connected with the paratenon (on the medial side 88.5%, on the lateral side 68.5%), the flexor retinaculum in 70%, the posterior process of the talus in 79%, the osteofibrosus tunnel for the flexor hallucis longus in 53%, the posterior talofibular ligament in 43.5% and the calcaneofibular ligament in 10.5%. The posterior talocalcaneal ligament was connected with the fibulotalocalcaneal ligament in 71%, with the osteofibrosus tunnel for the flexor hallucis longus in 76.5%, with the flexor retinaculum in 70%. The plantaris tendon showed projection to the crural fascia in 34 of % cases. CONCLUSION: In the Kager's fat pad there are present more connections than previously reported. All the connections unit at the level of the posterior process of the talus.

The double fascicular variations of the anterior talofibular ligament and the calcaneofibular ligament correlate with interconnections between lateral ankle structures revealed on magnetic resonance imaging.

The anterior talofibular ligament and the calcaneofibular ligament are the most commonly injured ankle ligaments. This study aimed to investigate if the double fascicular anterior talofibular ligament and the calcaneofibular ligament are associated with the presence of interconnections between those two ligaments and connections with non-ligamentous structures. A retrospective re-evaluation of 198 magnetic resonance imaging examinations of the ankle joint was conducted. The correlation between the double fascicular anterior talofibular ligament and calcaneofibular ligament and connections with the superior peroneal retinaculum, the peroneal tendon sheath, the tibiofibular ligaments, and the inferior extensor retinaculum was studied. The relationships between the anterior talofibular ligament's and the calcaneofibular ligament's diameters with the presence of connections were investigated. Most of the connections were visible in a group of double fascicular ligaments. Most often, one was between the anterior talofibular ligament and calcaneofibular ligament (74.7%). Statistically significant differences between groups of single and double fascicular ligaments were visible in groups of connections between the anterior talofibular ligament and the peroneal tendon sheath (p < 0.001) as well as the calcaneofibular ligament and the posterior tibiofibular ligament (p < 0.05), superior peroneal retinaculum (p < 0.001), and peroneal tendon sheath (p < 0.001). Differences between the thickness of the anterior talofibular ligament and the calcaneofibular ligament (p < 0.001), the diameter of the fibular insertion of the anterior talofibular ligament (p < 0.001), the diameter of calcaneal attachment of the calcaneofibular ligament (p < 0.05), and tibiocalcaneal angle (p < 0.01) were statistically significant. The presence of the double fascicular anterior talofibular ligament and the calcaneofibular ligament fascicles correlate with connections to adjacent structures.

Distribution of the subtendons in the midportion of the Achilles tendon revealed in vivo on MRI.

The aim of the study was to check if the subtendons of the Achilles tendon can be identified in vivo on MRI in the midportion of the tendon. The relation of the plantaris tendon to the Achilles tendon was also examined. A retrospective study of 200 MRI of ankle joints including the Achilles tendon was conducted. Statistical analysis of the correlation between the possibility of identifying the subtendons and the side, gender, presence of the central soleus tendon and plantaris tendon variation was performed. The inter-observer agreement between two reviewers in their evaluation of the subtendons was assessed using kappa statistics. The subtendon from the lateral head of the gastrocnemius muscle was identified in 65% (k = 0.63) and was located in the anterior part of the Achilles tendon. The subtendon from the soleus muscle was recognized in 12% (k = 0.75) comprising anterior part of the tendon. In 6% the subtendon from the medial head of the gastrocnemius muscle was identified (k = 0.58). The central soleus tendon was identified in 85% of cases. Statistical analysis shows the weak correlation of the presence of the central soleus tendon and the possibility of identifying the subtendon from the soleus muscle. The plantaris tendon was directly related to the insertion of the Achilles tendon in 42.5%. Identification of the subtendons of the Achilles tendon on MRI is challenging, and most often it is only possible to find the subtendon of the lateral head of the gastrocnemius muscle.

Eccentric Exercise Reduces Upper Trapezius Muscle Stiffness Assessed by Shear Wave Elastography and Myotonometry.

In this study, we tested the hypotheses that unaccustomed eccentric exercise (ECC) would reduce the elastic modulus and dynamic stiffness of the upper trapezius muscle and that these changes would correlate with increases in muscle thickness, reflecting muscle edema. Shear wave elastography was used to measure elastic modulus, dynamic stiffness was assessed using myotonometry, and muscle thickness was measured using ultrasonography. All measurements were performed at four locations over the upper trapezius before and 24 h after a single bout of ECC. Fourteen healthy participants (11 males and 3 females; 23.2 ± 3.0 years; height 175.1 ± 10.4 cm; body mass 73.8 ± 11.3 kg) took part in the study. Overall, ECC resulted in decreased elastic modulus (from 45.8 ± 1.6 to 39.4 ± 1.2 kPa, p < 0.01) and dynamic muscle stiffness (from 369.0 ± 7.3 to 302.6 ± 6.0 N/m, p < 0.01). Additionally, ECC resulted in increased muscle thickness (from 6.9 ± 0.4 to 7.3 ± 0.4 mm, p < 0.01). Spatial changes (across the four locations) were found for elastic modulus, stiffness and thickness. No significant correlations were found between changes in measures of muscle stiffness, or between changes in stiffness and changes in thickness. In conclusion, the present pilot study showed that ECC altered biomechanical muscle properties, reflected by decreased elastic modulus and dynamic muscle stiffness 24 h after ECC.

Ossa Sesamoidea - prevalence of sesamoid bones in human hands.

BACKGROUND: This study describes the morphology of sesamoid bones in the human hand. Ultrasound imaging was used to record the presence and measurements of sesamoids in 120 hands of 60 healthy, young adults of Caucasian ethnicity. MATERIALS AND METHODS: The mean number of sesamoid bones was 4.16 in the left hand and 4.03 in the right hand. 21.6% of cases showed asymmetry between the right hand and the left. There was a significant difference in the prevalence of sesamoid bones between right and left hand in males in this study. Females show a higher incidence of sesamoid bones overall, but do not demonstrate a significant difference between the sides. RESULTS: Prevalence findings: Two in the 1st Metacarpophalangeal joint (MCPJ) in 99.2% of cases, with one case of a single bone. One in the 2nd MCPJ in 43.3% of cases. One in the 5th MCPJ in 84.2% of cases. One in the 1st Interphalangeal joint (IPJ) in 83.4%of cases. Aside from that there was one case of sesamoid in the 3rd MCPJ and separate case of sesamoid in the 3rd proximal IPJ. CONCLUSIONS: Moreover, this study discusses discrepancies of opinion regarding sesamoid bones in morphological research.

Morphology and morphometry of pulmonary veins and the left atrium in multi-slice computed tomography.

PURPOSE: Pulmonary veins are involved in pathogenesis and treatment of atrial fibrillation and structures at risk during thoracic surgeries. There is lack of data regarding pulmonary vein morphology and morphometry in normal population. METHODS: The study was conducted using 135 chest computed tomography studies with intra-venous iodine contrast injection. The study population contained 86 females and 49 males, mean age was 60. 13 had atrial fibrillation.The studies were analyzed using radiological workstation. RESULTS: Mean dimensions of the left atrium: transverse 52 mm, coronal 49 mm, and sagittal 35 mm. The mean volume of the left atrium was 93 cm3. The mean volume of the left atrium in patients with atrial fibrillation was 176 cm3. The sagittal dimension and the volume of the left atrium were correlated with age, r = 0.43 and r = 0.42, respectively. Surface area of the left inferior pulmonary vein ostium was 136 mm2, significantly less than the surface area of other ostia of pulmonary veins. The mean distance between two pulmonary veins was 5.42 mm on the right and 4.02 mm on the left side. 13 types of pulmonary veins outflow patterns were described on the right side and 5 types on the left side. 66.7% of right pulmonary veins and 82% of the left pulmonary veins emptied into the left atrium with two venous trunks on each side (the typical pattern). CONCLUSIONS: Morphological features of pulmonary veins and morphometry of the left atrium and pulmonary veins are important for clinical purposes and are in accordance with previous papers.