Multiple variations in the branching pattern of the abdominal aorta.

We report on a unique clinically and surgically significant case of multiple abdominal aorta variations. Specifically, the left inferior phrenic, left gastric and splenic artery arose in common from the left aspect of the aorta constituting a common phrenogastrosplenic trunk, while the common hepatic artery originated separately from the midline of the anterior aspect of the aorta just inferiorly to the trunk. An accessory right hepatic artery arises from the right-anterior aspect of the abdominal aorta adjacent to superior mesenteric artery origin. On the left side, two renal arteries were observed. Moreover, the left gonadal artery exhibited a high origin, arising inferiorly to the upper left renal artery. We discuss about the embryological development of abdominal aorta arterial abnormalities and we attempt to sort the noticed variations according to existing classification in the literature. It is highlighted that the thorough knowledge of these arterial variations is important for the success of upper abdomen surgical operations such as liver and kidney transplantation, kidney preservation, abdominal aorta related vascular surgery, treatment of hepatocellular carcinoma by transcatheter arterial chemoembolizations as well as imaging interpretation of the region. Preoperative selective angiography or other abdominal aorta imaging studies are helpful for arterial variation demonstration and a precious tool for appropriate surgery planning.

DNA repair enables sex identification in genetic material from human teeth.

BACKGROUND: The purpose of this study was to test the effectiveness of a DNA repair protocol in improving genetic testing in compromised samples, frequently encountered in Forensic Medicine. METHODS: In order to stretch the experiment conditions to the limits, as far as quality of samples and DNA is concerned, we tried the repair protocol on ten ancient human teeth obtained from an equal number of skeletons from a burial site in Lerna, Middle Helladic Greece (2100-1700 BC). For these samples, sex was previously determined morphologically, serving as a reference to compare our molecular data with. The samples were analysed using the DNA amelogenin sex test assay prior and after DNA polymerase repair. For every individual, two molecular sex determinations were obtained by visualising PCR products on an agarose gel. RESULTS: DNA repair enabled genetic testing in these samples. Successful amplification of the amelogenin gene was obtained only from the repaired DNA in eight out of ten samples. Prior to the repair treatment, none of these samples yielded any PCR products, thus attesting to the authenticity of the amplified sequence. The concordance between morphological and molecular analysis was in reasonable agreement (71%). CONCLUSIONS: These results reveal the impact of the repair process in studying single copy genes from low quality DNA. This protocol could facilitate molecular analysis in compromised samples, encountered in forensic medicine, as well as enable genetic studies in ancient remnants.

The combination of silver techniques for studying the pathology of Alzheimer's disease.

Alzheimer's diseaseis a progressive neurodegenerative disorder, which implicates the whole central nervous system. The hallmarks of the disease are the development of neuritic plaques and neurofibrillary tangles, the accumulation of beta-amyloid in the cytoplasm of the neurons (soluble beta-amyloid oligomers) and the neuropile space (insoluble amyloidal fibrils), the neuronal loss, and the devastating synaptic alterations. Despite the fact that for the identification of the plaques and tangles and for the detection of the amyloid deposits and the neuronal loss, there are specific techniques even in light microscopy, synaptic pathology can be studied only with electron microscopy or indirectly with immunohistochemistry, because several alterations in the density of proteins located in synaptic junction (drebrin, synapsin, synaptophisin) may be occurring. Thus, this article presents original Nauta method impregnating degenerating axons as well as axonic terminals in post-mortem material derived from patients suffering from Alzheimer's disease. Furthermore, the article proposes its application in combination with Golgi method and Gallyas technique for a spheroid view of the neuronal degeneration and synaptic pathology in the study of any brain region in Alzheimer's disease.

Reelin immunoreactivity and morphological analysis of the human visual cortex.

Reelin is a secreted glycoprotein with a crucial role in development of the Central Nervous System. In adults, its function remains unclear but it may be involved in the modulation of synaptic plasticity. Having in mind this possible property of reelin, the authors decided to study the distribution of reelin immunoreactivity in the neurons of the human adult primary visual cortex and compare the findings with morphological analysis (Golgi method) of neuronal networks. The distribution of reelin in the primary visual cortex is different from other cortical area examined; reelin is mostly present in the neurons of second and sixth layer.

Adult sudden death caused by aspiration of chewing gum.

A case of a fatal foreign material aspiration is presented in the following text. A 24-year-old white male died suddenly. A piece of chewing gum lodged in a pool of frothy fluid was revealed at autopsy. Microscopic examinations revealed atelectasia emphysema, eosinophilic exudate and empty spaces. Blood and urine samples were analyzed, for alcohol and drug use by fluorescence polarization immunoassay (FPIA) on an Abbott AXSYM system. No alcohol or other drugs were detected in blood or urine.

Amphetamine derivative related deaths in northern Greece.

Until 1997, only one amphetamine related derivatives (AMPs) fatality had been reported in Greece. Since then, amphetamine (AMP) or AMPs have been found in seven out of 1,500 post-mortem toxicological cases. The cause and manner of death of these seven cases were: 3,4-methylenedioxy-N-methamphetamine (MDMA) and 3,4-methylenedioxy-N-ethylamphetamine (MDEA) poisoning (n = 1), drowning in water (n = 4), cranial injuries caused by a traffic accident (n = 1) and heart failure (n = 1). In the case where the use of AMP or AMPs was considered, the immediate cause of death post-mortem toxicological analysis revealed 2 microg/ml MDMA and 0.7 microg/ml MDEA in blood. MDMA was identified in two cases of drowning (2 microg/ml in blood in the first case and 1.7 microg/g in liver in the second case) and in the traffic accident case (0.4 microg/g in liver). Methamphetamine was detected in two cases of drowning (2.5 microg/ml in blood in the first case and 6 microg/g in liver in the second case). AMP was found in the heart failure case (0.2 microg/g in liver). Alcohol was present, together with AMP or AMPs, in four cases. These findings indicate an increase in the illegal abuse of AMPs in Greece. Because of this, we now routinely screen for AMPs.

Determination of opiates in postmortem bone and bone marrow.

Bone and bone marrow of a fatally poisoned heroin addict were analyzed by FPIA and GC-FID, immediately after death. A piece of the bone from the above case was buried for 1 year and analyzed by the same procedure. Morphine was detected in all specimens at concentrations of 195, 340 and 155 ng/g for bone marrow, bone and buried bone, respectively. A loss of 54.4% of morphine concentration was observed during 1-year burial. Such findings have potential forensic value in cases of skeletonized remains.

Bioequivalence of two tablet formulations of atenolol after single oral administration in healthy volunteers.

The pharmacokinetic parameters of two oral formulations of 100 mg tablets of atenolol (CAS 29122-68-7; Azectol as test and another commercially available preparation as reference) were compared in an open-label, randomized, single oral dose, two-period cross-over design to 17 healthy volunteers under fasting conditions. Serial blood samples were collected prior to each administration and at 17 points within 36 h after dosing. Plasma concentrations of atenolol were measured by a validated HPLC assay with fluorometric detection. The parametric 90% confidence intervals of the geometric mean values of the test/reference ratios were 94.4% to 112.9% (point estimate: 103%) for AUC0-infinity, 93.7% to 112.8% (point estimate: 103%) for AUC0-36, and 88.3% to 112.1% (point estimate: 100%) for Cmax, within the acceptance criteria for bioequivalence (80%-125%). Tmax values were analyzed by the nonparametric Wilcoxon test and the difference was not statistically significant. Therefore, it is concluded that the test and reference atenolol formulations are bioequivalent for both the extent and the rate of absorption.

Microsurgical Study of the Dorello's Canal.

The microsurgical anatomy of Dorello's canal was examined in 20 cadaver specimens. The study included dissections of this anatomic structure, under operative microscope and using microsurgical instruments. The detailed microanatomy of the canal was defined, as well as its relation to the sixth nerve, the clivus, the petrous apex, and the adjacent neurovascular elements.

Magnesium, calcium and zinc fluctuations on skin induced injuries in correlation with time of induction.

In the present study, fluctuations of trace elements Mg, Ca and Zn concentrations with time on skin-induced injuries was investigated. To accomplish this, 144 animals (pig) aged between 5-6 months scheduled for food provision process (slaughter) were used. At the gluteus area, injuries were induced prior to slaughter at intervals of 30 s, 30 min, 1, 2, 4, 8 h. Local anaesthesia and cold therapy for prompt relief of pain (ethylchloride, C2H5Cl) was applied. Postmortem tissue excision in and around the injured site was promptly performed. The tissue obtained was segmented into three zones of equal distances (2 cm) in between and weighed 3 g wet weight. Tissue specimens were analysed by atomic absorption spectroscopy for the three elements. The results were correlated with time of injury. Suggestive alterations in trace elements mean concentrations with time were confirmed. The ratios of the mean in twos (Ca/Zn, Ca/Mg, Mg/Zn) versus time were graphed. Effectively, the curves achieved by analysing postmortem tissues, serve to estimate the time of an injury induced in vivo.