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1.
Sci Rep ; 13(1): 11016, 2023 07 07.
Article in English | MEDLINE | ID: mdl-37419905

ABSTRACT

Ligaments anatomy often show a huge anatomy variations between species and individuals. For example calcaneofibular ligaments (CFL) characterize the great variability of morphological shape or presence of additional bands. The aim of this study was to propose first anatomical classification of CFL concerning on human fetuses. We investigated thirty spontaneously-aborted human fetuses aged 18-38 weeks of gestation at death. Sixty lower limbs (30 left and 30 right) fixed in 10% formalin solution were examined. The morphological variability of CFL was assessed. Four types of CFL morphology were observed. Type I was characterized by a band shape. This was the most common type, occurring in 53% of all cases. Based on our study we are proposing a classification based on four morphological types of CFL. Types 2 and 4 are further divided into subtypes. Present classification may be useful to better understand the anatomical development of ankle joint.


Subject(s)
Lateral Ligament, Ankle , Humans , Lateral Ligament, Ankle/anatomy & histology , Cadaver , Ankle Joint/anatomy & histology , Ligaments , Fetus
2.
Ann Anat ; 243: 151920, 2022 Aug.
Article in English | MEDLINE | ID: mdl-35278660

ABSTRACT

BACKGROUND: The purpose of this study was to characterize the morphology of the fibularis tertius (FT) in human fetuses, and to provide a classification based on its modes of origin in human fetuses. METHODS: The material comprised 100extremities from 50 spontaneously aborted human fetuses (19 male, 31 female, 100 lowerlimbs in total), aged 18-38 weeks of gestation. These were dissected and the presence or absence of the FT muscle as well as the type of its proximal attachment were determined, and the FT was measured morphometrically. RESULTS: The FT was present in 50% of fetuses. Four types of FT muscle origin were identified. The most common was Type 2, characterized by an origin on the middle third of the fibula and the intermuscular septum. Three other types were observed: Type 1 with an origin located on proximal third of the fibula and to the intermuscular septum, Type 3 characterized by an absent muscle belly, and an independent tendon originating from the that of the extensor digitorum longus, and Type 4 with an origin located on the distal third of the fibula and the intermuscular septum. CONCLUSIONS: The fibularis tertius demonstrates high morphological variability, with the most common origin located on third of the fibula and to the intermuscular septum.


Subject(s)
Leg , Muscle, Skeletal , Cadaver , Female , Fetus , Humans , Leg/anatomy & histology , Male , Muscle, Skeletal/anatomy & histology , Tendons/anatomy & histology
3.
Folia Morphol (Warsz) ; 80(1): 106-113, 2021.
Article in English | MEDLINE | ID: mdl-32020575

ABSTRACT

BACKGROUND: Although duodenal diverticula are associated with less frequent pathology than the colonic diverticula in the large intestine, their periampullary position may have significant clinical implications. The aim of the study was to identify any possible correlation between the type of localisation of the major duodenal papilla, duodenal diverticula, and some particular clinical issues. MATERIALS AND METHODS: In total, 628 patients (408 females and 220 males; aged 21-91 years), who underwent endoscopic retrograde cholangiopancreatography were included in this study. The patients were divided into two groups: a study group comprising 66 (10.5%) patients with periampullary position of diverticula (group A), and a control group comprising 562 (89.5%) patients without diverticula (group B). RESULTS: A duodenal diverticulum was diagnosed in the periampullary position in 66/628 (10.5%) patients: 41 women (aged 52-91 years) and 25 men (aged 54-83 years). CONCLUSIONS: Three types of localisation were observed for the major duodenal papilla with regard to the diverticula, with the most common type being next to each other (type III). In patients with diverticula, similar frequencies of gallstone occurrence are observed in men and women. Patients with papilla in the diverticulum who underwent cholecystectomy are more prone to develop lithiasis.


Subject(s)
Ampulla of Vater , Diverticulum , Duodenal Diseases , Taste Buds , Cholangiopancreatography, Endoscopic Retrograde , Female , Humans , Male
4.
Folia Morphol (Warsz) ; 80(4): 827-838, 2021.
Article in English | MEDLINE | ID: mdl-32964409

ABSTRACT

BACKGROUND: The inferior mesenteric artery (IMA) is the third main branch of the abdominal aorta and arises at the level of L3, supplying the large intestine from the distal transverse colon to the upper part of the anal canal. The aim of this study was to characterise the course and morphology of the terminal branches of the IMA, and also creating a new IMA classification, which seems to be necessary for clinicians performing surgery in this area. MATERIALS AND METHODS: The anatomical variations in the branching patterns of the IMA were examined in 40 cadavers fixed in a 10% formalin solution. Morphometric measurements were then obtained twice by two researchers. RESULTS: Due to the proposed classification system, type I characterised by a common trunk preceding bifurcation into sigmoidal branches and the superior rectal artery after giving left colic artery (LCA) occurred in 57.5% of cases, type II, trifurcation type, in 25%, type III with the superior rectal arteries originating firstly from the IMA in 5%, type IV with the ascending lumbar artery in 10% of cases and type V, a novelty, in 2.5%. The origin of IMA was observed at the level of L2/L3 in 22.5% of cases, at L3 in 25% of cases, at L3/L4 in 15% of cases, at L4 in 35% of cases and at the level of L5 in 2.5% of cases. More than one third (38.1%) of total cases with additional arteries and rapidly bifurcating branches occurred in types III, IV, and V. In women, only the IMA and LCA were significantly narrower than in men. Only the diameter of the IMA correlated with the diameter of the superior rectal artery. CONCLUSIONS: The IMA is characterised by high morphological variability. The introduction of a new, structured, anatomical classification seems necessary for all clinicians.


Subject(s)
Arteries , Mesenteric Artery, Inferior , Female , Humans , Male , Retrospective Studies
5.
Folia Morphol (Warsz) ; 80(3): 567-574, 2021.
Article in English | MEDLINE | ID: mdl-32710792

ABSTRACT

BACKGROUND: The diaphragm is supplied by the superior and inferior phrenic arteries. This present study focusses on the latter. The inferior phrenic arteries (IPA) usually originate from the abdominal aorta. The two arteries have different origins, and knowledge of these is important when performing related surgical interventions and interventional radiological procedures. The aim of this study was to identify variations in the origin of the IPA and conduct relevant morphometric analyses. MATERIALS AND METHODS: The anatomical variations in the origins of the left inferior phrenic artery (LIPA) and the right inferior phrenic artery (RIPA) were examined in 48 cadavers fixed in 10% formalin solution. A dissection of the abdominal region of the cadavers was performed according to a pre-established protocol using traditional techniques. Morphometric measurements were then taken twice by two of the researchers. RESULTS: In the cadavers, six types of origin were observed. In type 1, the most common type, the RIPA and LIPA originate from the abdominal aorta (AA) (14 = 29.12%). In type 2, the RIPA and the LIPA originate from the coeliac trunk (CT) (12 = 24.96%). In type 3, the RIPA and the LIPA originate from the left gastric artery, with no CT observed (3 = 6.24%). Type 4 has two subtypes: 4A, in which the LIPA originates from the AA and the RIPA originates from the CT (9 = 18.72%) and 4B, in which the RIPA originates from the AA and the LIPA originates from the CT (6 = 12.48%). In type 5, the LIPA originates from the AA and the RIPA originates from the AA (1 = 2.08%). Type 6 is characterised by the RIPA and LIPA forming a common trunk originating from the CT (3 = 6.24%). CONCLUSIONS: Our findings suggest the presence of six different types of LIPA and RIPA origin. The most common form is type 1, characterised by an IPA originating from the abdominal aorta, while the second most common is type 2, in which the IPA originates from the AA by a common trunk. The diversity of other types of origin is associated with the occurrence of coeliac trunk variation (type 3). No significant differences in RIPA diameter could be found, whereas LIPA diameter could vary significantly. No significant differences in RIPA and the LIPA diameter could be found according to sex.


Subject(s)
Aorta, Abdominal , Celiac Artery , Cadaver , Diaphragm , Gastric Artery , Humans
6.
Ann Anat ; 231: 151506, 2020 Sep.
Article in English | MEDLINE | ID: mdl-32173563

ABSTRACT

PURPOSE: The plantaris muscle (PM) is typically characterized by a short, slim and spindle-shaped muscle belly and long, thin tendon. It is situated posterior to the popliteal muscle, and anterior to the lateral head of the gastrocnemius muscle (GM). Little information exists regarding the high variability of origin of the PM. The main aim of the study was hence to characterize the morphology of the PM and its place of origin, classify it and evaluate its prevalence. METHODS: Classical anatomical dissection was performed on 142 lower limbs (77 left, and 65 right) fixed in 10% formalin solution. The morphology of the origin of the PM and its prevalence was evaluated. RESULTS: The PM was present in 128 lower limbs (90.1%). Six types of origin were observed, the most common being Type I (48.4%). This type was divided into two subtypes (A-B): subtype A attaching to the lateral head of the GM, lateral femoral condyle and to the capsule of the knee joint, and subtype B, attaching to the lateral head of the GM, the lateral femoral condyle, knee joint capsule and the popliteal surface of the femur. The second most common type was Type II (25%), attaching to the capsule of the knee joint and, indirectly, to the lateral head of the GM through the lateral femoral condyle. The third most common type was Type III (10.15%), attaching to the lateral femoral condyle and the knee joint capsule. Type IV (6.25%), the rarest type, attached to the lateral femoral condyle, knee joint capsule and to the iliotibial band. Type V (8.6%) originated only from the lateral condyle of the femur. Type VI (1.6%) contains only "rare cases". CONCLUSION: The PM presents high morphological variability, and its status as a residual muscle should be reconsidered. Our presented classification of its types of origin is a valuable addition for both clinicians and anatomists. Level of Evidence - II Basic Science Research.


Subject(s)
Knee Joint/anatomy & histology , Muscle, Skeletal/anatomy & histology , Adult , Aged , Aged, 80 and over , Cadaver , Dissection , Female , Humans , Leg/anatomy & histology , Male , Middle Aged , Muscle, Skeletal/physiology
7.
Folia Morphol (Warsz) ; 79(4): 817-822, 2020.
Article in English | MEDLINE | ID: mdl-31802470

ABSTRACT

BACKGROUND: The abductor pollicis longus (APL) originates from the lateral part of the dorsal surface of the body of the ulna below the insertion of the anconeus muscle, from the interosseous membrane, and from the middle third of the dorsal surface of the body of the radius. However, the number of its accessory bands and their insertion vary considerably. MATERIALS AND METHODS: Fifty upper limbs (2 paired, 31 male, 19 female) were obtained from adult Caucasian cadavers, and fixed in 10% formalin solution before examination. RESULTS: The APL muscle was present in all specimens. The muscles were divided into three main categories, with type II and III being dived into subtypes. Type I was characterised by a single distal attachment, with the tendon inserting to the base of the I metacarpal bone. Type II was characterised by a bifurcated distal attachment, with the main tendon inserting to the base of the first metacarpal bone; this type was divided into three subtypes (a-c). Type III was characterised by the main tendons inserting to the base of the first metacarpal bone, while the accessory band was characterised by mergers (fusion) with other tendons. This type was divided into two subtypes (a, b). CONCLUSIONS: The abductor pollicis longus is characterised by high morphological variability.


Subject(s)
Forearm , Muscle, Skeletal , Female , Hand , Humans , Male , Pilot Projects , Tendons , Thumb
8.
Folia Morphol (Warsz) ; 79(3): 645-648, 2020.
Article in English | MEDLINE | ID: mdl-31565787

ABSTRACT

The Pes Anserinus is characterised by high morphological variability. It consists of three tendons: the sartorius, gracilis and semitendinosus. The semitendinosus and gracilis tendons are routinely harvested for reconstruction anterior cruciate ligament, and the presence of accessory bands within them can handicap the harvesting process. This report presents a case of a rare insertion of accessory band of the semitendinosus tendon (to the fascia of the soleus muscle and tibia). The current classification should be extended to accommodate such "rare cases" to facilitate more successful hamstring grafts.


Subject(s)
Hamstring Tendons/pathology , Aged , Female , Humans
9.
Folia Morphol (Warsz) ; 78(4): 738-745, 2019.
Article in English | MEDLINE | ID: mdl-30906974

ABSTRACT

BACKGROUND: Confirming the branching pattern of the deep femoral artery (DFA) is vital in planning radiological and surgical procedures involving the medial circumflex femoral artery (MFCA) and the lateral circumflex artery (LFCA). The aim of this study was to characterise the course and morphology of branches of the DFA. MATERIALS AND METHODS: The anatomical dissection included 80 lower limbs which were fixed in 10% formalin solution. A dissection of the femoral region was carried out according to a pre-established protocol, using traditional techniques. Morphometric measurements were obtained twice by two researchers. RESULTS: Six types of medial and lateral femoral circumflex artery variations were distinguished. In type I, the DFA divides into the MFCA and the LFCA (observed in 45% of cases). In type II, the MFCA is absent and the LFCA origin normally from the DFA (18.75%). In type III, the MFCA arises from the femoral artery above the origin of the DFA, while the LFCA starts from the DFA (15%). Finally, in type IV, the LFCA arises from the femoral artery above the origin of the DFA, while the MFCA starts from the DFA (10%). In type V, the LFCA origin alone from the femoral artery below the origin of the DFA, while the MFCA origin from the DFA (7.5%), while in type VI (3.75%), both the MFCA and the LFCA origin from the femoral artery. The mean diameter of the femoral artery at the level of the DFA origin was greatest in type 2 (10.62 ± 2.07 mm) and the least in type 6 (7.90 ± 1.72 mm; p = 0.0317). The distance from inguinal ligament to where the DFA arose was the greatest in type 6 (78.24 ± 29.74 mm) and least in type 5 (28.85 ± 11.72 mm; p = 0.0529). CONCLUSIONS: The medial and lateral femoral circumflex arteries were characterised by high morphological variations. The diameter of the femoral artery at the level of inguinal ligament correlated with the diameter of the DFA and distance to where the DFA arises from femoral artery.


Subject(s)
Femoral Artery/anatomy & histology , Female , Femoral Artery/abnormalities , Humans , Male
10.
Transplant Proc ; 50(10): 3946-3949, 2018 Dec.
Article in English | MEDLINE | ID: mdl-30577292

ABSTRACT

INTRODUCTION: Hypertension is prevalent in most patients after renal transplantation, and it is the main factor contributing to cardiovascular diseases that cause death of a significant number of these patients. Up to 95% of patients after transplantation have hypertension, and among them are patients with refractory hypertension. Elevated blood pressure is one of the causes of deterioration of transplant function and may accelerate transplant loss. CASE REPORT: We present the first case in the world of a patient (who was 61 years old) in whom denervation of native renal arteries was performed after renal transplantation (2004). The patient was suffering from uncontrolled refractory hypertension. Antihypertensive therapy was used but the effect was not satisfactory. The patient received amlodipine, bisoprolol, clonidine, furosemide, and doxazosin in high doses. Clinical assessments with ambulatory blood pressure monitoring revealed a predominant blood pressure 149/96 with incidents of hypertensive crises. High blood pressure is a cardiovascular risk factor and it also has a significant influence on transplant failure, which was the reason for performing the denervation. The procedure was carried out through the femoral artery with the use of a 6F guiding catheter. During a 3-year observation, significant decreases in ambulatory blood pressure monitoring systolic and diastolic blood pressures were observed after the procedure (149/96 mm Hg vs 134/91 mm Hg before and after the denervation, respectively). There was a significant regression of left ventricle mass (577 g before denervation vs 470 g after 3 years). The functioning of the renal transplant became stable after 3 years of observation (38 mL/min before denervation and 38 mL/min after 3 years). CONCLUSIONS: The first case in the world of a renal transplant patient who had denervation of native renal arteries has demonstrated a positive effect in controlling blood pressure over a 3-year observation. Three years after denervation, a reduction of heart hypertrophy and stabilization of renal function were noted. The presented case shows that denervation of native renal arteries denervation may be successful and safe in kidney transplant recipients.


Subject(s)
Denervation/methods , Hypertension/surgery , Kidney Transplantation/adverse effects , Renal Artery/innervation , Renal Artery/surgery , Humans , Hypertension/etiology , Middle Aged , Treatment Outcome
11.
Biomed Res Int ; 2018: 9623579, 2018.
Article in English | MEDLINE | ID: mdl-29955614

ABSTRACT

PURPOSE: Although the plantaris muscle (PM) is vestigial in humans, it has a significant clinical role in procedures such as grafting. However, recent reports suggest its potential involvement in the tendinopathy of the midportion of the Achilles tendon. The aim of the study is therefore to evaluate morphological variation of the PM with regard to its potential conflict with the Achilles tendon. MATERIAL AND METHODS: Classical anatomical dissection was performed on 130 lower limbs (71 right, 59 left) fixed in 10% formalin solution. The morphology of the PM was assessed regarding the relationship between the course of the plantaris tendon and the calcaneal tendon. RESULTS: The PM was present in 89.2% of cases. The findings indicate the presence of a new type of PM tendon insertion in which the tendon is inserted into the tarsal canal flexor retinaculum, potentially affecting the tendinopathy of the tibialis posterior muscle. In 26 cases (22.4%), insertion blended with the Achilles tendon (Type II), which may increase the risk of Achilles tendinopathy. CONCLUSION: The anatomical variation of PM tendon morphology may create a potential conflict with the Achilles tendon and the tibialis posterior tendon, thus increasing the possibility of tendinopathy.


Subject(s)
Achilles Tendon/anatomy & histology , Muscle, Skeletal/anatomy & histology , Tendinopathy , Foot , Humans , Lower Extremity
12.
Folia Morphol (Warsz) ; 77(4): 785-788, 2018.
Article in English | MEDLINE | ID: mdl-29651792

ABSTRACT

The plantaris muscle is characterised by morphological variability, both for origin and insertion, and may sometimes be absent. Its strength allows the ligament to be used for reconstruction of other tendons and ligaments. This report presents the rare placements and course of the plantaris muscle in relation to the neurovascular bundle. In this case, the hypertrophy of this muscle might cause pressure on the tibial nerve and produce symptoms similar to sciatica.


Subject(s)
Muscle, Skeletal/anatomy & histology , Nervous System/anatomy & histology , Nervous System/blood supply , Tendons/anatomy & histology , Aged , Anatomic Variation , Cadaver , Humans , Male
13.
J Dent Res ; 97(5): 530-536, 2018 05.
Article in English | MEDLINE | ID: mdl-29439642

ABSTRACT

Step-growth thiol-Michael photopolymerizable resins, constituting an alternative chemistry to the current methacrylate-based chain-growth polymerizations, were developed and evaluated for use as dental restorative materials. The beneficial features inherent to anion-mediated thiol-Michael polymerizations were explored, such as rapid photocuring, low stress generation, ester content tunability, and improved mechanical performance in a moist environment. An ester-free tetrafunctional thiol and a ultraviolet-sensitive photobase generator were implemented to facilitate thiol-Michael photopolymerization. Thiol-Michael resins of varied ester content were fabricated under suitable light activation. Polymerization kinetics and shrinkage stress were determined with Fourier-transform infrared spectroscopy coupled with tensometery measurements. Thermomechanical properties of new materials were evaluated by dynamic mechanical analysis and in 3-point bending stress-strain experiments. Photopolymerization kinetics, polymerization shrinkage stress, glass transition temperature, flexural modulus, flexural toughness, and water sorption/solubility were compared between different thiol-Michael systems and the BisGMA/TEGDMA control. Furthermore, the mechanical performance of 2 thiol-Michael composites and a control composite were compared before and after extensive conditioning in water. All photobase-catalyzed thiol-Michael polymerization matrices achieved >90% conversion with a dramatic reduction in shrinkage stress as compared with the unfilled dimethacrylate control. One prototype of ester-free thiol-Michael formulations had significantly better water uptake properties than the BisGMA/TEGDMA control system. Although exhibiting relatively lower Young's modulus and glass transition temperatures, highly uniform thiol-Michael materials achieved much higher toughness than the BisGMA/TEGDMA control. Moreover, low-ester thiol-Michael composite systems show stable mechanical performance even after extensive water treatment. Although further resin/curing methodology optimization is required, the photopolymerized thiol-Michael prototype resins can now be recognized as promising candidates for implementation in composite dental restorative materials.


Subject(s)
Dental Materials/therapeutic use , Resins, Synthetic/therapeutic use , Composite Resins/therapeutic use , Dental Restoration, Permanent/methods , Fourier Analysis , Humans , Polymerization , Polymers/therapeutic use , Polymethacrylic Acids/therapeutic use , Sulfhydryl Compounds/therapeutic use
14.
Folia Morphol (Warsz) ; 77(2): 406-408, 2018.
Article in English | MEDLINE | ID: mdl-28832092

ABSTRACT

Pelvic rib is a rare anomaly where ectopic rib is found in a pelvic region. It is usually found occasionally in asymptomatic patients. We report a case of 15-year-old male, diagnosed with a symptomatic pelvic rib. It had an unusual presentation creating a pseudotumour associated with pain and reduced range of motion in the hip joint. Patient was operated on with good result and final diagnosis was confirmed in pathological examination. (Folia Morphol 2018; 77, 2: 406-408).


Subject(s)
Pelvis/pathology , Ribs/pathology , Adolescent , Humans , Male , Pelvis/diagnostic imaging , Ribs/diagnostic imaging , X-Rays
15.
Anat Sci Int ; 93(1): 42-47, 2018 Jan.
Article in English | MEDLINE | ID: mdl-27539031

ABSTRACT

Suprascapular notch is characterized by variable morphology. However, its development is not well studied. We hypothesize that it proceeds postnatally. Thus, the aim of this research was to characterize the morphology of the suprascapular notch in a pediatric population based on computed tomography. A retrospective analysis was performed of 291 chest computed tomography examinations of patients under 18 years old taken following other clinical indications. The inclusion criteria were as follows: both scapulae encompassed in a field of view; no artifacts; no pathologies concerning the scapulae. Based on visual assessment and measurements, the suprascapular notch was classified according to a fivefold classification (type I, deeper than wider; type II, equally deep and wide; type III, wider than deeper; type IV, bony foramen; type V, discreet notch). In all, 173 examinations were included (60 females and 113 males). The most common suprascapular notch types were discreet notch (type V, 225 scapulae; 65.0 %) and type III (114 scapulae; 32.9 %). Children with type V suprascapular notch were significantly younger than children with other types (26.1 ± 42.4 months vs. 111.2 ± 66.7 months; p < 0.05). In types I-III, a positive correlation was found between age and dimensions of the suprascapular notch (p < 0.05). This study provides the first description of the suprascapular notch in a pediatric population based on computed tomography. It confirms that morphology of the suprascapular notch undergoes postnatal development.


Subject(s)
Radiography, Thoracic , Scapula/diagnostic imaging , Scapula/growth & development , Tomography, X-Ray Computed , Adolescent , Anatomic Variation , Child , Child, Preschool , Female , Humans , Infant , Male , Retrospective Studies , Scapula/anatomy & histology
16.
Folia Morphol (Warsz) ; 75(4): 454-459, 2016.
Article in English | MEDLINE | ID: mdl-27830880

ABSTRACT

BACKGROUND: When closed by the superior transverse scapular ligament (STSL), the suprascapular notch (SSN) creates an osseo-fibrous tunnel which acts as a pathway for the suprascapular nerve (SN). Anatomical variations are common in this region, and these can increase the risk of neuropathy by restricting the space for nerve passage. The aim of this study is to identify any correlation between the area reduction coefficient parameters and the SN and vessel arrangements in the SSN region. MATERIAL AND METHODS: The SSN region was dissected in 88 formalin-fixed cadaveric shoulders (40 left and 48 right). During dissection, the topography of the SN, artery and vein was evaluated. Quantitative visual data analysis software was used to measure the areas of the STSL and the anterior coracoscapular ligament (ACSL), as well as the diameters of the SN and associated vessels, and to assign those structures to existing classifications. The area reduction coefficient (ARC) was calculated for each shoulder. RESULTS: The area of the STSL (aSTSL) and ACSL (aACSL) were significantly larger in Type IV than Type I of the triad. Similarly, the aSTSL and area of the SSN (aSSN) were found to be significantly larger in Type IV than Type III. However, no significant differences were found in the ARC of the STSL (ARCSTSL), the ARC of the ACSL (ARCACSL) or the total ARC (ARCtotal). CONCLUSIONS: Although the aSTSL, aACSL and aSSN varied according to the type of SN and vessel arrangement, coefficient analysis (ARCSTSL, ARCACSL and ARCtotal) indicated that combined effect of these variations did not significantly affect SSN morphology.


Subject(s)
Shoulder , Cadaver , Humans , Nerve Compression Syndromes , Scapula , Shoulder Joint
17.
Transplant Proc ; 48(5): 1858-60, 2016 Jun.
Article in English | MEDLINE | ID: mdl-27496508

ABSTRACT

We describe the case of a 54-year-old patient after renal and heart transplantation in whom uncontrolled hypertension was diagnosed. Despite combined antihypertensive therapy, no significant therapeutic effect was achieved. Clinical assessment of ambulatory blood pressure monitoring (ABPM) revealed the ineffectiveness of a bisoprolol, nitrendypin, klonidyn, ramipryl, furosemide, and doxasosine combination used at high doses. High blood pressure levels with their effect on a hypertrophic transplanted heart (left ventricular mass 254 g) and poor renal graft function (39 mL/kg/min) posed an extremely high risk of future cardiovascular complications, and were the reason to perform a native renal arteries denervation. The procedure was carried out through the right femoral artery with the use of a 6F guiding catheter. During a 1-year observation, significant decreases in ABPM systolic and diastolic blood pressures were observed after the procedure (168/88 mm Hg vs 154/77 mm Hg, respectively). Moreover a significant regression of left ventricular mass (215 g/m(2)) and stable renal graft function were noted. The presented case shows that native renal arteries denervation may be successful and safe in kidney and heart transplant recipients. Moreover, during the 1-year follow-up, the reduction in blood pressure was followed by a reduction in transplanted heart hypertrophy, both leading to regression of cardiovascular risk for the patient.


Subject(s)
Heart Transplantation , Hypertension/surgery , Kidney Transplantation , Kidney/blood supply , Renal Artery/surgery , Denervation , Female , Humans , Hypertension/physiopathology , Kidney/physiopathology , Kidney Transplantation/adverse effects , Male , Middle Aged , Renal Artery/physiopathology
18.
Folia Morphol (Warsz) ; 75(1): 87-92, 2016.
Article in English | MEDLINE | ID: mdl-26365856

ABSTRACT

BACKGROUND: The suprascapular notch is a clinically important site because it is the main site of injury and compression of the suprascapular nerve. Its shape and size are the most important factors in the aetiopathology of suprascapular nerve neuropathy. This article reports the first computed topography (CT) study on the correlation between the diameters of the suprascapular notch and anthropometric measurements of the human scapula. MATERIALS AND METHODS: A total of 130 scans of shoulders by a helical 32-row multidetector CT scanner were retrospectively analysed. The following scapular measurements were performed: morphological length, morphological width, projection length of the scapular spine, maximal width of the scapular spine, length of the acromion, maximal length of the coracoid process, length of the superior border of the scapula, morphological height of the supraspinous fossa, length of the lateral border of the scapula, and morphological height of infraspinous fossa. The following suprascapular notch dimensions were measured: maximal depth, superior transverse diameter, middle transverse diameter. RESULTS: The maximum depth of the suprascapular notch correlates with the morphological length of the scapula, the length of the lateral border of the scapula and the morphological width of the scapula. The superior transverse diameter of the suprascapular notch correlates with the length of the superior border of the scapula and negatively with the length of the lateral border of the scapula. In addition it has been shown that the length of the superior border of the scapula correlates more closely with the superior transverse diameter of the suprascapular notch than the middle transverse diameter of the suprascapular notch. CONCLUSIONS: It could be supposed that humans with longer scapulae have deeper notches. It may be also concluded that scapulae with a wider superior border have a shallower suprascapular notch.


Subject(s)
Scapula , Cadaver , Humans , Neck , Nerve Compression Syndromes , Tomography, X-Ray Computed
19.
Soft Matter ; 11(34): 6852-8, 2015 Sep 14.
Article in English | MEDLINE | ID: mdl-26234205

ABSTRACT

This investigation details the formation of polymer network trilayer laminates formed by thiol-X click chemistries, and their subsequent implementation and evaluation for quadruple shape memory behavior. Thiol-Michael addition and thiol-isocyanate-based crosslinking reactions were employed to fabricate each of the laminate's layers with independent control of the chemistry and properties of each layer and outstanding interlayer adhesion and stability. The characteristic features of step-growth thiol-X reactions, such as excellent network uniformity and narrow thermal transitions as well as their stoichiometric nature, enabled fabrication of trilayer laminates with three distinctly different glass transition temperatures grouped within a narrow range of 100 °C. Through variations in the layer thicknesses, a step-wise modulus drop as a function of temperature was achieved. This behavior allowed multi-step programming and the demonstration and quantification of quadruple shape memory performance. As is critical for this performance, the interface connecting the layers was evaluated in stoichiometric as well as off-stoichiometric systems. It was shown that the laminated structures exhibit strong interfacial binding and hardly suffer any delamination during cyclic material testing and deformation.


Subject(s)
Click Chemistry , Polymerization , Polymers/chemistry , Sulfhydryl Compounds/chemistry , Adhesiveness , Mechanical Phenomena , Temperature
20.
Orthop Traumatol Surg Res ; 100(5): 515-9, 2014 Sep.
Article in English | MEDLINE | ID: mdl-25082777

ABSTRACT

INTRODUCTION: Nerve can be compressed when traveling through any osteo-fibrous tunnel. Any eventual anatomic structure limiting this passage increases the risk of neuropathy. During dissection of the shoulder region we recognized a vein travelling on the inferior border of the suprascapular notch together with the suprascapular nerve. The aim of this work was to evaluate the morphological characteristics of this vein in cadaveric material. MATERIALS AND METHODS: The suprascapular notch (SSN) region was dissected in 60 cadaveric shoulders. The course, number and diameter of nerve and vessels in the suprascapluar notch region were evaluated. Length, proximal and distal width of the superior transverse scapular ligament were measured. Photographic documentation was taken to evaluate the suprascapular nerve passage area. RESULTS: The vein identified was named as the suprascapular notch vein. It was present in 58.3% of shoulders. In 11 specimens, it was double. Its mean diameter was 1.7 mm (SD 0.7 mm) and did not correlate with the suprascapular nerve passage area. A suprascapular notch vein co-occurred more often with the anterior coracoscapular ligament (ACSL). In comparison with the SSN without the ACSL, it has a significantly greater diameter (2 mm; SD 0.7 mm vs 1.5 mm; SD 0.6 mm, respectively; P=0.021). CONCLUSIONS: The suprascapular notch vein was a common structure that did not replace the suprascapular vein. Its presence correlated with the occurrence of the ACSL and was independent of body side, STSL type and SSN type. TYPE OF STUDY: Observational anatomic study.


Subject(s)
Nerve Compression Syndromes/etiology , Scapula/anatomy & histology , Shoulder Joint/anatomy & histology , Veins/anatomy & histology , Cadaver , Humans , Ligaments, Articular/anatomy & histology
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