Types of inferior phrenic arteries: a new point of view based on a cadaveric study.

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.

[Nephropathy in the course of inflammatory connective tissue diseases]. / Nefropatia w przebiegu zapalnych chorób tkanki lacznej.

The aim of the study was to assess the frequency of renal complications and also evaluation of renal efficiency with regard to sex and age in children with inflammatory connective tissue diseases. The examination embraced 18 children out of 5657 hospitalised in 19991-1998 in Military University School of Medicine-Dpt of Pediatrics suffering from inflammatory connective tissue diseases, which constitutes 0.32%. They found the following number of isolated cases: 9 cases of juvenile chronic arthritis (JCA), 6 cases of rheumatic fever (RF), and 3 cases of systemic lupus erythematosus (SLE). There were 9 girls and 9 boys. The most frequent symptom of kidneys affection was erythrocyturia. Due to chronic course, reccurrence and the possibility of further complications, children with inflammatory connective tissue diseases, after discharging from hospital, should stay under the care of rheumatological outpatient clinic.

[Nephropathy in the course of Schönlein-Henoch purpura]. / Nefropatia w przebiegu plamicy Schönleina-Henocha.

The aim of the study was to assess the frequency of renal complications and also evaluation of renal efficiency with regard to sex and age in children with Schonlein-Henoch purpura. 31 children with Schonlein-Henoch disease out of 5004 hospitalised in 6 years time (1994-1999) in Mil. Medical University-Dpt of Pediatrics, underwent the examination, which is 0.62% of all patients. The group of analysed cases consisted of 19 girls (61.3%) and 12 boys (38.7%). 15 of them had changes in kidneys, which constitutes 48.4%. The average age of examined children was 9.1 years. In the most cases upper respiratory tract infections preceded symptoms of the Schonlein-Henoch purpura. The most often complications found in the course of the Schonlein-Henoch purpura were renal ones. The most numerous renal complications affected children between 7 and 9 years of age. Because of chronic and insidious course of the disease, children, after discharging from hospital should stay under specialistic medical care.

[Cyclic vomiting with ketosis as a cause of acute kidney dysfunction: own clinical experience]. / Wymioty cykliczne z ketonemia jako przyczyna ostrych zaburzen czynnosci nerek--obserwacje wlasne.

The aim of the study was to evaluate renal activity during cyclic vomiting with ketosis. The clinical material was obtained from 50 cases of children hospitalized in Department of Pediatrics Military Medical University within 1993-1999 what makes about 1% of all patients. The examined group consisted of 26 boys (52%) and 24 girls (48%). Three of the children were repeatedly hospitalized (3 to 8 times) because of acetonemic vomiting. The special attention during the laboratory studies was paid to evaluation of renal activity. Vomiting with ketosis were associated with temporary kidneys acute dysfunction in 46% of cases. In 98% of cases the parenteral hydration was necessary. Ketonemic vomiting with kidneys dysfunction was observed mainly with the children in pre-school age.