Morphological Aspects of the Aberrant Right Subclavian Artery-A Systematic Review of the Literature.

BACKGROUND: The aberrant origin of the right subclavian artery (ARSA), also known as the lusoria artery, is a congenital malformation with an incidence of 0.5-4.4%. Most cases are incidental due to minimal clinical manifestations. Computer tomography (CT) is important in diagnosing and evaluating these patients. MATERIALS AND METHODS: We conduct a computerized search in two databases, PubMed and EMBASE, for articles published between 1 January 2022 and 31 December 2023, PROSPERO code: CRD42024511791. Eligible for inclusion were case reports and case series that presented the aberrant origin of the right subclavian artery. The main outcome was the highlighting of the morphological types of ARSA. In this context, we proposed a new classification system of this anomaly. The secondary outcome was the evaluation of the demographic distribution of the lusoria artery. RESULTS: Our search identified 47 articles describing 51 patients with ARSA. The typical course for ARSA is retroesophageal, being registered in 49 out of 51 patients. This malformation is frequently associated with Kommerell diverticulum (15 out of 51), troncus bicaroticus (7 out of 51), and aberrant origins of the right vertebral artery (7 out of 51). We observed a higher incidence of the condition among women (32 out of 51) compared to men (19 out of 51). From a demographic point of view, ARSA is more frequent in the "44 to 57 years" and "58 to 71 years" age ranges. CONCLUSIONS: ARSA is a congenital malformation resulting from a defect in the development of the aortic arches. The imaging studies such as computer tomography play a defined diagnostic role.

Healthcare Service Quality Evaluated Using the Degree of Satisfaction of Patients in Romanian Community Pharmacies.

Community pharmacy has evolved a lot in recent years in terms of pharmaceutical services and marketing policies applied in Romania. This study aimed to evaluate the degree of patient satisfaction in community pharmacies in Iași, Romania correlated with the frequency of returning to the pharmacy, level of education, gender, and stress level at the time when the pharmacist dispenses the medication. A total of 30 community pharmacies were involved, and in a period of three months, they issued questionnaires to patients. 722 patients responded, and to verify the first research hypothesis, the Pearson correlation was applied. Statistical analysis revealed that there is a negative, medium-level, and significant correlation between the level of satisfaction with pharmaceutical services and the frequency of visits to the pharmacy, r = -0.342, p < 0.0001. There is also a significant, negative correlation of low intensity between the level of satisfaction with pharmaceutical services and patient status, r = -0.202, p < 0.0001. The degree of patient satisfaction is influenced by the quality of the basic pharmaceutical service offered, by the frequency of visits to the pharmacy, by the level of stress, and by social class.

Sexual Dimorphism in the Buccolingual Dimensions of Permanent Anterior Teeth in the Young Iranian Population.

Objective: Evaluation of sexual dimorphism is a crucial concern for anthropologists, forensic scientists, and archaeologists. Teeth have been used as an alternative tool to determine sex in forensic anthropology. However, it is necessary to use data specific to a particular population, as different populations exhibit varying degrees of sexual dimorphism. This study aimed to determine the sexual dimorphism in the buccolingual dimensions of permanent anterior teeth in the young Iranian population. Materials and methods:A total of 100 students (50 females and 50 males) participated in the current study. A total of 1200 permanent anterior teeth were examined. The buccolingual dimension of all anterior teeth was measured using Vernier Calipers with a calibration of 0.01 mm. Data were analyzed using an independent sample T-test and paired sample T-test, and a P-value of less than 0.05 was considered statistically significant. Results:The mean values of the buccolingual dimension of the maxillary canines on the right and left sides (13, 23) were statistically greater in males than females (P=0.04, P=0.03) and had the greatest percentage of sexual dimorphism (4.08% and 5.26%, respectively). Conclusion:The buccolingual dimension of Iranian canines could be used as a reliable material to identify gender in forensic studies, and the degree of sexual dimorphism varies among different populations. Therefore, it is essential to use the relevant data samples for each population. It was concluded that Europeans had the greatest amount of sexual differences in the anterior teeth, while Iranians had the least amount of sexual dimorphism in the anterior teeth.

Epidemiological and pathological characteristics of spinal metastases from gastrointestinal cancers - a series of 40 cases.

Spinal metastases from gastrointestinal (GI) cancer are rare and as a result there are only case reports or small series in the literature. The aim of our work was to identify the demographic aspects, the location, and the histopathological aspects of spinal metastases from GI cancers diagnosed and treated in a reference Hospital in Romania over a period of nine years, and comparing the data obtained with those from the recent literature. This is a retrospective case series study on spinal metastases from GI cancers, developed in patients older than 18 years that were surgically treated between January 2013 and December 2021 within three Neurosurgery Clinics from Prof. Dr. Nicolae Oblu Emergency Clinical Hospital, Iasi, Romania, which is a tertiary Hospital in Romania regarding the surgical treatment of spinal metastases. We included in our study the patient's demographic data (age and gender), clinical data (location of spinal metastases), radiological investigations and pathological features of the lesions. Regarding the immunohistochemical stainings, the following antibodies were used: anti-cytokeratin (CK)7, anti-CK20, anti-CK19, anti-caudal-type homeobox 2 (CDX2), anti-human epidermal growth factor receptor 2 (HER2), and anti-Ki67. Our series included 40 adult patients (≥18 years old) with a male:female ratio of 3:1, in favor of male patients. The mean age of all patients was 66.42 years. The primary sites of spinal metastases from GI cancers were from all segments of the GI system: the most frequent, however, was from the colorectal level (40%) and the least from the oral cavity level (2.5%). The most common site of spinal metastases from GI cancer was predominantly lumbar region (47.5%), and the most frequent histological type was adenocarcinoma (57.5%), followed by hepatocellular carcinoma (27.5%), pancreatic ductal carcinoma (5%) and squamous cell carcinoma (2.5%). Our results have important clinical implications because they suggest that there are certain subsets of patients with certain types of GI cancers that cause metastases in certain regions of the spine.

Cervico-Dorsal Intramedullary Spinal Cord Abscess with Aspergillus fumigates following Pulmonary Infection in an Immunocompetent Patient.

Invasive forms of aspergillosis of the nervous system are relatively rare and are usually diagnosed in immunocompromised patients. We present the case of a young female patient, treated in the last two months with corticosteroids and antifungal drug for pulmonary aspergillosis, who developed progressive paraparesis. An intramedullary abscess at the C7-D1 level was identified and the lesion was treated with a combination of surgery and antifungal therapy. Histopathologic findings of surgical specimens showed myelomalacia with Aspergillus hyphae and a peripheral rim of neutrophils. We consider that the use of multiple drugs and corticosteroids for our patient's initial community pneumonia could be the factor that transformed her into a mildly immunocompromised individual and permitted the Aspergillus spp. to disseminate through the blood and into the spinal cord. Moreover, we highlight the fact that more attention should be paid to living and working conditions of the patients, as a simple colonization of the lung with Aspergillus spp. could develop, in a short time, into an invasive disease with a high risk of mortality.

Histological findings for the absorption of small and large liposomes - the basis of future drug delivery and contrast media systems.

BACKGROUND AND OBJECTIVES: The purpose of our study was to obtain and characterize carrier systems in different sizes that can affect oral absorption, since the mechanisms of liposome absorption are not yet fully understood. From stomach to the small intestine, liposomes can be gradually destroyed. Understanding the factors that affect oral absorption leads to developing safe and effective nanosystems to improve the oral delivery of therapeutics. MATERIALS AND METHODS: We determined the efficiency of the absorption of small and large liposomes at the level of gingival mucosa, heart, liver, testicles, kidneys, and lungs, using frozen-section fluorescence microscopy, on rat tissues after liposomes administration. A number of 36 male rats were divided in four groups: control groups, A and C, consisted of six rats each and did not receive liposomes; two other groups, B and D, were the experimental ones, and consisted of 12 male rats each. The animals received small liposomes (75-76 nm) and large liposomes (80-87 nm), respectively, administered either by endogastric tube or intraperitoneal injection. After 24 hours, the animals were sacrificed, and we harvested the organs. We performed frozen sections and analyzed them with fluorescence microscopy. RESULTS: The frozen sections obtained from all organs revealed a higher absorption level of small liposomes in the testicles, liver, and gum, while the large liposomes had a greater affinity for the liver, with variations dependent on the route of administration. CONCLUSIONS: Frozen-section fluorescence microscopy is a reliable technique for visualization of liposome absorption. Based on the size of these nanosystems, we revealed significant absorption for small liposomes in testicles, liver, heart, and gum, and for large liposomes mainly in the liver, compared with the control groups. The study advocates for the usage of liposomes for medical purposes, based on their absorption proprieties.

Kisspeptin Serum Levels in Patients with Endometriosis, New Research Pathways Regarding Female Infertility.

Introduction:Endometriosis is defined by the presence of endometrial tissue outside the uterus, therefore leading to a chronic inflammatory reaction, adhesions development, scar tissue and a distorted pelvic female anatomy, most of the times leading to female infertility. Kisspeptin represents a neuropeptide thought to have an essential role in the reproductive functions of both female and male patients. Recently, positive correlations with kisspeptins were noticed in patients diagnosed with endometriosis. Materials and methods: Our study was performed between January 2021-March 2022 in "Elena Doamna" Clinical Hospital of Obstetrics and Gynecology Iasi, Romania. It was a prospective case-control study and included two groups of patients. Both groups consisted in female patients aged between 18 and 45 years, with a body mass index (BMI) between 18,5-30 kg/m2 and similar medical data. Patients in the study group had primary or secondary infertility and endometriosis, while the control group consisted of women with no reproductive issues who had healthy regular menstruations and at least one child. All patients agreed to participate in our study and signed the consent form. Clinical examination, pelvic ultrasound and hormonal dosages were performed. We tested the levels of LH, FSH, kisspeptin, estradiol, prolactin, testosterone, insulin and the glycemic levels in both groups during the follicular phase of their menstrual cycle. Results: We managed to enroll eight patients with endometriosis in the study group and an equal number of patients in the control group. There were significant differences between serum kisspeptin levels, but not also between other hormonal dosages. All patients in the study group had medical evidences of endometriomas but none of them had been subjected to laparoscopy. Conclusion:When considering our study, we regarded the first attribution given to kisspeptin, the one of a metastasis suppressor, and concluded that the high serum values of kisspeptin in patients with endometriosis represented a compensatory-adaptive mechanism needed to constrain future spread of endometriomas in early stages of this pathology.

The Impact of the Early COVID-19 Pandemic on ST-Segment Elevation Myocardial Infarction Presentation and Outcomes-A Systematic Review and Meta-Analysis.

Background: The influence of the early COVID-19 pandemic on non-COVID-19 emergencies is uncertain. We conducted a systematic review and a meta-analysis to evaluate the impact of the first months of the COVID-19 pandemic on the presentation, management, and prognosis of patients presenting with ST-segment elevation myocardial infarction (STEMI). Methods: We searched the PubMed, Scopus, and Embase databases from January to August 2020. A meta-analysis of studies comparing the profile, STEMI severity at presentation, reperfusion delay, and in-hospital mortality for patients presenting before and during the early COVID-19 pandemic was conducted. Fifteen cross-sectional observational studies including 20,528 STEMI patients from the pre-COVID period and 2190 patients diagnosed and treated during the first months of the COVID-19 pandemic met the inclusion criteria. Results: Patients presenting with STEMI during the pandemic were younger and had a higher comorbidity burden. The time interval between symptoms and first medical contact increased from 93.22 ± 137.37 min to 142 ± 281.60 min (p < 0.001). Door-to-balloon time did not differ significantly between the two periods (p = 0.293). The pooled odds ratio (OR) for low left ventricular ejection fraction at presentation during the pandemic was 2.24 (95% confidence interval (CI) 1.54−3.26) and for a presentation delay >24 h was 2.9 (95% CI 1.54−5.45) relative to before the pandemic. In-hospital mortality did not increase significantly during the outbreak (p = 0.97). Conclusion: During the first months of the COVID-19 pandemic, patients presenting with STEMI were addressed later in the course of the disease with more severe left ventricular impairment. In-hospital emergency circuits and care functioned properly with no increase in door-to-balloon time and early mortality.

Treatments in Patients with Polycystic Ovary Syndrome and Effects on Kisspeptin Serum Levels.

Introduction: Polycystic ovarian syndrome (PCOS) is a common and multifactorial pathology among young women of reproductive age and one of the main causes for female infertility. Most patients are referred to a gynecologist due to specific symptoms such as menstrual irregularities, hirsutism, facial or body acne and inability to obtain a pregnancy. Lately, kisspeptin, a neuropeptide produced in the anterior region of the hypothalamus that seems to modulate the GnRH secretion and therefore the hypothalamic-hypophyseal-ovarian axis (HHO-axis), has been considered responsible for PCOS occurrence. Objectives:The aim of our study was to observe the changes in hormonal balances and kisspeptin serum levels in patients with PCOS after treatment with myo-inositol and vitex. Materials and methods:A prospective clinical study was conducted by us, between 4 January 2021 and 1 March 2022, in "Elena Doamna" Clinical Hospital of Obstetrics and Gynecology, Iasi, Romania. After obtaining the subjects' informed consent and agreement to participate, we identified 14 patients with PCOS and primary or secondary infertility, who underwent laboratory investigations during the follicular phase of their menstrual cycles, testing for kisspeptin, luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol, testosterone, insulin, blood sugar levels and prolactin. An abdominal-pelvic scan and full body examination were also performed. Patients, in accordance with their gynecologists' recommendation, preferred a medical therapy consisting of myo-inositol 750 mg/day and vitex 400 mg/day. After three months of treatment, patients agreed to have a second check up to see if any changes occurred. Results:We found significant positive differences when considering kisspeptin, estradiol, FSH and prolactin serum values. There was no significant difference in testosterone and insulin serum levels; on the other hand, we observed an increase in LH serum levels. The mean ovarian volume before treatment was 14.0 for the right ovaries and 13.8 for the left ovaries. After treatment and the recommended lifestyle changes, we noticed a decrease in the mean ovarian volume (13.5 for the right ovaries and 13.4 for the left ovaries). Discussions and conclusions: The etiology of PCOS, which is considered a multifactorial pathology, remains unclear. Multiple studies have been conducted and are still exploring the role of kisspeptin as an etiologic factor for PCOS associated with infertility. Our study showed a decrease in kisspeptin values after the use of myo-inositol and vitex in patients with PCOS, therefore supporting the long-standing theory that kisspeptin might have an essential role in the development of PCOS.

Hepatic injuries resulting from chronic alcohol abuse identified by forensics.

Alcohol intake is largely spread all over the world, although it is well-known that it causes important changes of the liver, from liver steatosis, hepatitis to liver cirrhosis. The study we performed on 93 patients deceased in suspicious circumstances and brought to the Institute of Forensic Medicine, Iasi, Romania, confirmed through the determination of Ethyl glucuronide, that these were alcohol consumers. The macroscopic analysis during necropsy highlighted the presence of alcoholic liver disease (ALD), while microscopy studies confirmed the macroscopic observations. The immunohistochemical studies showed the existence of a chronic liver inflammation, the transdifferentiation of stellate hepatic cells, the activation of Kupffer cells, important changes of the hepatic vascular network, hepatocyte necrosis, lipid loadings and the progression of liver fibrosis process.

Brain metastases originating in breast cancer: clinical-pathological analysis and immunohistochemical profile.

The incidence of brain metastases (BMs) originating in breast cancer (BC) is increasing due to advances in imaging techniques, which can detect such events early, and due to new therapies that can ensure longer survival. We performed a retrospective study on patients with BMs originating in BC and receiving surgical treatment in Neurosurgery Clinics of Prof. Dr. Nicolae Oblu Emergency Clinical Hospital, Iasi, Romania, from January 2018 to December 2019. We identified 10 consecutive patients who underwent a craniotomy for a BMs originating in a BC (either for diagnostic purpose or with therapeutic intent). Clinicopathological data were collected from the electronic medical record and included the patient demographics (age at diagnosis of their BM), morphological characteristics of BM [location, cytopathological features, histopathological (HP) subtype, and immunohistochemical features, i.e., cytokeratin 5∕6 (CK5∕6), mammaglobin, estrogen receptor (ER), progesterone receptor (PR), and Ki67 labeling index (LI)], and time from BC diagnosis to BM diagnosis. Ninety percent of patients were in their sixth and seventh decades of life, with a median age of 57.9 years (47-65 years). Median time from BC diagnosis to BM was 34.42 months. Fifty percent of BMs were located in the parietal lobes, and 70% of all cases have multiple (≥2) BMs. All cases (100%) had a cytopathological examination, showing a hypercellular pattern, with poorly cohesive clusters of mild or pleomorphic cells, with nuclei with homogeneously distributed fine granular chromatin membrane, and with small or enlarged and irregular nucleoli. The dominant histopathology was invasive breast carcinoma of no special type (IBC-NST) (70%), but we also identified specific subtypes, i.e., tubular carcinoma (TC) (20%) and invasive micropapillary carcinoma (IMPC) (10%). Correlating location with HP subtypes of BMs from BC, IBC-NST and IMPC were located mostly in parietal lobes, and TC developed only in the occipital lobe. We found three patterns of immunostaining: (i) CK5∕6 +∕-, mammaglobin+, ER+, PR-, which was much more characteristic for IBC-NST; (ii) CK5∕6-, mammaglobin+, ER-, PR-, being identified in tubular breast carcinoma; (iii) CK5∕6 +∕-, mammaglobin-, ER-, PR-, which were revealed by invasive micropapillary breast carcinoma. Our study revealed the fact that BMs originating in BC show heterogeneity of hormone receptor status, although morphologically there is not so much diversity. We also found a very variable Ki67 LI, which correlated especially with the morphological subtype.

Death-causing cardiac injuries after chronic alcohol intake identified by forensic medicine.

Ethyl alcohol is the most consumed drug, worldwide, with frequent consequences on the individual's health and lifestyle. Chronic alcoholism is a pathological state occurring after an excessive alcohol intake and may be observed in teenagers or very old individuals. The study performed by us investigated the changes caused by alcohol intake in the left ventricle myocardium in 77 bodies deceased at home under suspect circumstances and sent to the Institute of Forensic Medicine for establishing the cause of death. In all the individuals, there was determined high levels of blood Ethyl glucuronide, thus showing the alcohol intake up to 96 hours before death. The lesions present in the heart were represented by dilated cardiomyopathy, myocardial fibrosis, and myocardial infarction.

Clinical-pathological correlations in Warthin tumors of parotid gland: a series of 10 cases.

Warthin tumor is described using various terms, such as papillary cystadenoma lymphomatosum, adenolymphoma or monomorphic adenoma. It is a medical condition related to the salivary glands, namely a benign cystic tumor which contains an epithelial component and an abundant lymphoid stroma. It is also named Warthin tumor after Aldred Scott Warthin, the pathologist who described this entity in 1929 by observing it in two patients. Warthin tumor is a benign one and ranks secondly in terms of the most common not malignant salivary gland tumor located in the parotid gland. Because of its cystic nature, from the clinical point of view, it appears to be a slow-growing tumor often fluctuant on palpation. In terms of the treatment of choice, complete excision with wide tumor-free margins is preferred. The aim of the present article is to evaluate possible correlations between clinical-pathological features and postoperative complications in a target group made up of 10 patients diagnosed with Warthin tumor of the parotid gland admitted for surgery in a period of 21 years and to compare the results with literature.

Anatomical considerations on the masseteric fascia and superficial muscular aponeurotic system.

The masseteric region is considered by the most researchers as a subdivision of the parotideomasseteric region. Because of its surgical significance, we emphasize it has distinctive morphofunctional features. The aim of this manuscript is to highlight particular characteristics of the masseteric region and practical applications of this concept. The material used was represented by 12 embalmed cephalic extremities dissected in "Ion Iancu" Institute of Anatomy, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, 10 operating specimens from the Clinics of Maxillofacial Surgery and Plastic Surgery of the "St. Spiridon" University Hospital, Iasi, Romania, and computed tomography (CT) and magnetic resonance (MR) images from the same patients. Our results underline the importance and individual arrangement of the superficial muscular aponeurotic system (SMAS) of the face, at the level of masseteric region. The superficial fascia facilitates adhesion to the dermis of the mimic muscles of the region. This reveals that the masseteric superficial fascia will follow the masticatory movements of the mandible and masseter, but also those of the minor and major zygomaticus muscles. These muscles are the infra-SMAS layer and thus take part in the formation of a unitary complex together with the superficial fascia. The particularities of the SMAS in the masseteric region are especially important in plastic and reconstructive surgery.

Morphological changes in support mechanism of superficial face layers in Moebius syndrome.

Moebius syndrome, also called congenital facial paralysis is a rare neurological disease, whose etiology is not fully elucidated. It affects especially facial and oculomotor cranial nerves and its clinical feature is peripheral facial paralysis. The objective of the study is to highlight the anatomical and functional changes in the Moebius syndrome and establish certain criteria that should be the basis for reparative surgery in this disease. For this purpose, we used a group of six patients diagnosed with this pathology, in whom we pursued functional anatomical and histological changes of the superficial layers of the face that we have grouped in terms of their clinical impact. All the data obtained were centralized in order to assess anatomical functional changes occurring after evolution in time of lesions caused by Moebius syndrome. The results of the study led us to conclude that the face is made up of three main regions - median, medial and lateral -, which behave differently both in atresia of the facial nerve and in healthy individuals. This has an important echo on the way we emphasized the functional anatomy of superficial layers of the face and in surgery.

The anatomical and functional characteristics of parotid fascia.

Parotid superficial and profound fascias are considered to originate from a bifurcation of the profound fascia. Its relations with the facial nerve, the continuity with platysma, temporal and zygomatic fascias suggest it is related to a superficial fascial complex rather with a profound one. The aim of this study is to add clues which sustain the theory of parotid fascia origin from superficial fascia of the face. The study was conducted on 12 cephalic extremities, which were meticulously dissected in the "Ion Iancu" Anatomy Institute of "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania, and on a group of 10 patients admitted to the Clinic of Maxillofacial Surgery, "St. Spiridon" Emergency Clinical Hospital, Iasi, patients which were clinically and imagistically diagnosed [computed tomography (CT), magnetic resonance imaging (MRI)] with parotid tumors and underwent surgical interventions for total or partial parotidectomy. On each stage of dissection mesoscopic images were acquired, examined and further processed to remark the regional stratigraphic differences. Surgical interventions have allowed us segmental anatomical studies, providing in vivo visualization of the fascial and muscular structures, evaluating the possibilities of dissociating the plans and appreciating their vasculature. The collected specimens were processed by paraffin technique and stained with H special techniques for muscular and connective tissue. The results are clearly showing the belonging of parotid fascia to the superficial fascia of face.

Long-term survival in a patient with advanced gastric cancer and metachronous right-sided colon cancer.

Gastrointestinal carcinomas represent the most common cancers worldwide. The coexistence of gastric cancer with metachronous colon cancer represents a rare phenomenon, and the prognosis of the patient is poor. We present here a case of an elderly patient with primary gastric intestinal type well-differentiated adenocarcinoma (pT3N0, stage IIA) who developed a metachronous right-sided colon cancer diagnosed and treated after 11 years from the first surgical intervention. Histopathological and immunohistochemical examination revealed a well-differentiated adenocarcinoma (strongly positive staining for cytokeratin 20 and CDX2), pT3N0 stage IIA. The patient is still alive and active after 16 years from his first surgical intervention, even though no treatment has done after the removal of his second cancer. In conclusion, in any case of gastric cancer, first the surgeon, and then the general practitioner should be alert to recognize a second primary tumor with different origin and to perform complete postoperative control. The correct diagnosis could lead to the patients' best prognosis.

Histopathological consequences of hyperzincemia on rat teeth. Experimental study.

The aim of this study was to investigate the histopathological features of dental pulp in acute zinc (Zn) intoxication and to identify possible physiopathological mechanisms of the lesions. Twelve adult male Wistar rats were divided into two groups, the control one and the exposed group. Each animal from the experimental group received a single dose of zinc chloride (ZnCl2) by intraperitoneal injection. Blood samples were collected from exposed animals at 2, 4, and 6 hours after the injection and plasma Zn concentrations were determined by spectrophotometry. After six hours of observation, the animals were sacrificed and two teeth from every rat were removed. Twelve teeth were processed by standard histological technique using Hematoxylin-Eosin (HE) and Szekely trichrome stainings, and the other twelve were subjected to Schliff cutting-grinding technique. The experimental group showed increased plasma zinc concentration (0.46±0.06 mg÷L) after two hours and then slightly decreasing values in the next four hours. Undecalcified teeth did not showed any changing into the dentin or enamel structures, but decalcified teeth revealed numerous deposits into the dental pulp, which consisted of red acellular superposed sediments that could be made up of zinc with some plasma protein, or there could be an unknown compound which precipitated under the influence of zinc cation (Zn2+). We can presume that the dental pulp may be an elective place for zinc accretion and so it must be considered a potential target for this metal.

Supernumerary fronto-orbital arteries arising from contralateral anterior cerebral artery associated with partially duplicated anterior communicating artery - case study and literature review.

The anatomical variations of the fronto-orbital artery are uncommon and rarely described in literature. During the dissection of a 64-year-old female formalized brain, we discovered a particular congenital abnormality regarding the arterial supply of the right fronto-orbital gyrus. We identified three arterial sources: a low caliber ipsilateral fronto-orbital artery that arises from the A2 segment of the right anterior cerebral artery and ends in the posterior part of the fronto-orbital gyrus, a large aberrant contralateral fronto-orbital artery that arises from the A2 segment of the left anterior cerebral artery, supplying most of the right fronto-orbital gyrus and a small accessory branch of the left anterior cerebral artery passing towards the contralateral fronto-orbital gyrus. These abnormalities are associated with a partially duplicated anterior communicating artery. This case shows a unique pattern of congenital brain vascular abnormalities that may have clinical and surgical implications.

Morphological aspects of the rectal neovascularization in colorectal cancer - anatomical-surgical and imaging implications.

Colorectal neoplasia has an increasing incidence among the population, and this fact compels in achieving an early diagnosis and treatment protocols. The extramural vascular invasion (EMVI) score is a method used for staging cancer. It defines the presence of malignant cells in the blood vessels, outside its own vascular tunic. The purpose of the study is to evaluate the extramural vascular invasion, and thus the impact of this determination in diagnosis, treatment and prognosis of colorectal neoplasia. This was done using magnetic resonance images (MRI) of colonoscopic diagnosed patients with colorectal cancer and subsequently comparing these results with the control group of patients without malignancy. The EMVI criteria taken into account were correlated with the images obtained in patients in the study group. In each of the evaluated patients, we found both, arterial and venous blood vessels in 0 stage - EMVI correlated with T2 or T3 stage tumor. In T3 B stages, we could objectify suggestive images for stage 4 EMVI near and distant from the tumor. Blood and lymph vessels have a high density to their origin area and it decreases anteriorly. This distribution is consistent with a predisposition to the formation of a vascular rectal cancer, especially on the posterior wall. In conclusion, anatomical-imaging staging of colorectal cancers using EMVI score is very close to the colonoscopic diagnosis and to the accuracy of the classic cancer staging. Corroborating EMVI score with a vascular radiology reference pattern improves the accuracy for determining an appropriate treatment and assessment of prognosis.