Morphometric analysis of the patterns of calcaneal facets for the talus in Serbian population.

Literature describes different patterns of calcaneal facets for the talus in terms of whether some calcaneal facets are connected or separated from each other or completely absent. The aim of this study was to establish the patterns of calcaneal facets for the talus, to calculate their total area, and to analyse the data with respect to gender. The study involved 59 calcanei which were photographed. The patterns of calcaneal facets noted in this study were compared with the patterns from the literature. ImageJ program was used to measure different parameters on calcanei. The pattern 1 was the most commonly found in the study sample (45.76%), then the pattern 2 (40.68%), and finally the pattern 3 (13.56%). That order of frequencies is the same in both sexes. The patterns 1 and 2 have a larger contact surface for the talus in comparison to the pattern 3. Male bones have a larger contact surface for the talus than female bones. The sum of the pattern 1 and pattern 3 frequencies was high. Knowing the frequency of different patterns of calcaneal facets for the talus in a certain population is important for orthopaedic surgeons when performing foot osteotomy.

Noninvasive assessment of myocardial bridging by coronary flow velocity reserve with transthoracic Doppler echocardiography: vasodilator vs. inotropic stimulation.

BACKGROUND: To consider hemodynamic assessment of myocardial bridging (MB) adequate, it is believed that inotropic stimulation with dobutamine should be estimated because its dynamic nature depends on the degree of extravascular coronary compression. This study evaluated comparative assessment of hemodynamic relevance of MB using coronary flow velocity reserve (CFVR) measurements by transthoracic Doppler echocardiography (TTDE) with vasodilatative and inotropic challenges. METHODS: This prospective study included forty-four patients with angiographic evidence of isolated MB of the left anterior descending coronary artery (LAD) and systolic compression of ≥50% diameter stenosis. All patients were evaluated by exercise stress-echocardiography (ExSE) test for signs of myocardial ischemia, and CFVR of the distal segment of LAD during iv.infusion of adenosine (ADO:140µg/kg/min) and iv.infusion of dobutamine (DOB:10-40µg/kg/min), separately. RESULTS: Exercise-SE was positive for myocardial ischemia in 8/44 (18%) of patients. CFVR during ADO was significantly higher than CFVR during peak DOB (2.85±0.68 vs. 2.44±0.48, p=0.002). CFVR during peak DOB was significantly lower in SE-positive group in comparison to SE-negative group (2.01±0.16 vs. 2.54±0.47, p<0.001), but not for ADO (2.47±0.51 vs. 2.89±0.70, p=0.168), respectively. Multivariable logistic analysis showed that CFVR peak DOB was the most significant predictor of functional significant MB (OR 0.011, 95%CI: 0.001-0.507, p=0.021). Receiver-operating characteristic curves have shown that TTDE-CFVR obtained by high-dose of dobutamine infusion is better than those by adenosine regarding to functional status of MB (AUC 0.861, p=0.004; AUC 0.674, p=0.179, respectively). CONCLUSIONS: Non-invasive CFVR measurement by TTDE during inotropic stimulation, in comparison to vasodilation, provides more reliable functional evaluation of MB.

[Specificities of prosthetic and orthotic rehabilitation in amputees with head injury].

UNLABELLED: BACKGROUND/AIM. The prosthetic-orthotic rehabilitation (POR) of amputees with head injury within the polytrauma presents a specific entity. The number of traumas caused by the traffic and the low-intensity war conflicts, increases constantly. The aim of our study was to examine the influence of complications on the POR duration and outcome in polytrauma amputees with head injury (PTAHI) recording complications at the beginning and during the POR. METHODS: The study was carried out on the patients divided into two groups of 35 polytrauma male patients each of corresponding age with unilateral transfemoral amputation caused by the war injury. The experimental group consisted of the amputees with head injury. Standard clinical techniques and procedures, as well as special functional evaluation techniques were used. RESULTS: The PATHI started POR with a greater number of complications (average rate 7.29 vs 5.11 per patient; W = 928.000: Z = 3.730: p = 0.000). There was a highly significant positive correlation between this number and the Barthel Score value change (Fx, H, p < 0.01), and negative significant correlation considering prosthetic use and functional capacity test values (Fx, H p < 0.05). On admision, the amount of complications defined for the value 4 of POR outcome was significantly higher than values 2 and 3, respectively (H = 8.948; df = 2; p = 0.011). The PTAHI developed significantly more frequently complications during rehabilitation (X2 = 1.061; df = 1; p < 0.01). The proportion of the examinees with the value 4 who developed complications during rehabilitations was significantly higher than those with value 2 (Fp = 3.406; df1 = 2; df2 = 67; p = 0.038). The rehabilitation of the PTAHI lasted significantly longer (average 259.09 vs 183.63 days; W = 923.500; Z = -3.748; p = 0.000). CONCLUSION: The PTAHI including head injuries started prosthetic-orthotic rehabilitation with more prosthetic complications and their psychological status was worse, resulting in the longer duration of rehabilitation whereas the outcome itself was poor. The value 4 of the prosthetic-orthotic rehabilitation outcome can be expected more often in patients developing complications during rehabilitation.

[Influence of the myocardial bridging phenomenon on the myocardial structure and the coronary arteries wall structure changes].

BACKGROUND/AIM: Our research was performed to evaluate the influences of the myocardial bridgings of coronary arteries on the myocardial and coronary arteries wall structure chages, that could be a reason for multiple heart malfunctions. METHODS: We analyzed the autopsy material, collected during a five-years period, and especially the group of 575 cases with the major aim to diagnose mors naturalis. In all cases with the presence of myocardial bridge over the arterial coronary wall revealed at autopsy, samples were taken for microscopic verification and examination. RESULTS: We found myocardial bridges over the coronary arteries or their major branches in 27 of the cases (4.70%). We believe that myocardial bridges compromise coronary perfusion by cyclic compression of the overbridged vessels, and that it could be the initial factor in the pathogenesis of arteriosclerotic degeneration processes on the coronary artery wall. We found different grades of arteriosclerotic changes in 88.89% of the cases, as well as fibrosis of myocardium in 88.89% and lipomatosis in 66.67% of the cases with the present myocardial bridges. CONCLUSION: Our results suggested that myocardial bridging of coronary arteries and/or their branches was the pathological and even lethal phenomenon that de serves more intensive clinical evaluation.

Linear parameters of normal and abnormal cava septi pellucidi: a post-mortem study.

Anatomical variations in the dimensions of different brain structures have been correlated with clinical syndromes. This study on the parameters of normal and abnormal cavum septi pellucidi (CSP) can be of clinical significance. We obtained 479 brains from autopsied persons (310 males and 169 females, 377 normal or asymptomatic and 102 abnormal or symptomatic persons, aged 22-89 years) and observed that 110 brains (75 males and 35 females) had CSP. These cava were classified into two groups depending on the past medical histories of the autopsied person: 40 asymptomatic and 70 symptomatic cava. We have defined symptomatic cava as those in autopsied persons who had known past medical history of psychiatric or neurological disease. Asymptomatic cava were in autopsied persons who had no known past medical history of psychiatric or neurological disease. The CSP parameters (length, width, depth) of the symptomatic and asymptomatic groups were measured and were statistically analyzed. Analysis showed that the cava in the symptomatic group were significantly longer and wider. Discriminant function analysis was used to derive a mathematical formula to classify CSP into an asymptomatic or symptomatic group based on length and width measurements of the cavum.

Third coronary artery in monkey heart.

Investigations were carried out on 55 monkey (Cercopithecus aethiops, Macaca fascicularis) hearts by stereomicroscopic dissection and measurements. Latex-injected specimens and corrosion casts showed that, as in humans, the hearts were usually (in 98.2% of the cases) supplied by two coronary arteries (CAs)--the left (LCA) and the right coronary artery (RCA), and occasionally (in 1.8% of the cases) also by a third one (TCA). Furthermore, the orifice of the TCA was situated in the right aortic sinus at the same level as the RCA and 0.2 mm in front of it. The LCA and the RCA originated from the corresponding aortic sinuses and the external diameter of the LCA was greater [average: 1.65+/-0.39 (SD) mm] than that of the RCA [average 0.94+/-0.15 (SD) mm] and the TCA (0.8 mm). The LCA orifice was more often above (76.3%) than below the free edge of the left aortic valve leaflet. The longitudinal axis of the aortic root and of the initial part of the LCA formed an angle of 45-120 degrees (average: 52 degrees). The orifice of the RCA was usually above (82.3%) the free edge of the right aortic valve leaflet, and less frequently below it (17.7%). The longitudinal axis of the aortic root and of the initial part of the RCA formed an angle of 70-150 degrees (average: 103 degrees). The resemblance of monkey CAs to their human counterparts make them a suitable model for experimental studies on coronary circulation.

Allantoid duct, arteries and veins of the funiculus umbilicalis in bovines

Secciones transversales del funículo umbilical de 39 fetos de bovinos de la raza Holstein, fueron estudiados con microscopio de luz. Las secciones fueron cortadas en los tercios yuxtafetal, medio y yuxtaplacental y teñidos con hematoxilina-Eosina. Ambas arterias umbilicales y venas son caracterizadas por una túnica media espesa, siendo mucho más gruesa en la arteria que en las venas, gracias a la conspicua capa muscular, especialmente a nivel del tercio medio del cordón umbilical. Como regla el lumen de las venas es oval o elipsoide y relativamente más ancho que el lumen de las arterias el cual es estrellado, puntiforme o casi obliterado