Topographical distribution and morphology of NADPH-diaphorase-stained neurons in the human claustrum.

We studied the topographical distribution and morphological characteristics of NADPH-diaphorase-positive neurons and fibers in the human claustrum. These neurons were seen to be heterogeneously distributed throughout the claustrum. Taking into account the size and shape of stained perikarya as well as dendritic and axonal characteristics, Nicotinamide adenine dinucleotide phosphate-diaphorase (NADPHd)-positive neurons were categorized by diameter into three types: large, medium and small. Large neurons ranged from 25 to 35 µm in diameter and typically displayed elliptical or multipolar cell bodies. Medium neurons ranged from 20 to 25 µm in diameter and displayed multipolar, bipolar and irregular cell bodies. Small neurons ranged from 14 to 20 µm in diameter and most often displayed oval or elliptical cell bodies. Based on dendritic characteristics, these neurons were divided into spiny and aspiny subtypes. Our findings reveal two populations of NADPHd-positive neurons in the human claustrum-one comprised of large and medium cells consistent with a projection neuron phenotype, the other represented by small cells resembling the interneuron phenotype as defined by previous Golgi impregnation studies.

The role of Willis circle variations during unilateral selective cerebral perfusion: a study of 500 circles.

OBJECTIVES: During unilateral selective cerebral perfusion (uSCP), with right axillary artery or brachiocephalic trunk cannulation, the brain receives blood only via the right common carotid artery and right vertebral artery (VA). The left hemisphere is perfused mainly through the circle of Willis (CW). However, at least 50% of individuals have some variation in the CW. The aim of the present work was to study the variations in CW and VA that could have an impact on haemodynamics during uSCP. METHODS: From May 2005 to March 2012, a total number of 250 circles obtained via routine dissection for medico-legal reasons were examined. The external diameters of all CW segments and both VAs were measured. From January 2008 to March 2012, a total number of 250 patients subjected to computed tomographic angiography of the CW were also examined. RESULTS: Nine evident configurations of the CW that could cause hypoperfusion during uSCP were observed. They were subdivided in to seven types, according to location and the number of major vessels at risk of hypoperfusion. Type IA: hypo/aplasia of left posterior communicating artery (PComA), found in 35.6% of cases; Type IB: hypo/aplasia of anterior communicating artery (AComA), found in 2% of cases; Type IIA: hypo/aplasia of both left PComA and AComA, found in 4.8% of cases; Type IIB: hypo/aplasia of precommunicating (P1) segment of left posterior cerebral artery or right VA, found in 9.2% of cases; Type IIIA: hypo/aplasia of precommunicating (A1) segment of right anterior cerebral artery, found in 6% of cases; Type IIIB: hypo/aplasia of both right VA and AComA, found in 0.2% of cases; Type IV: hypo/aplasia of both right A1 and right VA or both right A1 and left P1, found in 0.8% of cases. All types were present in 58.6% of all examined CWs. CONCLUSIONS: Our results show that CW variations are present in a significant number of patients. Our data support the need for extensive preoperative examination and meticulous intraoperative monitoring of cerebral perfusion during uSCP. Finally, our data support the superiority of bilateral SCP over uSCP, because most of the variations reported do not have haemodynamic significance during bilateral SCP.

Variety of transversus thoracis muscle in relation to the internal thoracic artery: an autopsy study of 120 subjects.

BACKGROUND: The transversus thoracis muscle is a thin muscular layer on the inner surface of the anterior thoracic wall that is always in concern during harvesting of the internal thoracic artery. Because the muscle is poorly described in the surgical literature, the aim of the present study is to examine in details its variations. METHODS: The data was obtained at standard autopsies of 120 Caucasian subjects (Bulgarians) of both sexes (97 males and 23 females), ranging in age from 18 to 91 years (mean age 52.8 ± 17.8 years). The transversus thoracis morphology was thoroughly examined on the inner surface of the chest plates collected after routine incisions. RESULTS: An overall examination revealed that in majority of cases the transversus thoracis slips formed a complete muscular layer (left - 75.8%, right - 83.3%) or some of the slips (left - 22.5%, right - 15%) or all of them (left - 1.7%, right - 1.7%) were quite separated. Rarely (left - 3.3%, right - 5.8%), some fibrous slips of the transversus thoracis were noted. In 55.8% of the cases there was left/right muscle symmetry; 44.2% of the muscles were asymmetrical. Most commonly, the highest muscle attachment was to the second (left - 53.3%, right - 37.5%) or third rib (left - 29.2%, right - 46.7%). The sixth rib was the most common lowest attachment (left - 94.2%, right - 89.2%). Most frequently, the muscle was composed of four (left - 31.7%, right - 44.2%) or fifth slips (left - 53.3%, right - 40.8%). CONCLUSIONS: This study provides detailed basic information on the variety of the transversus thoracic muscle. It also defines the range of the clearly visible, uncovered by the muscle part of the internal thoracic artery and the completeness of the muscular layer over it. The knowledge of these peculiar muscle-arterial relations would definitely be beneficial to cardiac surgeon in performing fast and safe arterial harvesting.

DNA identification of biological traces and interpretation in a sexual assault case.

The approaches in research and practical work in the forensic laboratories of DNA profiling in a sexual assault case can be assessed by the individual valuation of the quality and quantity of available DNA and the choice of combination of the STRs loci that have been examined. The applied procedures are classic or modificated extraction, amplification, and electrophoretical procedures, which have been selected for every individual case. We set up to present a criminal case of sexual assault over a woman, where the suspect used a condom which--after being examined--gave a negative sperm cytologic result. Our aim is to put some debatable issues and to propose an interpretation of the obtained results based on an association of the DNA typing of the victim and the suspect, separated only by the condom.

Neuronal nitric oxide synthase immunopositive neurons in cat claustrum--a light and electron microscopic study.

Nitric oxide is a unique neurotransmitter, which participates in many physiological and pathological processes in the organism. Nevertheless there are little data about the neuronal Nitric Oxide Synthase immunoreactive (nNOS-ir) neurons and fibers in the dorsal claustrum (DC) of a cat. In this respect the aims of this study were: (1) to demonstrate nNOS-ir in the neurons and fibers of the DC; (2) to describe their light microscopic morphology and distribution; (3) to investigate and analyze the ultrastructure of the nNOS-ir neurons, fibers and synaptic terminals; (4) to verify whether the nNOS-ir neurons consist a specific subpopulation of claustral neurons; (5) to verify whether the nNOS-ir neurons have a specific pattern of organization throughout the DC. For demonstration of the nNOS-ir the Avidin-Biotin-Peroxidase Complex method was applied. Immunopositive for nNOS neurons and fibers were present in all parts of DC. On the light microscope level nNOS-ir neurons were different in shape and size. According to the latter they were divided into three groups-small (with diameter under 15 microm), medium-sized (with diameter from 16 to 20 microm) and large (with diameter over 21 microm). Some of nNOS-ir neurons were lightly-stained while others were darkly-stained. On the electron microscope level the immunoproduct was observed in neurons, dendrites and terminal boutons. Different types of nNOS-ir neurons differ according to their ultrastructural features. Three types of nNOS-ir synaptic boutons were found. As a conclusion we hope that the present study will contribute to a better understanding of the functioning of the DC in cat and that some of the data presented could be extrapolated to other mammals, including human.

Some variations of the circle of Willis, important for cerebral protection in aortic surgery--a study in Eastern Europeans.

BACKGROUND: During unilateral selective cerebral perfusion (SCP), via cannulation of the brachiocephalic trunk, the brain receives blood only through the right common carotid artery and the right vertebral artery. For perfusion of the contralateral (left) hemisphere it is counted on the competence of the circle of Willis (CoW). It is well known that variations of CoW are present in more than 50% of the people. Furthermore, these variations usually affect more than one vessel of the circle. The aim of the present work was to study the variations of CoW, which could have an impact on cerebral blood supply during unilateral SCP. METHODS AND MATERIALS: We study 112 CoWs obtained from cadavers via routine dissection in the Department of Forensic Medicine of Medical University, Sofia. The external diameter of both vertebral arteries and all arteries that form CoW was measured with a caliper-gauge. RESULTS: We identify the variations of CoW such as significant hypoplasy and/or lack of a branch of the circle. Bearing in mind the characteristics of the blood flow during unilateral SCP some of these variations were classified as significant during unilateral SCP. They were subdivided into groups according to most probable stroke site after unilateral SCP. CONCLUSIONS: Because of the high percent of the variations, hemodynamically significant during unilateral SCP, a suggestion for routine preoperative CT-angio of CoW could be made. Furthermore, an intraoperative follow-up with NIRO, transcranial Doppler, EEG, and so forth could also be recommended.

Parvalbumin in the cat claustrum: ultrastructure, distribution and functional implications.

The presence of the calcium-binding protein (CaBP) parvalbumin (PV) in the neuronal elements of the cat's dorsal claustrum was studied by immunohistochemistry at the light- and electron-microscopic level. PV-immunoreactive neurons and fibers were detected in all parts of the claustrum. The PV-immunoreactive neurons were divided into several subtypes according to their size and shape. Approximately 7% of all PV-immunoreactive neurons were classified as large, while approximately half of the labeled neurons were medium-sized. The small PV-immunoreactive neurons were 45% of the total PV-immunoreactive neuronal population. Ultrastructurally, many spiny and aspiny dendrites were heavily immunolabeled, and the reaction product was present in dendritic spines as well. Several types of synaptic boutons containing reaction product were also found. These boutons terminated on both labeled and unlabeled postsynaptic targets (soma, dendrites, etc.), forming asymmetric or symmetric synapses. Approximately 70% of all PV-immunoreactive terminals contained round synaptic vesicles and formed asymmetric synapses. The majority of these boutons were of the ''large round'' type. A lesser percentage were of the ''small round'' type. This paper represents the first study demonstrating the existence of PV, a CaBP, in the cat claustrum, and its distribution at the light and electron microscope level. Beyond the relevance of this research from the standpoint of adding to the paucity of literature on PV immunoreactivity in the claustrum of various other mammals (e.g. monkey, rabbit, rat, mouse), it is of particular significance that the cat claustrum is more similar to the rabbit claustrum than to any other mammalian species studied thus far, noted by the existence of four distinct morphologic subtypes. We also demonstrate a lack of intrinsic, and possibly functional, heterogeneity as evidenced by the uniform distribution of PV throughout the cat claustrum, across the four cell subtypes (i.e. inhibitory interneurons as well as projection neurons). Indeed, the association with, and influence of, the cat claustrum on diverse multisensory mechanisms may have more to do with its afferent than efferent relationships, which speaks strongly for its importance in the sensory hierarchy. Exactly what role PV plays in the claustrum is subject to discussion, but it can be postulated that, since CaBP is associated with GABAergic interneurons, synaptogenesis and neuronal maturation, it may also serve as a neuroprotectant, particularly with regard to pathologies associated with the aging process, such as in Alzheimer's disease.

[The first publication and the first manual on forensic medicine in Bulgaria]. / TT

The authors find out that during the whole period of the Ottoman yoke in our country there is only one publication on forensic medicine which is a Russian translation. Immediately after the Liberation of Bulgaria D. Pasmanik/ a Russian doctor, who has been working in our country/ has written the first manual on forensic medicine entitled 'Conclusions of the Forensic medicine' published in the the 'Juristic Review' journal.