Vascular geometry of vertebrobasilar tree with and without aneurysm.

AIM: To examine a possible relationship between the variable vascular geometry of vertebrobasilar joint angle and basilar bifurcation angle as well as the diameters of these blood vessels. METHODS: The study included 60 adult patients, of both sexes, who were divided into two groups. One group (30) consisted of patients without aneurysm of vertebrobasilar tree, and another group (30) of patients with aneurysm. The patients were examined using Magnetic Resonance Imaging (MRI) and Computed Tomography Angiography (CTA) of head and neck. RESULTS: In the group without aneurysm of vertebrobasilar tree, in 14 (46.6%) patients diameters of the right and the left vertebral artery were approximately the same. The average value of the angle of junctions of vertebral arteries was 65.43°, and the average angle of basilar bifurcation was around 94.53°. In the group with aneurysm of vertebrobasilar tree, in 12 (40%) patients diameters of the right and the left vertebral artery were also approximately the same. The average angle of junction of vertebral arteries was 68.46º, and the average angle of basilar bifurcation was 121.93º. CONCLUSION: Anatomic variations of the vertebrobasilar joint angle and basilar bifurcation angle, as well as the diameters of these blood vessels, are some of the factors in the increase of the incidence of aneurysm in this anatomic area.

Variations in diameters of vertebro-basilar tree in patients with or with no aneurysm.

INTRODUCTION: The morphological anatomy of the posterior circulation is very complex and variable. Aims of this research were to document the morphological anatomy of the posterior circulation along with variations in the Bosnian population, in patients with or without aneurysm. Measurements of the outer diameters of the vertebral artery, basilar artery and posterior cerebral artery were taken. The second aim was to determine the possible relationship between diameters of the area with subsequent aneurysm formation. MATERIAL AND METHODS: The study involved 60 consecutive patients, adults of both sexes, treated in the UKC Tuzla. The patients were divided into two groups. One group consisted of the patients without aneurysm of basilar artery, and the other group of patients with aneurysm. All the 60 patients were treated by means of MRI angiography. RESULTS: The mean diameter of the vertebral artery was 2.43 mm; 3.61 mm on the right and 2.83 mm; 3.94 mm on the left. The diameter of the basilar artery varied from 3.8 mm; 3.43 mm. The diameter of the posterior cerebral arteries 2.5 mm; 2.52 mm on the right and 2.46 mm; 2.62 mm on the left. CONCLUSIONS: We have documented the various morphometry variations as well as the differences of the anatomy in this area in Bosnian population as compared to the medicine literature.

Intrahepatic transposition of bile ducts.

Objective. To describe the intrahepatic bile duct transposition (anatomical variation occurring in intrahepatic ducts) and to determine the frequency of this variation. Material and Methods. The researches were performed randomly on 100 livers of adults, both sexes. Main research methods were anatomical macrodissection. As a criterion for determination of variations in some parts of bile tree, we used the classification of Segmentatio hepatis according to Couinaud (1957) according to Terminologia Anatomica, Thieme Stuugart: Federative Committee on Anatomical Terminology, 1988. Results. Intrahepatic transposition of bile ducts was found in two cases (2%), out of total examined cases (100): right-left transposition (right segmental bile duct, originating from the segment VIII, joins the left liver duct-ductus hepaticus sinister) and left-right intrahepatic transposition (left segmental bile duct originating from the segment IV ends in right liver duct-ductus hepaticus dexter). Conclusion. Safety and success in liver transplantation to great extent depends on knowledge of anatomy and some common embryological anomalies in bile tree. Variations in bile tree were found in 24-43% of cases, out of which 1-22% are the variations of intrahepatic bile ducts. Therefore, good knowledge on ductal anatomy enables good planning, safe performance of therapeutic and operative procedures, and decreases the risk of intraoperative and postoperative complications.

[Anatomical variations of roots of the common bile duct]. / Anatomske varijacije korijenova ductus hepaticus communis.

Variations of extrahepatic bile ducts are the basis of hepatobilliar surgery, and they may be a problem during the surgical procedures. In this paper we present the results of our research, wich is conducted on 100 human livers. Common hepatic duct wich is formed by connecting of right hepatic duct and left hepatic duct is noticed in 92% of cases, and in 5% of cases was formed by tree bile ducts. Aberant bile ducts was found in 3% of total number of examined.

Martin-Gruber anastomosis and transposition in cubital tunnel.

This describes the indivisible anastomosis of the main stem of median nerve with ulnar nerve through cubital tunnel followed by the anomaly of ulnar artery that appears as superficial ulnar artery. Both anomalies are found during the anatomical dissection of a grown-up male cadaver, on his right arm. Such case is very rare as, in the literature available to us, it has not been described.

[Variable anatomy of the kidneys--relationship and incidence between anatomical and clinical three-dimensional image methods]. / Varijabilna anatomija bubrega--odnosi i incidenca na anatomskim i klinickim trodimenzionalnim "image" metodama.

UNLABELLED: Research has been done at a 150 pairs of the human adult kidneys (50 anatomical preparedness plus 100 patients) both sex, randomly chosen. Variations of the kidneys have been analyzed and their respect at a live ones, by clinical tree-dimensional "image"methods and lifeless one by anatomical macro dissection plus corrosive method. CONCLUSION: At the most presence of noticed variation had into a size of the kidney, and the lowest one in the number of the kidneys. Technique of magnetic resonance (MR), in relation with computerized tomography (CT) had shown more types of the kidneys variations and more number of the kidney's variations in the form. Percentage of variations of the kidneys at an anatomical preparedness in relation with variations noticed by MR and CT, into a size had relation 44: 4: 0, in the form of 36: 6: 2, in the number 0: 2: 0 and into a location ( rotation) 0: 0: 4. The number and the type of noticed variations of the kidneys show the largest presence at an anatomical matiarials assigned by anatomical macro dissection and corrosive technique in relation with noticed variations of the kidneys by MR and CT. Because of that anatomy finding are set as an imperative into methodological researches of variable anatomy of the kidneys.

[Anatomic variations of the cystic duct and its junction with the common hepatic duct]. / Anatomske varijacije ductus cysticus-a i njegovog spoja sa ductus hepaticus communis.

The ductus cysticus is variable in the length, position and the site where it enters the ductus hepaticus communis--the cystohepatic junction. The investigations were carried out on 100 livers (50 anatomical preparations and 50 patients) adults of both sexes, randomized trial. Main methods of the research were: anatomical macrodissection and analysis of the clinical radiograms. The ductus cysticus were present as: flat--down course in 70%, flat--horizontal course in 2%, flat--ascendant course in 4%, curved in the shape "J" in 10%, curved in the shape "S" in 12% and curved in the shape "U" in 2%. The cystohepatic junction shows variations in topographic zones.

The ventilatory patterns of the left upper lobe of lung.

Having knowledge on models of the bronchial tree branching, is of a special interest for clinical and surgical pulmology, because the hemilobectomy, segmentectomy and subsegmentectomy are always determined by intralobar, intrasegmental and intrasubsegmental bronchial ramification. Investigations were performed on 100 lungs of children and adults of both sexes, one day to 85 years old, randomly chosen. There are two main types of branching of the left upper lobe bronchus: the bifurcation pattern as dominant model in 74% and the trifurcation model found in 26%. Out of 100 lungs studied, 21 lungs had the ventilatory variations of the bronchopulmonary segments. The classification and categorization of the ventilatory of bronchopulmonary segments of the left upper lobe of lung were made. This classification contains 5 categories and 8 subcategories.

[Variations in the position and point of origin of the vermiform appendix]. / Varijacije u polozaju i mjestu nastanka appendix vermiformis.

There were investigated variations of appendix vermiformis in the place of origin and position. The investigations were carried out on 50 human preparations of adults of both sexes, unintentional choice. The position and relation between intestinum caecum and appendix vermiformis were determined by forensic medical and pathoanatomical autopsy. Place of origin of appendix vermiformis, from wall of intestinum caecum is determined by anatomical dissection. Intestinum caecum has a variable shape and it occurs in two forms: conical, which dominates (56%) and square (44%). It has constant position in fossa iliaca dextra in 100% of 50 investigated cases. Appendix vermiformis is fully variable organ as for position and the place of origin from the wall of intestinum caecum. Dominantly (52%) it has rising position, and two subtypes are present: retrocecal (more expressed-38%) related to the retrocolic subtype (14%). Very frequent position of appendix vermiformis is a falling one (32%), in which pelvic position is more frequent (26%) related to descendent position (6%). Appendix vermifirmis is located subcaecaly in 8% of total number of investigated cases, found in three subtypes. It is found out that ostium appendicis vermiformis has a variable position in the wall of intestinum caecum. It is predominantly placed in the middle of the lower pole of the intestinum caecum (58%), in medial wall it is present in 32%, of all investigated, and in the lateral wall in the least number case 10%. The results of these investigations point out how important is to know variable anatomies of appendix vermiformis, for the clinical image of acute appendicitis is undoubtedly caused by the variable anatomical relations.