Macroscopic, mesoscopic and microscopic morphology of the gastric plexus--ontogeny of the celiac ganglion.

The vagus trunks, anterior and posterior, and their respective branches control the parasympathetic innervation of the stomach. After giving off a few thin branches, at the lower part of the esophagus and the cardiac region of the stomach, the anterior vagal trunk divides into its main branches: four or five consecutive direct branches which supply the upper part of the lesser curvature; these nerves do not form plexuses and thus, they may be individually dissected. One of the branches is stronger than the others and is called the principal anterior nerve of the lesser curvature (anterior nerve of Latarjet). The present study was conducted on eight fetuses of different gestational age (resulting from spontaneous abortions, without malformations), observing the Romanian laws of professional ethics, and 15 adult cadavers (male and female) whose celiac region was dissected macro- and mesoscopically to reveal both the celiac ganglia and their afferent and efferent vessels. For the microscopic study, we used the Bielschowsky silver staining method. The meso- and macroscopic dissections revealed the anterior and posterior vagal trunks in all the specimens (100%), as well as a rich gastric periarterial plexus. The microscopic samples focused on the ontogeny of the celiac ganglion in various gestational stages.

Chondrosarcoma of the upper end of the femur.

Chondrosarcoma is a malignant tumor that produces cartilage matrix. Occurs in the fourth to sixth decades and has a male to female ratio of 2/1. It is most common in the long bones and on the surface of the pelvis. The authors present a case of chondrosarcoma of the upper end of the femur of a 50-year-old female patient who has come in our Department of Orthopedics and Traumatology two month ago, complaining of severe and persistent pain in the left hip joint and presenting limitation of adduction movement, limitation of internal-external rotation movements, and also could not be able to do thigh flexion on the abdomen. The woman presented a four-month history of persistent and severe pain, not assigned at anti-inflammatory drugs. Laboratory tests not had shown any significance. On radiographies and magnetic nuclear resonance the lesion was shown very clear, deciding for biopsy. The tumor had been large surgical excised with safe limits. Histopathology indicated the histological feature as a differentiated chondrosarcoma, grade III. Our patient has started the chemotherapy and radiation.

The adult coeliac ganglion: a morphologic study.

The coeliac plexus is located on the sides of the coeliac trunk and nearby the origins of the superior mesenteric and renal arteries. Afferent branches get to this plexus from the vagus nerve, splanchnic nerves and the right phrenic nerve; efferents leave for viscera through periarterial plexuses and the retroportal nerves. The coeliac plexus ganglia - coeliac, superior mesenteric, aorticorenal - are prevertebral ganglia that receive the preganglionic sympathetic fibers brought by the splanchnic nerves from the thoracic spinal cord. For studying the adult coeliac ganglia dissections were performed then pieces were drawn for silver staining by the method of Bielschowsky on blocks and HE stains. The adult coeliac ganglia consist of well-defined ganglionic subunits, of a varying number of neurons with somata ranging from 14 to 48 microns and characteristically involved in extensive dendritic fields. Individual degrees of coalescence may justify the macroscopic appearance of the coeliac ganglion but its structure keeps distinctive subunits.

Enteric nervous system development in cavitary viscera allocated to the celiac plexus.

Enteric nervous system (ENS) is a network made of neuronal cells and nervous fibers. There are two plexuses: myenteric of Auerbach and sub mucous of Meissner and Henle. Many substances are involved in neurotransmission at ENS level. ENS assures all gastrointestinal system functions: digestion, absorption, etc. Our study is made on 23 human fetal specimens at different ages of evolution with crown-rump lengths from 9 to 28 cm, and three new born human specimens. We used the Trichrome Masson stain technique and the argental impregnation Bielschowsky on block technique for microscopic evidence. Our study concerned the cavitary viscera allocated to the celiac plexus, involving all layers of each studied viscera.

Study of the celiac ganglia development.

The celiac ganglia and the visceral plexus are complexes structures, disposed in the proximity of the main collateral branches of the aorta. Pre visceral ganglia are sympathetic ganglia chains between the lateral vertebral sympathetic chain and viscera. Our study is made in the anatomy lab on 30 adult human bodies, one of new born and 10 human fetal specimens with crown-rump lengths from 9 to 28 cm. It was used the argental impregnation by Bielschowsky on block and Trichrome Masson methods for microscopic evidence. Prenatal, celiac ganglia are not a good defined morphological unit. They show a delay of neuroblastic maturation, comparing with the par vertebral ganglia. The nervous functional unit is represented by the neuron. The ontogenesis of the celiac ganglia follows several stages. Then, the neuronal specialization and the functional neuronal maturation are processes based on the numeric and morphological remodeling of the neuronal connecting figure, pre ganglia and post ganglia.

Study of the diameter and number of the pulmonary veins orifices.

The present study was made in the anatomy laboratory on 100 heart specimens. It was studied the morphological parameters about diameter and number of the atrial orifices of the pulmonary veins. The number of the orifices and their diameter depends on the lungs weight. Generally (70% of the cases) the orifices number is four and rarely three or five. An increased number of orifices are more frequently in the right side and a decreased number especially in the left side. The orifices diameter is much larger at the male's veins than the female's ones, and much larger in the right than the left side and also much larger at the superiors than the inferior veins.

Considerations on the sinus node microangioarchitecture.

The importance of the sinus node as the cardiac pacemaker is well known. The aim of the present study was to investigate the microangioarchitecture at the level of the sinus node. Ten human adult hearts were injected with India ink in the initial segments of the coronary arteries. Pieces were drawn and diaphanized. The results of the study can be summarized: (1) the sinus node is rather an irregularly shaped structure, with peripheral strands intermingling with strands of the atrial myocardium; at this level two vascular patterns can be recognized: (a) the myocardial capillary networks that parallels the muscular bundles, and (b) the peripheral nodal networks built upon dichotomizing arterioles; (2) it seems that while the thick and large sinus node artery does not branch in the nodal tissue, the blood supply of this tissue is ensured by the peripheral nodal networks; (3) characteristically, in the periphery of the nodal tissue are largely present glomeruli made by capillaries with pericellular dispositions. The results strongly suggest that the nodal tissue is mainly supplied from its periphery and the sinus node artery is rather a scaffold than a supplier of that tissue.

Considerations on the left papillary muscles microangioarchitecture.

The aim of the present study was to bring macroscopic and microscopic evidence on the left papillary muscles blood supply in human hearts. For the study were used human adult hearts from patients without clinically known cardiac ischemic history. Ten hearts were used for injecting China ink in the coronary arteries and other twenty hearts were dissected to evidence the characteristics of the main arteries of the left papillary muscles. Pieces - left papillary muscles - were drawn from the injected hearts and diaphanised. In all dissected hearts the left anterolateral papillary muscles were supplied by the left coronary system: anterior interventricular artery, second diagonal branch and left (obtuse) marginal artery. In 70% the left posteromedial papillary muscles were supplied by the right coronary system (posterior interventricular artery, left retroventricular artery) and in 30% by the left coronary system (circumflex artery). The left papillary muscles were supplied each by one or two main arteries that penetrated the muscles longitudinally. The ventricular wall attaching the papillary muscles was supplied by the subepicardial vessel sending the main arteries of the papillary muscles but also by neighbor subepicardial vessels distributed in that wall. The mural vessels were finer than the papillary muscles main arteries. Injected papillary muscles presented each with two systems of blood perfusion: one represented by segmental centers of arterial branching and distribution of the main arteries of the muscle and other represented by capillary extensions of the mural networks at that level. From the segmental branching centers were perfused the neighbor segments of the papillary muscles and intrasegmental anastomoses were recognized. The microvascular study of the left papillary muscles proves the usual overlapping of sources for segmental supply; this overlapping is reinforced by the high capillary density to ensure the vascularisation of the papillary muscles.

Aspects referring to the morphological variability of the abdominal branches of pneumogastric nerve (nervus vagus).

Terminal part and the abdominal branches of pneumogastric nerve were and still is an up-to-date problem not only through the anatomic importance but also through its implications in surgical practice. The study was done on 50 corpses using the dissection method. We are looking after torsion variants of pneumogastric nerves around the esophagus, morphological variability of the periesophageal pnemogastric plexus among witch the pnemogastric nerves loose theirs individuality through the mixture and the anastomoses of the fibers and the morphological variability of abdominal branches of the nerve, grouped by us in anterior and posterior branches.

Correlations between the colic branches of the mesenteric arteries and the vascular territories of the colon.

The study, done on 100 corpses from the dissection rooms of anatomy laboratory, hinted the morphological variability of the colic arteries and their territories. Morphological variability of the colic branches derived from the mesenteric arteries (superior right colic artery -- 98%; middle right colic artery -- 88%; inferior right colic artery -- 100%; middle colic artery - 36%; superior left colic artery -- 100%; middle left colic artery -- 50%; inferior left colic artery -- 100%) allows us to give out a morphogenetic supposition related their ramification and number. Analyze of the results guide us to a tentative of setting down the vascular territories of the colon. In the beginning were established the territories of the mesenteric arteries (superior and inferior) and after that, were marked the subterritories for each colic artery. Establishing the vascular territories of the colic arteries have not only anatomical importance but also a surgical one, been known the difficult postoperatory colon's revitalization.