Anatomic and clinical correlations of the lenticulostriate arteries

The authors examined the lenticulostriate (perforating) arteries in the vascular casts of 48 middle cerebral arteries (MCA), as well as in the MRI or CT scans of 32 patients with cerebral infarcts in the MCA territory. The lenticulostriate arteries ranged between two and 12 in number, and from 80 microm to 1,400 microm in size. They originated from the main trunk, terminal trunks, bifurcation site, and/or leptomeningeal branches of the MCA, either separately or from common trunks (70.8%). The extreme variations of the supplying region of the perforators were noted in seven anatomic specimens. In addition to the basal ganglia, the genu, and the anterior limb of the internal capsule, the lenticulostriate arteries seemed to supply only the rostral portion of the superior part of the posterior limb of the capsule. The patients presented with occlusion of all the lenticulostriate arteries, individual arteries, or only their twigs. Complete occlusion of these arteries resulted in a huge central hemispheric infarct. Occlusion of an individual artery most often caused a large ganglionic-capsular infarct. The authors concluded that the lacunar infarcts usually follow occlusion of a terminal or a side branch of the lenticulostriate arteries.     

Anomalous subaortic left brachiocephalic vein in surgical cases and literature review

Anomalous subaortic left brachiocephalic vein (ASLBV) is a rare systemic venous anomaly. We review our experience with patients associated with ASLBV who underwent cardiac surgery at three institutions. From 1989 to 2009, the medical records of surgically treated patients with ASLBV were analyzed; the incidence of ASLBV, clinical characteristics, and associated anatomical findings were assessed. Fifteen patients had ASLBV. All ASLBVs coursed left lateral to the aortic arch, passed under the ascending aorta anterior to the central pulmonary artery, and joined the right brachiocephalic vein. Fourteen patients had congenital heart disease (CHD), and the remaining patient did not have cardiac anomalies. Its incidence was 0.57% (14 of 2,449) in patients with CHD and only 0.02% (1 of 4,805) in patients without CHD. In patients with CHD, 73.3% (11 of 15) of the patients had conotruncal cardiac anomalies such as tetralogy of Fallot, ventricular septal defect with pulmonary atresia, truncus arteriosus, and interruption of the aortic arch. Eight patients had aortic arch anomalies, including right aortic arch and cervical aortic arch. The deletion of chromosomal 22q11.2 was confirmed in two patients, and one patient was diagnosed with DiGeorge syndrome. ASLBV was clinically silent even without any surgical intervention. ASLBV is a very rare anomaly and is highly associated with conotruncal cardiac anomalies and aortic arch anomalies, including right aortic arch and cervical aortic arch. Preoperative diagnosis is important when any surgical interventions are intended, especially, in patients with conotruncal cardiac anomalies. Clin. Anat. 23:950–955, 2010. © 2010 Wiley‐Liss, Inc.     

Variant of the left coronary artery with an unusual origin and course: Anatomic and postmortem angiographic findings

This study demonstrates anatomic and postmortem angiographic findings characterizing the origin of the left coronary (LC) artery arising in common trunk with the right coronary (RC) artery from the right aortic sinus and its course via the ventricular septum (VS) to the left heart. This anomaly was a single finding observed among 388 angiographies and 60 corrosion castings. The course of the LC was divided in four segments. The first three form a curve that is upward concave. Large branches to the septomarginal trabecula (ST), VS, diagonals (DS), and the small anterior interventricular (anterior descending) artery originated from the outer part of this curve. In the anteroposterior x-ray, the above curve resembles a deep-bottom pot with a handle corresponding to the fourth segment. In the right anterior oblique, the first and second segments form a large erect angle. The third segment occupies the lower part of the absent proximal anterior interventricular artery, and the fourth crosses the outflow tract and the first segment in the middle. The course of these four segments of LC resembles the shape of the number 6. These findings are important for interpreting coronary angiographies in patients with this anomaly. Clin. Anat. 11:367–371, 1998. © 1998 Wiley-Liss, Inc.     

妊娠合并输尿管结石致顽固性肾绞痛的腔内处理

目的探讨妊娠合并输尿管结石致顽固性。肾绞痛安全有效的腔内处理方法。方法妊娠合并输尿管结石致肾绞痛经保守治疗无效患者14例，孕7～34周，平均27周。结石最大径5～12mm。输尿管上段结石8例，中段3例，下段3例。上段结石中6例单纯留置双J管，2例将结石推回肾盂后留置双J管。中下段结石中3例采用输尿管镜下气压弹道碎石术击碎结石，3例应用输尿管镜下双频激光碎石。结果12例术后。肾绞痛消失；2例单纯放置双J管者仍有间断轻微。肾绞痛，服用解痉药物可以缓解。8例未碎石患者在结石排出前每3个月更换双J管。14例孕妇均顺利生产，婴儿健康。结论妊娠合并输尿管结石致顽固性肾绞痛患者采用逆行输尿管插管或输尿管镜取石术安全有效。     

Anomalous muscle of the wrist

A case of an anomalous muscle found in the right wrist of a 52-year-old man during routine carpal tunnel decompression surgery is reported. The muscle was observed lying transversely across the carpal tunnel superficial and parallel to the flexor retinaculum. Its further definition was subsequently demonstrated by postoperative magnetic resonance imaging (MRI). No similar structure was detectable on MRI of the left wrist.     

Anomalous relationship between femoral artery and vein: A case report

The relationship between the femoral artery and vein, the artery lying lateral to the vein as they emerge from behind the inguinal ligament, is traditionally considered to be constant. The femoral pulse is used as an anatomical landmark for both open and closed procedures in the femoral triangle. A case is presented here which illustrates that the constancy of this relationship cannot always be relied upon.     

Anomalous origin of both vertebral arteries

The authors describe a case of an unusual origin of both vertebral arteries in a singular cadaver. On the left, the artery arises directly from the common trunk of vertebral and subclavian artery at the aortic arch and enters the transverse cervical foramina at C VI. On the right, the artery originates from the right common carotid artery and enters the transverse foramina at C III. Additional anomalies were observed on the aortic arch: the common trunk of both common carotid arteries, the common trunk of the left vertebral and subclavian artery, and as a last branch, the retroesophageal right subclavian artery. The morphometric measurements of the vertebral arteries were performed. The literature on the variations of the vertebral arteries is reviewed and their clinical importance for diagnostical procedures and head and neck surgery stressed. Clin. Anat. 12:281–284, 1999. © 1999 Wiley‐Liss, Inc.     

Anatomical variations of the human suprarenal arteries

This is on anatomical study of the suprarenal arteries and their variations in 30 cadavers aimed at providing in a subsequent article the anatomical basis of arterial segments of the gland. The suprarenal glands were supplied by 3 main groups of suprarenal arteries: superior, middle and inferior. Only the superior and the inferior groups were present in all cases, since the middle vessels appeared in only 93.3% +/- 4.6 of the cases. The superior group included on each side 4 arteries in males and 5 in females; the middle group presented only 1 artery on each side in both males and females, and the inferior group exhibited on each side 2 arteries in males and 1 artery in females. The most variable group was the middle one, the aortic origin being the most frequent but with a relatively low incidence (53.3% +/- 9.1 on the right and 46.7% +/- 9.1 on the left). The superior group originated from the posterior branch of the ipsilateral inferior phrenic artery in 83.3% +/- 6.8 on the right and 80% +/- 7.3 on the left. The arteries of the inferior group were branches of the ipsilateral renal artery in 70% +/- 8.4 on the right and 50% +/- 9.1 on the left. The origin of the middle suprarenal arteries from the trunk of the inferior phrenic artery on both sides (26.7% +/- 8.1 on the right and 36.7% +/- 8.8 on the left) should be considered relevant. The anatomical findings warrant a further investigation for the identification, illustration and nomenclature of arterial anatomicosurgical segments.     

Higher risk of colic in infants of nonmanual employee mothers with a demanding work situation in pregnancy

In this population-based study, we assessed the relation between socioeconomic and psychosocial conditions in 1,094 pregnant women and subsequent infantile colic by means of self-administered questionnaires measuring exposures in the 17th pregnancy week and telephone interviews at infant age 5 weeks. There was a higher risk of colic in infants born to younger mothers, mothers with low instrumental support in pregnancy, and mothers with nonmanual occupations. Having an “active” job situation, that is, high demands and high decision latitude at work, acted synergistically with a nonmanual occupation, yielding even higher odds ratios for colic as did concomitant low instrumental support and nonmanual occupation. An expected synergy between low social participation and nonmanual occupation could not be demonstrated. Findings from gender-related research may partly explain some of these results.     

选择性食管动脉插管的应用解剖

为提供与选择性食管动脉插管有关的应用解剖学资料,在31具成人尸体上,对食管动脉的支数、起始、位置,外径和角度进行了观测,并讨论了与临床应用的有关问题。     

A low allergen diet is a significant intervention in infantile colic: Results of a community-based study

Background: The effect of diet change in 38 bottle-fed and 77 breast-fed “colicky” infants, referred from community-based pediatric facilities was studied over a 1-week period in a double-blind (within each feeding mode), randomized, placebo-controlled trial. Methods: Bottle-fed infants were assigned to either casein hydrolysate or cow's milk formula. All mothers of breast-fed infants were started on an artificial color-free, preservative-free, additive-free diet and also randomized to an active low allergen diet (milk-, egg-, wheat-, nut-free) or a control diet. Results: The response to diet was assessed on day 1 and day 8 with the use of a previously validated infant distress chart on which parents recorded distress levels. If successful outcome was defined as a reduction in distress of 25% or more, after adjusting for age and feeding mode, infants on active diet had a significantly higher rate of improvement than those on the control diet (odds ratio, 2.32; 95% confidence interval, 1.07-5.0; p = 0.03). Analysis of the day 8 to day 1 distress ratio, again adjusted for age and feeding mode, showed that infants on the active diet had distress reduced by 39% (95% confidence interval, 26-50) compared with 16% (95% confidence interval, 0-30) for those on the control diet (p = 0.012). Conclusion: The results suggest a period of dietary modification with a low allergen diet and appropriate nutritional support should be considered in healthy infants with colic. (J ALLERGY CLIN IMMUNOL 1995;96:886-92.)     

Main trunk of the left coronary artery: anatomic study of the parameters of clinical interest

The objective of this study was to analyze in one single series all the characteristics of the main trunk of the left coronary artery (MT) that may be of use in the diagnosis and treatment of its pathologies. One-hundred human hearts from autopsies were used. The average age of the sample studied was 63.15 years +/- 18.76 (range = 17-94 years). The heart was removed after resection of the costosternum and placed in 10% formaldehyde. With gradual separation and retraction of the myocardial fasciculi the MT was exposed. The length of the MT, the luminal diameter of the MT at its midpoint, and the luminal diameter of the left coronary orifice were measured with a caliper. The angle of division between the anterior interventricular and circumflex branches was also measured, and the number of terminal branches originating from the MT was recorded. In four cases, there was no MT and the anterior interventricular and circumflex branches originated directly from the left aortic sinus. The average length of the MT was 10.8 +/- 5.52 mm (range = 2-23 mm); the average diameter at its midpoint was 4.86 +/- 0.80 mm; and there was no significant difference noted between the midpoint diameter of the MT and the diameter of the left coronary orifice. The most frequent type of division of the MT was bifurcation (62%); in 38% of cases the MT divided into three or more branches. An average value of 86.7 +/- 28.8 degrees was obtained for the angle of division of the terminal branches of the MT (range = 40-165 degrees ). There was a positive correlation between the length of the MT and the angle of division of its terminal branches, with the longest MTs having the largest angle of division.     

Middle mesenteric artery: an anomalous origin of a middle colic artery

Summary A case of anomalous mesenteric artery is reported. The artery was incidentally cannulated during angiography of a patient with a left renal tumor. It arose from the abdominal aorta between the superior and inferior mesenteric arteries. The artery then ascended directly upwards from its origin and supplied the transverse colon replacing the middle colic branch of the superior mesenteric artery. The anomaly must be a result of a anomalous concentration of unpaired visceral arteries in the developing embryo. This type of anomaly is very rare and it would be appropriate to name the artery the middle mesenteric artery.

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Artère mésentérique moyenne : une anomalie d'origine de l'artère colique moyenne

Résumé Un cas d'anomalie de l'artère mésentérique est rapporté. L'artère a été cathétérisée incidentallement lors de l'angiographie d'une patient présentant une tumeur rénale gauche. Elle naissait de l'aorte abdominale entre l'artère mésentérique supérieure et l'artère mésentérique inférieure. Elle montait directement à partir de son origine pour se distribuer au colon transverse et remplacer la branche colique moyenne normalement issue de l'artère mésentérique supérieure. Cette anomalie est sûrement le résultat d'une concentration anormale des artères viscérales impaires et médianes existant pendant la période embryonnaire. Ce type d'anomalie est très rare et justifierait le nom d'artère mésentérique moyenne.

     

Dual anterior interventricular arteries

A patient with dual left anterior descending (R. interventricularis anterior of the left coronary artery) coronary artery is presented. A normally arising left anterior descending was hypoplastic, and an anomalous left anterior descending, which arose from the right sinus aorticus had a normal caliber. The anomalous left anterior descending artery traversed between the aorta and the pulmonary artery supplying most of the anterior myocardial wall of the left ventricle. This rare coronary anomaly can potentially have implications on percutaneous coronary interventions or on surgical revascularization procedures. Clin. Anat. 12:153‐158, 1999. © 1999 Wiley‐Liss, Inc.     

Anomalous thymic branch of the right common carotid artery

A previously unreported anomalous thymic artery that branched from the anterior aspect of right common carotid artery approximately 1 cm above bifurcation of the brachiocephalic artery was found during routine dissection. It traveled inferiorly through a plexus of inferior thyroid veins for 6 cm in front of the brachiocephalic artery and crossed the anterior surface of the trachea where it divided into two branches that supplied the right and left lobes of the thymus. The development and blood supply of the thymus and their clinical anatomy are reviewed. Clin. Anat. 11:346–348, 1998. © 1998 Wiley-Liss, Inc.     

肌性动脉内弹性膜的观察分析

肌性动脉包括中等动脉、小动脉和微动脉 ,本研究用Gomori氏醛 -复红等染色方法显示胎儿、狗、兔、猴中等动脉和成人小动脉、微动脉管壁内的弹性膜 ,并对其进行对比观察 ,发现在胎儿中等动脉管壁内存在两层完整、清晰的内弹性膜结构 ,而在其它标本中未见此特殊现象。此结果为进一步研究肌性动脉的结构与功能提供实验依据。     

An anomalous muscle linking superior and inferior rectus muscles in the orbit

Dissections of the bilateral orbits in a 45-year-old female cadaver, who had no ocular movement disorders in her lifetime, revealed anomalous muscles linking the superior and inferior rectus muscles. The muscles, situated between the optic nerve and the lateral rectus muscle, originated from the annulus of Zinn and branched off two heads; one inserted into the medial inferior side of the superior rectus muscle and the other inserted into the central superior side of the inferior rectus muscle. Each insertion was located on a distal site of the myoneural junction of each rectus muscle. Histological investigations showed that the muscles had a striated muscle structure. No definite nerve insertion was observed in the muscles. Although this type of anomalous muscle has been reported in a few Caucasian cases, the present study is the first report in an Asian person. Anomalous orbital structures, which are a rare cause of strabismus, are important in the differential diagnosis of intra-orbital space-occupying lesions, rather than the differential diagnosis of strabismus.