Septal Aperture of the Humerus: Etiology and Frequency Rates in Two European Populations

Analysis of the septal aperture was conducted on two documented European populations. Collections from the National Museum of Natural History Lisbon, Portugal, and University of Athens, Greece, were used for the study. Both collections are modern and documented for sex and age. The Portuguese sample comprises 297 individuals (149 males and 148 females) between the ages of 18 and 88. A septal aperture was observed in 50 individuals resulting in a frequency of 16.83%. The Greek sample comprises 117 individuals (68 males and 49 females) between the ages of 20 and 65. Twenty-five septal apertures were observed, giving a frequency of 21.37%. Both populations had high frequencies which exceeded those observed in European countries in previous studies. Sex analysis shows that both samples confirm that septal apertures are more common in females. The Portuguese sample also supports that septal apertures are more common in the left humerus; however, the Greek sample had a higher frequency of bilateral cases. Measurements of the Portuguese sample were taken to determine whether robusticity correlates with presence of septal apertures. These measurements concluded that there was no difference in robusticity with presence or absence of a septal aperture, challenging previous studies. Anat Rec, 2019. © 2019 American Association for Anatomy Anat Rec, 303:1821–1830, 2020. © 2019 American Association for Anatomy     

Variation in accessory mental foramen frequency and number in extant hominoids

Nerves providing sensation to the lower face and jaw exit the mandibular canal via the mental foramen. In humans, there are many documented occurrences of additional foramina (accessory mental foramina, AMFs) on the lateral mandibular surface that may also contain nervous structures. There are large discrepancies in the literature regarding how often AMFs occur in humans, and investigations of non-human hominoid AMFs are rare. Consequently, the causes of interspecific diversity in this variable have not been explored. This project seeks to compare the frequency and number of AMFs between males and females, and among human regional groups and hominoid subspecies and species, and to investigate possible causal factors for any differences identified. No significant differences were found between males and females in any group. Gorillas and orangutans had the highest percentages of individuals with AMFs and the highest mean number of foramina, while modern humans and siamangs had the lowest figures for these variables. Significant differences (p < .05) were found for the mean number of foramina between most pairs of species. The results also showed that species with mandibles that are larger overall, have a larger area anterior to mental foramen, and a longer mandibular canal typically present more AMFs. The strongest correlation was found between the mean number of mental foramina and mandibular canal length. We suggest that these results provide preliminary support for the hypothesis that increasing mandibular canal length increases the likelihood that that nerves will ramify, leading to greater frequencies of accessory mental foramina.     

Determination of the Location of the Mental Foramen: A Critical Review

Introduction

The mental foramen (MF) is an important landmark to consider during surgical endodontic procedures. The purpose of this review article was to discuss the variety of techniques that have been developed to determine the location of the MF, to make recommendations for the current best technique available, and to discuss upcoming technologies.

Methods

Articles that have addressed the location of the MF were evaluated for information pertinent to include in this review.

Results

Different technologies have been used to help operators determine the clinical location of the MF. Most of the techniques have shortcomings such as magnification, radiation, and cost. Cone-beam computed tomographic imaging is the best current available imaging technology to determine the accurate location of the MF, but it has shortcomings such as radiation, cost, and not being real time, which means the data must be interpreted at a later time than when the information was computed.

Conclusions

In the future, magnetic resonance imaging and ultrasound technologies seem to provide promising noninvasive imaging techniques.     

经眶上锁孔入路Willis环前循环的显微解剖学研究

目的研究眶上锁孔入路下Willis环前循环的显露范围,为眶上锁孔入路治疗前循环动脉瘤提供解剖学参考依据。方法10个成人尸体头颅行眶上锁孔入路的手术解剖,手术显微镜下观察Willis环前循环的显露范围及其穿支动脉的显露情况。结果外侧可显露同侧大脑中动脉的最大范围(1.88±0.26)cm;内侧可显露对侧颈内动脉的最大范围(0.77±0.15)cm;上方可显露前交通动脉复合体最高点距前颅底平面(0.66±0.17)cm。前交通动脉的穿支数(3.10±1.20)支;A1的穿支数(6.35±2.18)支;Heubner返动脉平均(1.20±0.62)支,其中11/24起源于ACoA水平,8/24源于A2,5/24源于A1。结论眶上孔、额骨颧突、前床突、视神经及颈内动脉床突上段是眶上锁孔入路的解剖标志;眶上锁孔入路对于Willis环前循环及其穿支动脉显露良好,适用于Willis环前循环部位的动脉瘤手术。     

经眉弓眶上锁孔入路手术治疗前循环动脉瘤

目的探讨前循环动脉瘤经眉弓眶上锁孔入路手术夹闭的方法及相对适应证。方法分析我科用该手术方式治疗的14例(16个)颅内前循环动脉瘤的临床资料,着重阐述手术方法、注意事项、术中动脉瘤破裂处理及手术适应证。结果14例(16个)动脉瘤全部一次手术夹闭成功,其中4例术中有动脉瘤破裂出血,2例合并有脑积水并行脑室腹腔分流术,1例死于肺部感染及多脏器功能衰竭,其它患者恢复良好。结论用该方法治疗前循环动脉瘤安全、微创,值得临床推广应用。     

Primary and Secondary Prevention of Ischemic Stroke and Cerebral Hemorrhage: JACC Focus Seminar

Stroke is a leading cause of permanent disability. Therefore, primary prevention of first stroke and secondary prevention of recurrent stroke are a high priority. Primary prevention of ischemic stroke includes lifestyle modification and diet, treatment of risk factors including hypertension, diabetes mellitus and lipid disorders, antiplatelet therapy for high vascular risk patients, and anticoagulation in atrial fibrillation. Secondary prevention of ischemic stroke includes additional carotid surgery or stenting in selected symptomatic patients, closure of patent foramen ovale after cryptogenic stroke, treatment of insulin resistance, and best medical treatment of intracranial stenosis. The most important preventive strategies in the primary and secondary prevention of cerebral hemorrhage include the treatment of hypertension, reduction in alcohol intake, and occlusion of the left atrial appendage in patients with atrial fibrillation and permanent contraindications for oral anticoagulation.     

腰椎间盘突出症的椎间孔镜治疗

开放手术治疗腰椎间盘突出症虽然疗效确切,但对腰部软组织及脊柱附属结构破坏较大,脊柱正常载荷传导及运动功能的紊乱,加速邻近节段退变,从而影响手术的远期疗效。随着外科技术及器械的发展,微创治疗成为治疗腰椎间盘突出症的重要组成部分,其具有创伤小,恢复快,并发症少等优点。该文将目前主流微创技术的临床应用现状进行归纳总结。     

眉弓轮廓的三维CT初步测量及分析

目的　初步了解中国人眉弓的正常形态 ,为眉弓轮廓的美容改型提供依据。方法　采用计算机辅助三维CT重建技术 ,对 4 0例正常人眉弓形态结构做立体的定量测定与分析。结果　男性在额宽、额高、颅长、眶上嵴突、眶高、上下眶缘之差及耳前鼻根距均明显大于女性 (P <0 .0 5 ) ,而青年组在前额高、颅长、眶上嵴突、前额角也明显小于老年组 (P <0 .0 5 )。结论　眉弓轮廓存在性别差异 ,并有随年龄增大而前突的趋势。     

颈神经在椎间孔及脊神经沟处受嵌压致颈椎病的关系比较

目的　比较颈神经在椎间孔及脊神经沟处受嵌压的出现率及严重程度。方法　取 6 0具成年尸体 (男 2 8,女 32 ) ,通过对颈椎间孔及其脊神经根的外径以及对脊神经沟外口宽度及其沟内段脊神经前支横径的测量 ,得出颈神经前支横径 /脊神经沟宽度和颈神经根外径 /椎间孔大小的均值 ,得出比值大于或等于 1的出现率 ,并分别进行统计学处理。结果　颈神经在椎间孔处受压的出现率 ( 2 4.6 %)明显高于脊神经沟处 ( 6 .3%) ( P <0 .0 1)。结论　颈神经在颈椎间孔和脊神经沟处均可受累 ,颈神经在椎间孔处受累的严重性明显大于在脊神经沟处。临床诊治颈椎病在充分考虑椎间孔处神经受累的同时 ,也不可忽视颈椎脊神经沟处神经受累的可能性。