Pulmonary presentation and coil marcation of dirofilaria lung coin nodes - case report.

Clinicians face significant diagnostic challenges when dealing with nodal lesions of the lung. The majority of lung nodules are benign; however, a significant number can be cancerous. Dirofilaria infestation should also be considered in the differential diagnosis of nodal lung lesions. Most patients with Dirofilaria infestation are asymptomatic. To determine the etiology of nodal lung infiltrations, procedures like radiological imaging, bronchoscopy, endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA), transthoracic biopsy (TTB), tumor markers, nonspecific serological tests, or surgical removal of the lung coin lesions can be performed. Coil marking of the smaller lung lesions under computed tomography (CT) guidance is a helpful tool in determining the position and localization of the nodal lung lesions. Video-assisted thoracoscopic surgery (VATS) or robot-assisted thoracoscopic surgery (RATS) wedge resection is a diagnostic and therapeutic method of choice. No additional treatment of Dirofilaria other than wedge resection of the lung is necessary.

Somato-dendritic morphology and axon origin site specify von Economo neurons as a subclass of modified pyramidal neurons in the human anterior cingulate cortex.

Von Economo neurons (VENs) are modified pyramidal neurons characterized by an extremely elongated rod-shaped soma. They are abundant in layer V of the anterior cingulate cortex (ACC) and fronto-insular cortex (FI) of the human brain, and have long been described as a human-specific neuron type. Recently, VENs have been reported in the ACC of apes and the FI of macaque monkeys. The first description of the somato-dendritic morphology of VENs in the FI by Cajal in 1899 (Textura del Sistema Nervioso del Hombre y de los Vertebrados, Tomo II. Madrid: Nicolas Moya) strongly suggested that they were a unique neuron subtype with specific morphological features. It is surprising that a clarification of this extremely important observation has not yet been attempted, especially as possible misidentification of other oval or fusiform cells as VENs has become relevant in many recently published studies. Here, we analyzed sections of Brodmann area 24 (ACC) stained with rapid Golgi and Golgi-Cox in five adult human specimens, and confirmed Cajal's observations. In addition, we established a comprehensive morphological description of VENs. VENs have a distinct somato-dendritic morphology that allows their clear distinction from other modified pyramidal neurons. We established that VENs have a perpendicularly oriented, stick-shaped core part consisting of the cell body and two thick extensions - an apical and basal stem. The perpendicular length of the core part was 150-250 µm and the thickness was 10-21 µm. The core part was characterized by a lack of clear demarcation between the cell body and the two extensions. Numerous thin, spiny and horizontally oriented side dendrites arose from the cell body. The basal extension of the core part typically ended by giving numerous smaller dendrites with a brush-like branching pattern. The apical extension had a topology typical for apical dendrites of pyramidal neurons. The dendrites arising from the core part had a high dendritic spine density. The most distinct feature of VENs was the distant origin site of the axon, which arose from the ending of the basal extension, often having a common origin with a dendrite. Quantitative analysis found that VENs could be divided into two groups based on total dendritic length - small VENs with a peak total dendritic length of 1500-2500 µm and large VENs with a peak total dendritic length of 5000-6000 µm. Comparative morphological analysis of VENs and other oval and fusiform modified pyramidal neurons showed that on Nissl sections small VENs might be difficult to identify, and that oval and fusiform neurons could be misidentified as VENs. Our analysis of Golgi slides of Brodmann area 9 from a total of 32 adult human subjects revealed only one cell resembling VEN morphology. Thus, our data show that the numerous recent reports on the presence of VENs in non-primates in other layers and regions of the cortex need further confirmation by showing the dendritic and axonal morphology of these cells. In conclusion, our study provides a foundation for further comprehensive morphological and functional studies on VENs between different species.

The Zagreb Skull Collection-The unique identified collection of human skulls from fetuses to centenarians.

Skull anatomy and development have been extensively studied due to their significance in evolutionary biology, forensic anthropology, and clinical medicine. Bone collections are an indispensable resource for conducting such anthropological and anatomical studies. However, worldwide there are only few skull collections containing specimens covering the entire fetal and postnatal period. Herein we describe the Zagreb Skull Collection, an identified collection comprising more than 1100 skulls and skull bone sets from the early fetal period to centenarians. The Zagreb Skull Collection consists of two main parts: the unique Collection of Skull Bones containing 386 sets of separated skull bones from the early fetal period to adulthood and the Collection of Skulls containing 742 skulls (age range 4-101 years). The collection was the core source for numerous anatomical studies on the development, postnatal changes, and anatomical variations of the skull. However, the Zagreb Skull Collection is still an underexploited resource for anthropological, forensic, and anatomical studies with translatability to contemporary clinical practice.

Postnatal changes in osseous and mucosal morphology of the hard palate.

We investigated the postnatal changes in the dimensions, configuration, and surface pattern of the hard palate in 68 skulls, ranging in age from birth to 90 years of age. The number of palatine rugae of the palatine mucosa was assessed in 168 living subjects aged 11-98 years. Before the first dentition appeared, the osseous palate was concave, smooth, and lacked alveolar processes. In maxillar specimens from the end of the first year to the end of the fourth year of life, balloon-like osseous formations, containing the elements of permanent teeth, appeared bilaterally behind the deciduous incisors. With age, the concavity of the palate diminished and became flat with the loss of the teeth. The presence of teeth was associated with the height of the alveolar ridge, which decreased from 7.3 +/- 4.4 mm in specimens with intact teeth to 4.7 +/- 4.1 mm in specimens without teeth (P = 0.020). Palatine rugae were a common finding in living subjects, but were more often absent in older age (2.2% in 11-50 age group vs. 12.8% in 51-98 age group, P = 0.0183). Our results suggest that the morphology of the hard palate rapidly changes during deciduous and permanent teeth eruption and is related to the presence of alveolar ridges and teeth in adults. Palate osseous morphology may be morphologically and functionally independent from its mucosal morphology. Changes in the morphology of the osseous palate are clinically relevant for dental prosthetics and tooth implantation.

The sequence in appearance and disappearance of impressiones gyrorum cerebri and cerebelli.

We investigated the sequence and the intensity in the appearance and the disappearance of the impressiones gyrorum cerebri and cerebelli, of juga cerebralia and cerebellaria and of juga cerebellaria interlobularia in the collection of 34 macerated and disarticulated skull bones from the newborn to 30 years of age (68 specimens/halves of skulls) and 19 skulls in the period from 30 to 80 years of age (38 specimens). Juga cerebralia on the squama of the temporal bone and cerebral lamina of the frontal bone appeared already in the course of the first year of life, much earlier than cited in the literature. The intensity of the development of juga cerebralia increased to the third decade. After that age, the intensity decreased gradually, and the juga cerebralia disappeared completely in parietal bones, in the cerebral fossae of the occipital bones and finally in most cases also on the cerebral lamina of the frontal bones. Juga cerebellaria and impressiones gyrorum cerebelli appeared in the middle of the second year of age and persisted to the ten years of age, which coincides with the closure of the fissures among the parts of the occipital bone. Jugum cerebellare intersemilunare appeared in the first year of life and persisted in its complete length, or interrupted in different sections of its course, during the whole life. The intensity in appearance of juga is partly influenced by the increasing thickness of the diploe.

Ultrasonic morphological characteristics of yolk sac in pregnancy complicated with type-1 diabetes mellitus.

BACKGROUND/AIMS: In pregnancy complicated with type-1 diabetes mellitus (DM), information on the predictive value of yolk sac (YS) measurement and YS morphology on outcome has been scant. The aim of this study was to compare the size and shape of the YS using transvaginal sonography (TVS) in normal pregnancies and those complicated with well-regulated type-1 DM. METHODS: Sixty healthy pregnant women and 60 pregnant women with type-1 DM underwent TVS. The correlation coefficients between YS and gestational age (GA), YS and crown-rump length (CRL), and YS and human chorionic gonadotropin (HCG) were calculated. Statistical analysis showed that the difference between the YS diameters for each gestational week among the groups studied was highly statistically significant. Statistical analysis of the results was performed with SPSS 10 software. RESULTS: A highly statistically positive correlation was found between YS diameter and GA, CRL and HCG levels for both groups studied. The YS diameter in type-1 DM pregnancies was statistically significantly larger for GA than that of healthy pregnant women. The YS diameter in type-1 DM women was statistically significantly larger after 6 weeks of gestation and the HbA1c levels were >6% when compared to the YS dimensions in the group with HbA1c concentrations of <6%. CONCLUSION: A gross change in YS size may indicate or reflect significant dysfunction of the maternofetal transport system in early pregnancy which is complicated with type-1 DM.

Sudden death because of massive pulmonary thromboembolism and concomitant cerebrovascular trophoblastic embolism following artificial abortion.

A rare case of sudden death due to cerebral embolization of trophoblastic tissue and concomitant massive pulmonary embolization following artificial abortion in a 42-year-old woman with poorly regulated hypertension and chronic smoking is described. Histopathological analysis showed syncytiotrophoblast cells, positive on hPL immunostaining, obstructing vascular lumina in the small perforating arteries irrigating the diencephalon. There was no trophoblast invasion of capillary walls. Severe perivascular edema and lymphocytic infiltration were observed. No trophoblastic cells were found in the pulmonary circulation.