Musculus peroneus longus in foetal period.

BACKGROUND: The lateral compartment of the leg, due to its distal and concurrent superficial positioning, is a multiple trauma site. Detailed knowledge of compartimentum lateralis cruris (CLC) structure is crucial for physicians. Musculus peroneus longus (MPL) is located within the structures of the CLC most superficially. There is a lot of data on the morphology of the MPL but there is no publication analysing in detail its anatomy in the foetal period. The aim of the study was to determine the variability of metric and morphological parameters of MPL in a studied period of prenatal ontogenesis. MATERIALS AND METHODS: The analysis included 207 human foetuses (101 males and 106 females) at calendar age from 113 to 222 days. The analysed material comes from the local anatomy collection. Foetuses were stored in typical preservation solutions. Access to the muscle was obtained on the basis of standard preparation techniques. The authors evaluated the metric parameters of the muscle showing the presence of variable dynamics of metric increments of the examined muscle in particular age classes. RESULTS: In the studied period of prenatal ontogenesis, MPLs of the foetuses increased by about 60% in the length and width dimension and by about 100% in the thickness dimension. The topography of the initial and final muscle attachment was also evaluated. Statistically significant dimorphic differences were found in some aspects of muscle attachment topography. CONCLUSIONS: The analysis of the place of the origin and insertion of MPL showed a relatively large variety of these features.

Topography of the common fibular nerve terminal division in human foetuses.

BACKGROUND: The progress of paediatric surgery and increasingly better diagnosis of foetal defects require detailed knowledge of human developmental anatomy. Precise knowledge of the anatomy of innervation of the lower extremities corresponds to this subject and is not only cognitive but also clinically important. The end of the common fibular nerve is superficially located in the area exposed to frequent injuries as well as in the area subject to possible surgical repair procedures. MATERIALS AND METHODS: The analysis was carried out on 200 human foetuses aged from the 113th day to 222nd day of foetal life. The study material is a part of local foetal collection. The study incorporated the following methods: anthropological, preparational and image acquisition which was acquired with the use of high-resolution digital camera. Statistical analysis was carried out with the use of STATISTICA package. RESULTS: Based on the research results the new typology of the examined nerve was determined. The head of the fibula was the criterion: (i) high division - above the head of the fibula (1%); (ii) intermediate division - at the height of the head of the fibula (34%); (iii) low division - below the head of the fibula (65%). The mathematical analysis did not reveal statistically significant bilateral and gender differences. Moreover the additional branch was observed in 30% of foetuses, regardless of age class. This branch occurred in 50% of cases in both sides of the foetus. This nerve was defined as the accessory fibular nerve (nervous fibularis/peroneus accessorius). CONCLUSIONS: The created unique typology of the terminal division of common fibular nerve is an important supplement to the anatomical knowledge and at the same time, due to the peripheral and superficial location of the described structures, it has a relatively high clinical significance.

Maceration stage in corrosion cast specimen procedure in anatomy: a minireview.

The etching stage of the corrosive preparation is a crucial element of creating a high quality anatomical specimen, which can be a source of scientific knowledge and support the teaching process. Nowadays, thermal techniques such as microwave cooking, enzymatic corrosion, and chemical corrosion are used. Living organisms can also be used for tissue maceration. Interactions between the corrosive substance and the filler carry a risk of failure; thus, choosing the correct method is key to the success of this technique. In this paper, we have reviewed the latest literature in order to present the strengths and weaknesses of currently used corrosion techniques. We proposed a definition of an ideal corrosive medium and compared the available techniques of etching corrosive preparations with a hypothetical perfect medium.

Terminologia Anatomica and its practical usage: pitfalls and how to avoid them.

In 2016, the Federative International Programme for Anatomical Terminology tentatively approved the updated and extended version of anatomical terminology that replaced the previous version of Terminologia Anatomica (1998). This modern version has already appeared in new editions of leading anatomical atlases and textbooks, including Netter's Atlas of Human Anatomy, even though it was originally available only as a draft and the final version is different. We believe that updated and extended versions of anatomical terminology are important and they can be a powerful tool in communication between anatomists and other specialists around the world. In general, the new version uses more precise and adequate anatomical terms and many segments, including the part dealing with the nervous system, which is also known as the Terminologia Neuroanatomica, have been considerably improved. Nevertheless, some segments have not been extended or modernised, while other parts have been modified considerably, thereby posing a challenge to those who prefer the traditional version of Latin terminology because a number of official names for bones, muscles, organs and blood vessels have been changed. Whilst most of these changes seem to be inspired by a long anatomical tradition and thus cannot come as a surprise to anyone in the field, other modifications are characterised by terminological innovativeness. Selected new and unexpected changes that might cause confusion among those who prefer traditional anatomical terms and definitions are discussed here.

Branching patterns of the foetal popliteal artery.

BACKGROUND: The objective of the study is to evaluate the popliteal artery topography and the origin variability of its branches in human foetuses at the gestational age of from 4 to 9 months. The basis for the analysis are direct observations of classic anatomic dissections of the popliteal fossa. Possible dimorphic and bilateral differen- ces, as well as the gestational age variability at the foetal period, were considered. A typology of popliteal artery branches will be made on the basis of the studies. MATERIALS AND METHODS: The research material of this study comprises 231 foetuses (including 116 males and 115 females). The foetuses were divided into five 28-day age classes. The vessels of the lower extremity were injected with LBSK 5545 latex through the femoral artery. The bilateral dissection of the po- pliteal artery along with its branches was performed. No visible malformations were found in the research material, and the foetuses came from spontaneous abortions and premature births. RESULTS AND CONCLUSIONS: Ten per cent of the cases featured the variations of popliteal artery terminal branches. Three most commonly seen variations are the trifurcation, anterior tibial-peroneal trunk, and high terminal division of the po- pliteal artery. The most common course of the superior muscular branches is that there are two large branches which are distributed from the popliteal artery at the height of the knee joint cavity and they do not distribute cutaneous branches. Sural branches are also present as two large vessels without cutaneous branches. The genicular anastomosis branches that run on their own are a typical topographic system of these branches.

Modifiable risk factors for erectile dysfunction: an assessment of the awareness of such factors in patients suffering from ischaemic heart disease.

Up to 40% of cases of erectile dysfunction (ED) originate from vascular disturbances associated with atherosclerotic disease, leading to the previously proven concomitance between ischaemic heart disease (IHD) and ED. The aim of this study was to evaluate patients' knowledge about modifiable risk factors for ED. The evaluated group of patients was composed of 502 male patients undergoing cardiac rehabilitation and receiving treatment for IHD. The patients' knowledge of risk factors for ED linked to IHD was assessed with an original survey. The presence of ED was assessed using an abridged version of the International Index of Erectile Function-5 questionnaire. Increase in leisure-time physical activity was estimated using a leaflet based on the Framingham questionnaire. In all, 189 participants were unable to name any modifiable ED risk factors, and only 31 patients knew all 6 of them. The most frequently mentioned ED risk factor was smoking, whereas the least frequently mentioned was sedentary lifestyle. Awareness of smoking as an ED risk factor was closely related to the patients' level of education, place of residence, smoking and underlying ED in the individual patient. The ability to classify diabetes as a risk factor for ED was significantly related to the patients' level of education, place of residence, and the prevalence of diabetes in the evaluated group of respondents. The same relations were observed regarding hyperlipidaemia. Awareness of the negative impact a sedentary lifestyle has on the erectile process was found to be closely related to the patients' age, as well as their level of education. The performed study demonstrates the poor knowledge of IHD patients about the modifiable risk factors for ED. The factor that patients are the least aware of is sedentary lifestyle, which, simultaneously, is the risk factor that most frequently affects the respondents.

A case of elongated styloid process in a modern-age skull from Puerto Cabello, Venezuela.

BACKGROUND: The styloid process (SP) arises from cartilage of the second branchial arch and tends to calcify during later life. If the length of the SP is more than 30 mm, it can be considered abnormally elongated. Clinical symptoms associated with elongation of this type are defined as Eagle's syndrome. The paper presents a case of an elongated SP in a modern skull from Puerto Cabello, Venezuela, obtained from a series of skulls of African slaves kept at the Department of Anthropology, Polish Academy of Sciences in Wroclaw. MATERIALS AND METHODS: The skull belonged to a male individual, aged ca. 55 years at death (maturus). In terms of basic anthropometric features it had slightly greater facial width parameters in comparison to the cerebral part, and a shorter length of neurocranium when compared to average values of morphological features in African skulls from Uganda. RESULTS: Further macroscopic analysis revealed the presence of an elongated SP (ca. 70.1 mm) with secondary lesions remaining after a healed fracture. Imaging of the bone structure of the elongated SP was carried out using a computed to-mography scan, with multilevel image analysis without contrast. The elongation and calcification of the left ligament in anterior orientation could have caused irritation to the structure of cranial nerves, running within the parapharyngeal space, and to sympathetic fibres running in the wall of cervical arteries. CONCLUSIONS: Analyses of craniological materials recovered during excavations or as part of old osteological collections are rare due to the fragility of this bone structure, and for that reason they may be a valuable source of information on the health status of historic human populations.

Typology of the antegonial notch in the human mandible.

BACKGROUND: Surgical treatment for serious malocclusions and fractures of the organ of mastication is a golden standard in medicine. Procedures performed on the mandible require detailed knowledge of the anatomy of the organ. Antegonial notching constitutes a serious technical challenge for surgeons. Therefore, a detailed anatomical description of this structure, which is the subject of this paper, is essential. MATERIALS AND METHODS: We analysed 251 human Caucasian mandibles of identified sex and took measurements of all sections describing the mandibular antegonial notch. Depending on the proportion between sections we classified the shape of the antegonial notch into three types. The surface area of the notch was calculated. We analysed the dimorphic and bilateral differences for each of the three types of notch. We used variance analysis for the assessment of statistical difference. RESULTS: The analysis revealed that in both men and women, regardless of body side, the type 3 antegonial notch was the most frequent. Type 3 occurred with a frequency of between 38% in men on the right side and 55.9% in women on the left side of the body. Type 1 was the least frequent. Dimorphic differences in the presence of individual types of antegonial notch were statistically significant only for the left side of the body. The symmetrical type (type 2) occurred more frequently in men (by 11%) than in women. Type 3 was found more frequently in women (by 10%) than in men. Bilateral differences in men were revealed for the frequencies of types 1 and 3. On the right side type 1 was more frequent (by 8%), and on the left side type 3 was also more frequent (by 8%). The greatest surface area was found for the asymmetrical posterior type (type 1). The smallest surface area was found for the asymmetrical anterior type 3. This difference was statistically significant with respect to the surface area of types 1 and type 2 and found for both sexes for both sides of the body. However, no statistically significant differences were found between the surface areas of types 1 or 2. CONCLUSIONS: Knowledge of the preangular notch anatomy can be useful for surgeons during reconstructive and plastic procedures on the body of the mandible.

The influence of endurance training intensity on dynamics of post-exertional heart rate recovery adaptation in patients with ischemic heart disease.

PURPOSE: The intensity of post-exertion heart rate recovery, evaluated in the first minute of the recovery period (HRR60), is considered to be a strong predictor of risk for cardiac death. Intensification of physical activity performed as part of cardiac rehabilitation (CR) increases the HRR60 value in ischemic heart disease (IHD) patients. In this context, the impact of endurance training intensity (ETI) on change in HRR60 intensity seems to be an interesting issue. MATERIAL/METHODS: The study group consisted of 251 patients who were subjected to a CR cycle. 45 patients of this group participated in CR twice. The control group consisted of 35 patients who were not subjected to any CR. ETI was estimated by the training work. In all patients an exertion test on a treadmill was performed twice within six months, analyzing the initial and final HRR60 value and ΔHRR60. RESULTS: After a six-month observation, there was a statistically significant increase in the HRR60 value (17.98±8.33/min vs. 22.72±7.72/min, p<0.01) in the test group, which was not observed in the control group. Mean ΔHRR60 value in the test group was statistically significantly greater than in the control group. In the subgroup subjected to the two CR cycles, only the first cycle led to a statistically significant increase in the mean HRR60 value. CONCLUSIONS: A six-month CR cycle significantly increased the HRR60 value, while cardiac training intensity did not affect the exertion-evoked change in its intensity. Continuation of the CR cycle beyond 6 months no longer significantly affected the change in the HRR60 value.

Anatomical analysis of preangular mandibular notch in humans.

The authors have analysed in detail the mandibular preangular notch on the basis of 273 human cadaver mandibles. They have revealed that the pregonial notch is present in almost 90% of cases and that it is generally asymmetric and elliptical in shape. The depth and length of the anterior part of the notch is greater in males. Moreover, the preangular notch depth is greater on the right side (regardless of sex). Knowledge of the preangular notch anatomy can be useful for surgeons during reconstructive and plastic procedures on the mandibular shaft.

A contribution to the discussion concerning the variability of the third peroneal muscle: an anatomical analysis on the basis of foetal material.

The aim of the work was to make a systemic study of the variability of the human musculus peroneus tertius during the foetal period. Examination was made of 193 foetuses of ages ranging from 84 to 256 days after conception. The results obtained indicated that the musculus peroneus tertius was present in 83.16% of the human foetuses studied and that its intrauterine development was progressive and almost proportional. Previous studies have not revealed dimorphic or bilateral differences with respect to any of the features examined. On the basis of the examinations and bibliographical data a uniform typology of the musculus peroneus tertius variants was created and three final types were distinguished: the pithecogenic (44% cases), eugenic (34% cases) and progenic (22% cases).

The preliminary evaluation of HAP + TCP composite material biodegradation after implantation in muscular tissue of rats.

Ceramic biomaterials based on calcium phosphates have a special position among modern implantation material in osteosurgery. Non-reabsorbable hydroxyapatite (HAP) and reabsorbable tricalcium phosphate are the most popular calcium phosphate ceramics. The appropriate ratio of these two compounds should result in forming the gradually reabsorbable implants, overgrowing with the bone tissue which mechanical strength should not be negatively affected. The aim of this work was to evaluate a local tissue reaction and the HAP + TCP composite resorption rate as compared with HAP, after implantation in a muscle tissue of rats. On the basis of carried macroscopic and microscopic evaluations, it can be stated that the new HAP + TCP composite had high biocompatibility and were gradually reabsorbed. This enables faster overgrowing the implant with tissue.

[Anorexia as the main symptom of gastroesophageal reflux: case study of a 13.5-year-old girl]. / Jadlowstret glównym objawem refluksowego zapalenia przelyku u 13,5-letniej dziewczynki.

13.5-year-old girl who was admitted to hospital because of anorexia nervosa started to complain of abdominal pain in her 3-rd week of hospitalization. She underwent 24-hour pH-metry and upper GI endoscopy. These procedures showed that GER was the cause of anorexia. Therapeutic management led to marked improvement.

[Hemorrhagic diathesis in a 5-week-old infant with cystic fibrosis]. / Skaza krwotoczna u 5-tygodniowego niemowlecia z mukowiscydoza.

Haemorrhagic diathesis with secondary anaemia was diagnosed in a 5-week-old infant. The reason for the haemorrhagic diathesis was vitamin K deficiency caused by intrasecretory pancreatic insufficiency.