Accessory Flexor Carpi Ulnaris Muscle in Humans: A Rare Anatomical Case with Clinical Considerations.

Anatomical variations of the forearm flexor muscles are occasionally encountered. Though usually observed incidentally during autopsies or imaging studies, they may at times cause concern due to associated clinical symptoms. This report presents a case of unilateral accessory flexor carpi ulnaris (AFCU) muscle observed in a human male cadaver aged 78 years. During routine cadaveric dissection, an anomalous AFCU muscle was observed in the left forearm of a human male cadaver aged 78 years. Standard institutional guidelines pertaining to the use of human cadaver for teaching and research were followed. A thorough literature review about the flexor carpi ulnaris (FCU) through the PubMed, Embase and Google scholar databases was undertaken, using the keywords - accessory flexor carpi ulnaris muscle, aberrant flexor carpi ulnaris muscle and anatomical variation of flexor carpi ulnaris muscle. Relevant gross anatomical findings were recorded and photographed. AFCU was identified on the medial aspect of the distal third of the left forearm. The AFCU was found originating from the ante-brachial fascia and the fascia covering the FCU on the left forearm, forming a small separate belly deep to the main muscle. It terminated as a thin tendon running alongside the hypothenar muscles and attached distally to the base of the proximal phalanx of the little finger. The AFCU was found to be innervated by a branch of the ulnar nerve. Awareness about the rare AFCU muscle is clinically important as a possible cause of ulnar nerve compression but also as a possible graft in reconstruction surgeries.

Localization and hypersecretion of nerve growth factor in breast phyllodes tumors: Evidence from a preliminary study.

BACKGROUND: The pathophysiology of the breast phyllodes tumors is uncertain. Currently, wide surgical removal is the only available treatment option. The histopathological diagnosis of phyllodes tumors is often confused with that of fibroadenomas due to a striking histological resemblance. AIM: To identify a distinctive biomarker for phyllodes tumors of the breast. METHODS AND RESULTS: Fresh human breast tissue was obtained from surgically excised breast phyllodes and fibroadenoma tumors (test), breast cancer (positive control) and normal breast tissue (negative control). Immunohistochemistry and Sandwich ELISA were performed for the detection of nerve growth factor (NGF) in test and control tissues. A marked difference in NGF expression was detected in phyllodes tumors compared to fibroadenomas. The maximum NGF expression was observed in phyllodes tissue followed by cancer tissue, and the least expression in fibroadenomas (3-5 times less than in phyllodes; comparable with normal breast tissue). CONCLUSION: NGF secretion by a benign breast tumor is not known in literature. This study reports abundant NGF secretion by breast phyllodes, raising the possibility of its potential role in tumor pathogenesis and progression that can be exploited therapeutically. Additionally, NGF may be used as a distinct biomarker of phyllodes tumors, for differentiating them from fibroadenomas during histopathology.

Cysto-duodeno-colic ligament and its clinical relevance.

During a routine dissection class for the undergraduate students at All India Institute of Medical Sciences, New Delhi, a rare uncommon variation of the peritoneal ligament was found. Information regarding variation in such type of accessory peritoneal reflections is necessary for anatomists, surgeons, and radiologists. Normally there was no peritoneal reflection between gallbladder, duodenum and transverse colon, but in the present case report, it was present and termed as cysto-duodeno-colic ligament. Knowledge of such variation is necessary during gallbladder surgeries and liver transplantation surgeries.

A comparative evaluation of 3 root canal filling systems.

OBJECTIVE: This in vitro study was conducted to evaluate and compare the microbial leakage of a new obturation system: Guttaflow with resin-based Resilon cones and Epiphany sealer, keeping gutta-percha with AH plus sealer as the standard. STUDY DESIGN: The microbial leakage was tested using Enterococcus faecalis ATCC 29,212 as the bacterial marker in the microbial leakage test. These results were supplemented with scanning electron microscopy (SEM). RESULTS AND CONCLUSION: The microbial leakage test indicated good sealing abilities for Resilon and Guttaflow, with the latter resisting microbial leakage for a longer period. AH plus with gutta-percha showed poor sealing ability. Results of the scanning electron microscopy correlated with the microbial leakage test. This study indicates that newer obturation systems like Guttaflow and Resilon cones with Epiphany provide better seal against microbial leakage than the standard obturation material, gutta-percha used with AH plus sealer.

Endodontic management of horizontally placed molars after gunshot injury to mandible: a case report.

A 37-year-old man reported to our department with the history of gunshot injury to the mandible 15 years before. His anterior mandible had been resected earlier and bone graft was seen. Intraoral examination of lower jaw revealed 4 remaining mandibular molars. These teeth were severely rotated such that they lay horizontal with respect to the mandibular base. Preoperative Dentascan spiral computerized tomography (CT) of the patient revealed obliteration of the mesial canals of the mandibular right first molar and pear-shaped internal resorption defect in the distal canal of the same tooth. This paper reports the challenging endodontic management of a rare case of severely angulated teeth also exhibiting traumatic sequelae in both roots of the impact tooth. It also highlights the usefulness of spiral CT scan in diagnosis of traumatic sequelae such as pulp canal obliteration and internal resorption.

Aberrant attachment of orbicularis oculi: case report.

A morphological peculiarity was observed in the form of an aberrant lateral bony attachment of the orbital part of the Orbicularis oculi muscle on the zygomatic bone, during routine dissection of a cadaver of an adult male of Indian origin. Fibers of this part of the muscle are not known to show any lateral attachment on bone. This paper discusses the presentation, probable embryological cause and clinical implications of this unusual finding.