Topography of muscular branches of the superficial fibular nerve based on anatomical preparation of human foetuses.

BACKGROUND: The progress of pediatric surgery and increasingly better diagnosis of fetal 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 aim of this study was to analyse the anatomy of the topography of the muscular branches of the superficial fibular nerve (NPS) in the prenatal period, which will fill a gap in the literature. METHODS: The analysis was carried out on 207 human foetuses aged from the 113th day to 222nd day of foetal life. The study material is a part of the collection of the Division of Normal Anatomy of Wroclaw Medical University. 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 number of muscle branches of the examined nerve was determined. It was shown that in more than half of the cases the two nerve branches are responsible for Peroneus Longus innervation and in about 90% of cases one branch is responsible for Peroneus Brevis innervation. Based on the obtained data a unique, new typology of distribution of these branches was created. It has been shown that the bipinnate type is the most common in the examined fetal population. The presence of statistically significant differences in the frequency of occurrence of individual innervation patterns depending on sex and body side were excluded (p > 0.05). There were also no statistically significant changes in the frequency of occurrence of individual types of NPS branch distribution according to fetal age (p > 0.05). CONCLUSIONS: The created unique typology of NPS branch distribution based on extensive preparation material 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 relevant clinical significance.

Methodology of preparation of corrosive specimens from human placenta - A technical note.

Detailed knowledge of the anatomy of human placenta vessels is clinically essential and requires the use of many different anatomical and histological techniques. One of the interesting methods of visualising vessels is the corrosion technique. It enables spatial visualisation of the vascular network of the analysed organ. The authors present a developed, own method of preparing the corrosive preparations from human placenta. They underline the advantages and disadvantages of this technique. They describe solutions aimed at reducing the costs of the process. They show that corrosion technology enables relatively fast and inexpensive visualisation of arterial and venous vessels of the human placenta.

The sequence of lanugo pattern development on the trunk wall in human fetuses.

BACKGROUND: Due to a growing interest in developmental disorders, and in the long-term skin appendage diseases, both in the cosmetic industry and among specialists in dermatology (broadly defined), there is an increasing number of papers on hair development. The publications by the present team of authors are part of this trend. OBJECTIVES: The aim of the study was to describe the topography and typology of skin pilosity patterns in human fetuses. MATERIAL AND METHODS: A total of 278 fetuses (141 male and 137 female) were qualified for the study. The gestational age ranged from 69 to 226 days after conception. All fetuses were taken from a local collection. RESULTS: The study revealed that the first single hairs occur on the posterior wall of the trunk in the 17th week of fetal life, and on the anterior wall between the 18th and 19th week. It was found that in human fetuses lanugo appears statistically significantly later on the skin of the anterior of the trunk than on its posterior. The difference in absolute time is almost 2 weeks of fetal life. No other differences were found in the development cycle of lanugo on the anterior and posterior walls of the trunk. A full pattern was first observed on the posterior wall of the trunk in a fetus in the 19th week, and on the anterior wall in the 21st week. It was found that the process of lanugo development was completed on the posterior wall in the 23rd week, and on the surface of the abdomen in the 26th week. CONCLUSIONS: The lanugo developmental cycle, consisting in the appearance of the first single hairs, then partial hair and subsequently the formation of final patterns, is the same on both walls of the trunk.

Cardiovascular Risk Factors Among Lower Silesian Students of the Faculty of Medicine: Knowledge and Distribution.

BACKGROUND: Cardiovascular disease is a major contributor to the global burden of disease. Further reduction of cardiovascular mortality will require multidirectional prevention. Popularizing prevention measures requires the involvement of qualified and well-educated personnel. Before any modifications of educational programs it is necessary to assess the level of knowledge of future physicians. OBJECTIVES: The aim of the study was to evaluate medical students' knowledge of cardiovascular (CV) risk factors. The paper presents the outcomes of a study investigating the knowledge of CV risk factors and the prevalence of those risk factors in the study population. MATERIAL AND METHODS: The study was conducted between 2007 and 2012 and the study population was comprised of 1406 students (497 men and 909 women) from South and South Western Poland. A survey designed by the authors, based on the Framingham survey, was used for the interviews. RESULTS: The students correctly identified 4.38 ± 0.91 CV risk factors. The most frequently listed risk factors for cardiovascular diseases were a lack of physical activity and a fat-rich diet. The study participants who identified CV risk factors more or less accurately do not follow the recommendations aimed at prevention. Awareness, even relatively high awareness, does not correlate with a healthy lifestyle. Extreme examples of this are people who are aware of the negative effects of cigarette smoking but continue to smoke. CONCLUSIONS: The study revealed an insufficient level of awareness of CV risk factors among medical students.

The Application of Tensegrity Massage in a Professionally Active Musician - Case Report.

PURPOSE: The purpose of our study was to present options for the application of tensegrity massage to manage pain caused by the overload of soft tissues in musicians. DESIGN: Tensegrity massage was applied to a 34-year-old male violinist. METHODS: The methodology included a correct positioning and tensegrity massage with individually designed procedure. FINDINGS: After therapy, the patient achieved complete pain relief, and relaxation of muscles in the shoulder girdle and free part of the upper arm. The analgesic effect lasted for 6 months after the end of therapy. CONCLUSIONS: Massage is an effective method in eliminating pain caused by the overload of soft tissues. If used regularly before physical effort, it can prevent muscle overload. CLINICAL RELEVANCE: The presented massage procedure is an effective therapy in pain caused by the overload of soft tissues in musicians and it can be one of the elements of complex physiotherapy in active musicians.

Heart rate recovery, cardiac rehabilitation and erectile dysfunction in males with ischaemic heart disease.

OBJECTIVE: Heart rate recovery (HRR) is a recognised marker used in clinical practice for assessing the risk of sudden cardiac death. Physical exercise leads to an improvement in HRR and has a proven beneficial effect on erection quality (EQ) related to the activity of the autonomic nervous system in men with ischaemic heart disease (IHD). This paper evaluates the relationship between HRR and EQ in patients with IHD and erectile dysfunction (ED) who underwent cardiac rehabilitation. METHODS: The main analysis was based on the Mann-Whitney U test, Wilcoxon signed-rank test, Spearman correlation coefficient, Pearson's chi-square test, chi-square test, with the Yates correction and (if possible) parametric tests were used. This prospective, non-randomised intervention study included 124 men with IHD and ED [International Index of Erectile Function (IIEF-5) scores of ≤21]. Of these, 89 patients underwent a 6-month cardiac rehabilitation phase III programme, whereas 35 did not. The results of the participants' total IIEF-5 scores and their HRR, demographic and clinical data were analysed. RESULTS: The results of the 89 rehabilitated patients (mean age: 60.44±9.29 years) and 35 controls (mean age: 61.43±8.81 years) were analysed. In the rehabilitated patients, the mean baseline IIEF-5 score was 13.15±5.76 (95% CI: 11.93-14.36) and HRR was 16.49±7.68/min (95% CI: 14.88-18.11). After cardiac rehabilitation, the parameters of ED and HRR improved significantly and were significantly higher than those of the controls; the mean IIEF-5 score of the rehabilitated group increased to 15.36±6.51 (95% CI: 13.99-16.73), while HRR increased to 21.40±7.25/min (95% CI: 19.88-22.93). A significant correlation was found between ∆HRR and ∆EQ (r=0.409791) as a result of the 6-month cardiac training programme. CONCLUSION: Cardiac rehabilitation assessed by HRR has a sizable effect on autonomic balance in patients with IHD and ED, which plays a significant role in the mechanism of erection improvement.

Increased skeletal muscle expression of VEGF induced by massage and exercise.

INTRODUCTION: Numerous investigations have been carried out to describe the role of massage in preparing for and restoring efficiency after physical exercise. Furthermore, vascular endothelial growth factor (VEGF) enhances blood vessel growth, and in effect contributes to the regeneration of tissues. Since its expression in active skeletal muscles has not been yet determined, the aim of this study was to investigate whether muscle massage performed before and during running exercise affects the expression of VEGF-A in muscles. MATERIAL AND METHODS: The study was carried out on 75 adult Buffalo rats subjected to running exercise training for 10 weeks. Rats were massaged prior (group PM) or during exercise (group M) or were not massaged (group C). The massage consisted of spiral movements along the plantar surface of flexor digitorum brevis muscle. After 1, 3, 5, 7 and 10 week of training, five rats from every group were anesthetized and immunohistochemistry, Western blot, and PCR analyses were performed on obtained muscle tissue to determine VEGF-A expression. RESULTS: After the first week of training, a significant increase of VEGF-A gene expression analyzed by qPCR in muscle tissue was observed in the PM group, whereas in the third week, the predominant growth of studied marker was seen in the M group. Increased VEGF-A expression on the protein level was observed in both massaged groups following the first week. A moderate positive correlation was found between the expression of the VEGF-A gene and protein in all experimental groups (r = 0.389). CONCLUSION: Short-term repeated massage may contribute to processes of creation of new and development of already existing vascular networks in the skeletal muscle tissue during increased exercise.

Remembrance of professor Tadeusz Marciniak - Lviv tradition in Wroclaw.

After the seizure of Lviv by the Soviets, in the years 1944-1946, Tadeusz Marciniak worked in the Descriptive Anatomy Department in the State-Medical Institute of Lviv and also performed the function of the dean of the Medical Faculty. On receiving a proposal to assume the Chair of the Anatomy Department in Wroclaw, he made the decision to leave Lviv. By July 2nd, 1946, prof. Tadeusz Marciniak had taken over the duties of full professor of the Descriptive Anatomy Department of the Medical Faculty of the University and the Technical College of Wroclaw. On taking his job in Wroclaw, prof. Marciniak undertook attempts to restore the worn out parts of the Anatomy Department building. Due to the lack of Polish manuals, he also took to the preparation of scripts for medical students. Professor Marciniak was a member of the Wroclaw Section of the Polish Anthropological Association and a regular member of the Wroclaw Association of Science. His main scientific interests referred to the morphogenesis of the central nervous system and urinary system. He concentrated on circulatory system and muscular system tetralogies. Professor Marciniak also actively participated in administrative work at the university. In the years 1947-1948, he held the office of associate dean of the Medical Faculty, and till 1950 was a member of the Senate of the University and Technical College of Wroclaw. In the years 1959-1962, he was a vice rector of the Medical University of Wroclaw.

Antipapain activity in the serum of patients with breast cancer.

BACKGROUND: Complement information about the share the role of antipapain activity in serum people with breast cancer. OBJECTIVE: We measured the activity of cysteine peptidase inhibitors in the sera of 150 patients with breast cancer. Patients were divided into four groups depending on the cancer type and treatment method. We also analysed the control group. The activity of cysteine peptidase inhibitors was defined as a 'defensiveness' marker. METHODS: The activity of cysteine peptidase inhibitors was measured against papain using the colorimetric method and the BANA substrate. RESULTS: The highest activity of enzymes was found in the group of patients with BC and hereditary predisposition to it, and the lowest activity was found in patients after surgical treatment. CONCLUSION: The activity of cysteine peptidase inhibitors in serum was measured against papain. We found that the activity levels were correlated with the cancer stage and treatment method. The lowest activity was found in patients after surgical treatment; the highest in women with active cancer and a hereditary predisposition to it.

New concept of scapholunate dissociation treatment and novel modification of Brunelli procedure - anatomical study.

BACKGROUNDS: This paper describes a novel method in treatment of scapholunate dissociation accompanied with rotatory subluxation of the scaphoid. The idea of this method is to create a kind of axial lever that can fully reconstruct anatomical relationship between the scaphoid and the lunate, with no involvement of extrinsic ligaments, and with simultaneous restriction of pathological alignment of the scaphoid. Based on this technique, we have also proposed a new modification of Brunelli procedure in scapholunate dissociation with rotatory subluxation of the scaphoid and dorsal intercalated segmental instability. METHODS: At the initial stage of the study, 20 human wrists fixed in Ethanol were used, followed by 12 fresh human wrists used in part two. The first stage included functional, biomechanical and strength tests carried out by means of a 5 kg load and intended to find the most anatomical and durable treatment method. The second stage involved testing the proposed methods on fresh cadaver wrists. RESULTS: We have discovered that the new method is able to recreate anatomical forces and properties of scapholunate ligament; what's more, it can also prevent rotatory subluxation of the scaphoid. The performed strength tests have proven that it is possible to treat scapholunate instability also in case of dorsal intercalated segmental instability. CONCLUSIONS: We highly recommend using both the new technique and the new modification of Brunelli procedure for treatment of scapholunate dissociation in both dynamic and static instabilities.

Inability to have children caused by recurrent HELLP syndrome in early pregnancies - implications for a review of literature.

This review is inspired by a case of two pregnancies of the same patient complicated by HELLP syndrome, which suggests that there is a predisposition for the occurrence of preeclampsia and HELLP syndrome in early pregnancy. HELLP syndrome, uncommon below the 20th week and rarer still in two consecutive pregnancies, appeared in two pregnancies of the same woman. The aim of our work is to try to understand the cause of heterogeneity of HELLP syndrome and help find a way of prolonging such pregnancies. Recurrent HELLP syndrome in early pregnancy is a form of severe, fulminant preeclampsia. The preceding symptom is a surge in blood pressure. The hypertension becomes resistant to antihypertensive drugs, which indicates that preexisting hypertension is later accompanied by other factors contributing to the rise in blood pressure. Different effects of high dosage of corticosteroids on liver and platelets show that there are different factors responsible for liver damage and for thrombocytopenia. It seems that the symptoms have various origins, so the therapy with one drug only is not sufficiently effective. Nicotine analogues or a plant extract (from rootstock of Eriosema kraussianum) used by South African traditional healers for erectile dysfunction seem to give a chance of prolonging pregnancy and, consequently, having children.

"Dangerous" anatomic varieties of recurrent motor branch of median nerve.

UNLABELLED: Carpal tunnel release became one of the most common operations in the field of hand surgery. Many controversies has been made about frequency of the so-called dangerous variations of motor branch of the median nerve. Knowledge of all the anatomical variations motor branches is the duty of every surgeon dealing with the subject. The aim of the study was to present the incidence of dangerous variants of median nerve motor branch in the carpal tunnel based on both clinical experience and anatomical studies performed on 20 cadaver wrists. MATERIAL AND METHODS: Between 2006-2012 during minimally open carpal tunnel release we made photographic documentation of all visible dangerous varieties of recurrent motor branches of the median nerve. We also studied 20 cadaver wrists in the Department of Anatomy Medical University in Wroclaw. RESULTS: Dangerous varieties of the motor branch of median nerve was found in three clinical cases and in one cadaver wrist. Also In one wrist we found one regular branche, which, however, has atypical two separate branches supplying the thenar muscles. CONCLUSIONS: Dangerous varieties of the motor branch of median nerve occur very rare in the population, but does not release from the fact that in each case special attention must be given.We also conclude that, at the minimally open carpal tunnel release procedure, the transverse carpal ligament should be released rather from the line of radial border of the 4th finger to minimize the risk of injury to the recurrent motor branch of median nerve.

Massage-induced morphological changes of dense connective tissue in rat's tendon.

The aim of the experiment was to determine if possible changes in connective tissue induced by massage could have a positive effect justifing the use of massage in all post-traumatic connective tissue conditions, e.g. tendon injuries. The investigations were performed in a group of 18 Buffalo rats. The rats were divided into two groups (experimental and control). To standardize the massage procedure, it was performed with an algometer probe of 0.5 cm2 with constant pressure force of 1 kG (9,81 N). To analyse the number and diameter of collagen fibrils, two electron micrographs were performed for each rat of the collected segments of tendons of rat tail lateral extensor muscle. After image digitalization and calibration, the measurements were carried out using iTEM 5.0 software. The number of fibrils, their diameter and area were measured in a cross-sectional area. An increase of the number of collagen fibrils was observed in the tendons of massaged animals compared to the control group. Our study demonstrated that massage may cause a beneficial effect on metabolic activity of tendon's fibroblasts and, in consequence, may be applied for more effective use of massage for the prevention of tendon injury as well as after the injury has occurred. (Folia Histochemica et Cytobiologica 2013, Vol. 51, No. 1, 103-106).

Radiological and anatomical study to investigate possibility of relationship between scaphoid fracture and lunate morphology.

BACKGROUND: A connection between lunate type has been described for medical conditions like Kienbock's disease as well as for wrist osteoarthritis, e.g. STT osteoarthritis. Aim of the Study to investigate the possibility of a relationship between lunate type and the type of wrist injury mainly localised to the scaphoid bone. MATERIAL AND METHODS: 394 PA and lateral radiographs of the wrist (n = 394) were subjected to a detailed assessment by two independent surgeons. The X-rays were selected and analyzed from a computer and archive database run by St. Hedwig Hospital in Trzebnica, from the beginning of January 2011 till the end of December 2012. Most of the X-rays (69%) were obtained from citizens of Trzebnica District. In addition, detailed anatomical studies of the wrist bones were carried out on 20 human preparations fixed in ethanol. RESULTS: Lunate type I was found in 288 wrist radiographs (73%) and type II in the remaining 106 photos (27%). Various types of wrist injuries were diagnosed in 129 cases. These were mainly distal radius fractures, scaphoid fractures and isolated scapholunate instability. There exists a statistically confirmed relationship between scaphoid fracture and lunate type II as well as a connection between lunate type and gender. Anatomical examination of 20 wrists showed the presence of lunate type I in 11 cases and type I in 9 cases. CONCLUSION: 1. Lunate type II is more frequently encountered in men. 2. Scaphoid fractures are more common with lunate type II. 3. The joint surface for the hamate in lunate type II is 2-7 mm in width. 4. The presence of another articular surface for the hamate in lunate type II may contribute to the formation of degenerative changes in the lunohamate joint.

The efficacy and safety of leflunomide in patients with active rheumatoid arthritis.

OBJECTIVES: The aim of this study was to evaluate the efficacy and safety of leflunomide in patients with active rheumatoid arthritis (RA). MATERIAL AND METHODS: The study included 100 patients (88 women and 12 men) with rheumatoid arthritis (RA). The mean age was 46.5 years and the mean duration of the disease was 10.3 years. The inclusion criteria were a Disease Activity Score (DAS28) of over 3.2, and contraindications to methotrexate or failure of treatment with methotrexate for at least 3 months. The patients that were enrolled in the study had developed lesions of various grades according to the Steinbrocker Radiological Classification. Leflunomide was administered at a dose of 20 mg per day for the whole observation period. During the monitoring appointments the duration of morning stiffness, pain and disease activity were evaluated on a visual analogue scale (VAS), as well as the number of tender and swollen joints and the DAS28 score. In compliance with the leflunomide therapy protocol, the following control tests were performed: erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), hematology, creatinine and liver function tests. Safety assessment included monitoring of adverse events and laboratory test results. RESULTS: During the one-year monitoring period significant improvements were noted in 68% of the patients, expressed as a decrease of 1.2 or more in their DAS28 scores. DAS28 > 0 < 1.2 was achieved in a further 18% of the patients. No improvement was reported by 14% of the subjects. In one year of treatment leflunomide was effective in 74% of the patients with active RA. The most marked clinical improvement in the DAS28 index was noted between the third and sixth months of treatment. In the next six months ESR, CRP and DAS28 scores continued to decline steadily, but the differences were not as clear as those recorded in the previous time period. CONCLUSIONS: The most commonly observed adverse events were related to the gastrointestinal tract (i.e. diarrhea and periodic increases in liver function tests), and reported hair loss. Mild to moderate adverse events were observed in 19% of the patients; they resolved spontaneously or in response to medication, and were not a reason for discontinuing therapy in any of the cases.

Dynamics of stomach growth in the human fetal period: a postmortem study / Dinámica de crecimiento del estómago en el período fetal humano – un estudio post-mortem

The aim of this work was to analyze the stomach growth rate, variability of proportion and shape during prenatal period, as well as evaluation of final features differentiation process distinctive for perinatal period. It seems interesting to compare stomach growth analyzed in situ on post-mortem fetuses with results obtained by other authors evaluating this process in sonographic examinations. Research was conducted on 225 post-mortem fetuses 12th to 40 th week of fetal age. There were measurements of stomach total length, lengths of greater and lesser curvature and cardia and pylorus widths performed. We evaluated the thickness of stomach front wall and bottom and its total mass. Statistical analysis was performed using statistical program package Statistica 8. Rate of post mortem examined stomach dimensions growth - estimated on the base of mean conditional values is characterized by diverse rhythm. Proportions variability during prenatal period results from disharmonic growth of its dimensions. There were no dysmorphic differences in process of fetal stomach growth and in dynamics of its proportions and shapes changes found. In fetal period marks clearly tendency to organ shape changes consistent with fetal age. Based on analysis performed - four stages of stomach growth in fetal period were distinguished: 1. Intensive growth phase last till 22th fetal week. 2. Formation of final stomach shape between 20th and 26th gestational age. 3. Phase of stomach topography changes between 26th and 30th gestational age. 4. Phase of harmonic growth lasts from 30th week until childbirth.

El objetivo fue analizar la tasa de crecimiento del estómago, variabilidad de la proporción y forma durante el período prenatal, así como evaluar las características distintivas del proceso final de diferenciación para el período perinatal. Es interesante comparar el crecimiento del estómago de los fetos analizado in situ en el post-mortem con resultados obtenidos por otros autores tras la evaluación de este proceso en exámenes ecográficos. La investigación fue realizada en 225 fetos post-mortem desde la 12 a la 40 semana de edad fetal. Se determinaron la longitud total del estómago, la longitud de las curvaturas mayor y menor, y los anchos del cardias y píloro. Se evaluó el grosor de la paredes frontal e inferior del estómago y su masa total. El análisis estadístico se realizó mediante el programa Statistica 8. La tasa de crecimiento en las dimensiones de los estómagos post-mortem examinados se estimaron sobre la base de valores medios condicionales caracterizados por el ritmo diverso. Las proporciones de variabilidad en el periodo prenatal resultaron en un crecimiento inarmónico de sus dimensiones. No hubo diferencias dismórficas en proceso de crecimiento fetal del estómago, mientras que en la dinámica de sus proporciones y formas se encuentraron cambios. El período fetal, marca claramente la tendencia a cambios en la forma de órganos acorde con la edad del feto. Basado en el análisis realizado, se distinguen cuatro etapas de crecimiento de estómago en el período fetal: 1. Fase de crecimiento intensivo hasta finales de la semana 22 del feto. 2. Formación de la forma del estómago definitiva entre la 20 y 26 semana de gestación. 3. Fase de cambios en la topografía del estómago entre la 26 y 30 semana de gestació. 4. Fase de crecimiento armónico desde la semana 30 hasta el parto.

Data dimensionality reduction in anthropometrical investigations.

BACKGROUND: Very often it is necessary to make a decision or to establish a diagnosis on the basis of great amounts of different kinds of data. In this paper the principal component analysis procedure was applied to anthropometrical data analysis. OBJECTIVES: The aim was to simplify the process of decision making by data dimensionality reduction. A second aim was to check how the reduction affected an analysis of the pubertal growth process. MATERIAL AND METHODS: A group of 400 boys was investigated. Three main components were calculated and interpreted. In order to investigate growth changes, the variability of each component was approximated by fourth order polynomials. RESULTS: It was shown that the loss of information resulting from data dimensionality reduction is about 25%, so the three calculated principal components contained 75% of the entire information. It seems possible to make an appropriate decision on the basis of that amount of information. CONCLUSIONS: The results obtained fully supported using the approach presented for data analysis in the case under consideration.

Single nucleotide polymorphisms within functional regions of genes implicated in insulin action and association with the insulin resistant phenotype.

Type 2 diabetes and insulin resistance (IR) are characterized by severe anomalies in genes expression rate including genes involved in insulin signal transduction. Post-transcriptional regulation of gene expression is crucial for many physiological processes and is mediated mainly by untranslated region (UTR). Present study concentrated on the search for correlation between single nucleotides polymorphisms in UTRs of the INSR, PIK3R1, PTPN1, and SLC2A4 genes and IR. 130 unrelated diabetic patients and 98 healthy controls were analyzed in present study. Genotyping was performed by multiplex minisequencing preceded by multiplex PCR. Two single nucleotide polymorphisms (SNPs) showed significant differences in genotype frequencies between analyzed groups. Statistical significance was received for rs3745551 located in 3'-UTR of the INSR and rs3756668 located in 3'-UTR of the PIK3R1 gene with higher number of G/G genotype in insulin resistant subjects. Furthermore, patients carrying G/G genotype of those SNPs displayed higher BMI value, higher fasting glucose and insulin levels and were more insulin resistant assessed by HOMA-IR and QUICKI. Present study provides evidence for association between SNPs in UTRs of the INSR and PIK3R1 genes and insulin resistant phenotype.

Development of the descending colon during the human foetal period.

The growth, changes in shape, topography and relation to the peritoneum of the descending colon were assessed on the basis of material taken from 178 foetuses of both sexes, aged from 72 to 236 days of pregnancy. The statistical analysis method demonstrated that the descending colon growth process occurs about a month earlier in female foetuses as compared to male ones. From the statistical point of view, the longitudinal growth of the descending colon significantly slows down in the 7th and 8th months of pregnancy, while the width of this part of the large intestine increases sharply towards the end of the foetal development period. The statistically important process of the descending colon rising over the surface of the left kidney and adrenal gland was noticed in male foetuses. This occurs approximately one month earlier in female foetuses as compared to males. The ascent of this part of the colon is accompanied by a change in its shape from straight, to curved and, finally, to wavy in the oldest age group of male foetuses. The changes in relation to the peritoneum are manifest in a gradual change in the position of this section of the intestine from the intraperitoneal, where more than 40% of the cases examined had a fully movable mesentery, to the extraperitoneal, with 14% of foetuses having a mesentery in the 8th month of pregnancy.

Preliminary assessment of anatomical variability of nervus peroneus superficialis in the foetal period.

An assessment of the variability of the course and ramifications of the superficial peroneal nerve within the crus was made on a material of 33 foetuses of both sexes miscarried in the 6th month of foetal life. Particular attention was paid to the relation of the nerve under examination to the anterior intermuscular septum. To facilitate the analysis the material investigated was grouped into several types. The post mortem examination revealed that the nerve referred to followed a typical course within the shank in 54% of cases. At the same time in 15% of cases the examined nerve was split into two terminal branches within the fascial compartment of fibular muscles, leaving the fascia independently. In 19% of cases n. peroneus superficialis passes through the intermuscular septum to the anterior fascial compartment of the shank. Moreover, in 12% of cases the presence was demonstrated of n. peroneus superficialis accessorius passing together with n. peroneus profundus to the extensors chamber and further on into the medial cutaneous nerve of the foot.