Extensive pneumatisation of the sphenoid bone: anatomical investigation of the recesses of the sphenoid sinuses and their clinical importance.

BACKGROUND: There is a great variance between the extents of pneumatisation of the sphenoid sinuses that can reach beyond the body of the sphenoid bone. The purpose of this study was to find the prevalence of the recesses of the sphenoid sinuses in Polish adult population. MATERIALS AND METHODS: Two hundred ninety-six computed tomography (CT) scans of patients who did not present any pathology in the sphenoid sinuses were evaluated in this retrospective analysis. Spiral CT scanner (Siemens Somatom Sensation 16) was used to glean the medical images. Standard scan procedure was applied, with Siemens CARE Dose 4D option enabled. No contrast medium was administered. RESULTS: In the majority of the patients (93.92%), the pneumatisation of the sphenoid sinuses expanded beyond the body of the sphenoid bone; hence, there were recesses of the sinuses present. The most common variant was the presence of two recesses - 12.84% of cases. The prevalence of all the 17 recesses was only 0.34%. Amongst the uneven recesses present, the sphenoidal rostrum's recess (61.15% of the patients) and the inferior clinoid recess (56.42%) were the most common. Amongst the even recesses present, the lateral recess was prevalent in the majority (65.88%), whereas the posterior clinoid process' recess was the least common (9.8%). CONCLUSIONS: Presence of the recesses might facilitate access to the cranial fossae; hence, comprehensive evaluation of the sphenoid sinuses is of immense importance in order to avoid unnecessary drills through the hard bone, which could potentially damage the nearby neurovascular structures.

Anatomical eponyms - unloved names in medical terminology.

Uniform international terminology is a fundamental issue of medicine. Names of various organs or structures have developed since early human history. The first proper anatomical books were written by Hippocrates, Aristotle and Galen. For this reason the modern terms originated from Latin or Greek. In a modern time the terminology was improved in particular by Vasalius, Fabricius and Harvey. Presently each known structure has internationally approved term that is explained in anatomical or histological terminology. However, some elements received eponyms, terms that incorporate the surname of the people that usually describe them for the first time or studied them (e.g., circle of Willis, follicle of Graff, fossa of Sylvious, foramen of Monro, Adamkiewicz artery). Literature and historical hero also influenced medical vocabulary (e.g. Achilles tendon and Atlas). According to various scientists, all the eponyms bring colour to medicine, embed medical traditions and culture to our history but lack accuracy, lead of confusion, and hamper scientific discussion. The current article presents a wide list of the anatomical eponyms with their proper anatomical term or description according to international anatomical terminology. However, since different eponyms are used in various countries, the list could be expanded.

Early postnatal development of the lumbar vertebrae in male Wistar rats: double staining and digital radiological studies.

The aim of the study was to evaluate the physiological developmental changes of male rats' lumbar vertebrae during the first 22 days after birth. Morphology and mineralisation of lumbar vertebrae were evaluated using double-staining and digital radiography system, which allowed vertebral width and optical density to be determined. Pup weight, crown-rump length, body mass index and vertebral width increased during postnatal period and significantly correlated with their age. Bone mineralisation, as measured by optical density, did not show any significant differences. The complete fusion of the primary ossification centres had a cranio- -caudal direction and started on day 19 after parturition but was incomplete by day 22. It could be concluded that, unlike significant age-related increase of vertebral size, mineralisation was only slightly elevated during evaluated postnatal period. The method described is supplementary to alizarin red S staining as it provides both qualitative and quantitative data on mineralisation in a similar manner to micro computed tomography but does not allow 3 dimensional and microarchitecture examination.

Urinary bladder diverticulum as an unusual content of the inguinal canal.

The inguinal urinary bladder hernia is a rare pathology observed mostly in males. A new case of asymptomatic reducible acquired inguinal hernia was revealed in a 54-year-old male during computed tomography (CT) undertaken for oncological follow-up. The right nephrectomy was previously performed due to clear cell carcinoma. The hernia was not visible on the CT 6 months before and on ultrasound performed after voiding. Slight herniation with a wide invagination of transversalis fascia but with empty bladder was seen on CT 4 months after the initial detection of hernia.

Effect of iodothyronine hormone status on doxorubicin related cardiotoxicity.

The anthracycline anticancer agent doxorubicin has been recognised to induce a dose-dependent cardiotoxicity. The chronic form of such complication is characterized by an irreversible cardiac damage and congestive heart failure. Although the pathogenesis of anthracycline cardiotoxicity seems to be multifactorial, the pivotal role has been attributed to reactive oxygen species formation. Because redox equilibrium in cardiomyocytes may be regulated via iodothyronine hormones, the aim of the study was to appraise the effect of hypothyroidism on heart damages induced by doxorubicin. The rats received methimazole in drinking water (0.001 and 0.025%) after doxorubicin administration (2.0, 5.0 and 15 mg/kg). The cardiac morphology and blood biochemical markers of heart damage were assessed. Decreased levels of iodothyronine hormones had not significant impact on cardiac morphological changes and no effect on the level of B-type natriuretic peptide in rats receiving doxorubicin. Lower hormonal levels had sporadic, diverse effect on blood transaminases, lactate dehydrogenase and creatine kinase levels, but any relation to time, doxorubicin doses and hypothyroid status was found. Hypothyreosis leads to increase in fatty acid binding protein in rats receiving higher dose of doxorubicin. Hypothyreosis had no effect on heart stretching and on necrosis at morphological level, but caused biochemical symptoms of cardiomyocyte necrosis in rats receiving doxorubicin.

Morphology of the foramen magnum in young Eastern European adults.

BACKGROUND: The foramen magnum is an important anatomical opening in the base of the skull through which the posterior cranial fossa communicates with the vertebral canal. It is also related to a number of pathological conditions including Chiari malformations, various tumours, and occipital dysplasias. The aim of the study was to evaluate the morphology of the foramen magnum in adult individuals in relation to sex. MATERIAL AND METHODS: The morphology of the foramen magnum was evaluated using 3D computer tomography images in 313 individuals (142 male, 171 female) aged 20-30 years. RESULTS: The mean values of the foramen length (37.06 ± 3.07 vs. 35.47 ± 2.60 mm), breadth (32.98 ± 2.78 vs. 30.95 ± 2.71 mm) and area (877.40 ± 131.64 vs. 781.57 ± 93.74 mm2) were significantly higher in males than in females. A significant, positive correlation was found between foramen length and breadth. Significant correlations were reported for breadth and area of the foramen magnum and corresponding external cranial diameters in females. Round as well as longitudinal and horizontal oval-like types of the foramen shape were established according to the breadth/length index of the structure. All the cranial and foramen measurements were significantly higher in individuals with round-like type of the foramen magnum. CONCLUSIONS: There was a sexual dimorphism of the foramen magnum among the examined individuals. It was related mainly to its linear diameters and area, not to the shape. Unlike males, female skulls had higher correlation between the examined parameters of the foramen and proper external cranial measurements, which indicates more homogeneous growth in girls.

Anatomical classification of the shape and topography of the operated stomach.

The aim of the study was to present the classification of anatomical variants of the operated stomach, based on radiological and historical data. Different anatomical variants of the operated organ were found in 431 out of 2034 patients examined in the years 2006-2010. Four main groups were established: abnormal position along longitudinal (I) and horizontal axis (II), as well as abnormal shape (III) and stomach connections (IV). An additional group (V) encloses mixed forms that combine features of two or more of the main groups. The first group contains the partial and total translocation of the stomach into the thoracic cavity after the partial or total oesophagectomy. Depending on the applied surgical techniques used during the total oesophagectomy, the stomach could be located anteriorly or posteriorly to the pericardial sac. An elongated and gastrectatic form often with signs of pylorostenosis is visible in patients treated by vagotomy. The consequences of fundoplication included: lack of or narrow cardiac angle, and often a mild form of stomach cascade. The most common abnormal shape of the stomach was secondary to gastrectomy and gastric bending. The final organ shape depends on the type of applied surgical procedure that maintains physiological connection with the duodenum or an un-anatomical one, mostly with the jejunal loop. In banding, the body of the stomach forms an hourglass at the level of the artificial adjustable band, typically applied in surgical treatment of obesity (slim surgery).

Intrapancreatic accessory spleen.

A case of accessory spleen located in the tail of the pancreas in a stillbirth male foetus is reported. The congenital anomaly was revealed at autopsy. The intrapancreatic spleen was well demarcated and was composed of red and white pulp; however, same pancreatic ducts were intermingled with the splenic parenchyma. As well as the intrapancreatic lesion another minute accessory spleen was also found at the hilum of the proper organ. Since a lack of morphological features of trisomy 13 syndrome were found in the foetus, the ectopic spleens were regarded as incidental findings.

Anatomical variances and dimensions of the superior orbital fissure and foramen ovale in adults.

The aim of the study was the retrospective morphological analysis of selected structures of the middle cranial fossa, i.e. foramen ovale and superior orbital fissure, in relation to the external head and cranial diameters in adults from the Lublin region (Poland). The study was performed on data collected during computed tomography examinations of 60 individuals (age 20-30 years), without any cranial or brain abnormalities. Based on the post-processing reconstructions, 3-dimensional views of the skull and head were obtained. The length and width of both structures, as well as thickness of the frontal, temporal, and occipital squamae, were measured. The morphology of the ovale foramina and superior orbital fissures were checked. The length and width of the skull and head were the only parameters that significantly differed between males and females. The thickness of the frontal and temporal squama was insignificantly lower in males than in females. Almond and oval shapes were the most typical for the foramen ovale. The superior orbital fissure was found as a wide form - with or without accessory spine originating from its lower margin or as a laterally narrowed form. The length and width of the foramen ovale were insignificantly higher in males than in females. The same results were found for the area of the right superior orbital fissure. The thickness of the frontal and occipital squamae influenced the thickness of the temporal squama. The analysed individuals had asymmetrical, oval, or almond-shape ovale foramina. Unlike the seldom visible laterally narrowed form of the superior orbital fissure, a wide form with or without accessory spine was the most commonly observed. The diameters of both superior orbital fissures and ovale foramina indicated the asymmetry of the neurocranium.

Blue nevus of the endocervix.

The mucosa of the uterine cervix is normally devoid of melanocytes; therefore, melanin-containing lesions are very rare in this site. A new case of a common blue nevus in the cervix of a 57-year-old woman is reported. The lesion was an incidental finding in a total hysterectomy specimen performed for atypical endometrial hyperplasia. Gross and histological examination revealed minute dark macula on the mucosa of the posterior aspect of the endocervical canal, composed of loose conglomerates of spindle-shaped and dendritic cells located superficially within the stroma, containing multiple brownish granules, which exhibited positive immunostaining for HMB45 and melan A. Although the blue nevi seem to be lesions of low clinical significance, they require careful differential diagnosis with malignant melanoma, especially in scanty endocervical curettage or cervical biopsy specimens.

Sebaceous glands - unusual histological finding in the uterine cervix.

Sebaceous glands have been extremely rare findings in the female genital system. Excluding the vulva and recent findings, very few cases have been described. The origin of the lesions remains a topic of speculation. However, it appears that prolonged irritation induces a metaplastic response in the ectocervical epithelium. A new case of sebaceous glands in the ectocervix of a 46-year-old woman is reported. The lesions were unexpectedly found in a hysterectomy specimen. The procedure was carried out for multiple leiomyomas of the uterine corpus. Histological examination revealed three mature sebaceous glands located distally to the transformation zone, which opened directly onto the surface epithelium. It could be concluded that sebaceous glands in the ectocervix are rare lesions of unclear origin and low clinical significance. However, the glands could potentially be associated with sebaceous carcinoma of that anatomical site.

Cancer of the accessory breast--a case report.

Breast neoplasm may develop in ectopically located glandular tissue. This paper presents an interesting and rare case of a 50-year-old female who despite regular mammography screening examination developed an invasive accessory breast cancer. Clinical examination revealed a 2 cm - tumour localized 4 cm below the left inframammary fold. The lesion was immobile, the skin and the atrophic nipple were retracted, the tumour infiltrated the thoracic wall. Oligobiopsy and additional examinations showed an invasive stage IIIB ductal breast cancer (Bloom II, G-2). The receptor status was: ER(+), PGR(+), HER2(-). The increased level of cancer antigen 15.3 was found. The patient was submitted to pre-operative chemotherapy. She also underwent surgery and subsequently post-operative chemotherapy and radiotherapy. On the basis of the presented case, it could be concluded that the accessory mammary glands are out of the image of screening breast examinations. Accessory breast cancer is usually diagnosed by clinical examination and ultrasonography. Preventive resection of accessory breast in women at high risk of developing breast cancer can be considered as the treatment of choice in most patients.

Immunoexpression of constitutive and inducible cyclooxygenase isoforms in distinguishing and accessory structures of synovial joints in rat foetuses.

Joint formation is a developmental process regulated by various factors including bone morphogenetic proteins, transforming and growth factors, etc. Recently, a high expression of cyclooxygenase (COX) isoforms in the foetal cartilaginous elements was also revealed. On the other hand, various joint and skeletal abnormalities were seen in laboratory animal and human offspring, exposed in utero to several COX inhibitors. Immunoexpression of constitutive (COX-1) and inducible (COX-2) cyclooxygenase isoforms was evaluated in various articular structures of untreated and unfamiliar 21-day-old male rat foetuses. Both COX isoforms were detected in the articular cartilage and joint capsule, as well as in the intra-articular disc of the temporomandibular joint and meniscus of the knee joint. COX-1 immunostaining was revealed in the anterior and posterior cruciate ligament of the knee joint and the labrum of the hip and shoulder, whereas COX-2 immunoreactivity in those structures was not found. It could be concluded that both constitutive and inducible COX isoforms are physiologically expressed in various structures of synovial joints in rat foetuses at the end of prenatal development.

Morphology of root canals in adult premolar teeth.

The aim of the present study was to examine the morphology of root canals in premolar teeth with completely formed root apices. The material consisted of 139 extracted premolar teeth, including 83 first premolars (59.7%) and 56 second premolars (40.3%). Maxillary teeth made up 64% of the material and mandibular teeth 36%. In order to measure the actual root canal length an endodontic instrument was inserted into the root canal (in teeth with a single root canal this was instrument no. 25 and in teeth with two or three root canals no. 20) until its tip was visible in the anatomical foramen. The silicone limit was fixed at a reference point on the dental crown, and after removal of the instrument the real length was read using an endodontic ruler. The results were presented using descriptive statistical measures (mean, maximum, minimum, median value and quartiles). In order to compare mean values of root canal lengths the z test was used. Of the first maxillary premolars, 91% had two root canals and 9% had three root canals. As far as the second upper premolars are concerned, 14.7% were teeth with single root canals while as many as 85.3% were teeth with two root canals. The majority of the first lower premolars (89.3%) had one root canal and 10.7% of these teeth had two root canals. Most of the second lower premolars (68.2%) had a single root canal, while the remaining 31.8% had two root canals. None of the mandibular premolars examined had three root canals.

Immunoexpression of constitutive and inducible cyclo-oxygenase isoforms in the rat foetal and maternal digestive tract.

Cyclo-oxygenase (COX), which catalyses the conversion of arachidonic acid to prostaglandin endoperoxide and prostanoids, is widely expressed in mammalian organs. The aim of the study was to evaluate the immunoexpression of the constitutive and inducible cyclo-oxygenase isoforms (COX-1 and COX-2 respectively) in the oesophagus, stomach and the small and large bowels of untreated rat dams and foetuses on gestational day 21. The localisation of the COX isoforms was similar in the maternal and foetal organs, although the intensity of the reaction for COX-2 was stronger in the foetuses. Cytoplasmic COX-1 immunostaining was found in myocytes of the muscularis propria, muscularis mucosae and the blood vessels. It was also positive in the endothelial cells, scattered stromal cells of the lamina propria and the ganglion cells of the nerve plexus in the bowels. Apart from the keratinised layer, a strong reaction was revealed in the stratified squamous epithelium of the oesophagus and forestomach. Negative or weakly positive staining was found in the mucus-secreting cells covering the surface, gastric pits and pyloric glands, as well as in the parietal cells and the chief cells. Weakly positive COX-1 immunostaining was observed in epithelial cells of the small intestine crypts, but in some cases enterocytes and goblet cells covering villi were also positive. In the colonic mucosa weak COX-1 staining was typical of the absorptive, and goblet cells. The COX-2 immunostaining was nuclear and/or cytoplasmic. An inconsistent positive reaction was seen in the muscle of the muscularis mucosae, muscularis propria and the blood vessels. Positive staining was also found in scattered stromal cells of the lamina propria and adventitia and the ganglion cells. Weak nuclear staining was found in the stratified squamous epithelium of the oesophagus and forestomach. Unlike the strong foetal reactivity in the epithelial cells of the glandular stomach, a negative or weakly positive reaction was seen in the maternal parietal and/or mucous-secreting surface stomach cells. Some epithelial cells of the crypts both in the small and large bowel were also COX-2 positive. In conclusion, constitutive and inducible COX isoforms were detected in the digestive tract of pregnant female and in foetuses. COX-1 was the predominant isoform in both the adult and foetal organs.

Association of maternal pancreatic function and foetal growth in rats treated with DFU, a selective cyclooxygenase-2 inhibitor.

Constitutive (COX-1) and inducible (COX-2) cyclooxygenase isoforms have been detected in various mammalian tissues. Their activity is blocked by non-steroidal anti-inflammatory drugs that may induce various side reactions. The aim of the study was to evaluate the effects of DFU, a selective COX-2 inhibitor, on exocrine and endocrine pancreatic function and the immunoexpression of both COX isoforms in maternal and foetal rat pancreases. The compound was administered to pregnant Wistar rats once daily from the 8th to the 21st day of gestation. Glucose level and amylase activity were determined in the maternal sera. Maternal and foetal pancreases were examined histologically. Immunoexpression of COX-1 and COX-2 was also evaluated. Both biochemical parameters, as well as the histological structure of the pancreas were undisturbed in the dams and their foetuses. The maternal glucose level was found to be an important factor for foetal growth. Strong cytoplasmic COX-1 immunostaining was observed in acinar secretory cells, whereas in islets the immune reaction was weak. Endocrine cells also revealed strong cytoplasmic COX-2 staining in the maternal and foetal pancreases. Acinar cells exhibited nuclear reaction, which was strong in the foetal but weak in the maternal pancreases. No differences in COX immunoexpression were found between the DFU-exposed and the control groups in either mothers or foetuses. It should be stressed that DFU administered throughout mid and late pregnancy in rats did not change maternal or foetal pancreatic morphology or immunoexpression of either of the main COX isoforms in the organ.

Congenital ventricular septal defects and prenatal exposure to cyclooxygenase inhibitors.

Ventricular septal defects (VSDs) are common congenital abnormalities which have been reported to be associated with maternal fever and various environmental factors. The aim of the present study was to evaluate the effect of prenatal exposure to cyclooxygenase (COX) inhibitors on heart defects. A retrospective statistical analysis was performed using data collected in our laboratory during various teratological studies carried out on albino CRL:(WI)WUBR Wistar strain rats from 1997 to 2004. The observations were compared with concurrent and historic control data, as well as findings from other developmental toxicological studies with selective and nonselective COX-2 inhibitors. Despite the lack of significant differences in the frequency of VSDs between drug-exposed and control groups, statistical analysis by the two-sided Mantel-Haenszel test and historical control data showed a higher incidence of heart defects in offspring exposed to nonselective COX inhibitors (30.06/10,000). Unlike other specific inhibitors, aspirin (46.26/10,000) and ibuprofen (106.95/10,000) significantly increased the incidence of the VSD when compared with various control groups (5.38-19.72/10,000). No significant differences in length or weight were detected between fetuses exposed to COX inhibitors and born with VSD and non-malformed offsprings. However, a statistically significant increase of fetal body length and decrease of body mass index were found in fetuses exposed to COX inhibitors when compared with untreated control. We conclude that prenatal exposure to COX inhibitors, especially aspirin and ibuprofen, increased the incidence of VSDs in rat offspring but was not related to fetal growth retardation.

Congenital ventricular septal defects and prenatal exposure to cyclooxygenase inhibitors

Ventricular septal defects (VSDs) are common congenital abnormalities which have been reported to be associated with maternal fever and various environmental factors. The aim of the present study was to evaluate the effect of prenatal exposure to cyclooxygenase (COX) inhibitors on heart defects. A retrospective statistical analysis was performed using data collected in our laboratory during various teratological studies carried out on albino CRL:(WI)WUBR Wistar strain rats from 1997 to 2004. The observations were compared with concurrent and historic control data, as well as findings from other developmental toxicological studies with selective and nonselective COX-2 inhibitors. Despite the lack of significant differences in the frequency of VSDs between drug-exposed and control groups, statistical analysis by the two-sided Mantel-Haenszel test and historical control data showed a higher incidence of heart defects in offspring exposed to nonselective COX inhibitors (30.06/10,000). Unlike other specific inhibitors, aspirin (46.26/10,000) and ibuprofen (106.95/10,000) significantly increased the incidence of the VSD when compared with various control groups (5.38-19.72/10,000). No significant differences in length or weight were detected between fetuses exposed to COX inhibitors and born with VSD and non-malformed offsprings. However, a statistically significant increase of fetal body length and decrease of body mass index were found in fetuses exposed to COX inhibitors when compared with untreated control. We conclude that prenatal exposure to COX inhibitors, especially aspirin and ibuprofen, increased the incidence of VSDs in rat offspring but was not related to fetal growth retardation.

The activity and immunoexpression of cathepsin D in rat male reproductive organs.

Cathepsin D is a cysteine endopeptidase that belongs to the lysosomal enzyme family. The aim of the study was to evaluate the enzyme immunoexpression and activity in selected male genital organs in mature Wistar rats. The activity of cathepsin D was measured spectrophotometrically in homogenates of the testis, epididymis, seminal vesicle and prostate. Immunohistochemical staining was also performed in the ductus deferens. Enzyme activity was found in the following sequence: testis>epididymis>dorsal prostatic lobe>seminal vesicle>lateral prostatic lobe>ventral prostatic lobe. Although there were differences in enzyme activity between various organs of the male reproductive system, cathepsin D immunoreactivity was seen exclusively in the Sertoli and Leydig cells in the testis.

Selected biochemical parameters and ultrastructural picture of pancreas due to Ulinastatin treatment of experimental acute pancreatitis.

Urinary trypsin inhibitor (UTI, Ulinastatin) is a protease inhibitor that has not been yet used in Europe in any experimental trial of severe acute pancreatitis. We have combined the experimental model of severe, hemorrhagic form of acute pancreatitis, and pharmacological treatment with a protease inhibitor. Male Wistar rats were divided into four experimental groups: healthy controls, operated, operated with experimentally induced acute pancreatitis, and animals with acute pancreatitis--treated with UTI preparations. Subjects in the last group were administered UTI intraperitoneally 1 h after pancreatitis induction in an average standard dose of 3000 units/animal. Additionally, four subgroups were created in this treated group, based on the UTI administration time--number of standard doses received: 2 h - 1 standard dose, 6 h - 5 standard doses, 12 h - 11 doses, 24 and 48 h - 15 doses. Statistically significant differences in the serum amylase and lipase activity between the UTI-treated and non-treated subjects were found. In the group of non-treated animals, there a profound destruction of cellular organelles was observed with a total degradation of nuceli, endoplasmatic reticulum and zymogen granules. However, in the UTI-treated subjects, pathological processes proceeded with the significantly slower pace and in much smaller quantities.