Superficial brachioulnar artery in man.

The individual arterial pattern of the upper limb is considerably variable (11-24%) and relevant for intraarterial interventions performed by cardiologists, plastic and vascular surgeons, radiologists, anaesthesiologists, transplant specialists, orthopaedists and neurosurgeons. Arterial variants in the upper limb result from modifications in the maintenance and regression of the initial capillary plexus, which forms dominant arterial channels and gradually expands into the growing upper limb bud between stages 12 and 21. In this case report we present the superficial brachioulnar artery with its external diameter of 3 mm and length of 525 mm, and of relevant course in the left upper limb of a 78-year-old male Caucasian formalin-fixed cadaver. The superficial brachioulnar artery unusually started with the superior part of axillary artery, presented the following five parts: axillary, brachial, cubital, antebrachial and palmar, and was finally continuous with the superficial palmar arch. The typical ulnar artery was somewhat hypoplastic and limited to the forearm. To the best of our knowledge, this is the first report in the professional literature to describe the start of the superficial brachioulnar artery with the superior part of axillary artery. We conclude the individual arterial pattern of the upper limb to be indispensably recognised preoperatively, so as to circumvent any unwanted injuries to the superficial brachioulnar artery that is considerably large, overlies the antebrachial fascia and supplies the superficial palmar arch.

Quantitative anatomy of the growing supraspinatus muscle in the human fetus.

BACKGROUND: The supraspinatus muscle, one of the four rotator cuff muscles, initiates abduction of the arm, simultaneously stretching the articular capsule at the glenohumeral joint, and also contributes to exorotation of the arm. In the present study we aimed to evaluate the age-specific normative values for morphometric parameters of the supraspinatus muscle in human fetuses at varying ages and to elaborate their growth models. MATERIALS AND METHODS: Using anatomical dissection, digital image analysis (NIS Elements AR 3.0) and statistics (Student's t-test, regression analysis), the length, width, circumference and projection surface area of the supraspinatus muscle were measured in 34 human fetuses of both sexes (16 males, 18 females) aged 18-30 weeks of gestation. RESULTS: Neither sex nor laterality differences were found in numerical data of the supraspinatus muscle. In the supraspinatus muscle its length and projection surface area increased logarithmically, while its width and circumference grew proportionately to gestational age. The following growth models of the supraspinatus muscle were established: y = -71.382 + 30.972 × ln(Age) ± 0.565 for length, y = -2.988 + 0.386 × Age ± 0.168 for greatest width (perpendicular to superior angle of scapula), y = -1.899 + 0.240 × Age ± 0.078 for width perpendicular to the scapular notch, y = -19.7016 + 3.381 × Age ± 2.036 for circumference, and y = -721.769 + 266.141 × ln(Age) ± 6.170 for projection surface area. CONCLUSIONS: The supraspinatus muscle reveals neither sex nor laterality differences in its size. The supraspinatus muscle grows logarithmically with reference to its length and projection surface area, and proportionately with respect to its width and circumference.

Quantitative study of the primary ossification centre of the parietal bone in the human fetus.

BACKGROUND: Detailed morphometric data concentrating on the development of primary ossification centres in human fetuses is critical for the early detection of developmental defects. Thus, an understanding of the growth and development of the parietal bone is crucial in assessing both the normal and pathological development of the calvaria. MATERIALS AND METHODS: The size of the parietal primary ossification centre in 37 spontaneously aborted human fetuses of both sexes (16 males and 21 females) aged 18-30 weeks was studied by means of computed tomography, digital-image analysis and statistics. RESULTS: The numerical data of the parietal primary ossification centre in the human fetus displays neither sex nor laterality differences. With relation to fetal age in weeks, the parietal primary ossification centre grew in sagittal diameter according to the quadratic function: y = 16.322 + 0.0347 × (age)² ± 1.323 (R² = 0.96), in projection surface area according to the cubic function: y = 284.1895 + 0.051 × × (age)³ ± 0.490, while in both coronal diameter and volume according to the quartic functions: y = 21.746 + 0.000025 × (age)4 ± 1.256 and y = 296.984 + + 0.001 × (age)4, respectively. CONCLUSIONS: The obtained morphometric data of the parietal primary ossification centre may be considered age-specific references, and so may contribute to the estimation of gestational ages and be useful in the diagnostics of congenital cranial defects.

Extent of the frontal sinuses in the aspect of neurosurgical craniotomy approaches.

BACKGROUND: Frontal sinuses within the frontal bone can be a potential obstacle in neurosurgical approach in this region. Their unintended opening during craniotomy is not beneficial due to the risk of brain infections by bacteria inhabiting the sinus mucosa. Therefore, such opening should be avoided whenever the surgical procedure does not involve the sinus itself. The aim of the study was the morphometric analysis of the frontal sinuses based on computed tomography imaging. MATERIALS AND METHODS: The width, height, projection surface area and location of the highest and most lateral points of the sinuses were determined. RESULTS: The vertical diameter of the sinuses was found to be greater in men compared with women. The most lateral point of the sinuses was located higher in men, and in men was located higher on the left side. The results obtained may indicate that the frontal sinuses tend to be larger in men and that air cells in men extend further in the upper-lateral direction on the left side of the frontal bone. CONCLUSIONS: This may cause an increased risk of unintentional opening of the left frontal sinus during frontal craniotomy or pterional craniotomy with frontal extension.

Quantitative anatomy of primary ossification centres of the lateral and basilar parts of the occipital bone in the human foetus.

BACKGROUND: Computed tomography (CT)-based quantitative analysis of primary ossification centres in the cranium has not been carried out to date due to the limited availability of the foetal human material. Detailed morphometric data about the development of primary ossification centres in human foetuses may be useful in the early detection of developmental defects. Understanding the growth and development of the occipital bone is crucial in assessing the normal and pathological development of the cranial base, and the cranium as a whole. MATERIALS AND METHODS: The study material comprised 37 human foetuses (16 males and 21 females) aged 18-30 weeks of gestation. Using CT, digital image analysis software, three-dimensional reconstruction and statistical methods, the size of the primary ossification centres of the lateral and basilar parts of the occipital bone was evaluated. RESULTS: The morphometric characteristics of primary ossification centres of the lateral and basilar parts of the occipital bone display neither sex nor laterality differences. These ossification centres grow linearly with respect to their sagittal and transverse diameters, projection surface area and volume. CONCLUSIONS: The obtained morphometric data of primary ossification centres in the lateral and basilar parts of the occipital bone may be considered as normative for their respective prenatal weeks and may contribute to the estimation of gestational ages and the diagnostics of congenital defects.

Oxidative stress in blood of healthy people after diving.

AIM: The aim of this study was to investigate the effect of diving on the level of lipid peroxidation products and the activity of antioxidant enzyme in blood of healthy volunteers. METHODS: The studied group consisted of 11 experienced divers, who spent 40 min submerged in water, at an average depth of 6.2 m with water temperature of 13ºC. Blood samples were taken before diving and immediately after surfacing. The concentration of conjugated dienes (CD) and thiobarbituric acid reactive substances (TBARS) was assayed both in blood plasma and erythrocytes, while the activity of superoxide dismutase (SOD) in erythrocytes. RESULTS: A statistically significant increase of CD level in blood plasma and an increasing tendency in erythrocytes with concomitant decrease of SOD activity was observed after diving. No statistically significant changes in concentration of TBARS both in blood plasma and erythrocytes were revealed. CONCLUSION: The changes in environmental conditions during diving cause the oxidant-antioxidant imbalance, as it is evidenced by observed increase of CD level, which are the primary markers of lipid peroxidation and the decrease of SOD activity. No changes in the level of secondary products of lipid peroxidation - TBARS, may suggest that in studied subjects inhibition of free-radical processes occurs and/or the products of lipid peroxidation are quickly removed due to adaptation, what protect the divers against damages on cellular level.

Septomarginal trabecula and anterior papillary muscle in primate hearts: developmental issues.

The septomarginal trabecula is present in all human hearts as well as in the hearts of other primates. It usually connects the interventricular septum with the anterior papillary muscle, although there are many variations in how this is achieved. The object of the analyses was to estimate the bilateral topography of the septomarginal trabecula and the anterior papillary muscle in the context of the ontogeny and phylogeny of primates. A total of 138 hearts were examined from number of different non-human primates. The presence of the septomarginal trabecula was confirmed in 94.9% of cases, although not in the hearts of Lemur varius. Four configurations could be distinguished by defining the location of the septomarginal trabecula and its relation to the anterior papillary muscle.For the hearts of the Strepsirrhini and the majority of Platyrrhini neither structure was related, whereas in all examined representatives of Homino idea they had fused and created morphologically varying forms. On the basis of these results,a concept was developed for the sequence of changes which the topography of the septomarginal trabecula and the anterior papillary muscle undergo during ontogeny and phylogeny.

External diameters of the pulmonary arteries in human foetuses: an anatomical, digital and statistical study.

This study defines the growth patterns for the external diameters of the pulmonary arteries in human foetuses, including relationships with sex, side of body (right-left) and foetal age. Using anatomical dissection, digital-image analysis (system of Leica Q Win Pro 16) and statistical analysis (ANOVA, regression analysis), a range of external diameters for the right and left pulmonary arteries in 128 spontaneously aborted human foetuses aged 15-34 weeks was examined. No significant gender differences were found (p > 0.05). In the examined age range the values of the external diameter of the right pulmonary artery ranged from 0.97 +/- 0.24 to 2.95 +/- 0.89 mm, according to the linear function y = -0.7753 + 0.1148 x +/- 0.4580 (r = 0.83; p < 0.001). The values of the external diameter of the left pulmonary artery ranged from 0.88 +/- 0.25 to 2.63 +/- 0.80 mm, in accordance with the linear relationship y = -0.6228 + 0.1007 x +/- 0.4280 (r = 0.81; p < 0.001). The external diameters of the right pulmonary artery were greater than those of the left pulmonary artery (p < 0.001). Parallel to the increase in the values of the external diameters of both the pulmonary arteries, the pulmonary artery-to-ascending aorta diameter ratio (the relative diameter of the pulmonary artery) decreased with advanced foetal age from 0.46 +/- 0.10 to 0.43 +/- 0.13 for the right pulmonary artery, and from 0.43 +/- 0.10 to 0.39 +/- 0.12 for the left one. The growth curves generated may be useful as reference data for foetal diagnosis.

Length growth of the various aortic segments in human foetuses.

This study defines normal growth for the various aortic segments in 128 spontaneously aborted human foetuses aged 15-34 weeks. With the use of anatomical dissection, digital-image analysis (using the Leica Q Win Pro 16 system) and statistical analysis (ANOVA, regression equation), a range of length measurements for the ascending aorta, aortic arch and thoracic aorta was examined. No significant gender differences were found (p > or = 0.05). The length of the ascending aorta ranged from 2.63 +/- 0.42 to 10.80 +/- 1.49 mm, according to the linear function y = -4.678 + 0.4647 x +/- 0.8447. The aortic arch length increased from 3.93 +/- 0.57 to 15.25 +/- 1.98 mm, in accordance with the linear model y = -6.079 + 0.6370 x +/- 1.1133. The length of the thoracic aorta ranged from 12.49 +/- 1.85 to 48.82 +/- 6.31 mm, according to the linear pattern y = -19.654 + 2.0512 x +/- 3.5168. The sum of the lengths of these aortic segments generated the linear function y = -30.410 + 3.153 x +/- 5.4332. The relationships between the lengths of the various aortic segments generated the linear regressions: y = -0.2256 + 0.7276 x +/- 0.3093 (for the ascending aorta vs. the aortic arch), y = 0.0252 + 0.3105 x +/- 0.2189 (for the aortic arch vs. the thoracic aorta), and y = -0.2408 + 0.22709 x +/- 0.2026 (for the ascending aorta vs. the thoracic aorta). The ascending aorta, aortic arch and thoracic aorta also increased proportionally (5:7:22) during gestation.

Digital-image analysis of the left common carotid artery in human foetuses.

The rate of growth of the left common carotid artery during gestation has not been sufficiently evaluated. The present study was performed on 128 spontaneously aborted human foetuses aged 15-34 weeks to compile normative data for the dimensions of the left common carotid artery at varying gestational ages. Using anatomical dissection, digital image analysis (system of Leica Q Win Pro 16) and statistical analysis (ANOVA, regression analysis), a range of measurements (length, original external diameter and volume) for the left common carotid artery during gestation was examined. No significant gender differences were found (p > 0.05). The growth curves of the best fit for the plot of each morphometric parameter against gestational age were generated. The lengths ranged from 14.82 +/- 2.22 to 42.84 +/- 4.32 mm, according to the linear model y = -9.6918 + 1.5963 x +/- 3.1706 (r = 0.95; p < 0.001). The original external diameter increased from 0.72 +/- 0.18 to 3.28 +/- 0.40 mm, according to the linear function y = -1.5228 + 0.1428 x +/- 0.2749 (r = 0.95; p < 0.001). The left common carotid artery-to-aortic root diameter ratio increased from 0.356 +/- 0.062 to 0.480 +/- 0.101. The left common carotid artery-to-aortic arch diameter ratio increased from 0.447 +/- 0.079 to 0.535 +/- +/- 0.113. The volume ranged from 6.73 +/- 4.06 to 369.30 +/- 107.42 mm3 in accordance with the quadratic function y = 344.8 - 41.001 x + 1.254 x2 +/- +/- 46.955 (R2 = 0.87). The parameters examined have clinical application in the early recognition of arterial abnormalities, especially aortic coarctation.

Quantitative morphology of the left subclavian artery in human fetuses.

PURPOSE: The present study was performed to compile normative data for dimensions of the left subclavian artery at varying gestational age. MATERIAL AND METHODS: Using anatomical dissection, digital image analysis (Leica Q Win Pro 16 system) and statistical analysis (ANOVA, regression analysis) a range of measurements (length, original external diameter, volume) for the left subclavian artery in 128 spontaneously aborted human fetuses aged 15-34 weeks was examined. RESULTS: No significant gender differences were found (P>0.05). The length ranged from 4.62 +/- 0.49 to 12.28 +/- 1.25 mm, according to the linear function y = -2.1482 + 0.4302 x +/- 0.9972 (r = 0.93 P<0.001). The original external diameter increased from 0.68 +/- 0.16 to 2.89 +/- 0.29 mm, according to the linear model y = -1.2169 + 0.1233 x +/- 0.2389 (r = 0.95 P<0.001). The left subclavian artery-to-aortic root diameter ratio increased from 0.337 +/- 0.064 to 0.423 +/- 0.103. Distance between the left common carotid and left subclavian arteries increased from 0.57 +/- 0.17 to 3.92 +/- 0.91 mm. Aortic arch diameter to distance between the left common carotid and left subclavian arteries decreased with advanced fetal age, from 2.82 +/- 0.51 to 1.56 +/- 0.27. The volume ranged from 1.77 +/- 0.89 to 80.60 +/-; 22.18 mm3, in accordance with the quadratic function y = 76.0 - 8.956 x + 0.031 x2 +/- 10.945 (R2 = 0.85). CONCLUSIONS: The developmental dynamic of the length and diameter of the left subclavian artery follows a linear regression, whereas its volumetric dynamic follows a quadratic regression. The ratio of the aortic arch diameter to the distance between the left common carotid and left subclavian arteries has clinical application in the early recognition of aortic coarctation.

Morphometric features of the right atrioventricular orifice in adult human hearts.

The normal data of the tricuspid valve complex is of great clinical importance in the light of progress in cardiosurgery and the development of novel operating techniques. A range of measurements for the right atrioventricular orifice in 96 human adult hearts was examined by means of anatomical dissection, inspection, examination, and statistical analyses. The length of the attachment of the anterior leaflet increased significantly between group I (aged 18-40 years) and group II (aged 41-64 years) in women only. In men there were no significant differences in this parameter between any of the three age groups. In addition, the attachment length of the posterior leaflet in women increased statistically in the second age group. In men, in contrast, the attachment length of the posterior leaflet did not increase significantly between the first and second age groups and became significantly larger only in oldest age group, consisting of men aged over 65. No statistically significant differences between the three age groups were found for the attachment length of the septal leaflet (p>0.05). In female hearts significant increases in the frontal and sagittal dimensions of the tricuspid valve orifice were observed between the second age group and the group aged over 65. In male hearts both the frontal and sagittal dimensions increased significantly with advanced age. The right atrioventricular orifice expressed as the ellipse area was statistically greater than the triangular area (p<0.01) in each age group. It should be noticed that both areas increased significantly during ageing. This study has demonstrated that the shape of the right atrioventricular orifice evolves during life, from a triangular shape to a more elliptical shape.

The normal growth of the pulmonary trunk in human foetuses.

The rate of growth of the pulmonary trunk during gestation has not been sufficiently determined. The present study was performed on 128 spontaneously aborted human foetuses aged 15-34 weeks in order to compile normative data for pulmonary trunk dimensions at various gestational ages. With the use of anatomical dissection, digital-image analysis (the Leica QWin Pro 16 system) and statistical analysis (ANOVA, regression analysis) a range of measurements (length, diameter and volume) was analysed for the pulmonary trunk during gestation. No significant gender differences were found (p>0.05). Growth curves were generated of the best fit for the plot for each morphometric feature against gestational age. The results obtained show a statistically significant correlation (p<0.001) between the parameters examined and gestational age. Both the length and diameter of the pulmonary trunk were found to increase in a linear fashion throughout gestation. The length ranged from 3.17+/-0.36 mm to 13.54+/-1.39 mm, according to the linear function y=-5.6035+0.5705x+/-0.9171 (r=0.96). The diameter ranged from 1.51+/-0.24 mm to 5.30+/-1.53 mm, according to the linear model y=-1.4813+0.2154x+/-0.7452 (r=0.86). The pulmonary trunk volume ranged from 5.94+/-2.21 mm3 to 312.37+/-154.34 mm3, according to the quadratic function y=143.2-20.961x+0.791x2+/-63.306 (R2=0.74). The growth curves generated from my data may be useful as a reference for foetal echocardiographers in the detection of congenital cardiovascular abnormalities.

The normal growth of the thoracic aorta in human foetuses.

The present study was performed on 128 spontaneously aborted human foetuses aged 15-34 weeks in order to establish normal values for thoracic aorta dimensions at various gestational ages. Using anatomical dissection, digital-image analysis (the Leica QWin Pro 16 system) and statistical analysis (ANOVA, regression analysis) the growth of the length, the original and terminal external diameters and the volume of the thoracic aorta during gestation was examined. No significant gender differences were found (p>0.05). The growth curves were generated of the best fit for the plot for each morphometric feature against gestational age. Both the length and external diameters of the thoracic aorta increased in proportion to the advance in foetal age. The length ranged from 12.49+/-1.85 mm to 48.82+/-6.31 mm according to the linear function y=-19.654+2.0512x+/-3.5168. The original external diameter ranged from 1.25+/-0.28 mm to 5.65+/-0.48 mm according to the linear fashion y=-2.3834+0.2367x+/-0.3850. The terminal external diameter ranged from 1.15+/-0.26 mm to 5.18+/-0.45 mm, in agreement with the linear model y=-2.1438+0.2156x+/-0.3555 (r=0.96, p<0.001 for each feature). The volume of the thoracic aorta ranged from 15.75+/-8.06 mm3 to 1158.01+/-301.85 mm3 according to the quadratic function y=1376.2-154.42x+4.419x2+/-125.6 (R2=0.90). The growth curves generated from my data may be useful as a reference for foetal echocardiographers, who must distinguish abnormal from normal foetal development.

An angiographic study of the anterior tibial artery in patients with aortoiliac occlusive disease.

The anterior tibial artery is of great clinical relevance to vascular infrapopliteal surgery. The sources (origins), length and luminal diameter of the anterior tibial artery in 46 men and 30 women with Lerich syndrome were studied by means of radiological and digital methods. The results obtained were described by two-way analysis of variance (Multi-group ANOVA) for unpaired data--the means for six subtypes with regard to sex and side of the body, using the STATISTICA 5.5 program. The anterior tibial artery occurred most frequently (92.11%) as a terminal branch of the popliteal artery in its normal (IA: 87.5%, IB: 2.63%) and high (IIA 1: 1.32%, IIA 2: 0.66%) division. In the remainder (7.89%), the anterior tibial artery arose from both the anterior tibioperoneal trunks (IC: 1.97%, IIB: 5.92%). The statistical analysis of the sources of the anterior tibial artery did not show gender differences. Symmetry of the left and right popliteal patterns was observed in the two most frequent subtypes: IA (r1 = 0.80) and IIB (r2 = 0.83). The anterior tibial artery was the longest (p = 0.02 for men, p = 0.04 for women) in subtype IIA 2. The greatest diameter of the anterior tibial artery was characteristic for a trifurcation (IB) and the smallest for subtype IIA 2 (p = 0.04). Both the length (p = 0.03) and luminal diameter (p = 0.04) of the anterior tibial artery in men were significantly greater than in women in all the popliteal subtypes observed. Morphometric parameters of the right and left anterior tibial artery showed no statistically significant differences. The anterior tibial artery was the predominant vessel in a trifurcation (IB) and in the two subtypes with an anterior tibioperoneal trunk (IC, IIB). These results have implications in vascular grafting below the knee.

The variability and morphometry of the brachiocephalic trunk in human foetuses.

In prenatal and pediatric cardiovascular surgery knowledge of the various arrangements of the aortic arch and its branches as well as the normative data are essential. The variability and morphometric features of the brachiocephalic trunk in 131 human foetuses (65 male, 66 female) ranging from 15 to 34 weeks of gestation were studied by means of anatomical, digital and statistical methods. In all the foetuses examined the left aortic arches were found to have three different arrangements. In 74.05% of cases the usual pattern of the aortic arch with its three main branches were observed. A common origin of the brachiocephalic trunk and left common carotid artery occurred in 20.61% of individuals. In 5.34% of cases the left vertebral artery was an additional vessel and arose from the aortic arch between the left common carotid and subclavian arteries. No significant gender differences were found with respect to the brachiocephalic trunk (p > or = 0.05). The developmental increase in length (r1 = 0.78) and diameter (r2 = 0.83) correlated with a linear function but the increase in volume in relation to age corresponded to a quadratic function (r3 = 0.73). Our results show the largest increases in the brachiocephalic trunk according to the following parameters: the length - between the 4(th) and 5(th), and 7(th) and 8(th) months, diameter - between the 8(th) and 9(th) months and volume - between the 4(th) and 5(th), and 7(th) and 9(th) months of gestation (p < or = 0.01). The present study constructs a normal range for the morphometric features of the foetal brachiocephalic trunk.

External diameters of the crural arteries in patients with chronic critical limb ischaemia.

Knowledge of the diameters of the crural arteries forms the basis for reconstructive vascular surgery and percutaneous angioplasty. The external diameters of the crural arteries were examined in 152 specimens of lower limbs by anatomical, digital and statistical methods. The diameters of all the crural arteries were significantly greater (p < or = 0.01) in the male subjects. The differences between the right and left arterial diameters were statistically significant (p < or = 0.01) only in relation to the posterior tibial artery. In subtypes IC and IIB the anterior tibial artery was the strongest, the peroneal artery was of intermediate diameter and the posterior tibial artery was the weakest. In subtype IB the anterior tibial artery presented as the predominant vessel but in subtypes IIA-1 and IIA-2 it was the posterior tibial artery that did so. In subtype IA 24 examples of the coexistence of angiometric variants of the crural arteries were distinguished. It was demonstrated that the strongest vessel was the anterior tibial artery (32.24%), rarely the posterior tibial artery (14.47%) or the peroneal artery (9.87%). In most cases (21.71%) three of the crural arteries had intermediate diameters. In 13.16% of cases there were two arteries of intermediate diameter, the posterior tibial and the peroneal, which accompanied a strong anterior tibial artery and, the least common variant (6.58%), two intermediate tibial arteries with a weak peroneal artery. A hyperplastic peroneal artery (6.59%) compensated for either the anterior tibial artery (1.98%) or the posterior tibial artery (4.61%).

Large skin arteries of the leg and foot in man.

The anatomical method with Computer Digital Image Analysis system served to examine large skin arteries of the crus and the foot in 152 human specimens. Their sources were: 1. popliteal artery (rr. gastrocnemii:medialis--62.89%, lateralis--78.95%), 2. anterior tibial artery (a. peronealis lateralis superior--97.37%, a. peronealis lateralis inferior--62.50%, a. collateralis inferior lateralis--78.95%), 3. posterior tibial artery (r. circumflexus fibulae--75.66%, r. soleus lateralis--48.03%, r. musculi flexoris hallucis longi--84.87%), 4. peroneal artery (r. perforans--86.84%) and 5. medial plantar artery (r. profundus--89.47%). The following ones characterized themselves with the longest course: a. peronealis lateralis superior (112 +/- t21 mm), r. gastrocnemius medialis (93 +/- 11 mm) and r. soleus lateralis (91 +/- 8 mm). The largest flaps supplied successively: r. gastrocnemius medialis (8530 +/- 1125 mm2), a. peronealis lateralis superior (7920 +/- 1227 mm2), r. profundus a. plantaris medialis (7580 +/- 1820 mm2), r. gastrocnemius lateralis (7320 +/- 1320 mm2), r. soleus lateralis (7140 +/- 1630 mm2) and a. collateralis inferior lateralis (6220 +/- 1981 mm2).

Skeletopy of the brachiocephalic trunk and the common carotid arteries in human fetuses.

By means of anatomical and radiological methods and with help of the Computer Digital Image Analysis System the brachiocephalic trunk and the common carotid arteries in relation to the vertebral column were studied in 60 human fetuses. The vessels were found to be between the upper borders: of the third thoracic vertebra and the first cervical vertebra (Th3s-C1s). In the 6th month of the ontogenetic development the vessels descended by one vertebra and established their location in the next prenatal compartment (8-9) between the lower borders: of these same vertebra (Th3i-C1i). We have counted the skeletopie age correlation coefficients of these vessels and found the diminuation of their values. Sexual skeletopic dimorphism have not been observed. These investigations have clinical implications.

Retroperitoneal rupture of abdominal aortic aneurysms.

OBJECTIVE: About 40% of patients with ruptured abdominal aortic aneurysm (AAA) die before admission to the hospital. The next 40-50% of patients who reach a hospital die in the perioperative period or within 30 days after surgery. Two groups of patients with ruptured AAA can be distinguished: first-with intra-abdominal rupture, second-with retro-peritoneal rupture. The aim of the study was a retrospective analysis of the treatment results in patients with retro-peritoneal rupture of AAA. MATERIAL AND METHODS: 78 patients underwent a surgical procedure between 1.01.1985 and 30.10.1996. 78 patients (68 men and 10 women), mean age 67.6 (53-94) were included in this study. Based on diagnostic and surgical procedures, two periods of treatment can be distinguished. In the first period of the time from 1.01.1985 to 31.12.1992 patients were operated on immediately after admission to the hospital. In the second period from 1.01.1993 to 31.10.1996 patients were admitted to Intensive Care Unit. In this unit patients were intensively treated and prepared for surgical procedure. During this time the computerized tomography scanning (CT) was performed. RESULTS: In the first period the perioperative mortality was 75%. In the second period the perioperative mortality was 41.3%. DISCUSSION: The 1.5-2 hours postponement of operative procedure of the patients with retro-peritoneal rupture of AAA can decrease perioperative mortality. During the time patients were intensively treated and prepared for surgical procedure and CT examination enabled to choose proper surgical technique.