Reappraisal of the anatomical diversities of the pyramidalis muscle with their potential clinical applicability: cadaveric analysis.

INTRODUCTION: The present study examined the morphology and morphometric parameters of the pyramidalis muscle (PM) in detail with their potential applicability in making midline infra-umbilical incisions and biomechanics of the linea alba. METHODS: PM was examined in 51 formalin-fixed cadavers (36 males and 15 females), and based on the mode of insertion or the level of apex, the formation or shape of the muscle was classified into nine types (Mori's classification). RESULTS: Bilateral PM was more prevalent (39.21%) than unilateral (1.96%) (p = 0.001). All the cases showed side symmetry except one. Mori's type 7 (right PM is higher apex and the left PM with elongated origin) was the most common form. The mean length of PM in males and females was 4.51 ± 0.14 and 3.33 ± 0.12 cm on the right and 4.51 ± 0.11 and 3.26 ± 0.16 cm on the left side. The mean width of right-sided PMs in males and females was 1.90 ± 0.17 and 1.58 ± 0.13 cm and left-sided 1.88 ± 0.14 and 1.55 ± 0.38 cm. The mean of pyramidalis-pubo-umbilical index (PPI) in males and females was 32.82 ± 1.65 and 27.50 ± 1.08, respectively. The mean insertion angle was 24.56 ± 3.07 on right side and 23 ± 2.03 on the left side (p = 0.03). Male predominance existed on right- and left-sided PM length (p < 0.001 and p < 0.001), width (p = 0.001) and PPI (p = 0.001). The strong positive correlation (r = 0.83) between length and width indicates a symmetrical muscle augmentation in the two dimensions. CONCLUSION: PM is an inconsistent anatomical structure with persistent morphology. The level and angle of insertion into the linea are crucial in the biomechanics of linea alba. PPI, determining the termination level would be useful to surgeons making midline infra-umbilical incisions.

Anatomical relationship of pterygoid process pneumatization and vidian canal / Relação anatômica da pneumatização do processo pterigoide e o canal vidiano

Abstract Introduction The vidian canal acts as landmark for the identification of the petrous carotid artery, especially during extended endoscopic endonasal approaches in cranial base surgeries. In order to localize the canal and to understand the relationship of pneumatization of pterygoid process to the type of vidian canal, this study was designed. Objectives The objective was to describe the anatomical relationship of pneumatization of the pterygoid process with types of vidian canal. The length of vidian canal, relationship to medial plate of pterygoid process and relationship to the petrous part of internal carotid artery were evaluated. Methods Head computer tomography scans of 52 individuals for suspected paranasal pathology were studied. The degree of sphenoid sinus pneumatization, pterygoid process pneumatization and types of vidian canal (type 1, 2 and 3) were noted. The length of vidian canal, distance from the plane of medial pterygoid plate and relation of vidian canal to the junction of petrous and Gasserian (ascending) part of internal carotid artery was noted. Results 46 (92%) sphenoid sinuses were of the sellar variety. Out of 104 sides that were studied, 57 sides demonstrated a pneumatised pterygoid process and 47 were not pneumatised. In 49 sides (47.1%) the vidian canal was on the same plane as that of the medial pterygoid plate in the coronal section. The vidian canal partially protruded into the sphenoid sinus (type 2) was the most common type (50.9%), found both on right and left sides. There is a statistically significant association between the pterygoid process pneumatization and occurrence of type 2 and type 3 vidian canal configuration. The average length of the vidian canal was 16.16 ± 1.8 mm. In 96 sides, the anterior end of vidian canal was inferolateral to petrous part of internal carotid artery in the coronal plane. Conclusion Pneumatization of the pterygoid process indicates either type 2 or type 3 vidian canal configuration.

Resumo Introdução O canal vidiano atua como ponto de referência para a identificação da artéria carótida petrosa, especialmente durante abordagens endoscópicas endonasais extensas em cirurgias de base do crânio. Este estudo foi projetado com o objetivo de localizar o canal vidiano e entender a relação da pneumatização do processo pterigoide sobre o tipo de canal. Objetivos Descrever a relação anatômica da pneumatização do processo pterigoide com os tipos de canal vidiano. Foram avaliados o comprimento do canal vidiano, a relação com a placa medial do processo pterigoide e com a porção petrosa da artéria carótida interna. Método Foram estudadas tomografias computadorizadas de 52 indivíduos submetidos a tomografia computadorizada de cabeça por suspeita de doença em seio paranasal. Foram observados o grau de pneumatização do seio esfenoidal, a pneumatização do processo pterigoide e os tipos de canal vidiano (Tipos 1, 2 e 3). Observou-se o comprimento do canal vidiano, a distância do plano da placa pterigoide medial e a relação do canal vidiano com a junção da porção petrosa e gasseriana (ascendente) da artéria carótida interna. Resultados Eram do tipo selar 46 (92%) seios esfenoidais. Dos 104 lados estudados, 57 eram do processo pterigoide pneumatizado e 47 não eram pneumatizados. Em 49 lados (47,1%), o canal vidiano estava no mesmo plano que o da placa pterigoide medial na seção coronal. O canal vidiano em protusão parcial no seio esfenoidal (tipo 2) foi o tipo mais comum (50,9%), encontrado nos lados direito e esquerdo. Houve uma associação estatisticamente significante entre a pneumatização do processo pterigoide e a ocorrência da configuração do canal vidiano tipo 2 e tipo 3. O comprimento médio do canal vidiano foi de 16,16 ± 1,8 mm. Em 96 lados, a extremidade anterior do canal vidiano era inferolateral à porção petrosa da artéria carótida interna no plano coronal. Conclusão A pneumatização do processo pterigoide indica a configuração do canal vidiano tipo 2 ou tipo 3.

Anatomical relationship of pterygoid process pneumatization and vidian canal.

INTRODUCTION: The vidian canal acts as landmark for the identification of the petrous carotid artery, especially during extended endoscopic endonasal approaches in cranial base surgeries. In order to localize the canal and to understand the relationship of pneumatization of pterygoid process to the type of vidian canal, this study was designed. OBJECTIVES: The objective was to describe the anatomical relationship of pneumatization of the pterygoid process with types of vidian canal. The length of vidian canal, relationship to medial plate of pterygoid process and relationship to the petrous part of internal carotid artery were evaluated. METHODS: Head computer tomography scans of 52 individuals for suspected paranasal pathology were studied. The degree of sphenoid sinus pneumatization, pterygoid process pneumatization and types of vidian canal (type 1, 2 and 3) were noted. The length of vidian canal, distance from the plane of medial pterygoid plate and relation of vidian canal to the junction of petrous and Gasserian (ascending) part of internal carotid artery was noted. RESULTS: 46 (92%) sphenoid sinuses were of the sellar variety. Out of 104 sides that were studied, 57 sides demonstrated a pneumatised pterygoid process and 47 were not pneumatised. In 49 sides (47.1%) the vidian canal was on the same plane as that of the medial pterygoid plate in the coronal section. The vidian canal partially protruded into the sphenoid sinus (type 2) was the most common type (50.9%), found both on right and left sides. There is a statistically significant association between the pterygoid process pneumatization and occurrence of type 2 and type 3 vidian canal configuration. The average length of the vidian canal was 16.16 ±â€¯1.8 mm. In 96 sides, the anterior end of vidian canal was inferolateral to petrous part of internal carotid artery in the coronal plane. CONCLUSION: Pneumatization of the pterygoid process indicates either type 2 or type 3 vidian canal configuration.

Assessment of changes in insulin requirement in patients of type 2 diabetes mellitus on maintenance hemodialysis.

BACKGROUND: Hemodialysis improves insulin sensitivity. Currently, there is no recommendation for the adjustment of insulin dose on dialysis day and nondialysis day in diabetic patients. This study was undertaken to determine the variations in insulin requirement based on blood glucose levels on dialysis days and nondialysis days in type 2 diabetic patients with chronic kidney disease on maintenance hemodialysis. METHODOLOGY: Twenty-eight diabetic patients on hemodialysis were recruited into the study after obtaining written informed consent and approval from Azeezia Ethics Committee. Capillary blood glucose levels, just before dialysis and 2 h after dialysis, were checked and compared with fasting and postprandial glucose levels on-off dialysis days. RESULTS: Mean age of the patients was 59.5 (±2.3) years. The average duration of dialysis was 20.2 months. There was significant (35.8%) decrease in blood glucose levels 2 h after dialysis in comparison to predialysis levels (from mean level of 258-165 mg/dl). The decrease in the blood glucose levels from predialysis level to 2 h postdialysis level was statistically significant (P < 0.001). Both sets of data showed "strong" positive correlation with r = 0.657 and 0.849. The blood glucose levels on the day of dialysis were significantly lower than the off-day values. CONCLUSIONS: Diabetic patients with end-stage renal disease on hemodialysis have lower capillary blood glucose levels postdialysis. This has to be addressed clinically to prevent hypoglycemic episodes by reducing exogenous insulin administration on the day of dialysis.

Histomorphometric effects of gemcitabine on Swiss albino mice spermatogenesis.

BACKGROUND: Spermatogenesis is a highly conserved and regulated process and it is sensitive to fluctuations in the physical and chemical environment. Gemcitabine is a novel antimetabolic anticancer drug used frequently in the treatment of many cancers. This study aimed to investigate the histomorphometric effects of gemcitabine on spermatogenesis in Swiss albino mice. MATERIALS AND METHODS: Gemcitabine in high and low doses (80 and 40 mg/kg) injected intraperitoneally to inbred Swiss albino mice. Gross testicular features and seminiferous tubular histomorphometry was studies at the end of 7(th), 14(th) day and at 2 months sperm shape abnormalities were studied. RESULTS: Seminiferous tubular morphology was altered significantly, showing a reduction in height, perimeter and area in a dose dependent manner. Sertoli cell number decreased. Basement membrane thickness was reduced and it appeared to be permanent, with statistically insignificant changes even after 2 months. There was a reduction of intertubular spaces. Sperms have shown banana heading, decapitation and loss of normal hook of head. The effects were partially reversible at the end of 2 months. CONCLUSION: It was concluded that gemcitabine affects the process of spermatogenesis adversely in a dose and time dependent manner and the effects are partially reversible.

4-(4,5-Diphenyl-1H-imidazol-2-yl)-N,N-di-methyl-aniline.

The asymmetric unit of the title compound, C23H21N3, consists of two symmetry-independent and conformationally different mol-ecules [the comparable dihedral angles between the imidazole ring and the three benzene rings being 38.5 (2)/61.5 (3)/3.37 (17) and 45.8 (2)/36.01 (19)/46.94 (17)°]. In the crystal, inter-molecular imidazole N-H⋯N hydrogen-bonding inter-actions give a one-dimensional chain extending along [101].

(Z)-N-[2-(N'-Hy-droxy-carbamimido-yl)phen-yl]acetamide.

The asymmetric unit of the title compound, C9H11N3O2, contains two mol-ecules (A and B), which exist in Z conformations with respect to their C=N double bond. The dihedral angles between the benzene ring and the pendant hy-droxy-carbamimidoyl and acetamide groups are 28.58 (7) and 1.30 (5)°, respectively, in mol-ecule A and 25.04 (7) and 27.85 (9)°, respectively, in mol-ecule B. An intra-molecular N-H⋯N hydrogen bond generates an S(6) ring in both mol-ecules. Mol-ecule A also features an intra-molecular C-H⋯O inter-action, which closes an S(6) ring. In the crystal, the mol-ecules are linked by N-H⋯O, N-H⋯N, O-H⋯O, O-H⋯N, C-H⋯O and C-H⋯N hydrogen bonds and C-H⋯π inter-actions, generating a three-dimensional network.

2-(4-Meth-oxy-phenyl)-2-oxoethan-aminium chloride.

In the cation of the title compound, C(9)H(12)NO(2) (+)·Cl(-), the dihedral angle between the 2-oxoethanaminium N-C-C(=O)- plane [maximum deviation = 0.0148 (12) Å] and the benzene ring is 7.98 (8)°. The meth-oxy group is approximately in-plane with the benzene ring, with a C-O-C-C torsion angle of -2.91 (18)°. In the crystal, the cations and chloride anions are connected by N-H⋯Cl and C-H⋯Cl hydrogen bonds, forming a layer parallel to the bc plane. A C-H⋯π inter-action further links the layers.

N-[(E)-4-Chloro-benzyl-idene]-2,4-dimethyl-aniline.

The title mol-ecule, C(15)H(14)ClN, exists in a trans configuration with respect to the C=N bond [1.2813 (16) Å]. The dihedral angle between the benzene rings is 52.91 (6)°. The crystal structure is stabilized by weak inter-molecular C-H⋯π inter-actions.

2-[(E)-(2,4-Dimethyl-phen-yl)imino-meth-yl]phenol.

The asymmetric unit of the title compound, C(15)H(15)NO, contains two independent mol-ecules, both of which exist in trans configurations with respect to the C=N bonds [1.278 (2) and 1.279 (2) Å]. In each mol-ecule, intra-molecular O-H⋯N hydrogen bonds generate S(6) ring motifs. In one mol-ecule, the benzene rings form a dihedral angle of 13.38 (9)°, while in the other mol-ecule the dihedral angle is 30.60 (10)°. In the crystal, the two independent mol-ecules are linked via weak inter-molecular C-H⋯O hydrogen bonds.

2-[(E)-(2,4,6-Trichloro-phen-yl)imino-meth-yl]phenol.

The title mol-ecule, C(13)H(8)Cl(3)NO, exists in a trans configuration with respect to the C=N bond [1.278 (2) Å]. The benzene rings form a dihedral angle of 24.64 (11)°. The mol-ecular structure is stabilized by an intra-molecular O-H⋯N hydrogen bond, which generates an S(6) ring motif. In the crystal, π-π stacking inter-actions [centroid-centroid distances = 3.6893 (14) Å] are observed.

1-Isobutyl-N,N-dimethyl-1H-imidazo[4,5-c]quinolin-4-amine.

In the title compound, C(16)H(20)N(4), the 1H-imidazo[4,5-c]quinoline ring system is approximately planar, with a maximum deviation of 0.0719 (15) Å. An intra-molecular C-H⋯N hydrogen bond contributes to the stabilization of the mol-ecule, forming an S(6) ring motif. In the crystal, the mol-ecules are stacked along the b axis through weak aromatic π-π inter-actions between benzene and imidazole and benzene and pyridine rings [centroid-centroid distances = 3.6055 (10) and 3.5342 (10) Å, respectively].

4-Hydrazinyl-1-isobutyl-1H-imidazo[4,5-c]quinoline.

In the title compound, C(14)H(17)N(5), the 1H-imidazo[4,5-c]quinoline ring system is essentially planar, with a maximum deviation of 0.0325 (7) Å. In the crystal, a pair of inter-molecular N-H⋯N hydrogen bonds link neighbouring mol-ecules, forming an inversion dimer and generate an R(2) (2)(10) ring motif. These dimers are further connected into a chain along the b axis via inter-molecular C-H⋯N hydrogen bonds, resulting in an R(2) (2)(14) ring motif.

4-Chloro-benzaldehyde (1-isobutyl-1H-imidazo[4,5-c]quinolin-4-yl)hydrazone monohydrate.

In the title compound, C(21)H(20)ClN(5)·H(2)O, the 1H-imidazo[4,5-c]quinoline ring is approximately planar, with a maximum deviation of 0.0795 (7) Å, and it forms a dihedral angle of 7.65 (3)° with the chloro-phenyl ring. In the crystal, the components are linked into chains along the a axis via inter-molecular N-H⋯O, O-H⋯N and C-H⋯O hydrogen bonds. One of the H atoms of the water mol-ecule is disordered over two positions with a site-occupancy ratio of 0.80 (4):0.20 (4).