Variation in dental morphology and inference of continental ancestry in admixed Latin Americans.

OBJECTIVES: To investigate the variation in dental nonmetric traits and to evaluate the utility of this variation for inferring genetic ancestry proportions in a sample of admixed Latin Americans. MATERIALS AND METHODS: We characterized a sample from Colombia (N = 477) for 34 dental traits and obtained estimates of individual Native American, European, and African ancestry using genome-wide SNP data. We tested for correlation between dental traits, genetic ancestry, age, and sex. We carried out a biodistance analysis between the Colombian sample and reference continental population samples using the mean measure of divergence statistic calculated from dental trait frequencies. We evaluated the inference of genetic ancestry from dental traits using a regression approach (with 10-fold cross-validation) as well as by testing the correlation between estimates of ancestry obtained from genetic and dental data. RESULTS: Latin Americans show intermediate dental trait frequencies when compared to Native Americans, Europeans, and Africans. Significant correlations were observed for several dental traits, genetic ancestry, age, and sex. The biodistance analysis displayed a closer relationship of Colombians to Europeans than to Native Americans and Africans. Mean ancestry estimates obtained from the dental data are similar to the genetic estimates (Native American: 32% vs. 28%, European: 59% vs. 63%, and African: 9% vs. 9%, respectively). However, dental features provided low predictive power for genetic ancestry of individuals in both approaches tested (R2 < 5% for all genetic ancestries across methods). DISCUSSION: The frequency of dental traits in Latin Americans reflects their admixed Native American, European and African ancestry and can provide reasonable average estimates of genetic ancestry. However, the accuracy of individual genetic ancestry estimates is relatively low, probably influenced by the continental differentiation of dental traits, their genetic architecture, and the distribution of genetic ancestry in the individuals examined.

Stroke subtypes and comorbidity among ischemic stroke patients in Brasilia and Cuenca: a Brazilian-Spanish cross-cultural study.

BACKGROUND: With the increase in life expectancy worldwide, changes in stroke subtypes and burden of stroke population are expected in both developing and developed countries. Prevalence of stroke subtypes and comorbidity in ischemic stroke patients was assessed in Brasilia, Brazil, and Cuenca, Spain. METHODS: This was an international (Brazilian-Spanish) cross-sectional study. Stroke subtypes were assessed by means of Trial of ORG 10172 in Acute Stroke Treatment (TOAST) classification. Modified Rankin scale was used to measure functional recovery and the Cumulative Illness Rating Scale for Geriatrics (CIRS-G) was used to assess comorbidity. RESULTS: A total of 500 patients (mean age 66.2 ± 16.4 years; 48% female; 48.2% Spanish) were included in the study. Spanish patients were significantly older than Brazilian ones (76.4 ± 11.2 versus 56.7 ± 14.6 years; P < .0001). Prevalence of ischemic cardiopathy (20.3% versus 6.2%) and atrial fibrillation (25.7% versus 6.6%) was significantly higher in Spanish stroke patients, whereas they less frequently used tobacco (28.3% versus 52.9%); P less than .0001. Prevalence of stroke subtypes in Spanish and Brazilian stroke patients was: stroke of undetermined etiology (58.1% versus 32.4%), cardioembolism (24.5% versus 11.6%), lacunar infarct (11.6% versus 25.5%), atherothrombotic (3.7% versus 19.7%), and other causes (2.1% versus 10.8%); P less than .0001. The Spanish sample had a significantly higher frequency of comorbidities. The CIRS-G total score and CIRS-G mean number of affected organs significantly increased with age, and correlated with the level of functional dependence as measured by Rankin scale (rS = 0.50; P = .0005). CONCLUSION: Spanish stroke people had a higher frequency of comorbid conditions, atrial fibrillation, and cardioembolism and these facts were associated with age. Atherothrombotic and lacunar strokes were more common in the younger Brazilian stroke population.

Dental size variation in admixed Latin Americans: Effects of age, sex and genomic ancestry.

Dental size variation in modern humans has been assessed from regional to worldwide scales, especially under microevolutionary and forensic contexts. Despite this, populations of mixed continental ancestry such as contemporary Latin Americans remain unexplored. In the present study we investigated a large Latin American sample from Colombia (N = 804) and obtained buccolingual and mesiodistal diameters and three indices for maxillary and mandibular teeth (except third molars). We evaluated the correlation between 28 dental measurements (and three indices) with age, sex and genomic ancestry (estimated using genome-wide SNP data). In addition, we explored correlation patterns between dental measurements and the biological affinities, based on these measurements, between two Latin American samples (Colombians and Mexicans) and three putative parental populations: Central and South Native Americans, western Europeans and western Africans through PCA and DFA. Our results indicate that Latin Americans have high dental size diversity, overlapping the variation exhibited by the parental populations. Several dental dimensions and indices have significant correlations with sex and age. Western Europeans presented closer biological affinities with Colombians, and the European genomic ancestry exhibited the highest correlations with tooth size. Correlations between tooth measurements reveal distinct dental modules, as well as a higher integration of postcanine dentition. The effects on dental size of age, sex and genomic ancestry is of relevance for forensic, biohistorical and microevolutionary studies in Latin Americans.

A quantitative criterion for determining the order of magnetic phase transitions using the magnetocaloric effect.

The ideal magnetocaloric material would lay at the borderline of a first-order and a second-order phase transition. Hence, it is crucial to unambiguously determine the order of phase transitions for both applied magnetocaloric research as well as the characterization of other phase change materials. Although Ehrenfest provided a conceptually simple definition of the order of a phase transition, the known techniques for its determination based on magnetic measurements either provide erroneous results for specific cases or require extensive data analysis that depends on subjective appreciations of qualitative features of the data. Here we report a quantitative fingerprint of first-order thermomagnetic phase transitions: the exponent n from field dependence of magnetic entropy change presents a maximum of n > 2 only for first-order thermomagnetic phase transitions. This model-independent parameter allows evaluating the order of phase transition without any subjective interpretations, as we show for different types of materials and for the Bean-Rodbell model.

Tensor tympani muscle: strange chewing muscle.

This work seeks to alert medical and odontological staff to understanding and using interdisciplinary handling for detecting different pathologies common otic symptoms. It offers better tools for this shared symptomatology during therapy s conservative phase. Tensor tympani muscle physiology and function in the middle ear have been veiled, even when their dysfunction and anatomical relationships may explain a group of confused otic symptoms during conventional clinical evaluation. Middle ear muscles share a common embryological and functional origin with chewing and facial muscles. This article emphasizes that these muscles share a functional neurological and anatomical dimension with the stomatognathic system; these muscles increased tonicity ceases to be a phenomenon having no logical connections. It offers functionality and importance in understanding referred otic symptoms in common with other extra-otical symptom pathologies. Tinnitus, vertigo, otic fullness sensation, hyperacusia, hypoacusia and otalgia are not only primary hearing organ symptoms. They should be redefined and related to the neighboring pathologies which can produce them. There is a need to understand temporomandibular disorders and craniofacial referred symptomatology from neurophysiologic and muscle-skeletal angles contained in the stomatognathic system. Common symptomatology is frequently observed in otic symptoms and temporomandibular disorders during daily practice; this should be understood by each discipline from a broad, anatomical and clinical perspective.

The digastric muscle's anterior accessory belly: case report.

Digastric muscle is characterized by presenting occasional variations. The suprahyoid region of an 83 year-old male cadaver was dissected and an anatomic variation of the digastric muscle was observed in its anterior belly. It consisted of an accessory bilateral anterior belly originating in the intermediate tendon and inserted into the mylohyoid raphe. The implications of this variation are discussed from a diagnostic and functional perspective.

Hamular Bursitis and its possible craniofacial referred symptomatology: two case reports.

The diagnosis of craniofacial pain is conditioned by the interdisciplinary management of its presentation especially in the absence of unique and objective signs. Bursitis is a pathological entity recently found in the hamular area and should be included in the diagnosis for exclusion of temporomandibular disorders (TMD), ear-nose-throat pathologies, due to the similar symptomatology to other head and neck conditions. The hamular process bursitis is a painful condition that can easily be confused with glosopharinge or trigeminal neuralgia that generates an uncomfortable feeling in the oropharinge with ipsilateral referred--heteretopic-symptomatology to the head. This pathology, in chronic states, can be responsible for the amplification of the pain perceived by the central excitation effect. In this report are presented two clinical cases of hamular bursitis and its conservative therapeutic management. The recognition of the inflammation of the bursa of the tensor veli palati muscle supplies the specialist with another tool in the management of craniofacial pain.

Temporomandibular disorders: referred cranio-cervico-facial clinic.

The bond between temporomandibular disorders and referred craniofacial symptomatology is more and more evident. In it subsists the prevailing necessity of understanding the temporomandibular disorders and the cranio-cervico-facial referred symptomatology from a neurophysiologic and muscle-skeletal perspective contained in the stomatognatic system. Diagnosis in head and neck areas is difficult because of its complex anatomy. Some painful craniofacial syndromes exhibit the same symptoms although they don.t seem objectively possible and that is what confuses the specialist and the patient. Pain in the head and the neck is one of the most complex to diagnose because of its varied origins that can be neurological, vascular, muscular, ligamental and bony. This article seeks to show some reasonable anatomical and pathophysiological connections of this muscle-skeletal disorder expressed with symptoms like tinnitus, otic fullness, otalgia and migraine among others. Disciplines in health such as neurology, the otolaryngology and dentistry share common anatomical and pathophysiological roads constructed in an increased muscular activity that generates muscle-skeletal disorders and is difficult to locate referred craniofacial symptomatology. This revision aspires to sensitize the medical specialist and the odontologist in the understanding of the important interdisciplinary handling in the detection of this disorder. This offers better tools in the conservative therapy phase of this craniofacial referred symptomatology.

Morphologic evaluation of the renal veins: a study with autopsy material from Colombian subjects.

Renal venous drainage presents a large degree of variability. The purpose of this study was to determine the morphological expression of the renal veins. Renal vein formation patterns, their morphometry, and frequency of additional veins were studied in a sample of 156 pairs of kidneys, the vascular beds of which were subjected to an injection-corrosion technique, taken from cadaver specimens autopsied at National Institute of Legal Medicine and Forensics Sciences in Bucaramanga, Colombia. A single renal vein (RV) was found bilaterally in 122 (78.2%) samples, whereas 34 (21.8%) kidneys had additional RVs (left side 33 cases, right side one case). Of the specimens with multiple right renal veins (RRV), 28 (17.9%) had two RVs and five (3.2%) had three RVs. Of the left kidneys, 99.4% had one LRV and 0.6% had two LRVs. The lengths of the left and right renal veins were 56.5±12.7 mm and 23.6±8.21 mm, respectively; the caliber of the left renal vein (LRV) was 12.3±1.41 mm, whereas the caliber of the RRV was 10.9±1.56 mm, a statistically non-significant difference (p=0.262). 82.7% of the LRVs and the 73.1% of the RRVs (p=0.768) originated at the extra-hilum level. Renal vein formation pattern characterized by the confluence of upper and lower tributaries was found in 61.6% of the cases, whereas 16.3% of the specimens had upper, medium, and lower tributaries. Variation patterns found in this study point towards a wide morphological expression of these vessels that needs to be taken into account for both imaging and surgical procedures.

Biometría de dientes anteriores en mestizos: proporción largo/ancho intradental / Biometry of anterior teeth in mestizos: intradental long / wide ratio

Las proporciones largo/ancho intradental han sido propuestas en más de once diferentes modelos a la fecha pero no se han estudiando en población mestiza Colombiana. Se utilizaron modelos de agrupamiento jerárquico (K-Means) para entender cual explica mejor la distribución de los datos. También se analizaron co-variables de sexo, edad y atrición leve para evaluar su influencia sobre la distribución general. Fueron utilizadas fotografías estandarizadas de dientes anteriores de 274 individuos de ambos sexos con dientes completamente erupcionados y sanos. Las mediciones fueron realizadas con programas informáticos calibrados (error de 0,05 mm). Se utilizó la prueba Chi Cuadrado para demostrar que las co-variables el sexo (valor de p= 0,09), edad (valor de p= 0,54) y atrición leve (valor de p= 0,32) no tuvieron impacto en la distribución de las proporciones dentales. Con respecto al análisis de conglomerados a través de las K-Means, se identificaron dos grupos diferenciados en toda la muestra: proporciones verticales (dientes mas largos) y proporciones horizontales (dientes mas anchos). Un tercer grupo solapado entre las dos tendencias lo denominamos de proporciones balanceadas. No hay un modelo de proporción intradental universal que pueda describir toda la población, pero fue posible encontrar un conjunto de modelos para los diferentes subgrupos de población. Los ideales estéticos se encuentran en abierta interpretación. Los patrones absolutos son imprácticos en biología ya que no predicen la complejidad de esta.

The intradental length / width ratios have been proposed in more than eleven different models to date. However they have not been studied in the Colombian Mestizo population. Hierarchical clustering models (K-Means) were used to understand which best explains the distribution of the data. Co-variables of sex, age, and mild attrition were also analyzed to assess their influence on overall distribution. Standardized photographs of anterior teeth of 274 individuals of both sexes with fully erupted and healthy teeth were used. Measurements were taken with calibrated software (error of 0.05 mm). Chi square test was used to show that the co-variables sex (p value = 0.09), age (p value = 0.54) and mild attrition (p value = 0.32) had no impact In the distribution of dental proportions. With respect to the analysis of conglomerates through the K-Means, two distinct groups were identified throughout the sample: Vertical proportions (longer teeth) and horizontal proportions (wider teeth). A third group overlapping the two trends we called balanced proportions. There is no universal intraday proportion model that can describe the entire population, but it was possible to find a set of models for different population subgroups. Aesthetic ideals are in open interpretation. Absolute patterns are impractical in biology because they do not predict the complexity of biology.

Right coronary artery anatomy: anatomical and morphometric analysis.

BACKGROUND: It is necessary knowing the large variability of right coronary (RCA) artery specialty for its implications in surgical procedures and clinic events. This variability is usually related to the length, branches quantity, origin and irrigated territories. OBJECTIVE: To evaluate by direct examination the morphologic expression of RCA in Colombian people. METHODS: RCA were measured in 221 fresh hearts by RCA ostium canalization with polyester synthetic resin that was injected in their branches. RESULTS: The caliber of the RCA proximal segment and at the level of the acute angle of the heart was 3.42 ± 0.66 mm and 2.9 ± 0.50 mm, respectively. It ended between crux cordis and the left margin in 75.6% of specimens. Posterior interventricular artery (PIA) reached the inferior third, or the apex, or the anterior interventricular sulcus in 149 (67.4%) cases. Sinoatrial node artery (SNA) originated in the right coronary in 134 (60.6%) cases, 77 (34.9%) from circumflex artery (CxA) and from both in 10 (4.5%). Posterior right diagonal artery (PRDA) was noted in 38 (17.2%) hearts, but only 6% of the sample with long PIA, concomitantly presented the PRDA (P = 0.001). In right dominance SNA were originated from RCA in 54.7% and form CxA in 46.3% (P = 0.06). CONCLUSIONS: Caliber of the RCA and its branches is lesser than the majority of previous studies, while the PRDA frequency is slightly higher than the reported in literature. Clinical and pathological scenarios by these variations should be taken into account: hemodynamic procedures, cardiac surgery and arrhythmias from coronary occlusive disease.

Mestizo anterior teeth's proportions / Proporciones de los dientes anteriores en una población mestiza

Teeth proportions relate to beauty and harmony but aesthetic dental ideal proportion models show inconsistent results. Golden Proportion´s, Preston's, Fayyad's, Snow's, and Ward's models where characterized for best fit in a Colombian mestizo population anterior teeth. Models of teeth´s beauty proportions (Golden Proportion´s, Preston's, Fayyad's, Snow's, and Ward') are analyzed for best fit in a mestizo (mixed race) Colombian population and variables as sex, aesthetic balance or history of previous orthodontic treatments were also analyzed for their probable impact on the distribution of the dental proportions. It was used standardized photographs of anterior teeth on 351 individuals of both sexes with complete erupted and healthy teeth. The measurements were done by calibrated computer software (error of 0.05 mm). A Chi squared test was used to check whether sex, aesthetic balance and previous orthodontic treatment had an impact on the distribution of the dental proportions. Also a nonparametric Wilcoxon test was used to analysis the null hypothesis. A cluster analysis using k means was carried out to search for subgroups, which better explain the distribution of anterior dental proportions in the sample. For the considered results the null hypothesis of the mean equaling to the Golden Proportion was rejected (Wilcoxon test p value <0.001). For the whole population, the Chi squared test did not reject the null hypothesis of equal proportions among the groups with respect to the sex (p value= 0.56), aesthetic balance (p value= 0.98) and history of previous orthodontic treatments (p value= 0.67) variables. For the aesthetically balanced individuals, the Chi squared test also failed to reject the null hypothesis of equal proportions among the groups with respect to the sex (p value= 0.63) and history of previous orthodontic treatments (p value= 0.93) variables. Two Gaussian distributions were found for RED models fitting well in 58 % for RED 70 % (0.7 SD 0.03) and 42 % for RED 75 (0.75 SD 0.025). From the cluster analysis using k means, two groups were identified in the whole sample. No universal model can describe the whole population but is possible to find a set of models for the different population subgroups. Aesthetically ideals are open to interpretation. Clinical aesthetically standards for ideal teeth proportions are open to interpretation in a mestizo (mixed raced) population.

Las proporciones de los dientes se refieren a su belleza y armonía, pero los modelos de proporciones dentales estéticas ideales muestran resultados inconsistentes. La proporción Aurea y los modelos de Preston, Fayyad, Snow, y Ward fueron ajustados para caracterizar los dientes de una población colombiana mestiza. Modelos de proporciones de belleza de dientes (Proporción Aurea, Modelos de Preston, Fayyad, Snow y Ward) se analizaron para lograr alcanzar el mejor ajuste en una población colombiana mestiza (mezcla de razas), y también se analizaron las variables de sexo, equilibrio estético e historia de tratamientos de ortodoncia previos para evaluar su probable impacto sobre la distribución de las proporciones dentales consideradas. Fueron utilizadas fotografías estandarizadas de dientes anteriores de 351 individuos de ambos sexos con dientes completamente erupcionados y sanos. Las mediciones fueron realizadas con programas informáticos calibrados (error de 0,05 mm). Se utilizó la prueba Chi Cuadrado para comprobar si el sexo, el equilibrio estético y el tratamiento ortodóncico previo tuvieron un impacto en la distribución de las proporciones dentales. También se utilizó la prueba no paramétrica de Wilcoxon para el análisis de la hipótesis nula. Un análisis de conglomerados, utilizando la media k, se llevó a cabo para buscar subgrupos, que explicaron mejor la distribución de proporciones dentales anteriores en la muestra. Para que los resultados fueran considerados, la hipótesis nula de la media que equivale a la proporción áurea fue rechazada (Prueba de Wilcoxon, valor p <0,001). Para toda la población, la prueba de Chi Cuadrado no rechazó la hipótesis nula de proporciones iguales entre los grupos con respecto al sexo (valor de p= 0,56), equilibrio estético (valor de p= 0,98) y la historia de tratamientos de ortodoncia previos ( valor de p= 0,67). Para los individuos estéticamente balanceados, la prueba de Chi Cuadrado tampocó rechazó la hipótesis nula de proporciones iguales entre los grupos con respecto a las variables de sexo (valor p= 0,63) y la historia de los tratamientos de ortodoncia anteriores (valor p= 0,93). Se encontraron dos distribuciones gaussianas para los modelos RED que encajaron bien en el 58% para RED 70 % (0,7 DE 0,03) y el 42 % para RED 75 (0,75 DE 0,025). Con respecto al análisis de los conglomerados a través de las medias k, se identificaron dos grupos en toda la muestra. No hay un modelo universal que pueda describir toda la población, pero es posible encontrar un conjunto de modelos para los diferentes subgrupos de población. Los ideales estéticamente están abiertos a interpretación. Las normas clínicas de estética para dientes con proporciones ideales están abiertos a interpretación en una población mestiza.

Antropometría del yunque y articulaciones incudo-maleolar e incudo-estapedial en humanos: un estudio anatómico directo / Anthropometry of the incus and incudomalleolar and incudostapedial joints in humans: a direct anatomical study

Los estudios actuales sobre variaciones anatómicas del yunque en humanos a partir del registro morfométrico son insuficientes. Las características estructurales y dimensionales del yunque son registradas en 23 muestras de población mestiza adulta Colombiana. Las medidas registradas involucraron el cuerpo, la articulación incudo-maleolar, el proceso largo, el proceso corto y la articulación incudo-estapedial. Solo ocho de los treinta y cinco registros tomados en este estudio pudieron ser comparados concienzudamente con otros estudios anteriores que mostraron similitudes. El largo total del yunque fue de 6,51 mm (DE 0,32), la longitud del proceso largo del yunque fue de 5,35 mm (DE 0,25), la distancia entre proceso largo y corta fue de 6,06 mm (DE 0,35) y la proporción de longitudes entre ambos procesos fue de 82,18 por ciento (DE 8,9). Conforme a la población estudiada se encontró variación pareada en la anatomía del yunque en solo tres de los registros tomados, sin embargo, consideramos que es un hueso morfométricamente uniforme y estable.

Current studies on anatomical variations of the incus in humans from the morphometric register are insufficient. Structural and dimensional characteristics of the incus are registered in 23 samples of Colombian adult mestizo population. Registered measures involved incus body, incudo-maleolar joint, long process, short process and incudo-stapedial joint. Only eight of the thirty-five records taken in this study could be thoroughly compared to other anterior studies, which showed similarities. The total length of the anvil was 6,51 mm (SD 0.32), the length of the long process of the incus was 5.35 mm (SD 0.25), the distance between processes long and short was 6.06 mm (SD 0.35) and the ratio of lengths between both processes was 82.18 percent (SD 8.9 percent). In accordance with the studied population we found paired variation in the anatomy of the incus in only three of the records taken, however, we believe that it is a uniform and morphometrically stable bone.

Expresión morfológica de la arteria basilar: un estudio con material de autopsia de individuos colombianos / Morphological expression of the basilar artery: a study with colombian population's autopsy material

La arteria basilar (AB) presenta una expresión variable, la cual es determinante en la etiología de eventos clínicos que comprometen el tallo cerebral. El propósito de este trabajo fue determinar la expresión morfológica de la AB en una muestra de población colombiana. Fueron estudiados 100 tallos cerebrales de individuos a quienes se les practicó autopsia en el Institutode Medicina Legal de Bucaramanga. El sistema vertebro-basilar fue perfundido con resina sintética y evaluado los calibres, trayectorias, niveles de origen y finalización de la AB. La AB presentó trayectoria rectilínea en 68 por ciento, desviación a la derecha en 12 por ciento, sinuosa en 10 por ciento y desviación a la izquierda en 10 por ciento. La longitud total de la AB fue 30,2 mm DE 4,07 y la longitud con relación al origen de la arteria Cerebelar superior fue 28,1 mm DE 3,84. Los calibres proximal y distal de la AB fueron 3,96 mm DE 0,48 mm y 3,7 mm DE 0,58 respectivamente. Con relación a las arterias de origen de la AB, se observó hipoplasia ( 2 mm) de la arteria vertebral derecha en el 8 por ciento y de la arteria vertebral izquierda en el 11 por ciento (P = 0,30). Se observó el origen de la AB a tres niveles del surco pontomedular: a nivel en el 43 por ciento, por arriba de este en el 30 por ciento y por debajo de este surco en 27 por ciento de los casos. Las trayectorias sinuosas y desviadas de la AB observadas y la presencia de hipoplasias de la arteria vertebral son ligeramente superiores a los señalados en estudios previos, mientras que su longitud se ubica en un rango medio y su calibre es ligeramente inferior a lo señalado en la literatura.

The basilar artery (BA) has a variable expression which is determinant in the etiology of clinical events that compromise the brain stem. The purpose of this study was to determine the morphological expression of BA in a Colombian population sample. We studied 100 brainstems of individuals which underwent an autopsy at the Instituto de Medicina Legal of Bucaramanga. The vertebra basilar system was perfused with synthetic resin and its calibers, paths, levels of origin and end of the BA were evaluated. The BA presented a rectilinear trajectory in 68 percent, deviation to the right in 12 percent, sinuous in 10 percent and deviation to the left in 10 percent. The total length of the BA was 30.2 mm SD 4.07, its length in relation to the origin of the superior cerebellar artery was 28.1 mm SD 3.84. The proximal and distal caliber of the BA were 3.96 mm SD 0.48 mm and 3.7 mm SD 0.58 respectively. In relation to the origin arteries of the AB, hypoplasia was observed ( 2 mm) of the right vertebral artery in 8 percent and the left vertebral artery in 11 percent (P = 0.30). The origin of BA was observed at different spontomedullary groove levels: at level in 43 percent, above it in 30 percent and below it in 27 percent of the cases. The sinuous and diverted paths from the BA observed and the presence of vertebral artery hypoplasia are slightly higher than those reported in previous studies, while its length is at medium range and its caliber is slightly lower than reported in the literature.

Variations of the origin of collateral branches emerging from the posterior aspect of the brachial plexus.

BACKGROUND: The frequency of variation found in the arrangement and distribution of the branches in the brachial plexus, make this anatomical region extremely complicated. The medical concerns involved with these variations include anesthetic blocks, surgical approaches, interpreting tumor or traumatic nervous compressions having unexplained clinical symptoms (sensory loss, pain, wakefulness and paresis), and the possibility of these structures becoming compromised. The clinical importance of these variations is discussed in the light of their differential origins. METHODS: The anatomy of brachial plexus structures from 46 male and 11 female cadaverous specimens were studied. The 40-80 year-old specimens were obtained from the Universidad Industrial de Santander's Medical Faculty's Anatomy Department (dissection laboratory). Parametric measures were used for calculating results. RESULTS: Almost half (47.1%) of the evaluated plexuses had collateral variations. Subscapular nerves were the most varied structure, including the presence of a novel accessory nerve. Long thoracic nerve variations were present, as were the absence of C5 or C7 involvement, and late C7 union with C5-C6. CONCLUSION: Further studies are needed to confirm the existence of these variations in a larger sample of cadaver specimens.

Possible implications of an accessory abductor digiti minimi muscle: a case report.

BACKGROUND: Accessory ADM was first reported in 1868 although muscular, vascular and nervous variations of the hypothenar eminence are rare, contrary to anomalous muscles in the wrist which are relatively common. CASE PRESENTATION: This case report presents a bilateral variation of an accessory abductor digiti minimi muscle in a male specimen. Ulnar artery and ulnar nerves were taken into account regarding their position and trajectory related to this variation. CONCLUSION: Muscle size may be an important factor in considering whether a variation is able to produce neurovascular compression and clinical implications.

[Otological symptoms among patients with temporomandibular joint disorders]. / Síntomas óticos referidos en desórdenes temporomandibulares. Relación con músculos masticatorios.

Middle ear muscles have a common embryological and functional origin with masticatory and facial muscles. Therefore, symptoms referred to the ear may originate from the stomatognathic area. When a primary otological cause is discarded in the diagnostic work up for tinnitus, vertigo, hypoacousia, hyperacousia, ear pain or sensation of occluded ear, a temporomandibular joint dysfunction may be the cause of these symptoms. Temporomandibular joint dysfunction is twice more common among women and has environmental, physiological and behavioral causes. Among patients with this dysfunction, the prevalence of ear pain, tinnitus and dizziness varies between 33 and 76%

Right coronary artery anatomy: anatomical and morphometric analysis / Anatomia da artéria coronária direita: análises anatômicas e morfométricas

BACKGROUND: It is necessary knowing the large variability of right coronary (RCA) artery specialty for its implications in surgical procedures and clinic events. This variability is usually related to the length, branches quantity, origin and irrigated territories. OBJECTIVE: To evaluate by direct examination the morphologic expression of RCA in Colombian people. METHODS: RCA were measured in 221 fresh hearts by RCA ostium canalization with polyester synthetic resin that was injected in their branches. RESULTS: The caliber of the RCA proximal segment and at the level of the acute angle of the heart was 3.42 ± 0.66 mm and 2.9 ± 0.50 mm, respectively. It ended between crux cordis and the left margin in 75.6 percent of specimens. Posterior interventricular artery (PIA) reached the inferior third, or the apex, or the anterior interventricular sulcus in 149 (67.4 percent) cases. Sinoatrial node artery (SNA) originated in the right coronary in 134 (60.6 percent) cases, 77 (34.9 percent) from circumflex artery (CxA) and from both in 10 (4.5 percent). Posterior right diagonal artery (PRDA) was noted in 38 (17.2 percent) hearts, but only 6 percent of the sample with long PIA, concomitantly presented the PRDA (P = 0.001). In right dominance SNA were originated from RCA in 54.7 percent and form CxA in 46.3 percent (P = 0.06). CONCLUSIONS: Caliber of the RCA and its branches is lesser than the majority of previous studies, while the PRDA frequency is slightly higher than the reported in literature. Clinical and pathological scenarios by these variations should be taken into account: hemodynamic procedures, cardiac surgery and arrhythmias from coronary occlusive disease.

INTRODUÇÃO: É necessário conhecer a grande variabilidade da artéria coronária direita (ACD), especialmente por suas implicações nos procedimentos cirúrgicos e eventos clínicos. Esta variabilidade está geralmente relacionada à extensão, à quantidade de ramos, à origem e aos territórios irrigados. OBJETIVO: Avaliar por exame direto a expressão morfológica da ACD em sujeitos colombianos. Métodos: As ACD foram medidas em 221 corações frescos pela canalização do óstio da ACD com uma resina de poliéster sintético que foi injetada em seus ramos. RESULTADOS: O calibre do segmento proximal da ACD e ao nível do ângulo agudo do coração foi de 3,42 ± 0,66 mm e 2,9 ± 0,50 mm, respectivamente. A ACD terminou entre a crux cordis e a margem esquerda em 75,6 por cento da amostra. A artéria interventricular posterior (AIP) atingiu o terço inferior, o ápice ou o sulco interventricular anterior em 149 (67,4 por cento) casos. A artéria do nó sinoatrial (ANS) surgiu da artéria coronária direita em 134 (60,6 por cento) casos, 77 (34,9 por cento) da artéria circunflexa (ACx) e de ambas em 10 (4,5 por cento) amostras. A artéria diagonal posterior direita (ADPD) foi observada em 38 (17,2 por cento) corações, mas apenas 6 por cento da amostra com uma AIP longa, apresentaram a ADPD (P=0,001). Em corações com dominância direita, a ANS surgiu da ACD em 54,7 por cento e da ACx em 46,3 por cento dos casos (P=0,06). CONCLUSÕES: O calibre da ACD e seus ramos é menor do que o relatado na maioria de estudos anteriores, enquanto que a frequência da ADPD é ligeiramente superior ao relatado na literatura. Cenários clínicos e patológicos por estas variações devem ser levados em conta: procedimentos de hemodinâmica, cirurgia cardíaca e arritmias de doença coronária obstrutiva.

Evaluación de las ramas diagonales, anterosuperior, posterolateral derecha y lateral del corazón: un estudio en individuos colombianos / Evaluation of the heart diagonal, anterosuperior, right posterolateral and lateral branches: a study in Colombian individual

Las arterias que irrigan la cara pulmonar del corazón y la superficie posterior del ventrículo derecho presentan una expresión variable. Se evaluaron 154 corazones frescos de material de autopsia. Las arterias coronarias fueron sometidas a proceso de inyección con resinas sintéticas. Se observó la rama posterolateral derecha (sólo en dominancia derecha) en 24 corazones (15,6 por ciento), de los cuales 20 (83,3 por ciento) se originaron directamente de la arteria coronaria derecha y 4 de la marginal derecha. Ésta estuvo presente en el 40 por ciento de los casos que tenían una rama interventricular posterior corta y en el 5,6 por ciento con presencia de rama larga (p= 0,001). Se observó además, ramas diagonales en 74 corazones (48 por ciento), ramas anterosuperiores en 126 (81,8 por ciento) y ramas laterales en 123 (79,9 por ciento). Las ramas de longitud media fueron las más frecuentes: diagonales (52,3 por ciento); anterosuperiores (62,7 por ciento) y laterales (47,1 por ciento). El calibre de las ramas diagonales fue de 2,01 mm (DE 0,59). De las ramas diagonales, las que presentaron menor calibre correspondieron a los especímenes con dominancia izquierda 1,88 mm DS 0,52), sin ser significativo (P 0,608), mientras que las ramas laterales de mayor calibre correspondieron a corazones con dominancia izquierda (p=0,022). De las ramas diagonales se observaron puentes miocárdicos en 11 muestras (14,9 por ciento); 6 (4,8 por ciento) en las ramas anterosuperiores y 2 (8,3 por ciento) en los corazones que presentaban ramas posterolaterales derechas. Las ramas laterales no presentaron puentes miocárdicos. Se observó presencia de la rama posterolateral derecha en un sexto de los individuos con dominancia derecha y las ramas diagonales presentaron, en su mayoría, un curso epicárdico que finalizó en el tercio medio de la cara obtusa del corazón.

The arteries that irrigate the lung face of the heart and the posterior surface of the right ventricle present a variable expression. 154 fresh hearts were evaluated obtained as autopsy material. The coronary arteries were subjected to injection process with synthetic resins. Right posterolateral branch (right dominance) was observed in 24 hearts (15.6 percent), of which 20 (83.3 percent) originated of the right coronary artery and 4 of the marginal right artery. Within these in 40 percent of the cases were observed in short posterior interventricular branch and 5.6 percent with long branch (p = 0.001). It was observed diagonal branches in 74 hearts (48 percent), anterosuperior branches in 126 (81.8 percent) and lateral branches in 123 (79.9 percent). The branches of middle longitude were the most frequent: diagonals (52.3 percent); anterosuperiors (62.7 percent) and laterals (47.1 percent). The calliper of the diagonal branches was of 2.01 mm (SD 0.59). Of the diagonal branches, those that presented smaller calliper corresponded to the specimens with left dominance (1.88 mm SD 0.52), without significance (P 0.608), while the lateral branches of more calliper corresponded to hearts with left dominance (p=0.022). It was also observed myocardial bridges in 11 diagonal branches (14.9 percent); in 6 anterosuperior branches (4.8 percent) and in 2 right posterolateral branches (8.3 percent). The lateral branches do not presented myocardial bridges. Prevalence of the right posterolateral branch was observed in a sixth of the individuals with right dominance, and the majority of diagonal branches presented an epicardic course that concluded in the middle third of the obtuse face of the heart.

Síntomas óticos referidos en desórdenes temporomandibulares. Relación con músculos masticatorios / Otological symptoms among patients with temporomandibular joint disorders

Middle ear muscles have a common embryological and functional origin with masticatory and facial muscles. Therefore, symptoms referred to the ear may originate from the stomatognathic area. When a primary otológica! cause is discarded in the diagnostic work up for tinnitus, vertigo, hypoacousia, hyperacousia, ear pain or sensation of occluded ear, a temporomandibular joint dysfunction may be the cause of these symptoms. Temporomandibular joint dysfunction is twice more common among women and has environmental, physiological and behavioral causes. Among patients with this dysfunction, the prevalence of ear pain, tinnitus and dizziness varies between 33 and 76 percent.