RESUMO
STUDY OBJECTIVE: To determine and categorize the anatomic variations of the uterine artery (UA) as observed during laparoscopic hysterectomy with retroperitoneal dissection for benign conditions. DESIGN: A prospective, observational study. SETTING: A hospital department of obstetrics and gynecology, Uludag University Hospital, Bursa, Turkey. PATIENTS: A total of 378 female patients who presented with indications for laparoscopic hysterectomy for benign disease. INTERVENTIONS: Laparoscopic hysterectomy with retroperitoneal dissection was performed bilaterally in all patients between March 2014 and October 2018. The vascular anatomy beginning at the bifurcation of the common iliac artery down to the crossing of the UA with the ureter was exposed and subsequently studied. The UA was identified, and its variable branching patterns were recorded. The patterns were then categorized into groups adapted from classic vascular anatomy studies. MEASUREMENTS AND MAIN RESULTS: Retroperitoneal dissections of 756 UAs were performed in 378 female patients. The UA was the first anterior branch of the internal iliac artery in 80.9% of the cases (Model 1; Main Model). Three additional models adequately described other variations of the UA as follows: Model 2 (Cross Model), 3.7%; Model 3 (Trifurcation Model), 3.1%; and Model 4 (Inverted-Y Model), 7.4%. The origin of the UA could not be determined in 7.4% of the cases. CONCLUSION: The UA is the first anterior branch of the internal iliac artery in more than 80% of females. Surgeons should be aware of the anatomic variations of the UA to perform safe and efficient procedures.
Assuntos
Laparoscopia/métodos , Modelos Biológicos , Artéria Uterina/anatomia & histologia , Artéria Uterina/embriologia , Adulto , Dissecação , Feminino , Ginecologia , Humanos , Histerectomia/métodos , Artéria Ilíaca/anatomia & histologia , Artéria Ilíaca/patologia , Artéria Ilíaca/cirurgia , Pessoa de Meia-Idade , Estudos Prospectivos , Espaço Retroperitoneal/patologia , Espaço Retroperitoneal/cirurgia , Turquia , Ureter/patologia , Ureter/cirurgia , Artéria Uterina/patologia , Artéria Uterina/cirurgiaRESUMO
BACKGROUND: In 2008, members of the TEPARG provided first insights into the legal and ethical framework governing body donation in Europe. In 2012, a first update followed. This paper is now the second update on this topic and tries to extend the available information to many more European countries. METHODS: For this second update, we have asked authors from all European countries to contribute their national perspectives. By this enquiry, we got many contributions compiled in this paper. When we did not get a personal contribution, one of us (EB) searched the internet for relevant information. RESULTS: Perspectives on the legal and ethical framework governing body donation in Europe. CONCLUSIONS: We still see that a clear and rigorous legal framework is still unavailable in several countries. We found national regulations in 18 out of 39 countries; two others have at least federal laws. Several countries accept not only donated bodies but also utilise unclaimed bodies. These findings can guide policymakers in reviewing and updating existing laws and regulations related to body donation and anatomical studies.
Assuntos
Doadores de Tecidos , Obtenção de Tecidos e Órgãos , Humanos , Cadáver , Europa (Continente) , Corpo HumanoRESUMO
Mylohyoid bridging on the mandible is a hyperostotic variation considered as one of the cranial non-metric characteristics. Most researchers have indicated that such non-quantitative traits can be used for the investigation of population history and these traits show differences according to societies. In the present study, we investigated the incidence of mylohyoid groove bridging on 89 half-mandibles (48 right sides, 41 left sides; 39 complete mandibles, nine right and two left half-mandibles) from the Byzantine period, dated approximately eight centuries back. We observed that the incidence of mylohyoid bridging was 8.9% for the Byzantine mandibles with no side predilection. The incidence of bridging observed in the present sample was compared with those of earlier studies. Mylohyoid bridging may be useful as a non-metric feature in population studies when used in combination with other characteristics.
Assuntos
Mandíbula/anatomia & histologia , Adulto , Antropologia Física , Humanos , MasculinoRESUMO
In previous studies we have observed the expression of androgen binding protein (ABP) in the rat hypothalamo-neurohypophysial system. With immunocytochemical double staining we found partial co-localization with oxytocin. In the present study we used antibodies to the anti-diuretic hormone arginine vasopressin (AVP) for co-localization with ABP in the rat hypothalamus. Both antigens were seen in the magnocellular paraventricular and supraoptic nuclei. Dense fiber networks with varicosities containing both AVP and ABP immunoreactivity were visible throughout the hypothalamus, the median eminence and in the posterior pituitary lobe. Double immunostaining revealed also co-existence in the parvocellular portion of the paraventricular nucleus and in the suprachiasmatic nucleus. ABP immunoreactive neurons in the preoptic region were devoid of AVP staining, AVP neurons in the bed nucleus of the stria terminalis stained only occasionally for ABP. We conclude that both the magnocellular and the parvocellular hypothalamic vasopressin systems are capable of expressing the steroid binding globulin, which is probably subject to axonal transport, along with the peptide hormone. Intrahypothalamic expression of ABP may be among the mechanisms necessary for rapid actions of steroids on hypothalamic neuroendocrine systems.
Assuntos
Proteína de Ligação a Androgênios/metabolismo , Sistema Hipotálamo-Hipofisário/metabolismo , Hipotálamo/metabolismo , Neurônios/metabolismo , Vasopressinas/metabolismo , Animais , Sistema Hipotálamo-Hipofisário/anatomia & histologia , Hipotálamo/anatomia & histologia , Imuno-Histoquímica , Masculino , Eminência Mediana/anatomia & histologia , Eminência Mediana/metabolismo , Vias Neurais/anatomia & histologia , Vias Neurais/metabolismo , Neuro-Hipófise/anatomia & histologia , Neuro-Hipófise/metabolismo , Terminações Pré-Sinápticas/metabolismo , Ratos , Ratos WistarRESUMO
BACKGROUND: Interaction of sex hormone-binding globulin (SHBG) and oxytocin (OT) is among the factors that control smooth muscle proliferation and tumor growth through the oxytocin receptor (OTR). Also, a close functional interaction of OTR and caveolin-1 has been shown to modulate cell growth and proliferation. METHODS: We studied surgical samples from 23 leiomyoma patients (aged 33-66 years) with immunocytochemistry. Specimens from five patients (34-76 years), who had hysterectomy for other reasons, served as controls. Tissue samples were cut into serial 1-microm thick sections for co-localization of SHBG, OTR, proliferation marker p21 and caveolin-1. RESULTS: SHBG was found in smooth muscle cells in all samples. OTR staining occurred in most of these cells in myomas, while controls contained only scattered cells positive for OTR. There were no apparent differences in immunostaining for p21, while immunoreactivity for caveolin-1 was observed in most cells in myomas and in only few cells in controls. Caveolin-1 was mostly co-localized with SHBG and OTR in myoma samples whereas controls showed this co-localization only occasionally. CONCLUSIONS: Our observations indicate an interaction of SHBG and OTR, associated with caveolin-1, which may account in part for known non-genomic actions of ovarian steroids. Growth of leiomyomas may be linked to these mechanisms.