From a study of renal vascularization, we present 54 cases of double renal arteries supplying one kidney and originating from the aorta. Of the 54 cases, 42 were unilateral, showing a left predominance (25 cases), three of them with triple renal arteries on the opposite side. In six cases we encountered bilateral double renal arteries. Most often, the supplementary renal artery originated from the lateral side of the aorta (58%). Examination of the renal approach showed that in 28 cases the supplementary renal artery entered the kidney through the hilum (proper supplementary renal artery), in 16 cases it was inferior polar, in five cases it was superior polar and in five cases the supplementary renal artery terminated in two branches, equal in caliber, one polar and the other hilar, thus showing a combined character, identical with the manner of termination of the main renal artery. In most of the samples the supplementary renal artery ended with a bifurcation inside the kidney, either into the renal sinus (proper supplementary renal artery) or inside the renal parenchyma (polar supplementary renal artery). The course of the double renal arteries showed multiple variations: retroureteral passage of the supplementary renal artery (6 cases), right supplementary renal artery passing anterior to the inferior vena cava (5 cases), crossed course of the double renal arteries (5 cases). Double renal arteries may coexist with other uro-vascular variations, such as: double renal veins on the same side (4 cases) or on the opposite side (3 cases), double ureter on the same side (2 cases) or on the opposite side (1 case), persistence of the fetal renal lobulation on the adult kidney (3 cases) and genital artery originating from the supplementary renal artery (3 cases).
Recurrent artery of Heubner (RAH) is the largest and most constant perforating branch of anterior cerebral artery. It supplies blood to the medial portion of the orbitofrontal cortex, the anterior portion of the caudate nucleus, the anterior third of the putamen, the external segment of the globus pallidus, and the anterior crus of the internal capsule The anatomical variation of RAH is related to its traject, number, presence, or absence, and the diverse origin from ACA is of considerable clinical impact mainly from the point of view of the surgical procedures involving the anterior portion of the circle of Willis or the topographically related structures. The present study aimed to demonstrate vascular anatomy of this RAH and its variation. The study included 60 human cadaveric brains fixed in the formalin and examined under operating microscope. 22 freshly harvested human cadaveric brains, injected with a polymer (Technovit 7143), a partial coroded and also we have consulted 30 digital subtraction angiograms. We have evaluated the origin, traject and caliber of recurrent artery of Heubner, our results were compared with other anatomical studies published. The most obvious finding was the great variability of its origin but in 91% of the cases it was in the range of 2mm around anterior communicating artery, that could be harmed during aneurismal clipping. The RAH is commonly arising from ACA-ACoA junction. This portion of the circle of Willis is the place of many anatomical variations and malformations. The vessel can be absent, single, or multiple, and its diameter is highly variable. The awareness of these distinct anatomical and morphometric variations of the RAH is essential in planning the neurosurgical procedures in the anterior part of the circle of Willis to avoid the unexpected neurological complications.
Platelet-derived growth factor (PDGF) is known to stimulate osteoblast or osteoprogenitor cell activity. We investigated the effect of locally applied PDGF from poly-D,L-lactide (PDLLA)-coated implants on fracture healing in a rat model. A closed fracture of the right tibia of four-month-old Sprague-Dawley rats (n = 40) was stabilised with implants coated with a biodegradable PDLLA versus implants coated with PDLLA and PDGF. Radiographs were taken throughout the study, and a marker of DNA activity, bromodeoxyuridine (BrdU), was injected before the rats were killed at three, seven and ten days. The radiographs showed consolidation of the callus in the PDGF-treated group compared with the control group at all three time points. In the PDGF-treated group, immunohistochemical staining of BrdU showed that the distribution of proliferating cells in all cellular events was higher after ten days compared with that at three and seven days. These results indicate that local application of PDGF from biodegradable PDLLA-coated implants significantly accelerates fracture healing in experimental animals. Further development may help fracture healing in the clinical situation.
Introduction: Portal hypertension results from increased resistance to the portal blood flow. The ultrasound represents a noninvasive tool for assessing the structural and hemodynamic abnormalities in this condition.Objectives: The assessment of the hemodynamic blood flow of the liver and spleen by using Doppler ultrasound in patients with portal hypertension compared with healthy subjects and to identify correlations with the severity of liver cirrhosis and esophageal varices.Materials and Method: This study included 50 patients with liver cirrhosis and 20 healthy subjects as controls. Different correlations were carried out between hemodynamic variables obtained from the Doppler examination and the severity of cirrhosis as assessed by the Child score and the degree of esophageal varices at endoscopy.Results: The portal vein diameter was larger in cirrhotic patients compared with the control group. The mean portal vein velocity and the blood flow were significantly lower in advanced forms of liver cirrhosis. The portal vein congestion index, the pulsatility and resistivity indexes of the hepatic artery were significantly increased in patients with CHILD B and C cirrhosis compared with the control group and patients in CHILD class A. There were no statistically significant differences between the pulsatility and resistivity indexes of the splenic artery in patients with cirrhosis. The liver vascular index was significantly lower in patients with advanced cirrhosis.Conclusions: The ultrasound is a valuable noninvasive tool for cirrhotic patients with portal hypertension. However, it is not sufficiently accurate in differentiating between different classes of cirrhosis or degrees of esophageal varices.
Our study was conducted by the evaluation of angioCT's performed on a GE LightSpeed VCT64 Slice ct Scanner. the measurements were performed on the aortic arch at the following levels: at the origin of the aorta, the middle part of the ascending aorta, prior to the origin of the brachiocephalic arterial trunk and after the origin of the left subclavian artery. We measured the caliber of the aortic arch arteries and the data are correlated and reported by gender.
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