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Jugular phlebectasia presenting as globus pharyngeus

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Czyzowski J., Tomaszewski K. A., Walocha J. A.

Folia Morphologica

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2013

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tom 72

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nr 3

Even though much has been written on the aetiology of globus pharyngeus, it still remains elusive and multifactorial. We present a case of a 54-year-old woman who was referred by an orthopedist to the radiology department with a 6-day history of an intense feeling of “pressure” and “tightness” in the jugular notch. After performing a contrast-enhanced computed tomography scan, a phlebectasia of the right anterior jugular vein was discovered. When trying to determine the cause of the globus sensation one has to consider the possible existence of a phlebectasia of one of the jugular veins. (Folia Morphol 2013; 72, 3: 278–280)

2

The biology behind the human intervertebral disc and its endplates

100%

Tomaszewski K. A., Saganiak K., Gladysz T., Walocha J. A.

Folia Morphologica

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2015

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tom 74

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nr 2

The intervertebral discs (IVDs) are roughly cylindrical, fibrocartilaginous, articulating structures connecting the vertebral bodies, and allowing movement in the otherwise rigid anterior portion of the vertebral column. They also transfer loads and dissipate energy. Macroscopically the intervertebral disc can be divided into an outer annulus fibrosus surrounding a centrally located nucleus pulposus. The endplates surround the IVD from both the cranial and caudal ends, and separate them from the vertebral bodies and prevent the highly hydrated nucleus pulposus from bulging into the adjacent vertebrae. The IVD develop from the mesodermal notochord and receive nutrients mostly through the cartilaginous endplates. Physiologically they are innervated only in the outer annulus fibrosus by sensory and sympathetic perivascular nerve fibres, branches from the sinuvertebral nerve, the ventral rami of spinal nerves or from the grey rami communicantes. The IVD undergo changes with ageing and degeneration, the latter having two types i.e. “endplate-driven” involving endplate defects and inward collapse of the annulus fibrosus and “annulus-driven” involving a radial fissure and/or an IVD prolapse. This review summarises and updates the current state of knowledge on the embryology, structure, and biomechanics of the IVD and its endplates. To further translate this into a more clinical context this review also demonstrates the impact of ageing and degeneration on the above properties of both the IVD and its endplates. (Folia Morphol 2015; 74, 2: 157–168)

3

Median nerve thenar motor branch anatomical variations

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Mizia E., Tomaszewski K. A., Goncerz G., Kurzydlo W., Walocha J.

Folia Morphologica

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2012

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tom 71

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nr 3

Background: The aim of this study was to determine the prevalence of the different types of median nerve thenar motor branch and to compare them with literature data. Material and methods: This study was conducted using median nerves dissected from cadavers stored in a 10% solution of formaldehyde at the Department of Anatomy of Jagiellonian University Medical College (JUMC) and cadavers from the Department of Forensic Medicine JUMC. The research protocol was approved by the Jagiellonian University Ethics Committee (registry KBET/209/B/2002). Results: The studied group comprised 8 (26.7%) women and 22 men (age between 23 and 92 years), yielding a total of 60 thenar motor branches (30 right vs. 30 left). Forty-seven (78.3%) nerves were classified as extraligamentous, 12 (20%) were subligamentous, and 1 (1.7%) was transligamentous. As for the side of origin of the thenar motor branch, in 45 (75%) cases it was the radial side and in 2 (3.33%) cases it was the ulnar side. Conclusions: The obtained results confirm that the extraligamentous type of thenar motor branch is the most common and that the ulnar origin of the thenar motor branch is the rarest. (Folia Morphol 2012; 71, 3: 183–186)

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The mandible and its foramen: anatomy, anthropology, embryology and resulting clinical implications

88%

Lipski M., Tomaszewska I. M., Lipska W., Lis G. J., Tomaszewski K. A.

Folia Morphologica

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2013

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tom 72

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nr 4

The aim of this paper is to summarise the knowledge about the anatomy, embryology and anthropology of the mandible and the mandibular foramen and also to highlight the most important clinical implications of the current studies regarding anaesthesia performed in the region of the mandible. An electronic journal search was undertaken to identify all the relevant studies published in English. The search included MEDLINE and EMBASE databases and years from 1950 to 2012. The subject search used a combination of controlled vocabulary and free text based on the search strategy for MEDLINE using key words: ‘mandible’, ‘mandibular’, ‘foramen’, ‘anatomy’, ‘embryology’, ‘anthropology’, and ‘mental’. The reference lists of all the relevant studies and existing reviews were screened for additional relevant publications. Basing on relevant manuscripts, this short review about the anatomy, embryology and anthropology of the mandible and the mandibular foramen was written. (Folia Morphol 2013; 71, 4: 285–292)

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The use of computer-assisted image analysis in measuring the histological structure of the human median nerve

88%

Mizia E., Tomaszewski K. A., Lis G. J., Goncerz G., Kurzydlo W.

Folia Morphologica

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2012

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tom 71

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nr 2

Background and aim: The aim of this study was to assess the histological structure of the median nerve and its motor branch (number and arrangement of nerve bundles) and the cross-sectional area (CSA) of the median nerve (on the level of the carpal tunnel). Material and methods: This study has been conducted using median nerves dissected from cadavers stored in a 10% solution of formaldehyde at the Department of Anatomy of the Jagiellonian University Medical College and cadavers from the Department of Forensic Medicine of the Jagiellonian University Medical College. After dissection the median nerves were stained with haematoxylin and eosin and histological slides were prepared. These were later photographed (16¥ magnification) and analysed using ImageJ software. The research protocol was approved by the Jagiellonian University Ethics Committee (registry KBET/209/B/2002). Results: The studied group comprised 8 women and 22 men (age between 23–92 years), yielding a total of 60 median nerves (30 right vs. 30 left). In 4 (6.67%) cases an accessory motor branch was found. The mean CSA of the median nerve was 0.19 cm2. The median nerves from the right hand had a statistically larger CSA (p = 0.017). The number of nerve bundles in the median nerve varied between 13 to 38 and in the motor branch of the median nerve between 4 to 14. Conclusions: The nerve bundles of the median nerve, at the level of the carpal tunnel, display no particular type of arrangement. ImageJ software proved useful in the assessment of the histological structure of the human median nerve and its motor branch. (Folia Morphol 2012; 71, 2: 82–85)

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Endplate calcification and cervical intervertebral disc degeneration: the role of endplate marrow contact channel occlusion

88%

Tomaszewski K. A., Adamek D., Konopka T., Tomaszewska R., Walocha J. A.

Folia Morphologica

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2015

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tom 74

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nr 1

Background: The aim of this study was to determine the fundamental relationships between cervical intervertebral disc (IVD) degeneration, endplate calcification, and the patency of endplate marrow contact channels (MCC). Materials and methods: Sixty cervical IVDs were excised from 30 human cadavers. After sectioning the specimens underwent micro computed tomography (microCT) — from all images the number, calibre, diameter and distribution of endplate openings were measured using ImageJ. Next, the specimens were scored for macroscopic degeneration (Thompson’s classification), and subsequently underwent histological analysis for both IVD and endplate degeneration (Boos’s classification) and calcification. Results. The study group comprised 30 female and 30 male IVDs (mean age ± SD: 51.4 ± 19.5). Specimen’s age, macroscopic and microscopic degeneration correlated negatively with the number of MCCs (r = –0.33–(–0.95); p < 0.0001), apart from the MCCs > 300 µm in diameter (r = 0.66–0.79; p < 0.0001). The negative relationship was strongest for the MCCs 10–50 µm in diameter. Conclusions. There is a strong negative correlation between the number of endplate MCCs, and both macroscopic and microscopic cervical IVD and endplate degeneration. This could further support the thesis that endplate calcification, through the occlusion of MCCs, leads to a fall in nutrient transport to the IVD, and subsequently causes its degeneration. (Folia Morphol 2015; 74, 1: 84–92)

7

Vascular architecture of the human uterine cervix, as assessed in light- and scanning electron microscopy

76%

Bereza T., Tomaszewski K. A., Walocha J., Mizia E., Bachul P., Chmielewski P.

Folia Morphologica

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2012

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tom 71

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nr 3

Background: The aim of this study was to visualise and describe the vasculature of the human uterine cervix. Material and methods: The material for this study was obtained from women (age between 20 to 45 years) during autopsy. The material was collected not later than 24 h post-mortem. This study was performed using uteri from cadavers of menstruating nulliparas (33 uteri) and menstruating multiparas (27 uteri). Collected uteri were perfused via the afferent vessels with Mercox resin (for corrosion-casting and SEM assessment) or acrylic paint solution (light microscopy assessment). The research protocol was approved by the Jagiellonian University Ethics Committee (registry KBET/121/8/2007). Results: In all cases bilateral cervical branches (1–4), originating from the uterine artery, were found. Both in the vaginal and supravaginal parts of the cervix, four distinct vascular zones were found. In the pericanalar zone ran small veins, responsible for draining the mucosal capillaries. Both in the muscular layer, as well as in the pericanalar zone, arterioles, and venules passed close to each other, often adjoining. Conclusions: This study does not confirm the existence of a single “cervicovaginal” artery, but shows that the vascular supply of the cervix comes from several vessels. It also introduces the idea of two systems, responsible for draining blood from the mucosal capillaries. Neither assessment in light microscopy nor in SEM revealed any differences between multiparas and nulliparas, regarding the vascular architecture of the cervix. (Folia Morphol 2012; 71, 3: 142–147)

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Anatomic variability of groin innervation

76%

Bachul P., Tomaszewski K. A., Kmiotek E. K., Kratochwil M., Solecki R., Walocha J. A.

Folia Morphologica

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2013

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tom 72

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nr 3

Inguinal hernia repairs are very common yet fairly complex surgical procedures. Variations in the anatomical course of the inguinal nerves require that diligence is taken in their proper recognition. Inadvertent surgical injury to these nerves is associated with long term postoperative pain and complications. The aim of the present study was to highlight the complexity and variation in the innervation of the inguinal region in order to increase proper nerve identification during surgical interventions. Bilateral dissection of the inguinal and posterior abdominal regions in one human male cadaver revealed an atypical anatomic topography of the groin innervation. This unusual case was observed at the Jagiellonian University Anatomy Department during routine cadaveric preparations. The left ilioinguinal nerve was absent. The left genital branch of the genitofemoral nerve arose higher than expected from the lumbar plexus and supplied the groin region, which is typically innervated by the ilioinguinal nerve. Furthermore, the left lateral cutaneous femoral nerve and the right genital branch of the genitofemoral nerve also followed uncharacteristic courses. Awareness of topographical nerve variations during inguinal hernia repair will help surgeons identify and preserve important nerves, thus decreasing the incidence of chronic postoperative pain. (Folia Morphol 2013; 72, 3: 267–270)

9

Configurations of the circle of Willis: a computed tomography angiography based study on a Polish population

76%

Klimek-Piotrowska W., Kopec M., Kochana M., Krzyzewski R. M., Tomaszewski K. A., Brzegowy P., Walocha J.

Folia Morphologica

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2013

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tom 72

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nr 4

The aim of the study was to investigate the distribution of the circle of Willis variants in Polish population by means of computed tomography angiography (CTA). The results were then analysed and compared with another study that used similar methods but that was carried out on an ethnically distinct population. Patients presenting with intracranial pathology were excluded from the initial study population. In total, 250 CTA belonging to 129 female and 121 male patients were reviewed. A modified classification system of the circle was proposed, which took into consideration the anterior and the posterior aspects of the circle individually. The typical variant of Willis’s circle occurred in 16.80% of cases. The anterior and the posterior portions of the circle were normal in 47.20% and 26.80% of the patients respectively. As for the anterior part, lack of the anterior communicating artery was the most frequent abnormality (22.80%). Bilateral absence of posterior communicating arteries was the most common anomaly in the posterior part of the circle (29.20%). This type of anomaly was also the most common, when taking into consideration the entire circle (12.00%). There were statistically significant differences between the age groups and genders when considering the occurrence of an incomplete circle. Overall, a substantial proportion of patients manifested clinically important variants that were incapable of providing collateral circulation. Comparison with other imaging-based and cadaveric studies revealed noticeable differences, that may have resulted from the variable technical features of other studies or other factors such as the ethnical origins of the studied populations. (Folia Morphol 2013; 72, 4: 293–299)

10

Extra -and intracerebral course of the recurrent artery of Heubner

76%

Maga P., Tomaszewski K. A., Pasternak A., Zawilinski J., Tomaszewska R., Gregorczyk-Maga I., Skrzat J.

Folia Morphologica

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2013

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tom 72

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nr 2

Background: The aim of the current study was to analyse the extra- and intracerebral course of the recurrent artery of Heubner (RAH) to provide detailed information for neurosurgeons operating in this area. Materials and methods: The material for this study was obtained from cadavers (ages 31–75 years) during routine autopsies. A total of 70 human brains (39 male and 31 female) were examined. The material was collected not later than 48 h post-mortem. People who died due to neurological disorders were not included into the study. Right after dissection the arteries were perfused with either acrylic paint emulsion, polyvinyl chloride or Mercox CL-2R resin, through the Circle of Willis or electively through the RAH. The obtained material was analysed using a stereoscopic light microscope, magnification 2–40 x. Results: The RAH was present in 138 hemispheres with a mean of 1.99 RAH per hemisphere (275 RAH in total). The mean RAH length was 25.2 mm and the mean RAH diameter, in its place of origin, was 1 mm. In 168 (61%) cases the RAH ran superiorly, in 88 (32%) cases anteriorly, in 11 (4%) cases inferiorly and in 8 (3%) cases posteriorly to the A1 segment. In 70.2% of the cases the course of the RAH was parallel to the anterior communicating artery A1 segment, and in 29.8% of the cases the RAH arched towards the olfactory tract. As the extracerebral course of the RAH was always tortuous, its length was 1 to 5 times the distance between its place of origin and the most lateral point of anterior perforated substance (APS) penetration. The intracerebral course of the RAH was almost always univectorial — towards the head of the caudate nucleus. The course of RAH branches depended on their number. When the number of RAHs and their branches was low, they separated immediately after penetrating the APS and formed multiple small branches. When the number of RAHs and branches was high, post-APS branching was less frequent and occurred in distal segments. Conclusions: The origin and course of the RAH is highly variable. The RAH, in its extra- and intracerebral course, may join with the middle group of the lenticulostriate arteries or directly with the middle cerebral artery. This artery should be routinely identified during anterior communicating artery aneurysm clipping to prevent postoperative neurological deficits. (Folia Morphol 2013; 72, 2: 94–99)

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Validation of the Polish language version of the SF-36 Health Survey in patients suffering from lumbar spinal stenosis

76%

Klosinski M., Tomaszewski K. A., Tomaszewska I. M., Klosinski P., Skrzat J., Walocha J. A.

Annals of Agricultural and Environmental Medicine

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2014

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tom 21

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nr 4

12

Computer-assisted assessment of the histological structure of the human sural nerve

76%

Mizia E., Tomaszewski K. A., Rutowicz B., Konopka T., Pasternak A., Walocha J. A.

Folia Morphologica

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2014

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tom 73

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nr 3

Background: The aim of this study was to assess the histological structure (cross- -sectional area — CSA, number of nerve bundles) of the human sural nerve at the level above the lateral malleolus, using computer-assisted image analysis. Materials and methods: This study has been conducted using sural nerves dissected from cadavers during routine autopsies. The harvested tissues samples were dehydrated, embedded in paraffin, sectioned at 4 µm and stained with haematoxylin and eosin. Each cross-section was photographed (16 × magnification) and the images were analysed using Java ImageJ. Results: The studied group comprised 12 women and 25 men (mean age 60.1 ± 15.7 years), yielding a total of 74 sural nerves (37 right vs. 37 left). The mean ± standard deviation CSA of the sural nerve was 0.14 ± 0.07 cm². The mean number of nerve bundles in the sural nerve was 10.5 ± 6.0. In terms of gender and side, neither the CSA (p = 0.45 and p = 0.79, respectively) nor the number of nerve bundles revealed any differences (p = 0.34 and p = 0.47, respectively). Strong negative correlations were noted between the age of the donors and the sural nerve CSA (r = –0.69, p = 0.02), as well as the number of nerve bundles (r = –0.57, p = 0.06). Conclusions: This study shows that there are no statistical differences between the CSA and the number of nerve bundles in the sural nerve when compared by gender and side of the lower limb. This study also allows drawing the conclusion that the sural nerve degenerates with age in terms of both the CSA and the number of nerve bundles. (Folia Morphol 2014; 73, 3: 292–297)

13

‘Venous lakes’-a corrosion cast scanning electron microscopy study of regular and myomatous human uterine blood vessels

76%

Bereza T., Tomaszewski K. A., Lis G. J., Mizia E., Pasternak A., Mazur M., Mitus J.

Folia Morphologica

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2014

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tom 73

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nr 2

Background: The aim of this study was to evaluate the venous structure of regular and myomatous human uteri, using corrosion casting and scanning electron microscopy (SEM). Special attention was paid to the endometrium and the so called ‘venous lakes’. Materials and methods: Uteri collected at autopsy (n = 67) were injected with Mercox CL-2R resin, which penetrated the capillary bed and filled both arteries and veins. After the polymerisation of the resin, the corrosion was performed. The obtained vascular casts, visualising all vessels including capillaries, were examined using scanning electron microscopy. Results: Amongst the 67 uteri prepared for the corrosion casting, only 22 (15 containing leiomyomata) yielded casts of acceptable quality for SEM assessment. Veins of the endometrium and the myometrium were present in the form of a chaotic network, which did not run parallel to the arterial system, but was rather independent. Microscopic venous dilations (‘venous lakes’) were observed both within the functional layer of the endometrium and the myometrium. They were digit-like in shape and could be compared to venous sinuses. They drained the subendothelial capillary plexus and were supplied by numerous capillaries and venules. Their size ranged from 270 to 420 µm. Those dilatations were absent in the outer myometrium and the perimetrium, as well as the uterine cervix. We have not observed any arteriovenous anastomoses. Conclusions: The myomatous uteri tend to have larger venous lakes than the normal uteri. The number and size of venous lakes increases with menstrual cycle progression. Further data on morphology and changes in venous lakes using scanning electronic microscopy should be acquired. (Folia Morphol 2014; 73, 2: 164–168)

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The variable origin of the lateral circumflex femoral artery: a meta-analysis and proposal for a new classification system

64%

Tomaszewski K. A., Vikse J., Henry B. M., Roy J., Pekala P. A., Svensen M., Guay D., Saganiak K., Walocha J. A.

Folia Morphologica

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2017

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tom 76

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nr 2

The lateral circumflex femoral artery (LCFA) is responsible for vascularisation of the head and neck of the femur, greater trochanter, vastus lateralis and the knee. The origin of the LCFA has been reported to vary significantly throughout the literature, with numerous branching patterns described and variable distances to the mid-inguinal point reported. The aim of this study was to determine the estimated population prevalence and pooled means of these anatomical characteristics, and review their associated clinical relevance. A search of the major electronic databases was performed to identify all articles reporting data on the origin of the lateral circumflex femoral artery and its distance to the mid-inguinal point. Additionally, an extensive search of the references of all relevant articles was performed. All data on origin, branching, and distance to mid-inguinal point was extracted and pooled into a meta-analysis. A total of 26 articles (n = 3731 lower limbs) were included in the meta-analysis. Lateral circumflex femoral artery most commonly originates from the deep femoral artery with a pooled prevalence of 76.1% (95% confidence interval 69.4–79.3). The deep femoral artery-derived lateral circumflex femoral artery was found to originate with a mean pooled distance of 51.06 mm (95% confidence interval 44.61–57.51 mm) from the mid-inguinal point. Subgroup analysis of both gender and limb side data were consistent with these findings. Due to variability in the lateral circumflex femoral artery’s origin and distance to mid-inguinal point, anatomical knowledge is crucial for clinicians to avoid iatrogenic injuries when performing procedures in the femoral region, and thus radiographic assessment prior to surgery is recommended. Lastly, we propose a new classification system for origin of the lateral circumflex femoral artery. (Folia Morphol 2017; 76, 2: 157–167)

15

Evidence of interstitial Cajal-like cells in the human gallbladder

64%

Pasternak A., Gajda M., Gil K., Matyja A., Tomaszewski K. A., Walocha J. A., Kulig J., Thor P.

Folia Histochemica et Cytobiologica

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2012

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tom 50

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nr 4

Ograniczanie wyników

Jugular phlebectasia presenting as globus pharyngeus

The biology behind the human intervertebral disc and its endplates

Median nerve thenar motor branch anatomical variations

The mandible and its foramen: anatomy, anthropology, embryology and resulting clinical implications

The use of computer-assisted image analysis in measuring the histological structure of the human median nerve

Endplate calcification and cervical intervertebral disc degeneration: the role of endplate marrow contact channel occlusion

Vascular architecture of the human uterine cervix, as assessed in light- and scanning electron microscopy

Anatomic variability of groin innervation

Configurations of the circle of Willis: a computed tomography angiography based study on a Polish population

Extra -and intracerebral course of the recurrent artery of Heubner

Validation of the Polish language version of the SF-36 Health Survey in patients suffering from lumbar spinal stenosis

Computer-assisted assessment of the histological structure of the human sural nerve

‘Venous lakes’-a corrosion cast scanning electron microscopy study of regular and myomatous human uterine blood vessels

The variable origin of the lateral circumflex femoral artery: a meta-analysis and proposal for a new classification system

Evidence of interstitial Cajal-like cells in the human gallbladder