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Anatomical variations of peripheral nerves constitute a potentially important clinical and surgical issue. The aim of this work is to study the variations of the median nerve in the arm with respect to its branching pattern and distribution as well as its possible communication with the musculocutaneous and/or ulnar nerves. Sixty arms pertaining to 30 preserved human cadavers, ranging in age from 30 to 67 years, were dissected in pursuit of this aim. In one limb out of 60 (1.7%) the median nerve gave off muscular branches to the brachialis muscle as well as a branch from its lateral root to supply both heads of the biceps brachii muscle. Concomitantly the musculocutaneous nerve was absent. The same limb demonstrated a branch from the lateral cord of the brachial plexus supplying the coracobrachialis muscle. Three limbs (5%) showed a communicating branch between the median and the musculocutaneous nerves. These observations should be considered when a high median nerve paralysis is shown to originate in the axilla or proximal arm in a patient presenting with weakness of forearm flexion and supination. Similarly, it can explain weakness of the arm flexor muscles in thoracic outlet syndrome with median nerve affection.
On the right upper limb, during laboratory dissection the low division of the common trunk of the musculocutaneous nerve and the lateral root of the median nerve, low fusion of two roots of the median nerve as well as accessory heads of the coracobrachialis and biceps brachii muscles were found. The axillary and brachial arteries showed abnormal course.
Staphylococcus aureus is a human pathogen causing a wide range of diseases. Most staphylococcal infections, unlike those caused by other bacteria are not toxigenic and very little is known about their pathogenesis. It has been proposed that a core of se­creted proteins common to many infectious strains is responsible for colonization and infection. Among those proteins several proteases are present and over the years many different functions in the infection process have been attributed to them. How­ever, little direct, in vivo data has been presented. Two cysteine proteases, staphopain A (ScpA) and staphopain B (SspB) are important members of this group of enzymes. Recently, two cysteine protease inhibitors, staphostatin A and staphostatin B (ScpB and SspC, respectively) were described in S. aureus shedding new light on the com­plexity of the processes involving the two proteases. The scope of this review is to sum­marize current knowledge on the network of staphylococcal cysteine proteases and their inhibitors in view of their possible role as virulence factors.
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