Introduction. A number of rare anatomical anomalies, including retroexternal iliac ureter, extrarenal calyces (ERCs), and vascular anomalies, were observed in a 96-year-old female cadaver during a routine dissection. Description. A markedly dilated left extrarenal pelvis (ERP) with a diameter of 3.15 cm was noticed. Three major calyces were found outside of the normal-sized left kidney. The abdominal aorta (AA), instead of normal bifurcation, branched to the right common, left external, and left internal iliac arteries. The median sacral artery was a direct branch from the right common iliac artery. No hydronephrosis was observed on the affected side, and no urinary tract anomalies were observed on the right side. Significance. The retroiliac megaureter is a rare congenital anomaly, with fewer than 25 cases reported to date. Additionally, the ERCs are amongst the rarest anomalies of the renal collecting system. Further, the current case is one of few reported cases where the particular branching pattern of the AA was observed. The combination of such anatomical anomalies is rare, and the relationship between them is unclear. Common clinical manifestations of retroiliac ureters are the results of ureteric obstruction, hydronephrosis, and secondary infection. Precise knowledge of anomalies of the kidney and urinary tract can help radiologists and surgeons make a definitive diagnosis and prevent inadvertent injury during surgery.

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BackgroundThe brachial artery (BR) is the continuation of the axillary artery, beginning at the lower border of the teres major muscle. It terminates distal to elbow and divides into the ulnar and radial arteries and supplies the forearm and hand.During routine dissection, anomalies of the BR were found bilaterally in an 81‐year old male and unilaterally in an 89‐year old female. The bilateral variations were not identical. In the left arm, the BR divided into the ulnar and radial arteries 3.32 cm after the inferior border of the teres major muscle. High bifurcation of the BR has an incidence rate of 8%1. The radial artery branched medially from the BR following a course deep and medial to the median nerve, following a unique path as it descended to the forearm. The ulnar artery originated laterally from the BR, coursing deep to the median nerve and medial to the musculocutaneous nerve to descend to the forearm, giving off the common interosseous artery and anterior and posterior ulnar recurrent arteries below the elbow. In the right arm, the radial artery was observed originating from the axillary artery before the subscapular artery, a branch of the axillary artery. A high origin of the radial artery has an incidence rate of 15%1. The radial artery traveled through the two heads of the median nerve and traveled with it to cross the elbow into the forearm. The BR continued down the arm and became the ulnar artery below the elbow. The 89‐year old female showed a unilateral variation called a superficial ulnar artery (SUA). The BR gave rise to a SUA at the level of the inferior border of the teres major. The SUA passed between the two heads of the median nerve and traveled anteriolaterally to the medial epicondyle of the humerus. At the level of the neck of the radius, the BR divided into a deep ulnar artery and a radial artery. Once the SUA entered the medial aspect of the forearm, it ran laterally to the flexor carpi ulnaris muscle and travelled with the ulnar nerve. The SUA and ulnar nerve pass through Guyon's canal together to enter the hand. SUA are quite rare, with an incidence rate of 0.7% to 9.4%2,3. Surgeons must be aware of these variations of the BR as they may complicate procedures.Support or Funding InformationCenter for Anatomical Science and Education, Department of Surgery, Saint Louis University School of MedicineThis abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Introduction. Urogenital and vascular anomalies, including a left duplex kidney and a left aberrant renal artery that gave rise to the left ovarian artery, were observed in a 77-year-old female cadaver during a routine dissection. Description. A left aberrant renal artery, which gave rise to the left ovarian artery, was observed originating from the aorta 4 cm below the left renal artery. Two independent contributions to a bifid ureter were found originating from the hilum of the left kidney. These two contributions descended 12.4 cm and 10.6 cm, respectively, posterior to the left aberrant renal artery and lateral to the left ovarian artery before uniting anterior to the psoas major muscle to descend 12.7 cm to the bladder. Significance. While the duplex kidney is a relatively common congenital anomaly that can be asymptomatic, it can also potentially be associated with compression of renal vasculature or the ureter. Ureteral compression can then result in several pathologies including reflux, urinary tract infection (UTI), ureteropelvic junction obstruction, or hydronephrosis. Compression of renal and ovarian vasculature can result in altered blood flow to the kidney and ovary, potentially causing fibrosis, atrophy, or organ failure. Current imaging techniques alone are insufficient for correct diagnostics of such complications, and they must be supplemented with a thorough understanding of the respective anatomical variations.

Background Rheumatoid Arthritis (RA) is characterized by chronic systemic inflammation, primarily affecting the joints. In RA patients, high concentrations of inflammatory cytokines are found within the synovial fluid and serum (PMID: 1700672). These cytokines reduce the blood brain barrier (BBB) integrity by decreasing the expression of tight junction proteins (PMID: 29910805). In a RA animal model such decreased BBB integrity has been shown to affect the transport of amyloid beta peptide (Aβ) between the peripheral circulation and the brain, thereby promoting accumulation of Aβ within the cerebral vasculature followed by the endothelial cell degeneration (PMID: 22029666). In humans, a similar pathologic process is a major risk factor for Alzheimer’s Disease (AD) which accelerates neuronal loss and cognitive impairment associated with AD (PMID: 29377008). Assessment of cerebral vascular density is an emerging modality for detection and monitoring the progression of cerebrovascular disease (CVD) (PMID: 15564412). Advancements in computed tomography (CT) imaging technology and the development of novel contrast agents should provide more accurate assessment for CVD in humans. The main objective of this study was to test high‐resolution CT imaging using a recently developed BriteVu contrast agent in conjunction with conventional histological techniques for postmortem assessment of CVD and pathology in the cerebral cortex and hippocampus of two male cadavers. The first, 74‐year‐old (D1) was diagnosed with RA and AD, while the second, 90‐year‐old (D2) had RA. Results The D1 and D2 cadavers were fixed and perfused with BriteVu contrast agent. Heads were removed and scanned with a VimagoGT30 CT scanner at 300 µm. The images were subjected to volumetric analysis using Radiant software. The results showed that scans of the cerebral cortex from D2, specifically the middle frontal, inferior parietal, and superior temporal gyri, had significantly lower mean Hounsfield unit densities (MHUD) than those from the same regions of D1. The MHUD from the hippocampal scans revealed no significant difference. The lower MHUD count in the D2 cortex in comparison to D1 most likely reflects a lower vascular density in the respective brain region. The AD related pathology in both donors was assessed by histochemical and immunohistochemical techniques. To that end, the brains were extracted and fixed in formalin solution for 12‐16 weeks. The brain hippocampal and cortical sections were paraffin processed followed by H&E and immunohistochemical staining for Aβ 1‐42, phospho‐tau, and phospho‐TDP‐43. Analysis of the data confirmed the AD diagnosis in D1 and demonstrated distinct AD pathology in D2. The AD staging could be characterized as mild in D1 and intermediate in D2. Conclusions i) The vascular density within the cerebral cortex of elderly individuals with RA could correlate with the AD progression. ii) The adaptation of the reported CT imaging technique for its use in live individuals could provide more sensitive and accurate method for...