Development of the prostate was studied by serial section reconstruction and computer-assisted three-dimensional analysis. A comparison of ductal budding in species of rat and mouse and the human revealed patterns consistent with common developmental characteristics. Ventral, lateral and dorsal lines of epithelial buds, which emanated from the urogenital sinus into the surrounding periurethral mesenchyme, followed ventro-dorsal and cranio-caudal axes. Subsequent branching morphogenesis was associated with specific mesenchymal condensations. These patterns of budding were closely related to the adult lobe architecture in the rodent prostate. In the human fetus, prostate ductal budding exhibited patterns compatible with the current concept of zonal anatomy.
Tarsal tunnel syndrome is an infrequent and probably underdiagnosed clinical condition. Diagnosis and treatment depend on understanding the tibial branching pattern within the tarsal tunnel. A total of 68 foot dissections were performed. Bifurcation into the medial and lateral plantar nerves occurred within the tunnel in 93% and proximal in 7%. Proximal bifurcation may predispose to tarsal tunnel syndrome, and its infrequent occurrence correlates with the infrequent clinical diagnosis. Nine different calcaneal branching patterns were noted; they provide an anatomical explanation for heel sparing. An understanding of anatomic variations should aid in providing complete surgical release and in avoiding accidental heel denervations.
The surgical, clinical and radiological importance of the diagonal artery in the human heart and the extreme variability in its description prompted us to undertake its study. The investigation was performed in 150 hearts, dissected after injection of colored substance in the coronary arteries. The following results were obtained: The left coronary artery presented 3 types of division: bifurcation (54.7%), trifurcation (38.7%) and quadrifurcation (6.7%); the latter 2 patterns produced a diagonal artery. The trunk of the left coronary artery bifurcated more frequently in hearts of female Caucasians (57.1%) and male Caucasians (54.9%). It trifurcated more frequently (60%) in hearts of female non-Caucasians. The ramus diagonalis was found in 45.3% of the hearts. The incidence of a ramus diagonalis did not differ significantly between male Caucasians (45%), male non-Caucasians (42.8%) and female Caucasians (37%). However, it occurred more frequently in female non-Caucasians (66.5%). The length of the ramus diagonalis varied from 20.1 to 50mm (79.3%) and its relative length varied from 21 to 50% of the length of the left ventricle (75.3%). The ramus diagonalis was classified as short, medium and long types, the former 2 types were most frequent.
The incidence of bridges of myocardium seen on the external surface of the heart, through the epicardium, over portions of coronary arteries and their branches, was studied in 50 cadavers and found to be 78%. The bridges of the myocardium varied in size and in number (from one to six). Their location was predominantly found at the level of the anterior ventricular branch of the left coronary artery also called left anterior descending artery (52%), whereas in the territory of the right coronary artery the highest percentage was at the level of the anterior ventricular branch (12%). This myocardio-arterial relationship might be responsible for periodic or permanent reduction of the lumen, partial or total arterial obliteration, ischemia, atherosclerosis, angina, and sudden death.
In a series of 61 adult cadavers, the posterior gastric artery was found in 38 (62.3%), originating from the superior aspect of the mid-third of the splenic artery. The posterior gastric artery, running behind the parietal peritoneum of the omental bursa, produced a peritoneal fold before reaching the posterior wall of the superior portion of the gastric body, near the cardiac region, and the fundus. Its high incidence, hidden origin, deep course, and distribution make this artery very important for surgical procedures relating to the stomach, pancreas, spleen, and celiac region. It may be crucial, especially if partial gastric resection of splenectomy have obliterated other gastric vessels.
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