Human lumbosacral root and ligamentum flavum thicknesses: a magnetic resonance study

BACKGROUND

This study investigated the lumbosacral plexus (LSP) nerve root thickness and ligamentum flavum (LF) thickness and correlated them with age and sex. These findings provided a useful data for spinal nerve root micro-anastomosis surgery and lumbar decompression surgery.

MATERIALS AND METHODS

This retrospective study was conducted with 350 individuals with ages ranging from 21 to 80 years under magnetic resonance imaging to evaluate the possible cause of a lower back pain.

RESULTS

According to the morphometric measurements of the LSP root thickness, the diameter gradually increased from L1 to S1. L1 has the thinnest root (3.9 ± 0.81 mm) while S1 has the thickest root (5.45 ± 0.8 mm). The measurements revealed inconsiderable differences in the LSP thickness in relation to age, sex in the study population. Regarding the LF, the thickness of the LF was found to insignificantly increase with age. Besides, the LF thickness was inconsequentially higher in female. The mean thickness of the right LF at different spinal levels was measured (L2-L3 = 3.19 ± 0.27, L3-L4 = 3.38 ± 0.11 mm, L4-L5 = 3.71 ± 0.29 mm, and L5-S1 = 3.64 ± 0.21 mm). The mean thickness of the left LF was non-significantly higher.

CONCLUSIONS

The LSP root and LF thicknesses not related to age or sex.

Accessory right hepatic artery and aberrant bile duct in the hepatocystic triangle: a rare case with clinical implications

Awareness of variations in the hepatic vasculature and biliary system is extremely important for avoiding iatrogenic injury in upper-abdominal surgery. The objective of this study is to describe a rare case of abnormal vascular and biliary structures in the hepatocystic triangle (HCT) (the modern Calot's triangle). During anatomical dissection of the celiac trunk (CT) in an old man, the authors observed the presence of a hepatosplenic trunk arising from the CT and bifurcating into common hepatic and splenic arteries. The common hepatic artery divided into hepatic artery proper and gastroduodenal artery. The presence of accessory right hepatic artery (ARHA) arising from the superior mesenteric artery was also notable. The aberrant artery ascended retropancreatically ventral to the splenic vein, then posterolaterally to the portal vein before termination into the right hepatic lobe in the HCT. Within this triangle, there was an aberrant bile duct originating in the right hepatic lobe and ending in the common hepatic duct. This accessory duct crossed the ARHA and an associated branch (the cystic artery). There is no known previous report on the co-existence of an AHAR and an aberrant bile duct within the HCT, in addition to the hepatosplenic trunk. The clinical implications of the current case are addressed in discussion.

Vascular endothelial growth factor receptor inhibition enhances chronic obstructive pulmonary disease picture in mice exposed to waterpipe smoke

BACKGROUND

Chronic obstructive pulmonary disease (COPD) is marked by destruction of alveolar architecture. Preclinical modelling for COPD is challenging. Chronic cigarette smoke exposure, the reference animal model of COPD, is time-inefficient, while exposure to waterpipe smoke (WPS), a surging smoking modality, was not fully tested for its histopathological pulmonary consequences. Since alveolar damage and pulmonary vascular endothelial dysfunction are integral to COPD pathology, lung histopathological effects of WPS were temporally evaluated, alone or in combination with vascular endothelial growth factor receptor (VEGFR) inhibition in mice.

MATERIALS AND METHODS

Mice were exposed to WPS, 3 hours/day, 5 days/week, for 1, 2, 3, or 4 months. Another group of mice was exposed to WPS for 1 month, while being subjected to injections with the VEGFR blocker Sugen5416 (SU, 20 mg/kg) 3 times weekly. Control mice were exposed to fresh air in a matching inhalation chamber. Histopathological assessment of COPD was performed. Alveolar destructive index (DI) was counted as the percentage of abnormally enlarged alveoli with damaged septa per all alveoli counted. Mean linear intercept (MLI) was calculated as a measure of airspace enlargement.

RESULTS

Exposure to WPS resulted in significant increases in alveolar DI and MLI only after 4 months. Lung inflammatory score was minimal across all time-points. Importantly, combination of WPS and SU resulted in significantly increased DI, MLI, and inflammatory scores as early as 1 month post exposure.

CONCLUSIONS

Combined exposure to WPS and SU results in COPD picture, highlighting the role of pulmonary vascular endothelial dysfunction in the disease.