Morphology of the greater palatine foramen: a clinical point of view

PURPOSE

Anatomical characteristics of the greater palatine foramen (GPF) are essential during the greater palatine nerve block application to anesthetize maxillary teeth, gums, midface, and nasal cavities. The position of GPF is usually described in relation to adjacent anatomical structures. This investigation aims to examine the morphometric relationships of GPF and closely determine its position.

METHODS

The study included 87 skulls (174 foramina). They were photographed in a horizontal position with bases facing up. The digital data were processed in the ImageJ 1.53n software.

RESULTS

The average distance of the GPF from the median palatine suture was 15.94 mm. In relation to the posterior border of the bony palate, the distance was 2.05 mm. Statistical significance was found in comparing the angle between the GPF, incisive fossa, and the median palatine suture between the sides of the skulls (p = 0.02). Comparing tested parameters between males and females showed significant differences in GPF-MPS (p = 0.003) and GPF-pb (p = 0.012), with lower values in females. The most significant percentage of skulls (77.01%) had the GPF located at the level of the third molar. The most significant number of bony palates had one lesser opening (60.91%) on the left side.

CONCLUSION

GPF is located at the level of the maxillary third molar in most of the examined palates. Knowledge of the anatomical position of the greater palatine foramen and its variations is the basis for successfully implementing anesthesia and various surgical interventions.

[Morphology of ulnar trochlear notch and defining ideal position for olecranon osteotomy]

Aim

The aim of the study was to calculate the most important parameters of ulna and to determine its gender. Classifying trochlear notch joint surface types and to establish their representation in Serbian population. To determine the ideal position for olecranon osteotomy.

Material and methods

The study included 69 bones. Gender determination was performed using digital scale and photographs of the ulna. The bones weight, maximum and physiological length were measured. The place for the ideal position of olecranon osteotomy (projection of the bare area on its posterior wall) was determined on profile images.

Results

Gender related, 45 (65.21%) bones belonged to males, 24 (34.79%) ulnas belonged to females. Type I of the bare area was present in 38 (55%) ulnas, type II in 20 (29%), whereas type III was present in 11 (16%) bones. The average value for the ideal position of olecranon osteotomy was 23.02 mm. In males' ulnas, it was 23.22 mm, in females, it was 22.59 mm.

Conclusion

Type I of the bare area is the most common type of trochlear notch joint surface in Serbian population. The average value for the ideal position of olecranon osteotomy was 23.02 mm. We believe that a uniform name for the bare area should be established.

A survey of pelvic types on computed tomography images

BACKGROUND

In the medical literature several classifications of the pelvis according to its shape can be found. The most common classification distinguishes four general pelvis types: gynecoid, android, anthropoid and platypelloid. Natural childbirth may be significantly prolonged, difficult or even impossible if the pelvis shape is not in proportion to the size of the fetus. The objectives of our study were to calculate major diameters and conjugate diameters of the female bony pelvic ring and to determine the major pelvic types according to their shape. Based on the parameters obtained, we aimed to establish a relationship between some pelvic types and difficult childbirth.

METHODS

The study was prospective in design and included 54 female subjects of various ages who had been referred for computed tomography of the pelvis, as part of the diagnosis of an underlying condition. In each patient, five most important parameters in two planes were measured and the pelvic type was determined by using the brim index and a special formula for android type. All measurements were performed using the Vue PACS v 12.1.6.1005 program. The description of the pelvic inlet was used to confirm all pelvic types. Data on previous births were taken from the questionnaire filled out by the subjects during the radiological examination.

RESULTS

Gynecoid pelvic type was the most common in our sample (28 pelvises - 52%), followed by platypelloid type (11 pelvises - 20%), anthropoid type (8 pelvises - 15%) and finally android type (7 pelvises - 13%). There was a statistically significant difference in the diameter bispinous length (p<0.05) between the platypelloid and anthropoid pelvic types. Pathological degree of stenosis was present in seven pelvises (the first degree in six pelvises and the second degree in one pelvis). The frequency of cesarean section was 31.82% and this technique was most frequently used in the subjects with a gynecoid pelvic type. The duration of natural labor ranged from 4 to 18hours. There was no statistically significant difference in the duration of labor between subjects with different pelvic types.

CONCLUSIONS

Gynecoid pelvic type was present in more than half of our subjects. Although this type is considered ideal for labor, we have not established that it has a great influence on whether the labor will be performed naturally or by cesarean section, neither that it significantly affects the length of birth. The gross narrowing of the pelvic ring is present in non-gynecoid pelvic types. The data obtained will certainly be useful to the obstetrician when planning the labor and considering all the factors that may affect the course of birth.

Morphometric analysis of the patterns of calcaneal facets for the talus in Serbian population

Literature describes different patterns of calcaneal facets for the talus in terms of whether some calcaneal facets are connected or separated from each other or completely absent. The aim of this study was to establish the patterns of calcaneal facets for the talus, to calculate their total area, and to analyse the data with respect to gender. The study involved 59 calcanei which were photographed. The patterns of calcaneal facets noted in this study were compared with the patterns from the literature. ImageJ program was used to measure different parameters on calcanei. The pattern 1 was the most commonly found in the study sample (45.76%), then the pattern 2 (40.68%), and finally the pattern 3 (13.56%). That order of frequencies is the same in both sexes. The patterns 1 and 2 have a larger contact surface for the talus in comparison to the pattern 3. Male bones have a larger contact surface for the talus than female bones. The sum of the pattern 1 and pattern 3 frequencies was high. Knowing the frequency of different patterns of calcaneal facets for the talus in a certain population is important for orthopaedic surgeons when performing foot osteotomy.

Possible synergistic effect of apoE and LRP1 genotypes on metabolic syndrome development in Serbian patients

The modern way of life contributes to the higher frequency of a complex state medically called metabolic syndrome (MetS), which is an inevitable consequence of several most common diseases of modern civilization. Patients with MetS have three times higher risk of experiencing a heart attack or a stroke and twice higher possibility to die from them. Serbia holds the infamous third place in Europe in mortality from heart disease, just behind Russia and Ukraine. The study explores the correlation of every combination of genotypes of apoE (apolipoprotein E) and LRP1 (low density receptor- related protein 1) genes with presence of MetS, and the connection with each anthropometric and biochemical parameter in both tested groups. Study demonstrates the impact of genotype combinations on the emergence and development of the MetS in Serbia. 63 patients and 30 controls were included in the study, aged from 19 to 65. Each person genotype was determined by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) profile. Odds ratio (OR) values showed that the presence of apoE e3e4/LRP1 CC genotype combination of genotypes in patients multiplies the chance (7.6 times) for the occurrence of the MetS in comparison to the presence of other genotype combinations. Determining the genetic basis of MetS is one of the necessary steps in the prevention of disease, saving the cost of treatment, and in the design of targeted therapies.

What Do We Find Attractive about the Face?: Survey Study with Application to Aesthetic Surgery

The appearance of the face is one of the most important factors influencing our perception of beauty. However, few studies have attempted to quantitate what one perceives as beauty. Therefore, this study was conducted with the goal of providing physicians with anatomical data that demonstrate which facial traits most influence our perception of one's attractiveness. In the first phase of the study, faces of 60 participants (30 males and 30 females) were photographed. Next, the photographs were shown to another group of 120 study members (60 males and 60 females), who evaluated the facial features using a Visual Analogue Scale. The highest rated facial parts were then measured using the ImageJ program. In men, the most attractive parts of the face were Type 1:2 lips, a Type IV nose of medium width, blue eyes, brown hair, and a very narrow face. Among females, the most attractive parts of the face were Type 2:1 lips, Type III and V noses of medium width, dark brown eyes, blonde hair, and a narrow face. This is the first study in which the most aesthetically important facial parts have been comprehensively examined. The results obtained in our study show a higher degree of representativeness compared to other studies due to a different methodological approach and can be used as an aesthetic guide and can help in the planning of aesthetic surgery such as lip augmentation and rhinoplasty. Clin. Anat. 33:214-222, 2020. © 2019 Wiley Periodicals, Inc.

PALMARIS LONGUS ABSENT IN ONE IDENTICAL TWIN: A CASE REPORT

SUMMARY – Palmaris longus is a very variable muscle in the human body, but it is often used as an applicable tendon graft. We report on differences between one pair of identical twins regarding the existence of the palmaris longus, which were detected accidentally during examination of the presence/absence of this muscle in Caucasian population. In one of the twins, the palmaris longus was present at both forearms, while the other twin was lacking this muscle at both forearms. On search of the available literature, we found no articles about distinctions in the presence or absence of the palmaris longus in twins.

Application of algometry in patients with cervical and lumbar radiculopathy

BACKGROUND

Algometry, as a highly sensitive method, provides an objective insight into the degree of pain, while the use of questionnaires can estimate the patient's psychological status in a simple way.

OBJECTIVE

This study was conducted in order to measure the pressure pain threshold in patients with cervical and lumbar radiculopathy and to find a possible association of pain with the anxiety and depression.

METHODS

The study examined 60 hospitalized patients with cervical radiculopathy and 60 patients with lumbar radiculopathy before starting and after finishing kinesitherapy. The research was conducted using the digital algometry device and Hospital Anxiety and Depression Scale.

RESULTS

There was no statistically significant difference in algometric values between the patients with cervical radiculopathy and the patients with lumbar radiculopathy. The program of rehabilitation did not lead to significant improvement in the level of pain. Females have a lower pressure pain threshold than males. Psychological factors greatly affect the pain.

CONCLUSIONS

The applied methods will provide the implementation of appropriate therapy and would achieve better verification of the results in a rehabilitation program. Radiculopathy in conservative therapy should be treated in cervical-thoracic and lumbar region together. Rehabilitation period for patients with radiculopathy have to be longer.

The LRP1 Gene Polymorphism is associated with Increased Risk of Metabolic Syndrome Prevalence in the Serbian Population

The determination of genetic background in metabolic syndrome (MetS) represents one of the necessary steps to prevent the disorder, thus reducing the cost of medical treatments and helping to design targeted therapy. The study explores the association between individual alleles of the LRP1 gene and the diagnosis of MetS to find correlation between the low-density lipoprotein receptor-related (LRP1) gene polymorphism and each individual anthropometric and biochemical parameter. The study included 93 males and females, aged from 19 to 65, divided into two groups. The genotype of each person was determined from the restriction fragment length polymorphism-polymerase chain reaction (RFLP-PCR) profile. Results indicated the association of the T allele form of exon 3 LRP1 gene with development and progression of MetS that further pointed out its negative impact on tested anthropometric and biochemical parameters. The presence of the T allele in patients multiplies the chance of occurrence of deviations from the reference values of body mass index (BMI), (4.24-fold) and low-density lipoprotein (LDL) (20.26-fold) compared to C allele carriers. The results showed that T allele presence multiplies the chance (4.76 fold) for the occurrence of MetS in comparison to C allele carriers. Correlation found that the T allele of the LRP1 gene with MetS determinants is not negligible, therefore, the T allele may be considered as a risk factor for MetS development.

How often absence of palmaris longus and functional deficiencyof flexor digitorum superficialis occurs ?

This study was designed to find a possible correlation between the presence of the palmaris longus and function of the fifth flexor digitorum superficialis. We examined 300 participants to assess the absence of palmaris longus and flexor digitorum superficialis function by several clinical tests. Overall absence of palmaris longus, was seen in 157 participants (52.3%). Overall deficiency of flexor digitorum superficialis was noted in 100 participants (33.3%). In 15 participants (5%) we noted bilateral absence of palmaris longus and flexor digitorum superficialis deficiency. Five participants (1.7%) had unilateral absence of palmaris longus and flexor digitorum superficialis deficiency on the same, left or right hand. Bilaterally presence of these muscles we noted in 95 participants (31.7%). We believe that there is no connection between absent palmaris longus and absent function of flexor digitorum superficialis. We found a much higher prevalence of muscles absence individually and jointly than in other studies.