Normal Anatomic Variants Research Articles

Exploring Anatomical Variations in the Bony Architecture of the Greater Palatine Canal in Dry Bones.

Introduction The greater palatine canal (GPC) holds significant clinical importance due to its role in providing access to the branches of the maxillary division of the trigeminal nerve. Anatomical variations within this posterior maxillary region can complicate the surgical anatomy, making the identification of vital structures challenging. Therefore, a thorough understanding of both normal anatomy and common anatomical variations of the GPC is essential to minimize perioperative complications during surgical procedures.This study aims to investigate the bony architecture of the GPC in dry bones to identify anatomical variations and address significant lacunae in our current understanding of this structure. Despite its impact on the management of various dental and surgical procedures, there remains a limited and sometimes inconsistent knowledge of the normal and variant anatomy of the GPC.Existing literature often lacks comprehensive detail regarding the range of anatomical variations and their implications for surgical approaches. By systematically documenting these variations, this study aims to bridge these gaps in knowledge, justify the need for continued research in this area, and highlight its potential clinical implications. Materials and methods In total, 30 dried and intact adult skull specimens were selected, consisting of 19 males (63.3%) and 11 females (36.7%). The selection criteria included an intact hard palate with fully erupted third molars and an intact lateral nasal wall on both sides. The presence of erupted third molars was used to assess the degree of bone resorption, ensuring that only specimens with minimal bone loss were included. The exclusion criteria ruled out specimens with major craniofacial deformities, excessive bone resorption, and signs of advanced age. The bony walls of the GPC were observed by passing a black wire made of rubber material with a consistent diameter (approximately 5 mm), allowing us to qualitatively assess the bore of the canal. Results In four out of 30 specimens (13.3%), significant variations were noted in the bony medial wall of the GPC. Of these, three specimens were male (75%) and one was female (25%). These variations have been categorized into four distinct types for clarity and analysis. Type 1, in a male specimen, showed a deficiency in the lower segment of the bony medial wall of the left GPC above the greater palatine foramen. Type 2, in a male specimen, had a small bar of bone in the left GPC midway between the foramen and the pterygopalatine fossa. Type 3, in a female specimen, exhibited a small bar of bone above the greater palatine foramen on the right side, with no wall above it. Type 4, in a male specimen, displayed a bar of bone above the greater palatine foramen on the right side, with the medial wall completely absent on the left side. Conclusion The study identified anatomical variations in the bony architecture of the GPCbased on dry bone specimens. While these findings offer insights into potential variations that could affect surgical procedures, their clinical implications need validation through patient-based studies. Understanding these variations is crucial for improving preoperative planning and reducing surgical risks, but recommendations should be cautious given the limited sample size. Further research with larger samples and clinical validation is needed to fully understand the embryological basis and potential impact on surgical practice.

Assessing the Adequacy of Orbital Reconstruction With Titanium Mesh Using Clinical and Radiological Measures.

Background Orbital reconstruction aims to restore the original orbit volume and correct diplopia, enophthalmos, and ocular motility of the fractured orbit. This study aimed to assess the adequacy of orbital reconstruction using radiological and clinical factors. Methods In this retrospective study, patients with orbital blowout fractures meeting clinical or radiographic criteria underwent orbital reconstruction with titanium mesh. The orbital volume and anteroposterior displacement were calculated pre- and post-operatively using computed tomography. Diplopia, inferior orbital nerve examination, and ocular movement were also evaluated. Pre- and post-operative orbital volumes of the fractured and contralateral unfractured orbits were compared. Statistical analysis was performed using MS Excel (Redmond, USA) and STATA BE (Texas, US). Results There was a significant reduction in the difference in volumes between fractured and normal orbits postoperatively (p-value <0.001). The mean difference between the reconstructed orbital floor fracture and the contralateral normal orbit was 0.55 cm3, which is within the normal anatomic variation. Enophthalmos was corrected postoperatively in our patients per radiological parameters as a result of a reduction in the mean posterior displacement. Infraorbital nerve hypoesthesia was not resolved postoperatively. Conclusion Our study highlights the restoration of the normal anatomical variation in volume differences between the fractured and contralateral orbits post-surgery using CT-guided analysis, thereby improving clinical outcomes.

Coronary artery anomalies and normal anatomical variants in coronary computed tomography angiography (CCTA): a pictorial essay

Coronary artery anomalies and normal anatomical variants in coronary computed tomography angiography (CCTA): a pictorial essay

Statistical shape modeling of the geometric morphology of the canine femur, tibia, and patella.

Bone morphometry varies among dogs of different sizes and breeds. Studying these differences may help understand the predisposition of certain breeds for specific orthopedic pathologies. This study aimed to develop a statistical shape model (SSM) of the femur, patella, and tibia of dogs without any clinical orthopeadic abnormalities to analyze and compare morphological variations based on body weight and breed. A total of 97 CT scans were collected from different facilities and divided based on breed and body weight. The 3D models of the bones were obtained and aligned to a coordinate system. The SSM was created using principal component analysis (PCA) to analyze shape variations. The study found that the first few modes of variation accounted for a significant percentage of the total variation, with size/scale being the most prominent factor. The results provide valuable insights into normal anatomical variations and can be used for future research in understanding pathological bone morphologies and developing 3D imaging algorithms in veterinary medicine.

Lower eyelid retraction repair using autologous auricular scapha cartilage.

To assess the efficacy of lower eyelid retraction surgery utilizing autologous auricular scapha cartilage (located within the anterior surface groove between the helix and anti-helix) and to present the surgical outcomes in a patient cohort. Medical records of 21 patients who underwent lower eyelid retraction surgery with scapha cartilage were retrospectively reviewed. Retractions, present for an extended duration (6months to 20years), exhibited 1mm or more inferior scleral show, attributed to prior lower eyelid blepharoplasty, facial palsy, or as a normal anatomical variation. Surgical interventions included lateral canthotomy, cantholysis, incision of the subtarsal conjunctiva-lower eyelid retractors, lower eyelid retractor lysis, cartilage graft suturing to the defect area without conjunctival cover, and tightening of the lateral canthal corner in all patients. A total of 29 eyelids in 21 patients underwent surgery without intraoperative complications. Over a mean follow-up period of 11months (range: 6-30months), lower lid retraction improved in 96.5% of eyelids. Postoperative margin-to-reflex distance measurements (MRD2) significantly decreased compared to preoperative values (p = 0.001; p < 0.01). Average improvements in MRD2-a (midpupil to lower lid) and MRD2-b (lateral limbus to lower lid) were 1.77 ± 0.80 and 2.04 ± 0.81, respectively (p = 0.001; p < 0.01). Four eyelids (4/29) required revision due to canthal corner loosening, with correction necessitating periosteal flaps. All four patients had previously undergone two or more repairs elsewhere. The graft was visible in two lids but did not require further revision. One patient experienced mild helix deformity at the donor site, which did not warrant additional intervention. In cases of lower lid retraction associated with middle/posterior lamellar shortening, utilizing an autologous auricular scapha cartilage spacer graft offers notable benefits. These advantages comprise straightforward harvesting with minimal donor site complications, stability without experiencing shrinkage, a softer texture in comparison to posterior cartilage, a concave shape that facilitates proper fitting on the globe, and its autologous nature.

Rare Case Report: Radiologic Findings of Stress Fracture and Avascular Necrosis of the Type 2 Accessory Navicular Bone

The accessory navicular bone (ANB) is one of several accessory ossicles of the foot and is considered as a normal anatomic and radiographic variant (1). It occurs due to failure of fusion of a secondary ossification centre within the navicular bone. Fewer than %1 of ANBs are symptomatic, and most of symptomatic ANBs are type II ANBs. Stress fracture of the type II ANB is a rare cause of symptomatic accessory navicular syndrome. We report a case of stress fracture and avascular necrosis of the type II ANB on radiographs and magnetic resonance images in a 23- year- old male.

Left Ventricular Papillary Muscle: Anatomy, Pathophysiology, and Multimodal Evaluation.

As an integral part of the mitral valve apparatus, the left ventricle papillary muscle (PM) controls mitral valve closure during systole and participates in the ejection process during left ventricular systole. Mitral regurgitation (MR) is the most immediate and predominant result when the PM is structurally or functionally abnormal. However, dysfunction of the PM is easily underestimated or overlooked in clinical interventions for MR-related diseases. Therefore, adequate recognition of PM dysfunction and PM-derived MR is critical. In this review, we systematically describe the normal anatomical variations in the PM and the pathophysiology of PM dysfunction-related diseases and summarize the commonly used parameters and the advantages and disadvantages of various noninvasive imaging modalities for the structural and functional assessment of the PM.

The Buford Complex Redefined: A Pathologic Morphology in Sheep's Clothing.

Considered a normal anatomic variant, the Buford complex has not been studied in children. A Buford complex is not a normal anatomic variant and would, therefore, be present at a lower rate than that seen in the adult population. Cross-sectional study; Level of evidence, 3. Measurements were recorded from magnetic resonance imaging performed over 13 years in children aged ≤11 years for various pathologies unrelated to glenohumeral instability. Interrater reliability was determined to identify Buford complexes, sublabral foramens and tears, and normal shoulders via 16 preadolescent and adolescent patients with confirmed arthroscopic correlation. The Buford complex and labral foramen rates were then compared with a published rate in adults using a binomial probability test. A total of 122 children (62 girls; mean age, 6.4 years [age range, 2 months-10.9 years]) were evaluated. Interrater reliability was 0.846 (95% CI, 0.56-1) to identify anterosuperior labral variants. The expected sublabral foramen count was 23 children, but only 1 was identified (P < .001). The expected Buford complex count was 8 children, but none could be identified (P < .001). The absence of Buford complexes and the significant reduction in sublabral foramen abundance in younger children suggest that these anatomic variants are more likely to be developmental than congenital. The distinct possibility that these previously considered normal variants are truly pathologic findings cannot be ignored. Evidence of a Buford complex could potentially signify an underlying, long-term shoulder instability issue to the treating provider that warrants further investigation or management.

The Pterygomandibular Space: A Volumetric Evaluation Using the Novel A-Silicone Injections Method.

Inferior alveolar nerve block (IANB) is one of the most common procedures in operative dentistry, and a deep understanding of the normal anatomical variation of the pterygomandibular space (PM) is essential for its safe and successful administration. This cadaveric anatomical study aimed to use A-silicone injections to evaluate the volume of the PM. This study was conducted using 46 human cadaver heads (25 males and 21 females). A craniometric analysis was performed using the cadavers' ages, the number of silicone cartridges (carpules) used to fill the pterygomandibular space, Izard's Facial Index (FI), and the Cranial Index (CI). A Halstead mandibular block was performed by injecting 1.7 mL A-silicone cartridges (as an equivalent to standard local aesthetic carpules volume) into the PM. The cured silicone was extracted from the dissected mandibles. The volume (length, width, and thickness) of the extracted silicone and the number of silicone cartridges used to fill the space were evaluated. The results showed that there are statistically significant positive correlations between the CI and the width of the right PM, as well as the width and length of the left PM. A statistically significant correlation was found between the width of the left PM and the age of the cadaveric heads; the higher the age, the thicker the space on both sides. The volume of the PM corresponded to 1.5 cartridges on average.

Myocardial Bridging in Patients Undergoing Coronary Angiography for Coronary Artery Disease.

Introduction Myocardial bridge is a rare, benign, normal anatomical variant of the coronary artery that puts the patient at risk for significant cardiac symptoms, resulting in myocardial ischemia, arrhythmia, and sudden cardiac death. The aim of the study was to assess the prevalence and characteristics of myocardial bridging (MB) in patients with chest pain undergoing coronary angiography. Methodology A total of 1301 patients presenting with chest pain suggestive of acute coronary syndrome with associated non-invasive supportive cardiac evaluation were subjected to coronary angiography by Philips Allura Xper FD10 Cath Lab (Philips Healthcare, Andover, MA)and evaluated. Results Out of 1301 patients, the mean age was 54.70 ± 11.41 years with a male-to-female ratio of 1.9:1. Tobacco use and diabetes mellitus were the most common associated risk factors (49% and 44%, respectively). MBwas seen in 51 patients, making the prevalence 3.9%, with male predominance over females in the ratio of 3.9:1. The most common clinical presentation was unstable angina (UA) (n = 22, 43.1%), followed by stable angina (SA) (n = 11, 21.6%), non-ST-elevation myocardial infarction (NSTEMI) (n = 10, 19.6%), and ST-elevation myocardial infarction (STEMI) (n = 8, 15.7%). Myocardial bridgeswere more common among patients with stable coronary artery disease. The left anterior descending artery (n = 51, 3.9%) was involved in all the cases and the middle segment was affected in all patients with MB.Among patients with myocardial bridge, 26 patients (51%) had atherosclerosis and 25 patients had a normal artery. Among patients with myocardial bridge with atherosclerosis, 17 patients (65%) had atherosclerosis in the same artery in which the myocardial bridge was present. Among patients with myocardial bridge with atherosclerosis, nine patients (52%) had atherosclerosis proximal to the bridge, three patients (17%) had atherosclerosis distal to the bridge, and five patients (31%) had atherosclerosis both proximal and distal to the bridge. Conclusion The prevalence of MB in the Indian population is significantly lower than in the Western populations, and it is significantly higher in the male population with patients diagnosed as normal coronaries on coronary angiography.

Arthroscopy-Assisted Open Fabella Excision With Medial Meniscus Revision Repair

Background: The fabella is a sesamoid bone that is a normal anatomic variant yet a rare cause of pathology in the posterolateral portion of the knee. The fabella can cause chronic knee pain in patients with knee osteoarthritis and athletes at all levels and in rare cases can cause neuropathy. Initially, treatment for a painful fabella includes conservative measures, with surgical intervention after conservative treatments have failed. This technique describes our arthroscopic-assisted fabella removal technique with a concomitant medial meniscus revision repair. Indications: The goal of treatment is to relieve pain and numbness. Conservative measures (i.e., nonsteroidal anti-inflammatory drugs [NSAIDs], range of motion exercises, heel cord stretching, etc.) are the initial step in treatment. Patients are treated surgically after conservative measures have failed. The surgical approach involves an open incision, arthroscopy, or a combination. Technique Description: With the patient in the supine position, a physical examination is performed under anesthesia to compare to validate clinical findings. An open lateral knee approach helps to locate the fabella which is grasped with an Alice clap. An arthroscopy is performed, and viewing posterolaterally will confirm that the fabella is within the grips of the Alice clamp. After repair of the meniscus, the surgical bed is repositioned to identify the fabella properly. Excision of the fabella is performed sharply from the lateral gastrocnemius tendon, and palpation is demonstrated to ensure complete removal. Caution is essential to avoid complications including damage to nearby anatomic structures, such as the lateral gastrocnemius tendon, and incomplete fabella removal. Results: A clinical study by Dekker et al reported that 80% of patients were able to return to full activities and postoperative patient-reported outcomes improved from preoperative to postoperative. Fabella excision is recommended for patients with fabella pain who do not respond to conservative treatment. Discussion: We describe a technique for removing the fabella with arthroscopic assistance. Patients who have not responded appropriately to conservative treatment for a painful fabella should consider surgical intervention. With the early initiation of rehabilitation, patients will have an increased likelihood of decreased pain, resolution of symptoms, and reduced knee stiffness. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.

A radio-anatomical study of median arcuate ligament syndrome: unveiling the morphology and morphometry of median arcuate ligament, celiac trunk, and superior mesenteric artery.

In the context of medical literature, a significant lacuna exists in understanding median arcuate ligament syndrome (MALS). While clinical aspects are well documented, literature lacks a robust exploration of the anatomical relationship between the celiac trunk and the median arcuate ligament (MAL). Morphometric parameters, including the vertebral level of MAL origin, MAL thickness, celiac trunk (CeT) origin level, diameter, and distances between CeT/Superior Mesenteric Artery (SMA) and the MAL center were observed on 250 CT angiograms. Cadavers (n = 11) were dissected to examine the same parameters and histo-morphological examination of MAL tissue was done. Radiological findings established average MAL thickness of 7.79 ± 2.58mm. The celiac trunk typically originated at T12. The average distance between the celiac trunk and the MAL center was 1.32 ± 2.04mm. The angle of the celiac trunk to the abdominal aorta was primarily obtuse. The average celiac trunk diameter was 5.53 ± 1.33mm. Histological examinations revealed a diverse MAL composition, indicating variable mechanical properties. This study provides comprehensive morphometric data on the anatomical relationship between the MAL and the celiac trunk. In contrast to available literature which says the average MAL thickness of > 4mm is an indicator of increased thickness, we observed much higher average thickness in the studied population. The findings contribute to a better understanding of normal anatomical variations which can serve as reference values for accurate radiological diagnosis of MALS. The histological examination revealed the heterogeneous nature of the MAL tissue composition, suggesting variable mechanical properties and functions in different regions.

Interesting case report on Chiari network

The Chiari network is a congenital remnant that is typically found in the right atrium and is generally not associated with significant pathophysiological implications. Usually, this is detected on general routine health checkup screening or casual examination. But, occasionally in certain cases, it is possible for this condition to results in diagnostic ambiguity when assessing right atrial disorders. Additionally, it has potential to contribute to the development of thromboembolism by inducing flow blockage. The Chiari network can be accurately diagnosed by echocardiography. This network appear as a highly mobile, highly reflectant echo target at many regions in the right atrium during transthoracic and transesophageal echocardiography. In this study, we provide a case involving an 18 year old male students studying cardiac technology who was diagnosed incidentally during echocardiography practical classes with Chiari network, mild TR and mild PR. The value and precision of echocardiography are becoming more widely recognized and being used more frequently. The potential for finding normal anatomical variations and their potential incorrect interpretation as pathological states coincides with the wider implementation of this imaging method.

Angiographic cross-filling between inferior petrosal sinuses and alteration of adrenocorticotropic hormone sampling results for tumor localization in Cushing disease.

Inferior petrosal sinus (IPS) sampling (IPSS) is a diagnostic procedure used to guide diagnostic localization of imaging-negative adrenocorticotropic hormone (ACTH)-secreting pituitary microadenomas. However, the efficacy of IPSS has been suboptimal at accurately lateralizing the adenoma, reducing surgical cure rates and leading to unintended pituitary dysfunction due to the added exploration. One rationale for the occasional imprecision is the existence of additional petrosal sinus collateral channels that connect the IPS bilaterally, which may lead to false localization results during sampling. The aim of this study was to explore a potential connection between normal anatomical variation in the angioarchitecture of the IPSs and the ACTH results obtained in subsequent IPSS tests. A retrospective review was performed on all cases between 1998 and 2013 involving patients at a single institution who underwent IPSS for radiographically equivocal pituitary microadenomas. Cases were reviewed for tumor laterality noted on either operative or pathology reports, as well as the presence of angiographic evidence of cross-filling between the sinuses. In addition, ACTH levels from the right and left IPSs were documented at baseline and at 2, 5, and 10 minutes after corticotropin-releasing hormone (CRH) administration. A ratio of the change in ACTH levels measured at the time of maximal response (10 minutes) versus the levels measured at the initial response (2 minutes) was computed for each patient and compared between patients by their angiographic cross-filling status. There were 41 patients with a histopathologically confirmed right- or left-sided ACTH-secreting pituitary microadenoma who underwent preoperative IPSS. Among these patients, 28 (68%) showed angiographic evidence of cross-filling between the IPSs, and 13 showed no cross-filling. On average, ACTH levels increased by a factor of 3.91 ± 0.77 in the contralateral IPS in patients with angiographic cross-filling, compared with a factor increase of only 1.80 ± 0.27 in patients without cross-filling (p = 0.014). In comparison, ACTH levels increased by a factor of 2.01 ± 0.57 in the ipsilateral IPS in patients with cross-filling, and by 8.78 ± 7.30 in those without cross-filling (p = 0.373). The presence of angiographic cross-filling, suggestive of a greater degree of vascular channel networking between the right and left IPS, is a significant factor influencing the measured rates of change of ACTH in IPSS and may impact the specificity of this test to accurately determine microadenoma laterality in the preoperative setting.

The frequency and presentation of upper thoracic spinous process deviations, their relationship to articular morphology, and the potential influence on static palpation techniques

BackgroundStatic palpation of vertebral spinous process deviations from the midline are often utilized by manual therapists as a means to determine area for treatment of manipulable lesions. Previous research has discussed the diagnostic validity of this technique, but no correlation to vertebral morphology has been presented. AimTo evaluate the frequency and presentation of vertebral spinous process deviations and their relationship with articular morphology, and the impact this may have in terms of static palpation techniques in the upper thoracic spine. SettingThis study was conducted on human T1-T6 vertebrae. MethodA skeletal sample consisting of 58 humans T1-T6 vertebrae were photographed and linear and angular measurements taken utilizing ImageJ software and non-metric visual observations. ResultsSpinous process deviations in the entire sample group (n = 348) were found to occur in a frequency ranging from 19% (n = 11) at T1 to 41.4% (n = 24) at T3. However, when evaluated in terms of frequency within an individual's T1-T6, 83.3% (n = 25) of males and 67.86% (n = 19) of females demonstrated this feature, with an overall incidence of 77.59% (n = 45). Age of individuals did not show an increase in frequency, and no clear pattern could be identified regarding metric measurements and its presence. ConclusionSpinous process deviations in the upper thoracic spine are most probably the result of random normal variations between individuals and are more frequent in males. Static palpation without pain criteria is not a reliable diagnostic technique to determine areas needing manual treatment, as these may be considered normal osseous anatomical variations.

Arrested pneumatization of the sphenoid sinus: imaging characteristics

Objective: To explore and analyze the imaging features of arrested pneumatization of the sphenoid sinus, so as to provide reference for identifying sphenoid lesions. Methods: From May 2018 to September 2019, a retrospective analysis was conducted on 350 patients (183 males and 167 females, aged between 18 and 73 years) who had been completed the sinus CT examination in the outpatient department of Beijing Chaoyang Hospital Affiliated to Capital Medical University. Their imaging data were collected and the CT/MRI characteristics of the sphenoid body were observed. SPSS 26.0 software was used for statistical analysis. Results: The rate of arrested pneumatization of the sphenoid sinus was 2.0% (7/350), which occurred in the pteroid process, the slope region, and the sphenoid sinus body, respectively. CT showed a nondilated mixed-density lesion (7/7) in the pneumatizable sphenoid body. Within these regions, both fat and soft tissue density (7/7) were present. Internal curve calcification was observed in part of the region (3/7). The skull base canal structure was not affected (7/7). MRI showed a clear non-dilated lesion with an adipose signal, and none of the lesions showed medulla dilation or cortical destruction. Conclusions: Arrested pneumatization of the sphenoid sinus is a normal anatomic variation. When non-dilated lesions with clear bony boundaries and internal fatty components are encountered in the vaporizable region of the sphenoid sinus, the possibility of arrested pneumatization of the sphenoid sinus should be considered.

Evaluation of the Prevalence of Radix Entomolaris in First and Second Mandibular Molars in Yazd Population Using Cone-Beam Computed Tomography

Introduction: The third root of mandibular molar teeth is the most important normal anatomical variation in these teeth. Failure to recognize the presence of this root is one of the most common reasons for treatment failure in these teeth. Therefore, the aim of this study was to investigate the prevalence of Radix Entomolaris in the mandibular first and second molars in the population of Yazd City using CBCT imaging.&#x0D; Methods: In this study, 217 CBCT images prepared in an oral and maxillofacial radiology clinic were examined. The presence of the third root in the first and second molar teeth of the mandible was investigated according to the gender of the patients and the side of the tooth placement. Data were analyzed using SPSS16 software and Chi-Square statistical test. &#x0D; Results: The prevalence of Radix Entomolaris in the present study in first molar and second molar teeth was recorded 5.1% and 1.8%, respectively. It was reported that its bilateral prevalence was 1.4%. In unilateral cases it was observed more on the right side. The occurrence of Radix Entomolaris had no statistically significant relationship with gender (P&gt;0.05).&#x0D; Conclusion: The overall frequency of Radix Entomolaris in the population of Yazd City is 6.9%. Its frequency is more likely to be unilateral, mostly in the first molar and without the influence of gender.

FUNCTIONAL ASSESSMENT OF MRT AND EEG RESULTS OF THE BRAIN OF YOUNG PILOTS IN THE INTERESTS OF MEDICAL-FLIGHT EXAMINATION

Background. Nowadays, objective assessment of fitness for flight work is an important component in the prevention of early morbidity and prolongation of professional longevity in pilots. Magnetic resonance imaging of the brain as a method of neuroimaging is mandatory. Studying and analyzing the obtained MRI data of the brain of young pilots in comparison with electroencephalography data provides a functional approach to determining fitness for flight work and prognosis of professional longevity. Aim. To study the frequency and structure of various forms of brain structure changes using MRI of young pilots to ensure their examination within the framework of medical and flight expertise in comparison with electroencephalography data. Materials and Methods. A total of 320 pilots diagnosed as healthy were included in the study. The median age characteristics were 19.0 [17.0; 25.0] years. The study design was an empirical, single-moment study. All pilots without identified contraindications (n=320) underwent a contrast-free magnetic resonance study of the brain. An electroencephalograph-analyzer was used to record EEG. The data were recorded under standard conditions in a silent darkened room. Results. When evaluating the results, it was found that in 307 (88.2 %) cases the EEG data were within the age normal range. In group 1 patients (without any MRI features in the liquor system) 40 (11.5 %) people were found to have changes in the form of decreased total cortical electrogenesis in the form of the presence of alpha rhythm in occipitotemporal and temporal leads, as well as beta rhythm predominantly in the right cerebral hemisphere. In a single case (0.3 %) of a young pilot T. from group 2 (with the presence of dilatations of liquor spaces in various brain localizations) EEG changes showed no clear amplitude accent. At this patient's MRI dilated liquor spaces up to 10 mm in the posterior cerebellar region were visualized. Conclusions. Based on this study, the advantage of MRI in assessing intracranial changes in determining the degree of young pilots' fitness for military service has been proved. the data obtained indicate that the incidence of intracranial changes differs significantly from the figures presented in the available literature. Electroencephalography in comparison with brain neuroimaging is a functional method in determining the state of health of young pilots, but a significant number of structural features of intracranial formations determined by tomography are variants of normal anatomy and have no abnormalities on electroencephalography.

Detailed Morphometric Analysis on Left Coronary Artery in the Population of North-East India.

Introduction The left ventricle, the cardiac chamber responsible for blood supply to the whole of systemic vasculature, receives most of its blood supply from the left coronary arteries (LCAs). Atherosclerosis of these vessels leading to myocardial infarction is a leading cause of death. Several invasive diagnostic or therapeuticcoronary interventionsare available for such patients. Just like any vascular procedure, a prior comprehensive knowledge of the dimensions of these vessels and their branching pattern is essential to perform these procedures uneventfully. No previous studyin the population of North-Eastern India documents the population-specific reference for morphometric values of left coronary arteriesand their anatomic variations. So, this study aims to fill up this lacuna. Methods This study was conductedin the Department of Anatomyin collaboration with the Catheterization Lab, Department of Cardiology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong. Coronary angiograms (CAG) of 100 subjects - 38 females and 62 males - were obtained from the Cardiac Catheterization Lab. Coronary angiograms were studied for the normal variant anatomy and morphometryof the LCAs - the left main coronary artery (LMCA), left anterior descending (LAD), and left circumflex (LCX). Results The mean length and luminal diameter of LMCA werefound to be 9.13±3.23 mm and 4.38±0.58 mm, respectively. The mean length of LAD and LCX were109.46±14.49 mm and 66.27±11.56 mm, respectively. Ramus intermedius was present in 32% of the subjects, whereas the remaining subjects had bifurcations of LMCA. We also found that 86% of patients had "wrap-around LAD", while in 11% of our subjects, LAD failed to reach the apex. Diagonal branches originating from LAD were single, duplicated, and multiple in 14%, 62%, and 24% respectively. The marginal branches were found to be single, double, and multiple in 20%, 51%, and 29% respectively. Conclusion This study establishes abaseline reference on morphometry of the left coronary artery specific to thepopulation of North-East India.This study may be of assistance to radiologists and cardiologists when performing procedures on the left coronary arteries in the population of North-Eastern India, with respect to the prevalence of anatomic variations.

Normal variations of the superior vena cava and azygos venous system depiction by CT scan in the adult Thai population.

Identification of normal variations to the thoracic central venous system anatomy is essential in radiological intervention and cardiothoracic surgery to prevent complications. To estimate the prevalence and pattern of normal variations of superior vena cava (SVC) and azygos venous system as well as factors associated with normal variations of SVC. Venous-phase chest CT of 1336 patients were retrospectively reviewed. Age, sex, and underlying disease were recorded. SVC diameter and cross-sectional area were measured to evaluate for associations with normal variations. The prevalence of normal anatomical variations of SVC and azygos venous system were 0.3% and 1.5%, respectively. Duplicated SVC was the most common variations. The most common variation for the azygos venous system was the connection between the hemiazygos and accessory hemiazygos veins draining into the left brachiocephalic vein (12/1336 cases, 0.9%). The median (interquartile range [IQR]) cross-sectional area compared between normal SVC (297.2 mm2) and duplicated SVC (223.5 mm2) showed a statistically significant difference (P = 0.033). This study determined the prevalence of rare normal variations of the azygos venous system, a connection between the hemiazygos and accessory hemiazygos veins draining into the left brachiocephalic vein. The prevalence of normal variations of the SVC and azygos venous system in the adult Thai population was similar with that of previous publications. Cross-sectional area was the only factor with a significant association with SVC variations.